Does gait bout definition influence the ability to discriminate gait quality between people with and without multiple sclerosis during daily life?
Vrutangkumar V Shah, James McNames, Graham Harker and 6 others
PMID 33302221WHAT IT FOUND
Changing how long a pause defines the end of a walking bout alters gait quantity counts but not quality metrics like speed or stride length.
For clinicians using wearable data, quality measures remain stable across different bout definitions.
Key findings
01Gait quality measures (speed, stride length) remained discriminative between MS and healthy controls regardless of whether pauses of 1.25s, 2.5s, or 5s defined the end of a bout.
02The ability to distinguish groups based on gait quantity (number of bouts/hour) decreased significantly as the allowed pause length between steps increased.
03The change in bout quantity discrimination was driven by the healthy control group, who paused for longer periods than the 5-second threshold, while MS patients' bout counts remained stable.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Small sample size (15 MS, 16 HC). Only three specific pause thresholds were tested (1.25s, 2.5s, 5s). Analysis gave equal weight to all bouts regardless of length, which may not reflect real-world variability in gait quality over different distances. The study used a specific commercial algorithm (APDM), and results may not generalize to other sensor systems or algorithms.
Declared interests
Several authors have significant financial interests in APDM Wearable Technologies, the company that manufactured the sensors and software used in the study. One author also received honoraria from multiple pharmaceutical and academic institutions.
The easy way to misread this
Do not assume that all wearable gait metrics are robust to algorithmic changes. While quality measures like speed were stable, quantity measures like bout count changed significantly with different pause definitions, meaning activity data cannot be compared across devices or software versions without verifying their bout algorithms.