Free-living monitoring of ALS progression in upper limbs using wearable accelerometers.
Marcin Straczkiewicz, Katherine M Burke, Narghes Calcagno and 4 others
PMID 39707523WHAT IT FOUND
Wrist-worn accelerometers tracked upper limb movement decline in 202 people with ALS.
Counts of flexion and extension dropped while duration increased, correlating with worsening ALSFRS-RSE scores. This objective monitoring may complement clinical scales for tracking progression.
Key findings
01Daily count metrics of upper limb movements showed a significant decrease over time, while movement duration increased significantly.
02Upper limb movement measures were significantly associated with total ALSFRS-RSE scores and motor subdomains, reflecting functional decline.
03Ratios of movement metrics between dominant and non-dominant limbs differed based on which limb had disease onset.
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
Only 202 of 438 participants had sufficient sensor wear-time for the primary analysis. The average number of valid accelerometer days was low (48.4 days) compared to the total collection period. The method approximates limb movements and may not capture fine motor details like handwriting. The study was not designed to calculate minimal clinically important differences for these metrics.
Declared interests
The study was supported by the ALS Therapy Development Institute (ALSTDI) and the National Institute of Health (N.I.H.).
The easy way to misread this
Do not assume these movement metrics are ready for routine clinical use to diagnose or stage ALS. The study validates their correlation with existing scales in a research setting, but clinical thresholds for individual patient care have not been established.