Outcome measures of instrumented gait analysis in hereditary spastic paraplegia: a systematic review.
Veronika Koch, Alzhraa Ibrahim, Juergen Winkler and 3 others
PMID 40474269WHAT IT FOUND
In hereditary spastic paraplegia, instrumented gait analysis most often distinguishes patients from controls through walking speed and knee range of motion.
Foot lift and gait variability need validation.
Key findings
01In observational studies, walking speed was the most frequently differentiating parameter between HSP patients and controls, followed by step width and knee range of motion.
02Across the 9 interventional studies, 12 of 44 measured parameters showed a treatment effect; walking speed improved in 6 studies, but the studies used different treatments.
03The review did not combine results statistically because patient cohorts, test settings and equipment were too heterogeneous.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Most included studies were small: the mean sample size was 29 HSP patients, and 79% of studies had fewer than 50 participants. More than 50% of studies excluded patients who could not walk without walking aids, so the review says little about more advanced HSP gait. Studies used different equipment, disease stages, genotypes and pure or complicated HSP, so the results could not be combined statistically. Many gait parameters were measured only once across the included studies, so there is no clear set of standard outcome measures. The review was not prospectively registered and did not use a standard system to grade the quality of evidence. Some studies were done by the same working groups, so patient cohorts may have included the same people. Case reports and small case series were excluded, so findings from single patients were not included.
Declared interests
Funding was provided by the TreatHSP consortium, Deutsche Forschungsgemeinschaft collaborative research center EmpkinS, the EU-wide ERAPerMed project, Fraunhofer Internal Programs and Fraunhofer-Institut für Integrierte Schaltungen IIS. The article lists these funding sources but does not state author conflicts of interest.
The easy way to misread this
Do not read this review as proof that any treatment improves HSP gait. It mainly summarizes measurement studies, and the interventional studies used different treatments with small samples, so a single effective therapy cannot be inferred.