Quantity and quality of gait and turning in people with multiple sclerosis, Parkinson’s disease and matched controls during daily living

  • Vrutangkumar V. ShahEmail author
  • James McNames
  • Martina Mancini
  • Patricia Carlson-Kuhta
  • Rebecca I. Spain
  • John G. Nutt
  • Mahmoud El-Gohary
  • Carolin Curtze
  • Fay B. Horak
Original Communication


Clinical trials need to specify which specific gait characteristics to monitor as mobility measures for each neurological disorder. As a first step, this study aimed to investigate a set of measures from daily-life monitoring that best discriminate mobility between people with multiple sclerosis (MS) and age-matched healthy control subjects (MS-Ctl) and between people with Parkinson’s disease (PD) and age-matched healthy control subjects (PD-Ctl). Further, we investigated how these discriminative measures relate to the disease severity of MS or PD. We recruited 13 people with MS, 21 MS-Ctl, 29 people with idiopathic PD, and 20 PD-Ctl. Subjects wore 3 inertial sensors on their feet and the lumbar back for a week. The Area Under Curves (AUC) from the receiver operator characteristic (ROC) plot was calculated for each measure to determine the objective measures that best separated the MS and PD groups from their respective control cohorts. Adherence wearing the sensors was similar among groups for 58–66 h of recording (p = 0.14). Quantity of mobility (activity measures, such as a median number of strides per gait bout, AUC = 0.93) best discriminated mobility impairments in MS from MS-Ctl. In contrast, quality of mobility (such as turn angle, AUC = 0.90) best discriminated mobility impairments in PD from PD-Ctl. Mobility measures with AUC > 0.80 were correlated with MS and PD clinical scores of disease severity. Thus, measures characterizing mobility impairments differ for MS versus PD during daily life suggesting that mobility measures for clinical trials and clinical practice need to be specific to each neurological disorder.


Mobility Neurological disorders Parkinson’s disease Multiple sclerosis 



We thank our participants for generously donating their time to participate and Graham Harker for helping with data collection. This study was supported by the National Multiple Sclerosis Society Mentor Fellowship (MB0027), and National Institutes of Health grants from the National Institute on Aging (#R44AG055388 and #R43AG044863).

Compliance with ethical standards

Conflicts of interest

Drs. McNames, El-Gohary, and Horak have a significant financial interest in APDM, a company that may have a commercial interest in the results of this research and technology. Dr. Horak also consults with Biogen, Neuropore, Sanofi, and Takeda. This potential conflict has been reviewed and managed by OHSU.

Ethical standards

This study was conducted in accordance with the standards and approved by local human subjects ethics committees, and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. All subjects provided informed written consent prior to their inclusion in the study.

Supplementary material

415_2020_9696_MOESM1_ESM.docx (349 kb)
Supplementary file1 (DOCX 349 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2020

Authors and Affiliations

  • Vrutangkumar V. Shah
    • 1
    Email author
  • James McNames
    • 2
    • 4
  • Martina Mancini
    • 1
  • Patricia Carlson-Kuhta
    • 1
  • Rebecca I. Spain
    • 1
    • 3
  • John G. Nutt
    • 1
  • Mahmoud El-Gohary
    • 4
  • Carolin Curtze
    • 5
  • Fay B. Horak
    • 1
    • 4
  1. 1.Department of NeurologyOregon Health & Science UniversityPortlandUSA
  2. 2.Department of Electrical and Computer EngineeringPortland State UniversityPortlandUSA
  3. 3.Veterans Affairs Portland Health Care SystemPortlandUSA
  4. 4.APDM, Inc.PortlandUSA
  5. 5.Department of BiomechanicsUniversity of Nebraska at OmahaOmahaUSA

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