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Developing a smartphone application, triaxial accelerometer-based, to quantify static and dynamic balance deficits in patients with cerebellar ataxias

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Abstract

Background

Cerebellar ataxia is characterized by difficulty in the planning of movement and lack of anticipatory postural adjustments, which can result in deficits of balance. Being able to have quantitative measurements in clinical practice, to detect any improvements on balance resulting from new rehabilitation treatments or experimental drugs is very important.

Aim

The purpose of this study was to develop an application (APP) able to assess static and dynamic balance in patients with cerebellar ataxias (CA). The APP that works by a wearable device (smartphone) placed at the breastbone level and immobilized by an elastic band, measures the body sway by means of a triaxial accelerometer.

Methods

We investigated 40 CA patients and 80 healthy subjects. All patients were clinically evaluated using the “Berg Balance Scale” (BBS) and the “Scale for the Assessment and Rating of Ataxia” (SARA). Balance impairment was quantitatively assessed using a validated static balance evaluating systems, i.e., Techno-body Pro-Kin footboard. All participants underwent static and dynamic balance assessments using the new APP.

Results

We observed a strong correlation between the APP measurements and the score obtained with the BBS, SARA, and Pro-Kin footboard. The intra-rater reliability and the test–retest reliability of the APP measurements, estimated by intraclass correlation coefficient, were excellent. The standard error of measurement and the minimal detectable change were small. No learning effect was observed.

Conclusions

We can state that the APP is an easy, reliable, and valid evaluating system to quantify the trunk sway in a static position and during the gait.

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Author information

Authors and Affiliations

  1. Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University of Rome-Polo Pontino, Via Faggiana 34, 40100, Latina, Italy

    Giuseppe Arcuria, Christian Marcotulli, Claudio Galasso, Francesco Pierelli & Carlo Casali

  2. Department of Informatics, I.I.S. Ettore Majorana, Piazza Sen. Marescalchi 2, Piazza Armerina, EN, Italy

    Raffaele Amuso

  3. Department of Mathematical, Physical and Natural Sciences, University of Rome “Sapienza”, Piazzale Aldo Moro 5, 00185, Rome, Italy

    Giuliano Dattilo

  4. IRCCS Neuromed, Pozzilli, IS, Italy

    Francesco Pierelli

Authors
  1. Giuseppe Arcuria
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  2. Christian Marcotulli
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  3. Raffaele Amuso
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  4. Giuliano Dattilo
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  5. Claudio Galasso
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  6. Francesco Pierelli
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  7. Carlo Casali
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Contributions

GA contributed to structuring study design, developing the application, subject recruitment, data collection, data review, data analysis, data interpretation, writing and revising the manuscript. CM contributed to structuring study design, data interpretation, writing and revising the manuscript. RA contributed to developing the application. GD contributed to writing the manuscript, statistical data analysis, and revising the manuscript. CG contributed to recruiting patients and data collection. FP contributed to structuring study design, data analysis, and data interpretation. CC contributed to structuring study design, subject recruitment, data analysis, data interpretation, writing and revising the manuscript.

Corresponding author

Correspondence to Giuseppe Arcuria.

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Conflicts of interest

The manuscript has been approved by all the authors. The authors declare that they have no financial or any kind of relationships that might lead to a conflict of interests.

Ethical standards

This study was conducted in the Department of Medical and Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, at “Marco Pasquali” Institute—ICOT (Latina), from January 2018 to October 2018. All patients who participated in the study were informed of the use of measurements for research purposes and gave their written informed consent. All the procedures performed were in accordance with the ethical standards of the institutional and national research committee. The regulations of our institution concerning intellectual property have been respected. The ethical standards, laid down in 1964 Declaration of Helsinki and its later amendments, were respected.

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Arcuria, G., Marcotulli, C., Amuso, R. et al. Developing a smartphone application, triaxial accelerometer-based, to quantify static and dynamic balance deficits in patients with cerebellar ataxias. J Neurol 267, 625–639 (2020). https://doi.org/10.1007/s00415-019-09570-z

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  • DOI: https://doi.org/10.1007/s00415-019-09570-z

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