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Clinical and automated gait analysis in patients with vestibular, cerebellar, and functional gait disorders: perspectives and limitations

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Abstract

This article outlines recent developments in the clinical and automated assessment of neurological gait disorders. With a primary focus on vestibular, cerebellar, and functional gait disorders, we discuss how instrumented gait examination may assist clinical decision making in these disorders with respect to the initial differential diagnosis and prognosis as well as the objective monitoring of disease progression and therapeutic interventions. We delineate strategies for data handling and analysis of quantitative gait examinations that can facilitate the clinical characterization and interpretation of walking impairments. These strategies include data normalization and dimensionality reduction procedures. We further emphasize the value of a comprehensive, standardized gait assessment protocol. Accordingly, the examination of walking conditions that challenge patients with respect to their biomechanical, sensory, or cognitive resources are particularly helpful to disclose and characterize the causes underlying their gait impairment. Finally, we provide a perspective on the emerging implementation of pattern recognition approaches within the framework of clinical management of gait disorders and discuss their potential to assist clinical decision making with respect to the differential diagnosis and the prognosis of fall risk in individual patients.

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Acknowledgment

The work was supported by the German Federal Ministry for Education and Science (BMBF, IFB 01EO1401).

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Authors and Affiliations

  1. Department of Neurology, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Roman Schniepp & Ken Möhwald

  2. German Center for Vertigo and Balance Disorders (DSGZ), University of Munich, Marchioninistrasse 15, 81377, Munich, Germany

    Roman Schniepp, Ken Möhwald & Max Wuehr

Authors
  1. Roman Schniepp
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  2. Ken Möhwald
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  3. Max Wuehr
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Correspondence to Roman Schniepp.

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The authors declare that they have no conflict of interest.

Additional information

This manuscript is part of a supplement sponsored by the German Federal Ministry of Education and Research within the funding initiative for integrated research and treatment centers.

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Schniepp, R., Möhwald, K. & Wuehr, M. Clinical and automated gait analysis in patients with vestibular, cerebellar, and functional gait disorders: perspectives and limitations. J Neurol 266 (Suppl 1), 118–122 (2019). https://doi.org/10.1007/s00415-019-09378-x

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  • DOI: https://doi.org/10.1007/s00415-019-09378-x

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