Skip to main content
Log in

The Responsiveness of Triaxial Accelerometer Measurement of Gait Ataxia Is Higher than That of the Scale for the Assessment and Rating of Ataxia in the Early Stages of Spinocerebellar Degeneration

  • Original Paper
  • Published:
The Cerebellum Aims and scope Submit manuscript

Abstract

We reported previously that the average medial–lateral gait amplitude while walking on a straight path determined using triaxial accelerometers fixed on the middle of the upper back may be a quantitative and concise indicator for the severity of cerebellar ataxia. Considering that gait ataxia is a typical initial symptom in a variety of spinocerebellar degeneration (SCD), we aimed to develop quantitative biomarkers for cerebellar ataxia as metric variables. We used triaxial accelerometers to analyze gait parameters in 14 patients with SCD at 3 points over 3 years (at baseline, 1.5 years and 3 years). Analysis of covariance (ANCOVA) models adjusted for the baseline scores were used to estimate sample sizes. The mean medial–lateral amplitude (ML) gained by a triaxial accelerometer fixed on upper back could detect the each 1.5-year change. In the 14 patients, the mean ML(m) was 0.032 ± 0.007(SD) at entry, 0.037 ± 0.008 after 1.5-year follow, and 0.042 ± 0.020 after 3-year follow. In contrast, SARA gait scores were 2.9, 2.9, and 3.0, respectively. The responsiveness of the quantitative evaluation of gait ataxia by triaxial accelerometers is higher than that of the SARA within a 1.5-year follow-up period. Gait analysis by triaxial accelerometers will be complementary to the evaluation of scales like SARA in the assessment of clinical severity of SCD patients in early stage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Schmitz-Hubsch T, du Montcel ST, Baliko L, Berciano J, Boesch S, Depondt C, et al. Scale for the assessment and rating of ataxia: development of a new clinical scale. Neurology. 2006;66:1717–20. https://doi.org/10.1212/01.wnl.0000219042.60538.92.

    Article  CAS  PubMed  Google Scholar 

  2. Sato K, Yabe I, Soma H, Yasui K, Ito M, Shimohata T, et al. Reliability of the Japanese version of the Scale for the Assessment and Rating of Ataxia (SARA). Brain Nerve. 2009;61:591–5.

    PubMed  Google Scholar 

  3. Berg KO, Wood-Dauphinee SL, Williams JI, Maki B. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(Suppl 2):S7–11.

    PubMed  Google Scholar 

  4. Matsushima M, Yabe I, Uwatoko H, Shirai S, Hirotani M, Sasaki H. Reliability of the Japanese version of the Berg balance scale. Intern Med. 2014;53:1621–4.

    Article  PubMed  Google Scholar 

  5. Takakusaki K, Chiba R, Nozu T, Okumura T. Brainstem control of locomotion and muscle tone with special reference to the role of the mesopontine tegmentum and medullary reticulospinal systems. J Neural Transm (Vienna). 2016;123:695–729. https://doi.org/10.1007/s00702-015-1475-4.

    Article  Google Scholar 

  6. Takakusaki K, Takahashi M, Obara K, Chiba R. Neural substrates involved in the control of posture. Adv Robot. 2016;31:2–23. https://doi.org/10.1080/01691864.2016.1252690.

    Article  Google Scholar 

  7. Homma Y, Nonaka S, Matsuyama K, Mori S. Fastigiofugal projection to the brainstem nuclei in the cat: an anterograde PHA-L tracing study. Neurosci Res. 1995;23:89–102.

    Article  CAS  PubMed  Google Scholar 

  8. Mori S, Matsui T, Kuze B, Asanome M, Nakajima K, Matsuyama K. Stimulation of a restricted region in the midline cerebellar white matter evokes coordinated quadrupedal locomotion in the decerebrate cat. J Neurophysiol. 1999;82:290–300. https://doi.org/10.1152/jn.1999.82.1.290.

    Article  CAS  PubMed  Google Scholar 

  9. Bostan AC, Dum RP, Strick PL. Cerebellar networks with the cerebral cortex and basal ganglia. Trends Cogn Sci. 2013;17:241–54. https://doi.org/10.1016/j.tics.2013.03.003.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Shaikh AG, Meng H, Angelaki DE. Multiple reference frames for motion in the primate cerebellum. J Neurosci. 2004;24:4491–7. https://doi.org/10.1523/JNEUROSCI.0109-04.2004.

    Article  CAS  PubMed  Google Scholar 

  11. Timmann D, Horak FB. Perturbed step initiation in cerebellar subjects: 2. Modification of anticipatory postural adjustments. Exp Brain Res. 2001;141:110–20. https://doi.org/10.1007/s002210100858.

    Article  CAS  PubMed  Google Scholar 

  12. Yabe I, Matsushima M, Soma H, Basri R, Sasaki H. Usefulness of the Scale for Assessment and Rating of Ataxia (SARA). J Neurol Sci. 2008;266:164–6. https://doi.org/10.1016/j.jns.2007.09.021.

    Article  PubMed  Google Scholar 

  13. Shirai S, Yabe I, Matsushima M, Ito YM, Yoneyama M, Sasaki H. Quantitative evaluation of gait ataxia by accelerometers. J Neurol Sci. 2015;358:253–8. https://doi.org/10.1016/j.jns.2015.09.004.

    Article  PubMed  Google Scholar 

  14. Iosa M, Fusco A, Morone G, Paolucci S. Development and decline of upright gait stability. Front Aging Neurosci. 2014;6:14. https://doi.org/10.3389/fnagi.2014.00014.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Iosa M, Picerno P, Paolucci S, Morone G. Wearable inertial sensors for human movement analysis. Expert Rev Med Devices. 2016;13:641–59. https://doi.org/10.1080/17434440.2016.1198694.

    Article  CAS  PubMed  Google Scholar 

  16. ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med. 2002;166:111–7. https://doi.org/10.1164/ajrccm.166.1.at1102.

    Article  Google Scholar 

  17. Katsuno M, Banno H, Suzuki K, Takeuchi Y, Kawashima M, Yabe I, et al. Efficacy and safety of leuprorelin in patients with spinal and bulbar muscular atrophy (JASMITT study): a multicentre, randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2010;9:875–84. https://doi.org/10.1016/S1474-4422(10)70182-4.

    Article  CAS  PubMed  Google Scholar 

  18. May S, Gilman S, Sowell BB, Thomas RG, Stern MB, Colcher A, et al. Potential outcome measures and trial design issues for multiple system atrophy. Mov Disord. 2007;22:2371–7. https://doi.org/10.1002/mds.21734.

    Article  PubMed  Google Scholar 

  19. Terashi H, Utsumi H, Ishimura Y, Takazawa T, Okuma Y, Yoneyama M, et al. Deficits in scaling of gait force and cycle in parkinsonian gait identified by long-term monitoring of acceleration with the portable gait rhythmogram. ISRN Neurol. 2012;2012:306816. https://doi.org/10.5402/2012/306816.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Schmitz-Hubsch T, Fimmers R, Rakowicz M, Rola R, Zdzienicka E, Fancellu R, et al. Responsiveness of different rating instruments in spinocerebellar ataxia patients. Neurology. 2010;74:678–84. https://doi.org/10.1212/WNL.0b013e3181d1a6c9.

    Article  CAS  PubMed  Google Scholar 

  21. Fazio P, Granieri G, Casetta I, Cesnik E, Mazzacane S, Caliandro P, et al. Gait measures with a triaxial accelerometer among patients with neurological impairment. Neurol Sci. 2013;34:435–40. https://doi.org/10.1007/s10072-012-1017-x.

    Article  PubMed  Google Scholar 

  22. Matsushima A, Yoshida K, Genno H, Murata A, Matsuzawa S, Nakamura K, et al. Clinical assessment of standing and gait in ataxic patients using a triaxial accelerometer. Cerebellum Ataxias. 2015;2:9. https://doi.org/10.1186/s40673-015-0028-9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hickey A, Gunn E, Alcock L, Del Din S, Godfrey A, Rochester L, et al. Validity of a wearable accelerometer to quantify gait in spinocerebellar ataxia type 6. Physiol Meas. 2016;37:N105–N17. https://doi.org/10.1088/0967-3334/37/11/N105.

    Article  PubMed  Google Scholar 

  24. Stoodley CJ, Valera EM, Schmahmann JD. Functional topography of the cerebellum for motor and cognitive tasks: an fMRI study. Neuroimage. 2012;59:1560–70. https://doi.org/10.1016/j.neuroimage.2011.08.065.

    Article  PubMed  Google Scholar 

  25. Yabe I, Matsushima M, Yoshida K, Ishikawa K, Shirai S, Takahashi I, et al. Rare frequency of downbeat positioning nystagmus in spinocerebellar ataxia type 31. J Neurol Sci. 2015;350:90–2. https://doi.org/10.1016/j.jns.2014.12.042.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank all patients and control individuals for their active cooperation. We thank Mitsuru Yoneyama, MS, Mitsubishi Chemical Corporation Yokohama R&D Center, Yokohama, Japan, for data processing.

Funding

This work was supported by a Grant from the Japan Agency for Medical Research and Development (to H.S. and I.Y.), and by a Grant from the Research Committee on the Medical Basis of Motor Ataxias, Health and Labor Sciences Research Grants, The Ministry of Health, Labor and Welfare, Japan (to H.S.)

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hidenao Sasaki.

Ethics declarations

This clinical study was approved by the ethics panels of Hokkaido University Hospital and Kushiro Rosai Hospital.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shirai, S., Yabe, I., Takahashi-Iwata, I. et al. The Responsiveness of Triaxial Accelerometer Measurement of Gait Ataxia Is Higher than That of the Scale for the Assessment and Rating of Ataxia in the Early Stages of Spinocerebellar Degeneration. Cerebellum 18, 721–730 (2019). https://doi.org/10.1007/s12311-019-01025-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12311-019-01025-5

Keywords

Navigation