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Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait

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Abstract

This study aimed to assess the ability of 25 gait indices to characterize gait instability and recurrent fallers among persons with primary degenerative cerebellar ataxia (pwCA), regardless of gait speed, and investigate their correlation with clinical and kinematic variables. Trunk acceleration patterns were acquired during the gait of 34 pwCA, and 34 age- and speed-matched healthy subjects (HSmatched) using an inertial measurement unit. We calculated harmonic ratios (HR), percent recurrence, percent determinism, step length coefficient of variation, short-time largest Lyapunov exponent (sLLE), normalized jerk score, log-dimensionless jerk (LDLJ-A), root mean square (RMS), and root mean square ratio of accelerations (RMSR) in each spatial direction for each participant. Unpaired t-tests or Mann–Whitney tests were performed to identify significant differences between the pwCA and HSmatched groups. Receiver operating characteristics were plotted to assess the ability to characterize gait alterations in pwCA and fallers. Optimal cutoff points were identified, and post-test probabilities were calculated. The HRs showed to characterize gait instability and pwCA fallers with high probabilities. They were correlated with disease severity and stance, swing, and double support duration, regardless of gait speed. sLLEs, RMSs, RMSRs, and LDLJ-A were slightly able to characterize the gait of pwCA but failed to characterize fallers.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences and Biotechnologies, “Sapienza” University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy

    Stefano Filippo Castiglia, Dante Trabassi, Davide Di Lenola, Ettore Cioffi, Gianluca Coppola, Carlo Casali & Mariano Serrao

  2. Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy

    Antonella Tatarelli, Alberto Ranavolo, Tiwana Varrecchia & Lorenzo Fiori

  3. Department of Human Neurosciences, Sapienza University of Rome, viale dell’Università 30, 00185, Rome, Italy

    Antonella Tatarelli, Ettore Cioffi & Manikandan Raju

  4. Department of Physiology and Pharmacology, Sapienza University of Rome, piazzale Aldo Moro, 5, 00185, Rome, Italy

    Lorenzo Fiori

  5. Unità Operativa Complessa Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy

    Pietro Caliandro

  6. Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy

    Mariano Serrao

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  1. Stefano Filippo Castiglia
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  4. Alberto Ranavolo
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  5. Tiwana Varrecchia
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  6. Lorenzo Fiori
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  8. Ettore Cioffi
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  9. Manikandan Raju
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  10. Gianluca Coppola
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  11. Pietro Caliandro
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  12. Carlo Casali
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  13. Mariano Serrao
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Contributions

Conceptualization: Mariano Serrao, Pietro Caliandro, Stefano Filippo Castiglia; Methodology: Dante Trabassi, Antonella Tatarelli, Lorenzo Fiori; Formal analysis and investigation: Tiwana Varrecchia, Dante Trabassi, Ettore Cioffi, Davide Di Lenola, Manikandan Raju; Writing — original draft preparation: Stefano Filippo Castiglia, Mariano Serrao, Dante Trabassi; Writing — review and editing: Gianluca Coppola, Pietro Caliandro, Alberto Ranavolo; Supervision: Carlo Casali, Mariano Serrao.

Corresponding author

Correspondence to Stefano Filippo Castiglia.

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The study was approved by the local ethics committee (CE Lazio 2, protocol number 0139696/2021).

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The authors declare no competing interests.

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Castiglia, S., Trabassi, D., Tatarelli, A. et al. Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait. Cerebellum 22, 46–58 (2023). https://doi.org/10.1007/s12311-021-01361-5

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