Published In

Frontiers in Digital Health

Document Type

Article

Publication Date

9-2-2025

Subjects

Gait -- IMUs -- wearable technology, Daily life monitoring, Spinocerebellar ataxia

Abstract

Background:

Recent findings suggest that a single gait assessment in a clinic may not reflect everyday mobility.ObjectiveWe compared gait measures that best differentiated individuals with spinocerebellar ataxia (SCA) from age-matched healthy controls (HC) during a supervised gait test in the clinic vs. a week of unsupervised gait during daily life.

Methods: Twenty-six individuals with SCA types 1, 2, 3, and 6, and 13 (HC) wore three Opal inertial sensors (on both feet and lower back) during a 2-minute walk in the clinic and for seven days in daily life. Seventeen gait measures were analyzed to investigate the group differences using Mann–Whitney U-tests and area under the curve (AUC).ResultsTen gait measures were significantly worse in SCA than HC for the clinic test (p <  0.003), but only 3 were worse in daily life (p <  0.003). Only a few gait measures consistently discriminated groups in both environments. Specifically, variability in Swing Time and Double Support Time had AUCs of 0.99 (p <  0.0001) and 0.96 (p <  0.0001) in the clinic, and 0.84 (p <  0.0003) and 0.80 (p <  0.002) in daily life, respectively. Clinical gait measures showed stronger correlations with clinical outcomes (ie, SARA and FARS-ADL; r = 0.50–0.77) than between daily life gait measures (r = 0.31–0.49). Gait activity in daily life was not statistically significant between the SCA and HC groups (p > 0.06).

Conclusions: Digital gait measures discriminate SCA in both environments. In-clinic measures are more sensitive, while daily life measures provide ecological validity, highlighting a trade-off and offering complementary insights.

Rights

Copyright: © 2025 Shah, Muzyka, Jagodinsky, Casey, McNames, El-Gohary, Sowalsky, Safarpour, Carlson-Kuhta, Horak and Gomez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

DOI

10.3389/fdgth.2025.1590150

Persistent Identifier

https://archives.pdx.edu/ds/psu/44068

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