Correlate with fear of falling, quality of life and mobility
The value of four functional gait measures combined, as a reflection of fear of falling, quality of life and mobility was established in this study of 22 people with pure HSP.
Objective: Gait impairment is the cardinal motor symptom in hereditary spastic paraplegias (HSPs) possibly linked to increased fear of falling and reduced quality of life (QoL). Disease specific symptoms in HSP are rated using the Spastic Paraplegia Rating Scale (SPRS). However, limited studies evaluated more objectively easy-to-apply gait measures by comparing these standardized assessments with patients’ self-perceived impairment and clinically established scores. Therefore, the aim of this study was to correlate functional gait measures with self-rating questionnaires for fear of falling and QoL, and with the SPRS as clinical gold standard.
Methods: HSP patients (“pure” phenotype, n = 22) fulfilling the clinical diagnostic criteria for HSP and age-and gender-matched healthy subjects (n = 22) were included in this study. Motor impairment was evaluated using the SPRS, fear of falling by the Falls Efficacy Scale-International (FES-I), and QoL by SF-12. Functional gait measures included gait speed and step length (10-meter-walk-test), the Timed up and go test (TUG), and maximum walking distance (2-min-walking-test).
Results: Functional gait measures correlated to fear of falling (gait speed: r = -0.726; step length: r = -0.689; TUG: r = 0.721; 2-min: r = -0.709) and the physical component of QoL (gait speed: r = 0.541; step length: r = 0.531; TUG: r = -0.512; 2-min: r = 0.548). Furthermore, FES-I (r = 0.767) and QoL (r = -0.728) correlated with the clinical gold standard (SPRS). Gait measures strongly correlated with SPRS (gait speed: r = -0.787; step length: r = -0.821; TUG: r = 0.756; 2-min: r = -0.791).
Conclusion: Functional gait measures reflect fear of falling, QoL, and mobility in HSP. The metric, semi-quantitative gait measures complement the clinician’s evaluation and support the clinical workup by more objective parameters.
SOURCE: Clin Neurol Neurosurg. 2021 Oct;209:106888. doi: 10.1016/j.clineuro.2021.106888. Epub 2021 Aug 17. PMID: 34455170 Copyright © 2021 Elsevier B.V. All rights reserved.
Functional gait measures correlate to fear of falling, and quality of life in patients with Hereditary Spastic Paraplegia: A cross-sectional study
Heiko Gaßner 1 , Julia List 2 , Christine F Martindale 3 , Martin Regensburger 2 , Jochen Klucken 4 , Jürgen Winkler 2 , Zacharias Kohl 5
1. Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
2. Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany.
3. Machine Learning and Data Analytics Lab, FAU, Erlangen, Germany.
4. Medical Valley – Digital Health Application Center GmbH, Bamberg, Germany; Fraunhofer Institute for Integrated Circuits IIS, Erlangen, Germany.
5. Department of Molecular Neurology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany; Department of Neurology, University of Regensburg, Regensburg, Germany.