Journal Article

Evaluation of walking activity and gait to identify physical and mental fatigue in neurodegenerative and immune disorders: preliminary insights from the IDEA-FAST feasibility study

Kristen Davies, Victoria Macrae, Teemu Ahmaniemi, Tiago Guerreiro, Diogo Branco, Svenja Aufenberg, Hanna Hildesheim, Clemence Pinaud, C. Janneke van der Woude, Ioannis Pandis, Kirsten Emmert, Ralf Reilmann, Silvia Del Din, Geert Van Gassen, Lynn Rochester, Dan Jackson, the IDEA-FAST Consortium, Wan-Fai Ng, Rana Zia Ur Rehman, Meenakshi Chatterjee, Chloe Hinchliffe, Jennifer Kudelka, Walter Maetzler, Nikolay V. Manyakov, Emma Paulides

2024

Overview

Background Many individuals with neurodegenerative (NDD) and immune-mediated inflammatory disorders (IMID) experience debilitating fatigue. Currently, assessments of fatigue rely on patient reported outcomes (PROs), which are subjective and prone to recall biases. Wearable devices, however, provide objective and reliable estimates of gait, an essential component of health, and may present objective evidence of fatigue. This study explored the relationships between gait characteristics derived from an inertial measurement unit (IMU) and patient-reported fatigue in the IDEA-FAST feasibility study. Methods Participants with IMIDs and NDDs (Parkinson's disease (PD), Huntington's disease (HD), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), primary Sjogren’s syndrome (PSS), and inflammatory bowel disease (IBD)) wore a lower-back IMU continuously for up to 10 days at home. Concurrently, participants completed PROs (physical fatigue (PF) and mental fatigue (MF)) up to four times a day. Macro (volume, variability, pattern, and acceleration vector magnitude) and micro (pace, rhythm, variability, asymmetry, and postural control) gait characteristics were extracted from the accelerometer data. The associations of these measures with the PROs were evaluated using a generalised linear mixed-effects model (GLMM) and binary classification with machine learning. Results Data were recorded from 72 participants: PD = 13, HD = 9, RA = 12, SLE = 9, PSS = 14, IBD = 15. For the GLMM, the variability of the non-walking bouts length (in seconds) with PF returned the highest conditional R2, 0.165, and with MF the highest marginal R2, 0.0018. For the machine learning classifiers, the highest accuracy of the current analysis was returned by the micro gait characteristics with an intrasubject cross validation method and MF as 56.90% (precision = 43.9%, recall = 51.4%). Overall, the acceleration vector magnitude, bout length variation, postural control, and gait rhythm were the most interesting characteristics for future analysis. Conclusions Counterintuitively, the outcomes indicate that there is a weak relationship between typical gait measures and abnormal fatigue. However, factors such as the COVID-19 pandemic may have impacted gait behaviours. Therefore, further investigations with a larger cohort are required to fully understand the relationship between gait and abnormal fatigue.

• Publisher: Springer Science and Business Media LLC,BioMed Central,BioMed Central Ltd,BMC
• Subject: Accelerometry - instrumentation / Accelerometry - methods / Adult / Aged / Biomedical and Life Sciences / Biomedical Engineering and Bioengineering / Biomedicine / Degeneration / Digital health / Fatigue / Fatigue - diagnosis / Fatigue - etiology / Fatigue - physiopathology / Feasibility Studies / Female / Gait / Gait - physiology / Gait Analysis - instrumentation / Gait Analysis - methods / Health aspects / Humans / Immune System Diseases - complications / Immune System Diseases - physiopathology / Immunologic diseases / Machine learning / Male / Medical research / Medicine, Experimental / Mental Fatigue - diagnosis / Mental Fatigue - etiology / Mental Fatigue - physiopathology / Middle Aged / Nervous system / Neurodegenerative Diseases - complications / Neurodegenerative Diseases - physiopathology / Neurology / Neurosciences / Neurosciences. Biological psychiatry. Neuropsychiatry / Physiological aspects / Psychological aspects / RC321-571 / Real-world gait / Rehabilitation Medicine / Self Report / Walking / Walking - physiology / Wearable devices / Wearable Electronic Devices / Young Adult