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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

Lookup NU author(s): Dr Chloe HinchliffeORCiD, Dr Rana RehmanORCiD, Dan JacksonORCiD, Dr Kristen Davies, Victoria Macrae, Professor Lynn RochesterORCiD, Professor Fai Ng, Dr Silvia Del DinORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© The Author(s) 2024. 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.


Publication metadata

Author(s): Hinchliffe C, Rehman RZU, Pinaud C, Branco D, Jackson D, Ahmaniemi T, Guerreiro T, Chatterjee M, Manyakov NV, Pandis I, Davies K, Macrae V, Aufenberg S, Paulides E, Hildesheim H, Kudelka J, Emmert K, Van Gassen G, Rochester L, van der Woude CJ, Reilmann R, Maetzler W, Ng W-F, Del Din S

Publication type: Article

Publication status: Published

Journal: Journal of NeuroEngineering and Rehabilitation

Year: 2024

Volume: 21

Online publication date: 05/06/2024

Acceptance date: 21/05/2024

Date deposited: 19/06/2024

ISSN (electronic): 1743-0003

Publisher: BioMed Central Ltd

URL: https://doi.org/10.1186/s12984-024-01390-1

DOI: 10.1186/s12984-024-01390-1

Data Access Statement: The data for this study are available from the corresponding author on reasonable request and subject to the approval of the IDEA-FAST consortium.

PubMed id: 38840208


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Funding

Funder referenceFunder name
853981
EU Innovative Medicines Initiative 2 Joint Undertaking
Innovative Medicines Initiative 2 Joint Undertaking (IMI2 JU) project Mobilise-D—Grant Agreement 820820
National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC) based at The Newcastle Upon Tyne Hospital NHS Foundation Trust
NIHR/Wellcome Trust Clinical Research Facility (CRF) infrastructure at Newcastle upon Tyne Hospitals NHS Foundation Trust

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