Use of wrist-worn accelerometers to quantify bilateral upper limb activity and asymmetry under free-living conditions in people with multiple sclerosis.

BACKGROUND: Although upper limb (UL) dysfunctions are quite common among people with Multiple Sclerosis (pwMS), there is a scarcity of information about actual UL usage under free-living conditions. The aim of the present study is to quantitatively assess 'real-world' activity time, intensity and possible asymmetry of use among dominant and non-dominant ULs in pwMS. METHODS: Twenty-eight pwMS (20 women, 8 men, average EDSS 4.3) and 28 age- and sex-matched unaffected individuals were required to wear a tri-axial accelerometer on each wrist 24h/day for 2 weekdays. Raw accelerations were processed to calculate parameters associated with time and intensity of use of UL both when engaged in uni- or bilateral activities. RESULTS: During the 2-day monitoring period, pwMS were characterized by significantly lower overall activity, they used their dominant limb for a significantly longer time and, while performing bilateral activities, their dominant limb expressed movements of superior intensity in a proportion higher than what was observed in unaffected individuals. CONCLUSION: The instrumental monitoring of UL activity with two wrist-worn sensors may represent an effective tool for assessing the contribution of each limb to uni- and bilateral movements. Such data can be employed to monitor the progression of UL dysfunctions and the effectiveness of pharmacologic and rehabilitative treatments.

Lower Limb Kinematics in Individuals with Hip Osteoarthritis during Gait: A Focus on Adaptative Strategies and Interlimb Symmetry.

Among the functional limitations associated with hip osteoarthritis (OA), the alteration of gait capabilities represents one of the most invalidating as it may seriously compromise the quality of life of the affected individual. The use of quantitative techniques for human movement analysis has been found valuable in providing accurate and objective measures of kinematics and kinetics of gait in individuals with hip OA, but few studies have reported in-depth analyses of lower limb joint kinematics during gait and, in particular, there is a scarcity of data on interlimb symmetry. Such aspects were investigated in the present study which tested 11 individuals with hip OA (mean age 68.3 years) and 11 healthy controls age- and sex-matched, using 3D computerized gait analysis to perform point-by-point comparisons of the joint angle trends of hip, knee, and ankle. Angle-angle diagrams (cyclograms) were also built to compute several parameters (i.e., cyclogram area and orientation and Trend Symmetry) from which to assess the degree of interlimb symmetry. The results show that individuals with hip OA exhibit peculiar gait patterns characterized by severe modifications of the physiologic trend at hip level even in the unaffected limb (especially during the stance phase), as well as minor (although significant) alterations at knee and ankle level. The symmetry analysis also revealed that the effect of the disease in terms of interlimb coordination is present at knee joint as well as hip, while the ankle joint appears relatively preserved from specific negative effects from this point of view. The availability of data on such kinematic adaptations may be useful in supporting the design of specific rehabilitative strategies during both preoperative and postoperative periods.