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Title: Gait analysis in cerebellar ataxia
Author: Buckley, Ellen
ISNI:       0000 0004 9358 3646
Awarding Body: University of Sheffield
Current Institution: University of Sheffield
Date of Award: 2020
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Background: Cerebellar ataxias (CA) are a group of movement disorders that cause problems with balance and walking. Diagnosis and disease monitoring in CA involve subjective clinical rating scales. These methods are not sensitive to subtle longitudinal changes in mobility and there are no reliable biomarkers of disease progression in ataxia. Gait analysis techniques can objectively quantify gait and have potential to modernise clinical assessment of mobility in CA. Methods: A systematic review and meta-analysis of available literature relating to spatiotemporal gait characteristics of CA were completed to define consistent gait abnormalities in CA. A validation study of gait analysis equipment was completed. A clinical study of instrumented gait tests in CA was undertaken with follow-up tests occurring 12-18 months and 24 months post-baseline. Results: Meta-analysis established a consistent spatiotemporal gait pattern in CA. Our portable gait analysis system showed a good level of agreement and accuracy of gait event measurements compared with a 3D motion capture system in a healthy adult cohort (n=24). CA (n=27) cohort displayed by reduced preferred-pace gait speed, increased step width, asymmetry, and variability, as well as impaired attenuation of upper body motion and reduced postural symmetry and regularity compared with HC (n=27). After a 12-month interval (CA n=16), no disease progression occurred. Although step width, gait asymmetry and regularity variables showed statistically significant deterioration as clinical measures did not reflect a genuine change in function. Conclusion: A thorough characterisation of gait in CA with variables novel to an ataxic cohort has been completed. Spatiotemporal gait abnormalities and impaired dynamic stability differentiate between people with CA and HC and stratifies by disease severity. As no substantial disease progression was detected in the clinical measures or gait measures over a 12-month period, these variables require comparison to other disease groups and exploration over a longer follow-up interval to confirm their use as biomarkers for disease progression in CA.
Supervisor: McNeill, Alisdair ; Mazzà, Claudia Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available