Tracking gait and balance changes in people with MS

Professor Mary Galea

The University of Melbourne, VIC

| Better treatments | Social And Applied Research | Project | 2019 | Investigator Led Research |


Medications currently available for MS aim to keep people free from relapses and to slow progression of their disease. However, current tests used in clinics for walking and balance are not sensitive enough to pick up some of the more subtle signs of disease activity. Better ways are urgently needed to monitor disease progression so that we can test the effectiveness of medications for progressive MS and develop ways to measure these small changes in the clinical setting to adjust the management and treatment of MS for individuals. Using laboratory-based measuring systems, Professor Mary Galea and her team have previously shown that they can detect subtle changes in walking and balance in people with MS, even when there isn’t any obvious sign of disease progression.

This project is using sensors attached to the torso and legs to measure changes in walking and balance in people with MS over time. These devices can also be used to develop a new measure of walking stability called the Local Divergence Exponent (LDE), which the team believe might be possible to match up with changes to the brain and spinal cord shown on magnetic resonance imaging (MRI) scans.

Project Outcomes

Professor Galea and her team have recruited and conducted baseline assessments for 60 participants. Of these, 21 have had three or more assessments and 23 have had two assessments.

The study has yielded a rich dataset on the characteristics of changes in walking and balance in people with MS. Although the LDE was the primary focus of their research, the data allowed calculation of other measures which also have potential to be sensitive markers of changes in walking and balance.

The use of wearable sensors is proving to be very useful clinically, in that they are easy to use, acceptable to people with MS and provide immediate data on various walking parameters (speed, step length, step width etc), and balance. LDE derived from a sensor placed on the sternum (mid chest) was found to be more sensitive than that of a sensor placed on the sacrum (lower back). Additionally, the sensors have proven to be accurate in their data collection.

Professor Galea and her team have shown that the LDE can discriminate between people with MS with no or mild disability (EDSS 0-1) and people without MS, unlike the accepted clinical test, the Timed 25-Foot Walk (T25FW). To date, the walking and balance measurements are consistent with the team’s previous findings of reduced speed, increased double support (the use of support equipment for both sides of the body) and reduced balance for people with MS. Therefore, the LDE could be considered as a sensitive outcome measure for walking and balance instead of current clinical tests.

Professor Galea and her team have found that changes in the LDE may be predictive of a relapse, although this needs to be confirmed. Specifically, they will investigate if a change in the LDE from baseline to two years is associated with changes in MRI (brain volume, lesion volume and new lesion counts) over the same period.

More sensitive outcome measures such as this will mean that clinicians can determine the comparative effectiveness of existing treatments, and adapt them to improve outcomes for people with MS.

The results of this work have been presented at several conferences and published in scientific journals. Three further scientific manuscripts are in preparation.

Updated: 05 January, 2019

Stages of the research process

Fundamental laboratory

Laboratory research that investigates scientific theories behind the possible causes, disease progression, ways to diagnose and better treat MS.

Lab to clinic timeline: 10+ years

Research that builds on fundamental scientific research to develop new therapies, medical procedures or diagnostics and advances it closer to the clinic.

Lab to clinic timeline: 5+ years
Clinical Studies
and Clinical Trials

Clinical research is the culmination of fundamental and translational research turning those research discoveries into treatments and interventions for people with MS.

Lab to clinic timeline: 1-5 years


Grant Awarded

  • Project Grant

Total Funding

  • $206,743


  • 4 years

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Tracking gait and balance changes in people with MS