Feasibility of Using Wearable Sensors To Assess Body Sway and Gait Across An International Leukodystrophy Cohort

Introduction: Leukodystrophies are a group of rare neurologic disorders that feature progressive sensorimotor dysfunction. In a subset there is a prominent myeloneuropathy. These patients experience impaired balance and gait that leads to loss of independence in walking, ability to perform daily activities, and severely diminished quality of life. The variable progression rate complicates disease monitoring and identification of outcome measures for clinical trials. Deploying wearable sensors for remote assessment allows for readily accessible and frequent body sway and gait variable collection. Furthermore, multi-center cohorts are required to sufficiently power leukodystrophy natural history studies and trials. We explored the feasibility of training investigators across several countries in a universal protocol of balance and gait testing using wearable sensors. Methods: Data was collected annually from patients from three institutions trained in a universal protocol. Static sway and spatiotemporal gait parameters were measured using wearable accelerometers. Patient demographics and responses on quality of life, ambulatory status, and global function were obtained. Results: Wearable sensor measures of sway and gait show consistent results compared with prior studies using lab-based measures. Select variables of sway identify individuals who require an assistive device. We show clinically meaningful relationships between sway and gait with falls, use of a device, and quality of life. Conclusion: We demonstrate a feasible approach across international sites to increase participation of subjects with leukodystrophies. These measures may be well suited as primary outcomes for clinical trial design to assess myeloneuropathy and to monitor disease progression in individual patients. There are no disclosures.