Multiple sclerosis and related disorders · 2025
Peak 30-minute cadence as a digital biomarker of real-world mobility in people with multiple sclerosis.
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de Queiroz Rayssa Soares, Alves José Humberto, Virtuoso Júnior Jair Sindra, Dos Santos Amorim Paulo Roberto, Sebastião Emerson, de Sousa Marlos Aureliano Dias, Pereira Igor Antônio, Motl Robert, Sasaki Jeffer Eidi
Аннотация
PURPOSE: This study examined whether accelerometer-derived Peak 30-Minute Cadence (Peak-30CAD) could serve as a digital biomarker of real-life mobility in people with multiple sclerosis (MS).
METHODS: Fifty-four participants (37.96±10.25 years; BMI = 26.54 ± 5.18 kg/m²) with relapsing-remitting MS participated in the study. Participants underwent clinical and functional assessments, including the Expanded Disability Status Scale, Patient-Determined Disease Steps (PDDS), Timed Up and Go (TUG), and the 6-Minute Walk Test (6MWT). Free-living physical activity data were collected using a hip-worn accelerometer for seven consecutive days and used to derive common physical activity metrics, including moderate to vigorous physical activity, steps per day, and peak one-minute cadence (Peak-1CAD). Peak-30CAD metric was calculated as the mean of the highest 30 non-consecutive minutes of step cadence per day and averaged across valid days of wear time.
RESULTS: Peak-30CAD was the only free-living metric significantly correlated with all clinical mobility measures (PDDS, r = -0.525; TUG, r = -0.293; and 6MWT, r = 0.495), such that lower Peak-30CAD values were associated with higher disability levels and reduced walking capacity. Of note, participants with disability (PDDS 1-4) had significantly lower 6MWT distances (-99.9 m, P = 0.001) and Peak-30CAD values (-23.8 steps/min, P < 0.001) than those without disability (PDDS = 0). The effect size for Peak-30CAD was larger than for 6MWT, suggesting higher potential for Peak-30CAD in differentiating disease status than the 6MWT.
CONCLUSION: These findings support Peak-30CAD as a valid digital biomarker for assessing mobility in people with MS under real-world conditions.
METHODS: Fifty-four participants (37.96±10.25 years; BMI = 26.54 ± 5.18 kg/m²) with relapsing-remitting MS participated in the study. Participants underwent clinical and functional assessments, including the Expanded Disability Status Scale, Patient-Determined Disease Steps (PDDS), Timed Up and Go (TUG), and the 6-Minute Walk Test (6MWT). Free-living physical activity data were collected using a hip-worn accelerometer for seven consecutive days and used to derive common physical activity metrics, including moderate to vigorous physical activity, steps per day, and peak one-minute cadence (Peak-1CAD). Peak-30CAD metric was calculated as the mean of the highest 30 non-consecutive minutes of step cadence per day and averaged across valid days of wear time.
RESULTS: Peak-30CAD was the only free-living metric significantly correlated with all clinical mobility measures (PDDS, r = -0.525; TUG, r = -0.293; and 6MWT, r = 0.495), such that lower Peak-30CAD values were associated with higher disability levels and reduced walking capacity. Of note, participants with disability (PDDS 1-4) had significantly lower 6MWT distances (-99.9 m, P = 0.001) and Peak-30CAD values (-23.8 steps/min, P < 0.001) than those without disability (PDDS = 0). The effect size for Peak-30CAD was larger than for 6MWT, suggesting higher potential for Peak-30CAD in differentiating disease status than the 6MWT.
CONCLUSION: These findings support Peak-30CAD as a valid digital biomarker for assessing mobility in people with MS under real-world conditions.