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Quantitative Gait Evaluation in Multiple System Atrophy: Supervised versus Unsupervised Analysis

F. Marchand, J. Labreuche, T. Ollivier, D. Guehl, A. Delval, L. Defebvre, AK. Berger, J. Wiedemann, L. Kjaersgaard, T. Warlop, A. Fasano, BR. Bloem, D. Devos, C. Moreau (Lille, France)

Meeting: 2025 International Congress

Keywords: Gait disorders: Clinical features, Multiple system atrophy(MSA): Anatomy

Category: MSA, PSP, CBS: Biomarkers (non-neuroimaging)

Objective: This study aims to compare gait parameters in real-world (RW) home settings with supervised clinical assessments on 6-minutes walking test (6MWT) in MSA patients and to determine which better correlates with clinical severity.

Background: Multiple System Atrophy (MSA) is a progressive neurodegenerative disorder characterized by parkinsonian features, cerebellar ataxia and autonomic dysfunction. MSA patients present more severe gait disorders than Parkinson’s Disease (PD). No effective treatment is available to slow disease progression, highlighting the need for new biomarkers.

Method: Eighteen patients with early-stage MSA were enrolled. Gait was analyzed using FeetMe® connected insoles both during an in clinic 6MWT and then at home over 10 days. Recorded parameters were stride length and duration, swing and stance duration and percentage, gait velocity (mean and 95th centile), swing velocity, cadence and center of pressure trajectory. Gait parameters were derived and compared from both evaluation conditions and in addition correlation to clinical scales (e.g., Unified Multiple System Atrophy Rating Scale (UMSARS)) were evaluated.

Results: Significant differences were observed between RW and 6MWT gait data for most parameters, with RW data showing stronger correlations with clinical severity. RW parameters seems more correlated with clinical disability than supervised evaluation.

Conclusion: We demonstrated that home-based gait evaluation provides a more accurate assessment of clinical disability in MSA than supervised tests. This suggests that RW gait analysis could be used a surrogate biomarker for disease progression and outcome measurement in neuroprotective and symptomatic trials.

Demographic and descriptive characteristics

Demographic and descriptive characteristics

Agreement levels between 6MWT and RWD

Agreement levels between 6MWT and RWD

FeetMe® connected insoles

FeetMe® connected insoles

Correlation of gait parameters with UMSARS 1

Correlation of gait parameters with UMSARS 1

Correlation of gait parameters with UMSARS 2

Correlation of gait parameters with UMSARS 2

To cite this abstract in AMA style:

F. Marchand, J. Labreuche, T. Ollivier, D. Guehl, A. Delval, L. Defebvre, AK. Berger, J. Wiedemann, L. Kjaersgaard, T. Warlop, A. Fasano, BR. Bloem, D. Devos, C. Moreau. Quantitative Gait Evaluation in Multiple System Atrophy: Supervised versus Unsupervised Analysis [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/quantitative-gait-evaluation-in-multiple-system-atrophy-supervised-versus-unsupervised-analysis/. Accessed October 5, 2025.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/quantitative-gait-evaluation-in-multiple-system-atrophy-supervised-versus-unsupervised-analysis/

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