Objective: To record mobility in everyday life of patients with MSA, PSP and IPD using sensor-technology over several days.

Background: Even in the early disease stages, patients with atypical parkinsonian syndromes (APD) present with an impaired gait and postural stability. This has an impact on mobility and quality of life of these patients and their caregivers. Physical activity in everyday life is often not adequately recorded with questionnaires and clinical scales, which is why digital biomarkers can be used as objective measurement methods.

Method: Recruitment took place as part of the Mobility_APP study (NCT04608604). Clinical impairment was assessed using the MDS-UPDRS and the sub-score for axial symptoms (PIGD score) was calculated. All participants underwent a recording phase of seven consecutive days, where physical activities were monitored with accelerometer and gyroscope sensors.

Results: A total of 23 MSA, 20 PSP and 41 IPD patients were included in the analysis. MSA and PSP patients were clinically more severely impairment compared to IPD (p<0.001).

The average gait speed was 1.02m/sec for IPD, 0.77m/sec for MSA and 0.92m/sec for PSP (p=0.007) for walking bouts longer than 30 seconds. Gait speed showed moderate correlation with the MDS-UPDRS (r²=0.27) and the PIGD score (r²=0.26).

IPD patients spent on average more time on physical activity (21%) compared to MSA (14%) and PSP (12%, p=0.004). With on average 9,614 steps/day, IPD patients were more active compared to MSA (6,578) and PSP (5,982; p<0.001). Both activity parameters show moderate correlation with the MDS-UPDRS (activity % r²=0.21; steps/day r²=0.25) and the PIGD subscore (activity % r²=0.20; steps/day r²=0.23).

Conclusion: This study shows the first analysis of physical activity in daily life in patients with APDs. It shows a significantly lower activity of daily living in patients with MSA and PSP compared to IPD, which correlates with both general impairment and axial symptoms. Even though the clinical evaluation provides us with important information about mobility, it should be noted that outpatient examinations are snapshots, where influencing factors like levodopa intake, daily fluctuations and situational attention like the “white coat effect” are not taken into account. Particularly in clinical trials, an analysis of home-activity can be a useful supportive method to measure activity and independence in daily life.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/physical-activity-in-patients-with-atypical-parkinsonian-syndromes-collection-of-real-world-data/