Evaluation of walking activity and gait to identify physical and mental fatigue in neurodegenerative and immune disorders: preliminary insights from the IDEA-FAST feasibility study

Background
Fatigue is a disabling symptom in neurodegenerative (NDD) and immune-mediated inflammatory disorders (IMID). Current assessments rely on subjective patient-reported outcomes (PROs). Wearable inertial sensors provide objective gait measures and may offer complementary indicators of fatigue. This study examined associations between gait characteristics and self-reported fatigue in the IDEA-FAST feasibility study.

Methods
Participants with NDDs and IMIDs (Parkinson’s disease, Huntington’s disease, rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren’s syndrome, and inflammatory bowel disease) wore a lower-back inertial measurement unit for up to 10 days at home. Physical and mental fatigue PROs were collected up to four times daily. Macro- and micro-gait features were extracted from accelerometer data. Associations with fatigue were assessed using generalized linear mixed-effects models and machine-learning classification.

Results
Seventy-two participants were included. Variability of non-walking bout length showed the strongest association with physical fatigue (conditional R² = 0.165), while associations with mental fatigue were minimal (highest marginal R² = 0.0018). Machine-learning models showed limited performance, with the highest accuracy of 56.9% for mental fatigue using micro-gait features and intrasubject cross-validation. Acceleration magnitude, bout length variability, postural control, and gait rhythm were the most relevant features.

Conclusions
Overall, gait characteristics showed weak associations with abnormal fatigue. Behavioral changes during the COVID-19 pandemic may have influenced gait patterns. Larger studies are needed to better understand the relationship between gait and fatigue.

Rights

Use and reproduction:


CC BY 4.0

Please note that individual components of the publication may be subject to other licensing or copyright conditions.

Cite

Citation style:
Could not load citation form.