To establish a reliable method for remote at-home gait assessment for clinical examination and monitoring.

Gait measurement is important for multiple sclerosis (MS) clinical evaluation, with changes indicating disease progression and potential disability. There is a critical need for remote at-home assessments in response to COVID-19 pandemic and beyond.

We developed a protocol for remote and precise gait assessment using a commercially-available tri-axial accelerometer system (RunScribe), validated with gait measurements obtained at in-clinic baseline visit using a gold-standard wearable tri-axial accelerometer (G-sensor, BTS Bioengineering). A 42-year old woman with progressive MS (EDSS: 6.5) and moderate-severe level of mobility impairment (T25-FW time: 33.8 sec; TUG time: 41.86 sec) completed an initial gait assessment during a routine outpatient visit and was provided with two shoelace wearable sensors (shoe mount) in the context of a telemedicine visit.  She was trained during the video visit to setup and position the sensors, connect to the app, and complete a walking test at home. She repeated the gait assessments independently on a weekly basis. In-clinic baseline measures were compared with the remotely-obtained measurements for validation.

In-clinic baseline walking speed was 0.54 m/s, while left and right stride length were 0.56 m and 0.60 m, respectively. During the first video visit walking speed was 0.48 m/s, while the stride length was 0.47 m and 0.48 m for left and right side, respectively. The patient completed 5 weekly gait self-assessments with an average gait velocity of 0.47 ± 0.10 m/s. The gait parameters were reliable over time when measured at home and comparable to those obtained at baseline in-clinic.

The spatiotemporal parameters measured in at-home setting by shoe-mounted accelerometers provided valid remote measurement of gait parameters. This protocol provides a method for obtaining reliable assessment of gait functioning in the context of telemedicine.