Abstract Details

Title Hereditary Spastic Paraplegia: The Relationships of Patient Perceived Functional Impact and Objective Quantified Multi-Dimensional Gait Analysis

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 10-049

Objective

Utilize objective multi-dimensional gait parameters to quantify functional impairment in a cohort of people with HSP (PwHSP) and relate these findings to patient perspective of disease impact across multiple PRO’s.

Background Hereditary spastic paraplegias (HSPs) are genetically heterogeneous syndromes in which lower extremity spasticity and weakness occur in both variable proportions and degrees. Characterizing HSP's natural history provides insight into genotype-phenotype correlation and is essential for emerging clinical trials that utilize patient-centric outcome parameters. Patient reported outcomes (PRO) provide opportunities to understand patient perception of disease impact, and when combined with objective gait parameters, provides an attractive option for monitoring of both perceived and objective disease impact.

Design/Methods PwHSP were asked to: complete standardized validated PRO: Activity Balance Confidence (ABC), Modified Falls Efficacy Scale (MFES), Neuro-QoL Lower Extremity Function (QoL-LE), and then ambulate 20’ with 3 repetitions for both preferred walking speed-PWS and subsequently dual tasking-DT while ambulating on a 20’ Zeno Mat. The relationship between these 3 PROs and stride velocity (SV) and double support (DS, velocity independent measure of gait efficiency) for both conditions of ambulation were then analyzed.

Results 60 PwHSP, average age 52.2 (23-73) years, 59.4% female. Significant inverse relationships across a continuum of self-reported ability were noted for SV and DS for all 3 PRO’s across both PWS and DT walking conditions respectively (p<0.01 across all values). Greater PRO functional impairment was associated with slower DT SV. DT overall resulted in greater gait impairment than PWS.

Conclusions

Quantified gait assessment provides examiner independent objective information that correlates with patient reported functional impairment in HSP. This provides additional insight not easily obtained by routine examination to improve understanding of both disease impact on functional ability in the real world as well as both quantify and identify individual patient change.

Authors/Disclosures
Jared Srinivasan PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
Myassar Zarif	Myassar Zarif has nothing to disclose.
Barbara Bumstead, NP	Ms. Bumstead has nothing to disclose.
Marijean Buhse (Stony Brook University)	Marijean Buhse has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Biogen.
	No disclosure on file
	No disclosure on file
	No disclosure on file
John K. Fink, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
Mark Gudesblatt, MD (South Shore Neurology Assoc. PC)	The institution of Dr. Gudesblatt has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for genentech. The institution of Dr. Gudesblatt has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen.

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