Open-source dataset reveals relationship between walking bout duration and fall risk classification performance in persons with multiple sclerosis

Abstract

Falls are frequent and associated with morbidity in persons with multiple sclerosis (PwMS). Symptoms of MS fluctuate, and standard biannual clinical visits cannot capture these fluctuations. Remote monitoring techniques that leverage wearable sensors have recently emerged as an approach sensitive to disease variability. Previous research has shown that fall risk can be identified from walking data collected by wearable sensors in controlled laboratory conditions however this data may not be generalizable to variable home environments. To investigate fall risk and daily activity performance from remote data, we introduce a new open-source dataset featuring data collected from 38 PwMS, 21 of whom are identified as fallers and 17 as non-fallers based on their six-month fall history. This dataset contains inertial-measurement-unit data from eleven body locations collected in the laboratory, patient-reported surveys and neurological assessments, and two days of free-living sensor data from the chest and right thigh. Six-month (n = 28) and one-year repeat assessment (n = 15) data are also available for some patients. To demonstrate the utility of these data, we explore the use of free-living walking bouts for characterizing fall risk in PwMS, compare these data to those collected in controlled environments, and examine the impact of bout duration on gait parameters and fall risk estimates. Both gait parameters and fall risk classification performance were found to change with bout duration. Deep learning models outperformed feature-based models using home data; the best performance was observed with all bouts for deep-learning and short bouts for feature-based models when evaluating performance on individual bouts. Overall, short duration free-living walking bouts were found to be the least similar to laboratory walking, longer duration free-living walking bouts provided more significant differences between fallers and non-fallers, and an aggregation of all free-living walking bouts yields the best performance in fall risk classification. Author summary Falls are both highly prevalent and injurious in persons with Multiple Sclerosis (PwMS), thus we are interested in finding methods to understand the fall risk of PwMS. To examine the differences between PwMS in a clinic environment and at home, we collected and made publicly available a dataset where PwMS performed daily life activities in the clinic and then wore wearable sensors at home for two days. We found people walk very differently at home vs in-clinic. However, the longer they walk for, the closer their walking attributes relate to how they walk in-clinic. Additionally, in examining multiple approaches, we found both the full length and short bouts of at-home walking periods can identify the fall risk of PwMS- each providing varying levels of performance. Crucially, we find that methods and assessments developed for in-clinic methods may need to be adjusted to function properly at home and when performing walking analysis at home, analyzing differing durations of walking will impact the results.