Revealing the Optimal Thresholds for Movement Performance: A Systematic Review and Meta-Analysis to Benchmark Pathological Walking Behaviour

Authors

Deepak K. Ravi, ETH Zürich
Michelle Gwerder, ETH Zürich
Niklas König Ignasiak, Chapman UniversityFollow
Christian R. Baumann, University Hospital Zürich
Mechtild Uhl, University Hospital Zürich
Jaap H. Dieën, Vrije Universiteit Amsterdam
William R. Taylor, ETH Zürich
Navrag B. Singh, ETH Zürich

Document Type

Article

Publication Date

10-19-2019

Abstract

In order to address whether increased levels of movement output variability indicate pathological performance, we systematically reviewed and synthesized meta-analysis data on healthy and pathological motor behavior. After screening up to 24’000 reports from four databases, 85 studies were included containing 2409 patients and 2523 healthy asymptomatic controls. The optimal thresholds of variability with uncertainty boundaries (in % Coefficient of Variation ± Standard Error) were estimated in 7 parameters: stride time (2.34 ± 0.21), stride length (2.99 ± 0.37), step length (3.34 ± 0.84), swing time (2.94 ± 0.60), step time (3.35 ± 0.23), step width (15.87 ± 1.86), and dual-limb support time (6.08 ± 2.83). All spatio-temporal parameters exhibited a positive effect size (pathology led to increased variability) except step width variability (Effect Size = −0.21). By objectively benchmarking thresholds for pathological motor variability also presented through a case-study, this review provides access to movement signatures to understand neurological changes in an individual that are apparent in movement variability. The comprehensive evidence presented now qualifies stride time variability as a movement biomarker, endorsing its applicability as a viable outcome measure in clinical trials.

Comments

This article was originally published in Neuroscience and Biobehavioral Reviews, volume 108, in 2019. https://doi.org/10.1016/j.neubiorev.2019.10.008

Recommended Citation

Ravi DK, Gwerder M, Ignasiak NK, et al. Revealing the optimal thresholds for movement performance: A systematic review and meta-analysis to benchmark pathological walking behaviour. Neurosci Biobehav Rev.. 2019;108:24-33. https://doi.org/10.1016/j.neubiorev.2019.10.008

Peer Reviewed

1

Copyright

The authors

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 License.