Digital health metrics reveal upper limb impairment profiles in ARSACS


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Date

2023-05-15

Publication Type

Journal Article

ETH Bibliography

yes

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Abstract

Objective Adults with autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) often present with reduced upper limb coordination affecting their independence in daily life. Previous studies in ARSACS identified reduced performance in clinical assessments requiring fine and gross dexterity as well as prehension. However, the kinematic and kinetic aspects underlying reduced upper limb coordination in ARSACS have not been systematically investigated yet. In this work, we aimed to provide a detailed characterization of alterations in upper limb movement patterns and hand grip forces in 57 participants with ARSACS. Methods We relied on a goal-directed technology-aided assessment task, which provides eight previously validated digital health metrics describing movement efficiency, smoothness, speed, and grip force control. Results First, we observed that 98.3% of the participants were impaired in at least one of the metrics, that all metrics are significantly impaired on a population level, and that grip force control during precise manipulations is most commonly and strongly impaired. Second, we identified high inter-participant variability in the kinematic and kinetic impairment profiles, thereby capturing different clinical profiles subjectively observed in this population. Lastly, abnormal goal-directed task performance in ARSACS could be best explained by reduced movement speed, efficiency, and especially force control during precise manipulations, while abnormal movement smoothness did not have a significant effect. Interpretation This work helped to refine the clinical profile of ARSACS and highlights the need for characterizing individual kinematic and kinetic impairment profiles in clinical trials in ARSACS.

Publication status

published

Editor

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Volume

448

Pages / Article No.

120621

Publisher

Elsevier

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Edition / version

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Date collected

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Subject

ARSACS; Digital health metrics; Impairment profiles

Organisational unit

03827 - Gassert, Roger / Gassert, Roger check_circle

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