Assessment of Fall Risk in Neurological Disorders and Technology: Relationship Between Silver Index and Gait Analysis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Biomechanics

Background:

• Falls are a significant complication of neurological disorders, including stroke, Parkinson's Disease (PD), and Multiple Sclerosis (MS).
• Early identification of fall risk factors is crucial for preventing adverse outcomes and tailoring rehabilitation strategies.
• Existing methods for assessing fall risk may not fully capture the complexity in all neurological conditions.

Purpose of the Study:

• To investigate the relationship between fall risk, assessed by the Silver Index, and gait parameters (spatiotemporal and kinematic) in patients with stroke, PD, and MS.
• To determine if gait analysis can inform personalized rehabilitation for these patient groups.
• To identify potential differences in fall risk factors across different neurological conditions.

Main Methods:

• Ninety patients with stroke, PD, or MS participated in an eight-week home-based rehabilitation program (device-assisted or paper-based).
• Fall risk was evaluated using the Silver Index on the hunova® robotic platform at baseline (T0) and post-intervention (T2).
• Instrumental gait analysis was performed to record spatiotemporal and kinematic parameters at T0 and T2.

Main Results:

• Significant correlations were found between the Silver Index and several gait spatiotemporal parameters (stance, swing, double support, cycle length, cadence) in stroke patients at both T0 and T2.
• No significant correlations between the Silver Index and gait parameters were observed in Parkinson's Disease (PD) or Multiple Sclerosis (MS) patients.
• No significant correlations were found between the Silver Index and gait kinematic parameters in any of the studied neurological conditions.

Conclusions:

• The Silver Index and gait spatiotemporal analysis may help identify fall risk patterns specifically in post-stroke patients.
• In PD and MS, fall risk appears influenced by factors beyond gait parameters measurable by current instrumental analysis, necessitating a multidimensional assessment including cognitive aspects.
• Current instrumental gait analysis may be insufficient for comprehensive fall risk evaluation in PD and MS, highlighting the need for integrated assessment approaches.