IMU-based segmental root mean square analysis of gait in individuals with cerebellar ataxia: a pilot cross-sectional study

Cerebellar ataxia (CA) affects limb movement, balance, and gait. Subjective rating scales like Scale for the Assessment and Rating of Ataxia (SARA) may underestimate gait severity. Inertial measurement units (IMUs) offer an objective gait analysis. Impaired trunk control might compromise gait performance and stability in individuals with ataxia. This study quantified trunk kinematics and gait parameters using Root Mean Square (RMS) values, comparing CA to healthy individuals. Ten CA cases and twenty healthy controls were recruited. Six IMU sensors positioned at anatomical landmarks recorded data via two ESP32 microcontrollers using Wi-Fi. Participants walked a 10-meter path at a self-selected pace. RMS mean linear and angular velocity and angular deviation were calculated. Individuals with CA showed decreased mediolateral linear acceleration at the left shoulder (p = 0.001) and an increased vertical linear acceleration at the right ankle (p = 0.015), left shoulder (p = 0.028), and back (p = 0.019). Total angular velocity was lower at the right shoulder (p = 0.017), left shoulder (p = 0.005), back (p = 0.002), and both ankles (right: p = 0.001; left: p = 0.001). The correlation between IMU-derived features and SARA-gait score in the CA group was not statistically significant (all p > 0.05), except for the right shoulder's mediolateral angular velocity (p = 0.046). Both ankle segments' angular deviations (right: p = 0.001; left: p = 0.006) were reduced. The CA group revealed reduced RMS linear and angular velocities. IMU-based trunk and gait analysis provides a more objective method that would help in planning targeted rehabilitation treatments.Trial registration: The study was approved by the Institutional Ethics Committee (IEC), Kasturba Medical College, Mangalore, Manipal Academy of Higher Education (IEC KMC MLR 12/2023/483) on 21st December 2023 and the Clinical Trial Registration (CTRI/2024/07/070614) on July 15th, 2024.