Wearables demonstrate transition technique relates to balance confidence and fatigue in persons with multiple sclerosis

Falls are common in people with multiple sclerosis (PwMS) and important predictors of experiencing a fall include fatigue and balance. While fatigue fluctuates, clinicians rely on self-report measures administered at discrete time points to assess fatigue and by extension, fall risk. Wearable inertial sensors are a promising technology for community-based monitoring of fluctuating symptoms; however, there are currently limited accelerometer-derived metrics to inform acute fall risk. We used a single thigh inertial sensor to derive features during repeated sit-to-stand transitions and quantified their associations with clinical assessments of balance confidence, fatigue and disease severity that have been associated with fall risk. We found that multiple temporal and kinematic measures derived from the accelerometry signal were related to clinical measures of fatigue and balance confidence. The stand-to-sit transition should be further explored as a predictor of increased fall risk.