@incollection{bohn02_understanding_2025,
author = "Kristina Bohn and Jens Seemann and Martin A. Giese and Matthis Synofzik and Winfried Ilg",
abstract = "Impairments in gait– with a key component of dynamic balance– and stance– with a key component of static balance- represent the key hallmarks of ataxia; not only in clinical assessments and clinician-reported outcomes; but also in patients’ voice burden of disease severity and patient-reported outcomes. While it is obvious that both features are not independent from each other, their interplay in ataxia – in terms of underlying control mechanisms- remains unknown. Here we aimed to assess the interaction be-tween dynamic balance (gait) and static balance (stance) in response to longitudinal changes in cerebellar ataxia using wearable sensors. We assessed cross-sectional and longitudinal balance of subjects with degenerative cerebellar disease (SARA:7.5±5.14) at baseline and 1-year follow-up (n=60) by 3 body-worn inertial sensors in two conditions: (1) stance with feet together (30 seconds), (2) straight walking (2 minutes). Based on the hip sensor, sway path length was calculated as a measure of static balance during stance using both directions of sway (PLtotal), as well as exclusively anterior-posterior (PLap) and medial-lateral (PLml) direction. Gait analysis focussed on ataxic-sensitive measures of spatio-temporal variability: stride length variability (SLCV) in gait direction and lateral step deviation (LSD) as well as upper body range of motion during gait in respective directions (ROMap, ROMml). Cross-sectional analyses revealed significant correlations between PLtotal and LSD as well as ROMml (r {\textgreater}0.6), and between PLtotal and SLCV and ROMap (r{\textgreater}0.4). Matching directions of sway showed a mildly increased effect (e.g. LSD{\textbackslash}PLap:r\_total=0.61,r\_ap= 0.63). Corresponding stance and gait measures showed similar correlations to patient-reported balance confidence (ABC-score;PLtotal:0.65,LSD:0.69). Longitudinal changes in static balance were correlated with changes in dynamic bal-ance specifically in the corresponding direction (e.g. deltaLSD{\textbackslash}deltaPLml:r=0.40). We were able to identify specific influences of the static balance mechanism on gait, demonstrating the patient's relevance of static stance testing and related balance exer-cises in rehabilitation.",
booktitle = "International Congress for Ataxia Research (ICAR) London",
title = "{U}nderstanding the relationship of static and dynamic balance measures in ataxic stance and gait",
year = "2024",
}