A wearable device perspective on the standard definitions of disability progression in multiple sclerosis

Gloria Dalla Costa, Carlos Nos, Ana Zabalza, Mathias Buron, Melinda Magyari, Finn Sellebjerg, Ana Isabel Guerrero, Lucia Roselli, Maria Libera La Porta, Matteo Martinis, Raquel Bailon, Spyridon Kontaxis, Estela Laporta, Esther Garcia, Florian B Pokorny, Björn W Schuller, Amos Folarin, Callum Stewart, Letizia Leocani, Srinivasan VairavanNicholas Cummins, Richard Dobson, Matthew Hotopf, Vaibhav Narayan, Xavier Montalban, Per Soelberg Sorensen, Giancarlo Comi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


INTRODUCTION: Multiple sclerosis (MS) is a leading cause of disability among young adults, but standard clinical scales may not accurately detect subtle changes in disability occurring between visits. This study aims to explore whether wearable device data provides more granular and objective measures of disability progression in MS.

METHODS: Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) is a longitudinal multicenter observational study in which 400 MS patients have been recruited since June 2018 and prospectively followed up for 24 months. Monitoring of patients included standard clinical visits with assessment of disability through use of the Expanded Disability Status Scale (EDSS), 6-minute walking test (6MWT) and timed 25-foot walk (T25FW), as well as remote monitoring through the use of a Fitbit.

RESULTS: Among the 306 patients who completed the study (mean age, 45.6 years; females 67%), confirmed disability progression defined by the EDSS was observed in 74 patients, who had approximately 1392 fewer daily steps than patients without disability progression. However, the decrease in the number of steps experienced over time by patients with EDSS progression and stable patients was not significantly different. Similar results were obtained with disability progression defined by the 6MWT and the T25FW.

CONCLUSION: The use of continuous activity monitoring holds great promise as a sensitive and ecologically valid measure of disability progression in MS.

Original languageEnglish
Pages (from-to)103-112
Number of pages10
JournalMultiple sclerosis (Houndmills, Basingstoke, England)
Issue number1
Publication statusPublished - Jan 2024


  • Female
  • Humans
  • Male
  • Middle Aged
  • Disability Evaluation
  • Disabled Persons
  • Multiple Sclerosis/diagnosis
  • Walk Test
  • Walking/physiology
  • Wearable Electronic Devices
  • Adult


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