Abstract：
OBJECTIVE: Chemotherapy-induced peripheral neuropathy (CIPN) and falls can be persistent side effects of cancer treatment. Standing postural sway and gait tests with body-worn, inertial sensors provide objective digital balance and gait measures that represent several different domains controlling mobility. Specific domains of balance and gait that related to neuropathy and falls are unknown. The aim of this study was to determine which domains of balance and gait differed between cancer survivors who report (1) CIPN symptoms versus no symptoms, (2) a history of falls in the past 6 months versus no falls, and (3) prospective falls over 12 months versus no falls.
METHODS: Postural sway during 30 seconds of quiet standing and gait characteristics from a 7-m timed up and go test were recorded with six synchronized inertial sensors (Opals by APDM Wearable Technologies, a Clario Company) in 425 older, female cancer survivors (age: 62 ± 6 years). A principal component analysis (PCA) approach was used to identify independent domains of mobility from 15 balance and gait measures.
RESULTS: PCA analysis revealed five independent domains (PC1 = sway amplitude, PC2 = gait pace, PC3 = sway frequency, PC4 = gait spatial-temporal, and PC5 = turning) that accounted for 81% of the variance of performance. Cancer survivors who reported CIPN symptoms had significantly higher sway frequency (PC3) than asymptomatic survivors. Past fallers had significantly larger sway area (PC1) and slower gait pace (PC2) than nonfallers. Prospective fallers showed a significantly smaller stride length (PC4) than nonfallers.
CONCLUSIONS: Digital balance and gait measures using wearable sensors during brief standing and walking tests provide objective metrics of CIPN-related mobility impairment and fall risk that could be useful for oncology clinical trials.
METHODS: Postural sway during 30 seconds of quiet standing and gait characteristics from a 7-m timed up and go test were recorded with six synchronized inertial sensors (Opals by APDM Wearable Technologies, a Clario Company) in 425 older, female cancer survivors (age: 62 ± 6 years). A principal component analysis (PCA) approach was used to identify independent domains of mobility from 15 balance and gait measures.
RESULTS: PCA analysis revealed five independent domains (PC1 = sway amplitude, PC2 = gait pace, PC3 = sway frequency, PC4 = gait spatial-temporal, and PC5 = turning) that accounted for 81% of the variance of performance. Cancer survivors who reported CIPN symptoms had significantly higher sway frequency (PC3) than asymptomatic survivors. Past fallers had significantly larger sway area (PC1) and slower gait pace (PC2) than nonfallers. Prospective fallers showed a significantly smaller stride length (PC4) than nonfallers.
CONCLUSIONS: Digital balance and gait measures using wearable sensors during brief standing and walking tests provide objective metrics of CIPN-related mobility impairment and fall risk that could be useful for oncology clinical trials.
摘要：
目的：化疗引起的周围神经病变（CIPN）和跌倒可能是癌症治疗的持续副作用。站立姿势摇摆和步态测试与身体磨损，惯性传感器提供客观的数字平衡和步态措施，代表了几个不同的领域控制移动性。与神经病变和跌倒相关的平衡和步态的具体领域是未知的。本研究的目的是确定报告（1）CIPN症状与无症状的癌症幸存者之间的平衡和步态领域有所不同，(2)过去6个月跌倒的历史与没有跌倒的历史，(3)预期下跌超过12个月与没有下跌。
方法：用6个同步惯性传感器记录了7米时间和行走测试中30秒安静站立过程中的姿势摇摆和步态特征（APDM可穿戴技术公司的蛋白石，克拉里奥公司)425年老，女性癌症幸存者（年龄：62±6岁）。使用主成分分析（PCA）方法从15种平衡和步态度量中识别出独立的移动性域。
结果：PCA分析揭示了五个独立的域（PC1=摇摆幅度，PC2=步态速度，PC3=摇摆频率，PC4=步态时空，和PC5=转弯)，占性能差异的81%。报告CIPN症状的癌症幸存者的摇摆频率（PC3）明显高于无症状幸存者。过去的跌倒者的摇摆面积（PC1）和步态速度（PC2）明显大于非跌倒者。前瞻性跌倒者的步幅长度（PC4）明显小于非跌倒者。
结论：在简短的站立和行走测试中使用可穿戴传感器的数字平衡和步态测量提供了CIPN相关的移动性损害和跌倒风险的客观指标，可能对肿瘤学临床试验有用。
方法：用6个同步惯性传感器记录了7米时间和行走测试中30秒安静站立过程中的姿势摇摆和步态特征（APDM可穿戴技术公司的蛋白石，克拉里奥公司)425年老，女性癌症幸存者（年龄：62±6岁）。使用主成分分析（PCA）方法从15种平衡和步态度量中识别出独立的移动性域。
结果：PCA分析揭示了五个独立的域（PC1=摇摆幅度，PC2=步态速度，PC3=摇摆频率，PC4=步态时空，和PC5=转弯)，占性能差异的81%。报告CIPN症状的癌症幸存者的摇摆频率（PC3）明显高于无症状幸存者。过去的跌倒者的摇摆面积（PC1）和步态速度（PC2）明显大于非跌倒者。前瞻性跌倒者的步幅长度（PC4）明显小于非跌倒者。
结论：在简短的站立和行走测试中使用可穿戴传感器的数字平衡和步态测量提供了CIPN相关的移动性损害和跌倒风险的客观指标，可能对肿瘤学临床试验有用。
