Gait Speed May Improve Detection of Short-term Disease Progression in Friedreich’s Ataxia

Gait speed might be used as an objective measure to assess disease progression in adults with Friedreich’s ataxia who are still able to walk, according to a small study which suggested that the measure is more sensitive in detecting neurological changes in the short term.

Because current tools for measuring short-term disease progression are not optimal, gait speed measurements might improve outcome analyses in clinical trials that evaluate new Friedreich’s ataxia treatments.

The study, “Longitudinal gait and balance decline in Friedreich’s Ataxia: A pilot study,” was published in the journal Gait & Posture.

Currently, disease progression in Friedreich’s ataxia patients is assessed using three rating scales: the Friedreich’s Ataxia Rating Scale (FARS), the Scale for the Assessment and Rating of Ataxia (SARA), and the International Cooperative Ataxia Rating Scale (ICARS).

While these tools are reliable, researchers at the University of South Florida Ataxia Research Center suggested that they may not be optimal for detecting short-term changes, particularly in gait and balance.

The research team designed a pilot study to assess two gait and balance specific tools. The tools were compared to the FARS in eight patients with Friedreich’s ataxia and eight healthy controls.

Participants in the study were followed for two years. They were assessed using the GAITRite Walkway System and the Biodex Balance System, as well as the FARS at the study’s start and after six, 12, and 24 months.

Gait speed during comfortable walking decreased by 8% after 12 months, and by 24.1% after 24 months. Meanwhile, gait speed during fast walking decreased by 13.9% after 12 months and 30.3% after two years. Researcher also observed a decline in other gait features.

Over the 24 months of the trial, participants also showed a decrease in balance. During this time, patients also had a 17.7% increase in FARS neurological exam scores. Control participants had no changes in gait or balance during the study.

Analyses showed that several aspects of gait and balance measurements correlated with the FARS neurological scores. Various FARS subsection scores were also linked to gait and balance parameters.

While the researchers admit that more studies are needed to validate the use of gait and balance-specific measurements to detect small changes in neurological function, they suggest that gait speed may be a key factor in detecting disease progression and in people with Friedreich’s ataxia.