gms | German Medical Science

16. Deutscher Kongress für Versorgungsforschung

Deutsches Netzwerk Versorgungsforschung e. V.

4. - 6. Oktober 2017, Berlin

PASS-MS – a clinically feasible measurement protocol to assess MS motor symptoms with visuo-perceptive computing

Meeting Abstract

  • Sebastian Mansow-Model - Motognosis UG, Berlin, Germany
  • Karen Otte - Motognosis UG, Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Theresa Krüger - Charité - Universitätsmedizin Berlin, Berlin, Germany
  • Anuschka Grobelny - Charité - Universitätsmedizin Berlin, Berlin, Germany
  • Tim Sebastian Vater - Charité - Universitätsmedizin Berlin, Berlin, Germany
  • Ludwig Rasche - Charité - Universitätsmedizin Berlin, Berlin, Germany
  • Bastian Kayser - Motognosis UG, Berlin, Germany
  • Friedemann Paul - Charité - Universitätsmedizin Berlin, Berlin, Germany
  • Alexander Brandt - Charité – Universitätsmedizin Berlin, Berlin, Germany
  • Tanja Schmitz-Hübsch - Charité – Universitätsmedizin Berlin, Berlin, Germany

16. Deutscher Kongress für Versorgungsforschung (DKVF). Berlin, 04.-06.10.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocP066

doi: 10.3205/17dkvf225, urn:nbn:de:0183-17dkvf2251

Veröffentlicht: 26. September 2017

© 2017 Mansow-Model et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe



Background: Multiple sclerosis (MS) is a common chronic inflammatory and neurodegenerative disease that normally begins in young adulthood, typically affecting patient quality of life and leading to high rates of early retirement. Impairment of gait and balance are major factors that restrict daily activity and may occur as early as after a first clinical episode.

After 5-years disease duration, about 30% of patients name walking and postural stability as their major concern, along with reported falls and fear of falling. About 80% of MS patients develop poor postural stability within 10–15 years after diagnosis.

In current clinical practice, balance and gait impairment are quantified using a combination of clinical examination and patients’ reported maximum walking distance: The Kurtzke‘s Functional Systems and Expanded Disability Status Scale (EDSS) are widely used both in clinical practice and for clinical trials. The EDSS provides a good overview of current neurologic status, gait impairment and mobility dysfunction, but it has limitations. It is a relatively subjective measure with high intra- and inter-rater variability and quantifying mild symptoms and symptom progression is challenging.

Instrumental motor assessment has been proposed to increase objectivity, but most current systems are time and cost intensive. We here propose the use of commercially available depth sensors along with customized software as a clinically applicable tool for instrumental motor assessment in MS.

Research Objective: The development and validation of a comprehensive test battery for assessment of motor dysfunction in multiple sclerosis (MS) based on visuo-perceptive computing using commercially available depth sensors.

Methods: We compiled a short motor assessment battery including 10 different tasks (stance with open and closed eyes, dual task stance with open and closed eyes, stepping in place, short walk with comfortable speed, short walk with maximum speed, tandem walk, stand up and sit down test, pronator drift test, finger-nose test, finger tapping test) for recording with a Microsoft Kinect V2 depth sensor. We used custom-written software (Motognosis Labs) to record kinematic data, Matlab R2015a for post processing and parameter quantification, and SPSS 22.0 for statistical analysis. EDSS was scored during clinical examination.

Results: Interim analysis of an ongoing cross-sectional study demonstrated good applicability and protocol compliance in 72 patients with MS (PwMS), 79 patients with clinical isolated syndrome (PwCIS) and 76 healthy controls (HCs), as well as suitability of a range of kinematic parameters to describe postural imbalance and impairment of gait and fine motor skills. Student’s t-test shows significant differentiation (p<0.05) between HCs and PwMS for POCO, SMSW, SLW, PDT and FNAC. Inclusion criteria were diagnosis of MS according to the revised McDonald Criteria 2010 and EDSS between 0.0 and 8.0.

Discussion: Motor system assessment using Microsoft Kinect V2 proved to be well tolerated by study subjects. Repeated measurement reliability can be refined in the future by improved parameter extraction. Our data suggests video-based motor assessment to be a fast, non-invasive, feasible and well-tolerated method to detect clinical alterations in gait, posture, trunk and extremity coordination.

Practical Implications: Visuo-perceptive computing allows for fast and reliable motor diagnostics at the point of care. As a comparably inexpensive method and due to its simple usage, it has the potential to effectively complement neurological examination and establish instrumental assessment of motor symptoms in clinical routine.