# Instrumented Timed Up and Go Test as a Tool to Early Detection of Gait and Functional Mobility Impairments in Multiple Sclerosis

## TL;DR

This study shows that instrumented TUG test can detect early gait and balance issues in multiple sclerosis patients that traditional timing methods miss.

## Contribution

The study introduces specific iTUG parameters as a more sensitive tool for early MS detection compared to total test duration.

## Key findings

- Total iTUG duration did not differ significantly between MS and healthy groups.
- MS patients showed significant differences in gait parameters like trunk flexion and turning velocity.
- Spatiotemporal parameters and subphase times are more effective for detecting early MS impairments.

## Abstract

Background/Objectives: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system that typically affects adults aged 20–50. Its early stages can be difficult to diagnose due to the variable clinical course, although subtle impairments often appear in balance and motor control. The Timed Up and Go (TUG) test is commonly used to assess functional mobility; however, traditional evaluation based solely on total test duration may not be sensitive to early gait alterations. The use of inertial measurement units enables instrumented analysis of individual TUG subphases (iTUG). The aim of this study was determine whether iTUG parameters can help detect balance and movement difficulties indicative of early-stage MS. Methods: A total of 30 healthy people and 30 people in the early stages of MS with an expanded disability status score between 1 and 2 were included. The iTUG was performed using three Noraxon inertial sensors placed on the feet and upper spine. Results: No significant differences were observed in total iTUG duration between the MS and control groups (p = 0.888). In contrast, individuals with MS demonstrated significant differences in spatiotemporal gait parameters, trunk flexion range of motion (p = 0.003), number of steps during gait (p = 0.004), and turning velocity compared with healthy controls (p = 0.008). Conclusions: Analysis of iTUG duration is not enough to identify subtle gait and balance impairments in individuals with early-stage MS. Parameters that should be considered when performing an iTUG for the assessment of early stages of MS are spatiotemporal parameters, number of steps, and speed of rotation and subphase times.