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Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis

To assess the usefulness of a theoretical postural instability discrimination index (PI(th)) in amyotrophic lateral sclerosis (ALS). Prospective regression analyzes were performed to identify the biomechanical determinants of postural instability unrelated to lower limb motor deficits from gait init...

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Autores principales: Vallée, Rodolphe, Vallée, Alexandre, Vallée, Jean-Noël, Abidi, Malek, Couillandre, Annabelle, Termoz, Nicolas, Pradat, Pierre-François, de Marco, Giovanni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844064/
https://www.ncbi.nlm.nih.gov/pubmed/35165398
http://dx.doi.org/10.1038/s41598-022-06471-6
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author Vallée, Rodolphe
Vallée, Alexandre
Vallée, Jean-Noël
Abidi, Malek
Couillandre, Annabelle
Termoz, Nicolas
Pradat, Pierre-François
de Marco, Giovanni
author_facet Vallée, Rodolphe
Vallée, Alexandre
Vallée, Jean-Noël
Abidi, Malek
Couillandre, Annabelle
Termoz, Nicolas
Pradat, Pierre-François
de Marco, Giovanni
author_sort Vallée, Rodolphe
collection PubMed
description To assess the usefulness of a theoretical postural instability discrimination index (PI(th)) in amyotrophic lateral sclerosis (ALS). Prospective regression analyzes were performed to identify the biomechanical determinants of postural instability unrelated to lower limb motor deficits from gait initiation factors. PI(th) was constructed using a logit function of biomechanical determinants. Discriminatory performance and performance differences were tested. Backward displacement of the pression center (APA(amplitude)) and active vertical braking of the mass center (Braking-index) were the biomechanical determinants of postural instability. PI(th) = − 0.13 × APA(amplitude) − 0.12 × Braking-index + 5.67, (P < 0.0001, RSquare = 0.6119). OR (APA(amplitude)) and OR (Braking-index) were 0.878 and 0.887, respectively, i.e., for a decrease of 10 mm in APA(amplitude) or 10% in Braking-index, the postural instability risk was 11.391 or 11.274 times higher, respectively. PI(th) had the highest discriminatory performance (AUC 0.953) with a decision threshold value [Formula: see text] 0.587, a sensitivity of 90.91%, and a specificity of 83.87%, significantly increasing the sensitivity by 11.11%. PI(th), as objective clinical integrator of gait initiation biomechanical processes significantly involved in dynamic postural control, was a reliable and performing discrimination index of postural instability with a significant increased sensitivity, and may be useful for a personalized approach to postural instability in ALS.
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spelling pubmed-88440642022-02-16 Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis Vallée, Rodolphe Vallée, Alexandre Vallée, Jean-Noël Abidi, Malek Couillandre, Annabelle Termoz, Nicolas Pradat, Pierre-François de Marco, Giovanni Sci Rep Article To assess the usefulness of a theoretical postural instability discrimination index (PI(th)) in amyotrophic lateral sclerosis (ALS). Prospective regression analyzes were performed to identify the biomechanical determinants of postural instability unrelated to lower limb motor deficits from gait initiation factors. PI(th) was constructed using a logit function of biomechanical determinants. Discriminatory performance and performance differences were tested. Backward displacement of the pression center (APA(amplitude)) and active vertical braking of the mass center (Braking-index) were the biomechanical determinants of postural instability. PI(th) = − 0.13 × APA(amplitude) − 0.12 × Braking-index + 5.67, (P < 0.0001, RSquare = 0.6119). OR (APA(amplitude)) and OR (Braking-index) were 0.878 and 0.887, respectively, i.e., for a decrease of 10 mm in APA(amplitude) or 10% in Braking-index, the postural instability risk was 11.391 or 11.274 times higher, respectively. PI(th) had the highest discriminatory performance (AUC 0.953) with a decision threshold value [Formula: see text] 0.587, a sensitivity of 90.91%, and a specificity of 83.87%, significantly increasing the sensitivity by 11.11%. PI(th), as objective clinical integrator of gait initiation biomechanical processes significantly involved in dynamic postural control, was a reliable and performing discrimination index of postural instability with a significant increased sensitivity, and may be useful for a personalized approach to postural instability in ALS. Nature Publishing Group UK 2022-02-14 /pmc/articles/PMC8844064/ /pubmed/35165398 http://dx.doi.org/10.1038/s41598-022-06471-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Vallée, Rodolphe
Vallée, Alexandre
Vallée, Jean-Noël
Abidi, Malek
Couillandre, Annabelle
Termoz, Nicolas
Pradat, Pierre-François
de Marco, Giovanni
Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
title Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
title_full Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
title_fullStr Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
title_full_unstemmed Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
title_short Theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
title_sort theoretical discrimination index of postural instability in amyotrophic lateral sclerosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844064/
https://www.ncbi.nlm.nih.gov/pubmed/35165398
http://dx.doi.org/10.1038/s41598-022-06471-6
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