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The Sixth Sign: What It Means

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How you walk says a lot about your health.

Gait characteristics are sometimes regarded as the sixth vital sign in humans. They serve as a valuable indicator of a person’s health, particularly in older adults – so why not measure them? A team of EPFL researchers is taking part in a major European project to design a device that can assess a person’s gait more accurately.

Credit: EPFL

The way we walk is a direct indicator of our health. It can even give us an estimate of how many years we have left to live. These findings have been proven by several studies involving thousands of patients in the last two decades, and form the basis of an ambitious European project called MOBILISE-D. The project consortium consists of 34 partners from the academic, pharmaceutical and industrial fields, including EPFL. Researchers at EPFL’s Laboratory of Movement Analysis and Measurement (LMAM) are working on a device that can measure people’s gait during their everyday activities. Today marks the official launch of the project.

Gait speed is increasingly regarded as the sixth vital sign, alongside body temperature, blood pressure, breathing rate, heart rate and pain. “It has been proven that older adults who walk more slowly than one meter per second have more health problems on average,” says Kamiar Aminian, who heads the LMAM. “Conversely, people who have a good gait speed show greater cognitive function, develop fewer illnesses, suffer fewer falls and spend less time in the hospital. Scientists have even established a direct link between gait and lifespan.”

That is why the project leaders are so intent on finding ways of analyzing people’s gait, both for preventive purposes and to develop new drugs and therapeutic tools. This is particularly important in Europe, where over-65s now make up almost 20% of the population. Gait analysis is also practical because it is simple to do: currently, patients only have to walk for three or four meters for a device to gauge their average speed. However, the MOBILISE-D project aims to achieve much greater precision and to identify the key factors involved in gait.

Studying slow walkers

“One of our main challenges will be to develop a portable system that can reliably analyze people with a very slow gait speed. This is more difficult – and the margin of error is much larger – than with people who walk rapidly,” explains Aminian.

The device is being designed for everyday use, and must be very simple, with only one sensor. It must be able to tell whether each step is intentional and also to distinguish between phases of walking, i.e., times when a person stops, slows down or speeds up, and changes direction or turns around. The system must also be able to capture data such as the number, length and height of each step, as well as gait consistency and any limping. In terms of accuracy, the system’s algorithms must be able to capture changes in speed of as little as five centimeters per second, as this has already proven to be significant for health. To meet these technical requirements, several specialist laboratories around the world, including the LMAM, are working together, sharing results and data.

MOBILISE-D was launched with the support of the European Federation of Pharmaceutical Industries and Associations (EFPIA), and it is being led by the University of Newcastle in the UK. It has a budget of 50 million euros, of which the European Union is contributing 29 million euros. It is expected to run for five years: two years of technical work and three years of clinical trials.

A selection of studies looking at gait speed as the sixth vital sign:
Jerome, Gerald J., et al. “Gait characteristics associated with walking speed decline in older adults: results from the Baltimore Longitudinal Study of Aging,” Archives of gerontology and geriatrics 60.2 (2015): 239-243.

Miller, Michael E., et al. “Gait Speed and Mobility Disability: Revisiting Meaningful Levels in Diverse Clinical Populations,” Journal of the American Geriatrics Society 66.5 (2018): 954-961.
Studenski, Stephanie, et al. “Gait speed and survival in older adults,” Jama 305.1 (2011): 50-58.

Contacts and sources:
Author: Sarah Perrin
EPFL – École polytechnique fédérale de Lausanne


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