Associations Between Self-Reported Symptoms and Gait Parameters Using In-Home Sensors in Persons With Multiple Sclerosis Pamela Newland 1 , PhD, RN, CMSRN, Amber Salter 2 , PhD, Alicia Flach 3 , PT, DPT, NCS, Louise Flick 4 , DrPH, MSN, MPE, Florian P. Thomas 5 , PhD, MD, MA, Elsie E. Gulick 6 , PhD, RN, FAAN, Marilyn Rantz 7 , PhD, RN, FAAN & Marjorie Skubic 8 , PhD Abstract Background and Purpose: Multiple sclerosis (MS) is a progressive neurological disorder, characterized by exacerbations and remis- sions, often resulting in disability affecting multiple neurological functions. The purpose of this article was (1) to describe the frequen- cies of self-reported symptoms in a natural environment and (2) to determine characteristics and associations between self-reported symptoms and home gait parameters (speed, stride time, and stride length) at baseline and at 3 months in patients with MS. Methods: Participants completed the self-report MS-Related Symptom Scale to measure symptoms. A three-dimensional depth imaging system (Foresite Healthcare) was used to measure gait parameters in the home environment. Results: These data show significant correlations between the following symptoms: knee locking or collapsing, difficulty sleeping, depression, and anxiety with decreased number of average walks per day; however, the symptoms including trouble-making toilet: day and difficulty in starting urine were positively correlated with average walks per day. The symptom numbness was significantly correlated with decreased speed and decreased stride length. Discussion and Conclusions: Our findings suggest that certain groups of symptoms were more frequently reported with certain gait parameters (stride time/speed) in persons with MS. Rehabilitation nurses can provide optimal care to prevent future decline in symptoms and gait. Keywords: Gait variability; home monitoring; multiple sclerosis; symptoms. Multiple sclerosis (MS) is a progressive neurological disor- der, characterized by exacerbations and remissions, affecting mobility, balance, sensation, cognition, vision, mood, and bowel and bladder function (Disanto et al., 2010). The disease process involves demyelination of the central nervous system (Lassmann, 2013; Lucchinetti et al., 2011), axonal damage, and the formation of sclerotic plaques in the brain (e.g., cerebellum, brain stem), optic nerves (Balk et al., 2017), and spinal cord. Symptoms of MS vary from person to person and can fluctuate based on an individual’s fatigue, heat exposure, intercurrent illness, medication use, and other factors (Powell, Liossi, Schlotz, & Moss-Morris, 2017). Worsening mobility has been strongly correlated with progression of MS (Balk et al., 2017; Burschka et al., 2012; Fritz & Lusardi, 2009) and risk for adverse outcomes including falls (Shahrbanian, Duquette, Kuspinar, & Mayo, 2015), reduced quality of life, and increased caregiver burden (Newland, Flick, Thomas, & Shannon, 2014). Decreased mobility may lead to increased burden of other symptoms, such as bowel and bladder management (Zwibel, 2009), as well as increased likelihood of worsen- ing disability. Although providers can assess problems with walking and other symptoms during routine clinic visits, Correspondence: Pamela Newland, Barnes Jewish College Goldfarb School of Nursing, St Louis, MO. E-mail: pamela.newland@bjc.org 1 Barnes Jewish College Goldfarb School of Nursing, St Louis, MO, USA 2 Division of Biostatistics, Washington University, St Louis, MO, USA 3 Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA 4 Saint Louis University, St. Louis, MO, USA 5 Multiple Sclerosis Center, Department of Neurology and Neuroscience Institute, Hackensack University Medical Center and Seton Hall-Hackensack-Meridian School of Medicine, Hackensack, NJ, USA 6 College of Nursing, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA 7 Sinclair School of Nursing, University of Missouri-Columbia, Columbia, MO, USA 8 Electrical Engineering and Computer Science Department, University of Missouri Columbia-Columbia, Columbia, MO, USA Copyright © 2019 Association of Rehabilitation Nurses. Cite this article as: Newland, P. c., Salter, A., Flach, A., Flick L., Thomas, F. P., Gulick, E. E., Rantz, M., … Skubic, M. (2019). Associations between self- reported symptoms and gait parameters using in-home sensors in persons with multiple sclerosis. Rehabilitation Nursing, 00(0), 00–00. doi: 10.1097/rnj.0000000000000210 FEATURE Month 2019 • Volume 00 • Number 0 www.rehabnursingjournal.com 1 Copyright © 2019 by the Association of Rehabilitation Nurses. Unauthorized reproduction of this article is prohibited.