Methodologies to objectively assess gait and postural control features in Rett syndrome - With a comment on specific challenges and how to address them

Abstract

New pharmacological agents and behavioral interventions designed to ease key symptoms of individuals with Rett syndrome are currently emerging. To carefully evaluate these interventions in this complex and relatively rare disorder, it is paramount to develop robust and objective measures which can be utilized and compared across clinics and research centers.  The ability to compare objectively measured movement data obtained from Rett patients will facilitate assessment of the patient’s performance over time.  It will also increase the potential for Rett-related research centers to share and compare findings thereby increasing the ability to determine if future intervention strategies are effective. This report details an objective data acquisition and analysis protocol of gait and posture that will serve to provide an enhanced evaluation of motoric characteristics of individuals with Rett syndrome than is currently conducted.  To establish the feasibility of this protocol, eighteen females ranging in age from 4 to 20 years participated in three basic tasks: over ground walking, accelerating treadmill walking, and stationary bipedal postural assessment. The feasibility and practicality of obtaining this set of detailed data on gait and posture from individuals with Rett syndrome demonstrates that the protocol can be easily transferred to other gait centers. Even if not all of the assessment components are available it can easily be adapted. We suggest that our assessment protocol can provide a standard for objective assessment in a gait laboratory associated with the diagnosis and treatment of Rett syndrome.