biostudies-literatureUnknown7Shah VV<h4>Background</h4>Recent findings suggest that a single gait assessment in a clinic may not reflect everyday mobility.<h4>Objective</h4>We compared gait measures that best differentiated individuals with spinocerebellar ataxia (SCA) from age-matched healthy controls (HC) during a supervised gait test in the clinic vs. a week of unsupervised gait during daily life.<h4>Methods</h4>Twenty-six individuals with SCA types 1, 2, 3, and 6, and 13 (HC) wore three Opal inertial sensors (on both feet and lower back) during a 2-minute walk in the clinic and for seven days in daily life. Seventeen gait measures were analyzed to investigate the group differences using Mann-Whitney <i>U</i>-tests and area under the curve (AUC).<h4>Results</h4>Ten gait measures were significantly worse in SCA than HC for the clinic test (<i>p</i> < 0.003), but only 3 were worse in daily life (<i>p</i> < 0.003). Only a few gait measures consistently discriminated groups in both environments. Specifically, variability in Swing Time and Double Support Time had AUCs of 0.99 (<i>p</i> < 0.0001) and 0.96 (<i>p</i> < 0.0001) in the clinic, and 0.84 (<i>p</i> < 0.0003) and 0.80 (<i>p</i> < 0.002) in daily life, respectively. Clinical gait measures showed stronger correlations with clinical outcomes (ie, SARA and FARS-ADL; r = 0.50-0.77) than between daily life gait measures (r = 0.31-0.49). Gait activity in daily life was not statistically significant between the SCA and HC groups (<i>p</i> > 0.06).<h4>Conclusions</h4>Digital gait measures discriminate SCA in both environments. In-clinic measures are more sensitive, while daily life measures provide ecological validity, highlighting a trade-off and offering complementary insights.Frontiers in digital health1590150https://www.ebi.ac.uk/biostudies/studies/S-EPMC12440962biostudies-literatureClinic vs. daily life gait characteristics in patients with spinocerebellar ataxia.PMC12440962Sowalsky KSafarpour DJagodinsky ACarlson-Kuhta PShah VVEl-Gohary MMcNames JCasey HMuzyka DGomez CMHorak FBfalseClinic vs. daily life gait characteristics in patients with spinocerebellar ataxia.<h4>Background</h4>Recent findings suggest that a single gait assessment in a clinic may not reflect everyday mobility.<h4>Objective</h4>We compared gait measures that best differentiated individuals with spinocerebellar ataxia (SCA) from age-matched healthy controls (HC) during a supervised gait test in the clinic vs. a week of unsupervised gait during daily life.<h4>Methods</h4>Twenty-six individuals with SCA types 1, 2, 3, and 6, and 13 (HC) wore three Opal inertial sensors (on both feet and lower back) during a 2-minute walk in the clinic and for seven days in daily life. Seventeen gait measures were analyzed to investigate the group differences using Mann-Whitney <i>U</i>-tests and area under the curve (AUC).<h4>Results</h4>Ten gait measures were significantly worse in SCA than HC for the clinic test (<i>p</i> < 0.003), but only 3 were worse in daily life (<i>p</i> < 0.003). Only a few gait measures consistently discriminated groups in both environments. Specifically, variability in Swing Time and Double Support Time had AUCs of 0.99 (<i>p</i> < 0.0001) and 0.96 (<i>p</i> < 0.0001) in the clinic, and 0.84 (<i>p</i> < 0.0003) and 0.80 (<i>p</i> < 0.002) in daily life, respectively. Clinical gait measures showed stronger correlations with clinical outcomes (ie, SARA and FARS-ADL; r = 0.50-0.77) than between daily life gait measures (r = 0.31-0.49). Gait activity in daily life was not statistically significant between the SCA and HC groups (<i>p</i> > 0.06).<h4>Conclusions</h4>Digital gait measures discriminate SCA in both environments. In-clinic measures are more sensitive, while daily life measures provide ecological validity, highlighting a trade-off and offering complementary insights.2025-01-01T00:00:00Z20252026-06-03T12:06:50.981Z2026-04-27T03:11:32.53ZS-EPMC124409624097014010.3389/fdgth.2025.1590150