{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T17:33:14Z","timestamp":1793122394051,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005202","name":"Muscular Dystrophy Association","doi-asserted-by":"publisher","award":["MDA629259"],"award-info":[{"award-number":["MDA629259"]}],"id":[{"id":"10.13039\/100005202","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007721","name":"Cure SMA","doi-asserted-by":"publisher","award":["PT18\u20102886"],"award-info":[{"award-number":["PT18\u20102886"]}],"id":[{"id":"10.13039\/100007721","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["CBET\u20102229538"],"award-info":[{"award-number":["CBET\u20102229538"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["TI\u20102322980"],"award-info":[{"award-number":["TI\u20102322980"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006426","name":"State of New Jersey Department of Health","doi-asserted-by":"publisher","award":["CAUT22ACP004"],"award-info":[{"award-number":["CAUT22ACP004"]}],"id":[{"id":"10.13039\/100006426","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction\/Aims<\/jats:title><jats:p>Despite disease\u2010modifying therapies, fatigability persists in spinal muscular atrophy (SMA). Performance fatigability (PF) during the six\u2010minute walk test (6MWT) is mostly unchanged in treated SMA. This cross\u2010sectional study characterized PF using instrumented insoles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ambulatory individuals with SMA (<jats:italic>n<\/jats:italic>\u2009=\u200914) and controls (HC) (<jats:italic>n<\/jats:italic>\u2009=\u200910) were included. Spatiotemporal and kinetic parameters were collected with custom\u2010engineered instrumented insoles during the 6MWT. Linear mixed models analyzed parameter trends, with trend slope representing PF. Changes in mean velocity (Vavg) and stride\u2010by\u2010stride parameters were compared between minute 1 and 6 and between groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Decreases in Vavg were greatest for severe SMA (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Changes were found in stride length (SL) (<jats:italic>p<\/jats:italic>\u2009=\u20090.048) and stride velocity (SV) (<jats:italic>p<\/jats:italic>\u2009=\u20090.030) for severe SMA, and in stance phase (%St) (<jats:italic>p<\/jats:italic>\u2009=\u20090.012) and percent terminal double support (%DS) (<jats:italic>p<\/jats:italic>\u2009=\u20090.02) for mild SMA. SMA subgroups showed downward trends from minute 1 to 6 in SL, SV, and anterior\u2013posterior center of pressure (AP\u2010COP) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and increases in Absolute COP\u2010Cyclogram Asymmetry Index (|ASI|) (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Trends differed between severe SMA and other groups for SL, SV, %St, and %DS (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and for AP\u2010COP and |ASI| (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Trends for SL (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), SV and AP\u2010COP (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) differed between HC and mild SMA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>PF in SMA manifests as changes in gait parameters. Instrumented insoles revealed fatigue\u2010related changes not captured with the conventional method of comparing the first and last minutes of the 6MWT. Spatiotemporal and kinetic parameters contribute to understanding of impairments and inform therapeutic development.<\/jats:p><jats:p>\n<jats:bold>Trial Registration:<\/jats:bold> <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>: NCT04193085<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.28461","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T05:00:20Z","timestamp":1750827620000},"page":"493-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Wearable\u2010Derived Patterns of Performance Fatigability During Gait in Spinal Muscular Atrophy"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7357-0819","authenticated-orcid":false,"given":"Jacqueline","family":"Montes","sequence":"first","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1414-6890","authenticated-orcid":false,"given":"Cara H.","family":"Kanner","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ton","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering Stevens Institute of Technology  Hoboken New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rafael","family":"Rodriguez\u2010Torres","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine Columbia University Irving Medical Center  New York New York USA"},{"name":"Department of Neurology Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Uher","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation and Regenerative Medicine Columbia University Irving Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9322-0608","authenticated-orcid":false,"given":"Sally Dunaway","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Neurology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rabia","family":"Farooquee","sequence":"additional","affiliation":[{"name":"Department of Neurology Stanford University School of Medicine  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abby","family":"Druffner","sequence":"additional","affiliation":[{"name":"Department of Physical and Occupational Therapy Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Department of Physical and Occupational Therapy Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Fragala\u2010Pinkham","sequence":"additional","affiliation":[{"name":"Department of Physical and Occupational Therapy Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3514-6889","authenticated-orcid":false,"given":"Damiano","family":"Zanotto","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering Stevens Institute of Technology  Hoboken New Jersey USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12103458"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010020\u201010227\u20105"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023\u2010020\u201001498\u20102"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201068051\u2010w"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nmd.2017.07.007"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073813493663"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.26633"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.28225"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.28269"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno\u20102021\u2010000164"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.21917"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/1260852"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.802516"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010022\u201010998\u2010z"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25484"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1109\/LRA.2022.3188895"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25120"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.166.1.at1102"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2022.3143094"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2019.2958679"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1109\/BioRob49111.2020.9224273"},{"key":"e_1_2_12_23_1","volume-title":"2022 9th IEEE RAS\/EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob)","author":"Duong T.","year":"2022"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1109\/TNSRE.2023.3338519"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003847"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181d3e308"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2007.11.004"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.3233\/JND\u2010200550"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415\u2010019\u201009646\u2010w"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2006.09.008"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/ncpneuro0886"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2019.01098"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.23656"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinbiomech.2007.01.010"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2004.04.006"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/mus.24081"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gaitpost.2010.06.003"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/0883073811425423"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelekin.2022.102640"},{"key":"e_1_2_12_40_1","doi-asserted-by":"publisher","DOI":"10.1177\/22143602241313326"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.28461","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T14:14:03Z","timestamp":1754921643000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.28461"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":39,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1002\/mus.28461"],"URL":"https:\/\/doi.org\/10.1002\/mus.28461","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]},"assertion":[{"value":"2025-01-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-06-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}