{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T17:10:00Z","timestamp":1788973800066,"version":"build-2803163510"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>For people with multiple sclerosis (MS), mobility impairment is common and a significant contributor to reduced quality of life. With advancements in wearable technology, step count data has emerged as a promising method to track mobility and monitor functional decline. However, studies comparing the replicability of wearable mobility data using varying devices remain limited in MS populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This study investigates the reliability of step count data and its associations with clinical outcomes in MS patients using two independent cohorts with different wearable devices: California (CA) (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f97 Fitbit wrist sensor, 4-week wear) and Virginia (VA) (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f61; ActiGraph hip sensor, 7-day wear). We analyzed correlations between average daily step counts and common MS clinical measures [disability: Expanded Disability Status Scale (EDSS); walking speed: Timed 25-Foot Walk (T25FW)] as well as patient-reported outcomes (12-item MS walking scale, MSWS-12, Modified Fatigue Impact score, MFIS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analysis of the VA cohort revealed similar average daily step counts to those seen in the CA cohort (6,010 vs. 5,478 steps\/day). Step count variability (standard deviation) decreased with increasing EDSS in both cohorts. Step counts in the VA cohort were significantly correlated with EDSS (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.34), T25FW (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.58), MSWS-12 (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.57), and MFIS (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f\u22120.45), similar to findings from the CA cohort. Additionally, within-subject reliability over 7\u202fdays was moderate (ICC\u202f=\u202f0.599), with high correlations between 4-day and 7-day averages (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f\u2265\u202f0.98).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>The step count analyses from two different wearable devices show replicable associations with clinical and patient-reported outcomes in MS, highlighting their promise as digital biomarkers for clinical monitoring and care, rehabilitation, and patient self-management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1709389","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T05:23:45Z","timestamp":1761801825000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Validating wearable step counts in multiple sclerosis research: a replication study"],"prefix":"10.3389","volume":"16","author":[{"given":"Myla D.","family":"Goldman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhavana","family":"Kunisetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey M.","family":"Gelfand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A. C.","family":"Cree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie J.","family":"Block","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"ref1","article-title":"Multiple Sclerosis","volume-title":"Harrison's principles of internal medicine","author":"Cree","year":"2026"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"189","DOI":"10.2165\/11591150-000000000-00000","article-title":"Impact of walking impairment in multiple sclerosis: perspectives of patients and care partners","volume":"4","author":"Larocca","year":"2011","journal-title":"Patient"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1186\/s12984-024-01383-0","article-title":"Effects of multidisciplinary inpatient rehabilitation on everyday life physical activity and gait in patients with multiple sclerosis","volume":"21","author":"Prigent","year":"2024","journal-title":"J Neuroeng Rehabil"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"7627643","DOI":"10.1155\/2018\/7627643","article-title":"The role of wearable devices in multiple sclerosis","volume":"2018","author":"Sparaco","year":"2018","journal-title":"Mult Scler Int"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"S0003-9993(25)00708-7","DOI":"10.1016\/j.apmr.2025.05.005","article-title":"Psychometric properties of free-living step-based metrics (daily steps and peak cadence) in multiple sclerosis","author":"Zheng","year":"2025","journal-title":"Arch Phys Med Rehabil"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1007\/s11910-019-0997-9","article-title":"Next steps in wearable technology and community ambulation in multiple sclerosis","volume":"19","author":"Frechette","year":"2019","journal-title":"Curr Neurol Neurosci 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Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1259413","DOI":"10.3389\/fneur.2023.1259413","article-title":"Progression risk stratification with six-minute walk gait speed trajectory in multiple sclerosis","volume":"14","author":"Goldman","year":"2023","journal-title":"Front Neurol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1534","DOI":"10.1016\/j.apmr.2012.12.014","article-title":"Steps per day among persons with multiple sclerosis: variation by demographic, clinical, and device characteristics","volume":"94","author":"Dlugonski","year":"2013","journal-title":"Arch Phys Med Rehabil"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/NPT.0b013e3182097190","article-title":"Ambulatory activity in individuals with multiple sclerosis","volume":"35","author":"Cavanaugh","year":"2011","journal-title":"J Neurol Phys Ther"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1162278","DOI":"10.3389\/fspor.2023.1162278","article-title":"The effect of exercise and physical activity-interventions on step count and intensity level in individuals with multiple sclerosis: a systematic review and meta-analysis of randomized controlled trials","volume":"5","author":"Arntzen","year":"2023","journal-title":"Front Sports Act Living"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1016\/j.gaitpost.2017.10.015","article-title":"Real-world walking in multiple sclerosis: separating capacity from behavior","volume":"59","author":"Engelhard","year":"2018","journal-title":"Gait Posture"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1709389\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T05:23:45Z","timestamp":1761801825000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1709389\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":17,"alternative-id":["10.3389\/fneur.2025.1709389"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1709389","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"article-number":"1709389"}}