{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T14:11:43Z","timestamp":1764079903110,"version":"build-2065373602"},"reference-count":49,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2023,6,29]],"date-time":"2023-06-29T00:00:00Z","timestamp":1687996800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Innovative Medicines Initiative 2 Joint Undertaking","award":["115902","TED2021-131106B-I00","T39_23R"],"award-info":[{"award-number":["115902","TED2021-131106B-I00","T39_23R"]}]},{"name":"National Institute for Health Research (NIHR) Biomedical Research Centre","award":["115902","TED2021-131106B-I00","T39_23R"],"award-info":[{"award-number":["115902","TED2021-131106B-I00","T39_23R"]}]},{"name":"Maudsley NHS Foundation Trust","award":["115902","TED2021-131106B-I00","T39_23R"],"award-info":[{"award-number":["115902","TED2021-131106B-I00","T39_23R"]}]},{"name":"King\u2019s College London","award":["115902","TED2021-131106B-I00","T39_23R"],"award-info":[{"award-number":["115902","TED2021-131106B-I00","T39_23R"]}]},{"name":"Ministerio de Ciencia e Innovaci\u00f3n","award":["115902","TED2021-131106B-I00","T39_23R"],"award-info":[{"award-number":["115902","TED2021-131106B-I00","T39_23R"]}]},{"name":"Arag\u00f3n Government","award":["115902","TED2021-131106B-I00","T39_23R"],"award-info":[{"award-number":["115902","TED2021-131106B-I00","T39_23R"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>The aim of this study was to investigate the feasibility of automatically assessing the 2-Minute Walk Distance (2MWD) for monitoring people with multiple sclerosis (pwMS). For 154 pwMS, MS-related clinical outcomes as well as the 2MWDs as evaluated by clinicians and derived from accelerometer data were collected from a total of 323 periodic clinical visits. Accelerometer data from a wearable device during 100 home-based 2MWD assessments were also acquired. The error in estimating the 2MWD was validated for walk tests performed at hospital, and then the correlation (r) between clinical outcomes and home-based 2MWD assessments was evaluated. Robust performance in estimating the 2MWD from the wearable device was obtained, yielding an error of less than 10% in about two-thirds of clinical visits. Correlation analysis showed that there is a strong association between the actual and the estimated 2MWD obtained either at hospital (r = 0.71) or at home (r = 0.58). Furthermore, the estimated 2MWD exhibits moderate-to-strong correlation with various MS-related clinical outcomes, including disability and fatigue severity scores. Automatic assessment of the 2MWD in pwMS is feasible with the usage of a consumer-friendly wearable device in clinical and non-clinical settings. Wearable devices can also enhance the assessment of MS-related clinical outcomes.<\/jats:p>","DOI":"10.3390\/s23136017","type":"journal-article","created":{"date-parts":[[2023,6,30]],"date-time":"2023-06-30T01:14:12Z","timestamp":1688087652000},"page":"6017","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Automatic Assessment of the 2-Minute Walk Distance for Remote Monitoring of People with Multiple Sclerosis"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1297-0691","authenticated-orcid":false,"given":"Spyridon","family":"Kontaxis","sequence":"first","affiliation":[{"name":"Laboratory of Biomedical Signal Interpretation and Computational Simulation (BSICoS), University of Zaragoza, 50018 Zaragoza, Spain"},{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28006 Barcelona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6776-8522","authenticated-orcid":false,"given":"Estela","family":"Laporta","sequence":"additional","affiliation":[{"name":"Laboratory of Biomedical Signal Interpretation and Computational Simulation (BSICoS), University of Zaragoza, 50018 Zaragoza, Spain"},{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28006 Barcelona, Spain"}]},{"given":"Esther","family":"Garcia","sequence":"additional","affiliation":[{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28006 Barcelona, Spain"},{"name":"Department of Microelectronics and Electronic Systems, Autonomous University of Barcelona, 08193 Bellaterra, Spain"}]},{"given":"Matteo","family":"Martinis","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University Vita-Salute and Hospital San Raffaele, 20132 Milan, Italy"}]},{"given":"Letizia","family":"Leocani","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University Vita-Salute and Hospital San Raffaele, 20132 Milan, Italy"}]},{"given":"Lucia","family":"Roselli","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University Vita-Salute and Hospital San Raffaele, 20132 Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1260-1156","authenticated-orcid":false,"given":"Mathias Due","family":"Buron","sequence":"additional","affiliation":[{"name":"Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5891-2123","authenticated-orcid":false,"given":"Ana Isabel","family":"Guerrero","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center of Catalonia (CEMCAT), Department of Neurology\/Neuroimmunology, Hospital Universitari Vall d\u2019Hebron, Universitat Autonoma de Barcelona, 08035 Barcelona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3860-5251","authenticated-orcid":false,"given":"Ana","family":"Zabala","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center of Catalonia (CEMCAT), Department of Neurology\/Neuroimmunology, Hospital Universitari Vall d\u2019Hebron, Universitat Autonoma de Barcelona, 08035 Barcelona, Spain"}]},{"given":"Nicholas","family":"Cummins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"}]},{"given":"Srinivasan","family":"Vairavan","sequence":"additional","affiliation":[{"name":"Janssen Research and Development, LLC, Titusville, NJ 08560, USA"}]},{"given":"Matthew","family":"Hotopf","sequence":"additional","affiliation":[{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"}]},{"given":"Richard J. B.","family":"Dobson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, London SE5 8AF, UK"},{"name":"Institute of Health Informatics, University College London, London NW1 2DA, UK"}]},{"given":"Vaibhav A.","family":"Narayan","sequence":"additional","affiliation":[{"name":"Davos Alzheimer\u2019s Collaborative, Wayne, PA 19087, USA"}]},{"given":"Maria Libera","family":"La Porta","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University Vita-Salute and Hospital San Raffaele, 20132 Milan, Italy"}]},{"given":"Gloria Dalla","family":"Costa","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University Vita-Salute and Hospital San Raffaele, 20132 Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0972-5222","authenticated-orcid":false,"given":"Melinda","family":"Magyari","sequence":"additional","affiliation":[{"name":"Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark"}]},{"given":"Per Soelberg","family":"S\u00f8rensen","sequence":"additional","affiliation":[{"name":"Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark"}]},{"given":"Carlos","family":"Nos","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Center of Catalonia (CEMCAT), Department of Neurology\/Neuroimmunology, Hospital Universitari Vall d\u2019Hebron, Universitat Autonoma de Barcelona, 08035 Barcelona, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1272-0550","authenticated-orcid":false,"given":"Raquel","family":"Bailon","sequence":"additional","affiliation":[{"name":"Laboratory of Biomedical Signal Interpretation and Computational Simulation (BSICoS), University of Zaragoza, 50018 Zaragoza, Spain"},{"name":"Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), 28006 Barcelona, Spain"}]},{"given":"Giancarlo","family":"Comi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University Vita-Salute and Hospital San Raffaele, 20132 Milan, Italy"},{"name":"Casa di Cura del Policlinico, 20144 Milan, Italy"}]},{"name":"on behalf of the RADAR-CNS Consortium","sequence":"additional","affiliation":[]}],"member":"1968","published-online":{"date-parts":[[2023,6,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: Insights from the Atlas of MS","volume":"26","author":"Walton","year":"2020","journal-title":"Mult. Scler. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3163","DOI":"10.3892\/etm.2017.4410","article-title":"Multiple sclerosis: Pathology, diagnosis and treatments","volume":"13","author":"Huang","year":"2017","journal-title":"Exp. Ther. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1177\/1352458508088916","article-title":"Patient perception of bodily functions in multiple sclerosis: Gait and visual function are the most valuable","volume":"14","author":"Heesen","year":"2008","journal-title":"Mult. Scler. J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Oliva Ramirez, A., Keenan, A., Kalau, O., Worthington, E., Cohen, L., and Singh, S. (2021). Prevalence and burden of multiple sclerosis-related fatigue: A systematic literature review. BMC Neurol., 21.","DOI":"10.1186\/s12883-021-02396-1"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1001\/jama.2020.26858","article-title":"Diagnosis and treatment of multiple sclerosis: A review","volume":"325","author":"McGinley","year":"2021","journal-title":"JAMA"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Gustavsen, S., Olsson, A., S\u00f8ndergaard, H., Andresen, S., S\u00f8rensen, P.S., Sellebjerg, F., and Oturai, A. (2021). The association of selected multiple sclerosis symptoms with disability and quality of life: A large Danish self-report survey. BMC Neurol., 21.","DOI":"10.1186\/s12883-021-02344-z"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"4","DOI":"10.7224\/1537-2073-13.1.4","article-title":"Evaluating walking in patients with multiple sclerosis: Which assessment tools are useful in clinical practice?","volume":"13","author":"Bethoux","year":"2011","journal-title":"Int. J. MS Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1080\/14737175.2020.1801425","article-title":"Clinical assessment, management, and rehabilitation of walking impairment in MS: An expert review","volume":"20","author":"Soler","year":"2020","journal-title":"Expert Rev. Neurother."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1177\/1352458517690823","article-title":"Validity of the timed 25-foot walk as an ambulatory performance outcome measure for multiple sclerosis","volume":"23","author":"Motl","year":"2017","journal-title":"Mult. Scler. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102512","DOI":"10.1016\/j.autrev.2020.102512","article-title":"Clinical outcome measures in multiple sclerosis: A review","volume":"19","author":"Inojosa","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1212\/WNL.33.11.1444","article-title":"Rating neurologic impairment in multiple sclerosis: An expanded disability status scale (EDSS)","volume":"33","author":"Kurtzke","year":"1983","journal-title":"Neurology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1001\/archneur.1989.00520460115022","article-title":"The fatigue severity scale: Application to patients with multiple sclerosis and systemic lupus erythematosus","volume":"46","author":"Krupp","year":"1989","journal-title":"Arch. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.jns.2017.09.049","article-title":"Performed and perceived walking ability in relation to the Expanded Disability Status Scale in persons with multiple sclerosis","volume":"382","author":"Feys","year":"2017","journal-title":"J. Neurol. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"247","DOI":"10.7224\/1537-2073.2015-006","article-title":"Validity and reliability of four clinical gait measures in patients with multiple sclerosis","volume":"19","author":"Bennett","year":"2017","journal-title":"Int. J. MS Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1177\/13524585211017013","article-title":"The timed 25-foot walk in a large cohort of multiple sclerosis patients","volume":"28","author":"Kalinowski","year":"2022","journal-title":"Mult. Scler. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.jns.2018.02.026","article-title":"Is the impact of fatigue related to walking capacity and perceived ability in persons with multiple sclerosis? A multicenter study","volume":"387","author":"Dalgas","year":"2018","journal-title":"J. Neurol. Sci."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"166","DOI":"10.3138\/ptc.2009-62","article-title":"Six-minute walk test for persons with mild or moderate disability from multiple sclerosis: Performance and explanatory factors","volume":"63","author":"Wetzel","year":"2011","journal-title":"Physiother. Can."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Jones, E., Pike, J., Marshall, T., and Ye, X. (2016). Quantifying the relationship between increased disability and health care resource utilization, quality of life, work productivity, health care costs in patients with multiple sclerosis in the US. BMC Health Serv. Res., 16.","DOI":"10.1186\/s12913-016-1532-1"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"315","DOI":"10.4258\/hir.2015.21.4.315","article-title":"Are currently available wearable devices for activity tracking and heart rate monitoring accurate, precise, and medically beneficial?","volume":"21","author":"Nounou","year":"2015","journal-title":"Healthc. Inform. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1212\/CPJ.0000000000000382","article-title":"Wearable biosensors to monitor disability in multiple sclerosis","volume":"7","author":"Bradshaw","year":"2017","journal-title":"Neurol. Clin. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1186\/s12984-015-0013-9","article-title":"Novel algorithm for a smartphone-based 6-minute walk test application: Algorithm, application development, and evaluation","volume":"12","author":"Capela","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Pires, I.M., Denysyuk, H.V., Villasana, M.V., S\u00e1, J., Marques, D.L., Morgado, J.F., Albuquerque, C., and Zdravevski, E. (2022). Development technologies for the monitoring of six-minute walk test: A systematic review. Sensors, 22.","DOI":"10.3390\/s22020581"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Storm, F.A., Cesareo, A., Reni, G., and Biffi, E. (2020). Wearable inertial sensors to assess gait during the 6-minute walk test: A systematic review. Sensors, 20.","DOI":"10.3390\/s20092660"},{"key":"ref_24","doi-asserted-by":"crossref","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. Rep."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1109\/JBHI.2020.2998187","article-title":"Smartphone-and smartwatch-based remote characterisation of ambulation in multiple sclerosis during the two-minute walk test","volume":"25","author":"Creagh","year":"2020","journal-title":"IEEE J. Biomed. Health Inform."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1647","DOI":"10.1007\/s10072-020-04519-x","article-title":"Real-time assessment of COVID-19 prevalence among multiple sclerosis patients: A multicenter European study","volume":"41","author":"Leocani","year":"2020","journal-title":"Neurol. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/s12984-015-0001-0","article-title":"Spatial and temporal characteristics of gait as outcome measures in multiple sclerosis (EDSS 0 to 6.5)","volume":"12","author":"Novotna","year":"2015","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Trentzsch, K., Melzer, B., St\u00f6lzer-Hutsch, H., Haase, R., Bartscht, P., Meyer, P., and Ziemssen, T. (2021). Automated analysis of the two-minute walk test in clinical practice using accelerometer data. Brain Sci., 11.","DOI":"10.3390\/brainsci11111507"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Moon, Y., McGinnis, R.S., Seagers, K., Motl, R.W., Sheth, N., Wright, J.A., Ghaffari, R., and Sosnoff, J.J. (2017). Monitoring gait in multiple sclerosis with novel wearable motion sensors. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0171346"},{"key":"ref_30","first-page":"2055217316634754","article-title":"Accuracy and precision of smartphone applications and commercially available motion sensors in multiple sclerosis","volume":"2","author":"Balto","year":"2016","journal-title":"Mult. Scler. J. Exp. Transl. Clin."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1016\/j.gaitpost.2011.09.005","article-title":"Accuracy of the actibelt\u00ae accelerometer for measuring walking speed in a controlled environment among persons with multiple sclerosis","volume":"35","author":"Motl","year":"2012","journal-title":"Gait Posture"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1177\/1545968314521010","article-title":"Responsiveness and clinically meaningful improvement, according to disability level, of five walking measures after rehabilitation in multiple sclerosis: A European multicenter study","volume":"28","author":"Baert","year":"2014","journal-title":"Neurorehabilit. Neural Repair"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1007\/s00415-016-8334-6","article-title":"Continuous daily assessment of multiple sclerosis disability using remote step count monitoring","volume":"264","author":"Block","year":"2017","journal-title":"J. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.gaitpost.2021.10.023","article-title":"Does Time of Day influence postural control and gait? A review of the literature","volume":"92","author":"Halpern","year":"2022","journal-title":"Gait Posture"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1093\/abm\/kay018","article-title":"Daily temporal associations between physical activity and symptoms in multiple sclerosis","volume":"53","author":"Kratz","year":"2019","journal-title":"Ann. Behav. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.gaitpost.2019.07.125","article-title":"Walking endurance in multiple sclerosis: Meta-analysis of six-minute walk test performance","volume":"73","author":"Cederberg","year":"2019","journal-title":"Gait Posture"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"158","DOI":"10.7224\/1537-2073.2017-046","article-title":"Validation of the 2-minute walk test with the 6-minute walk test and other functional measures in persons with multiple sclerosis","volume":"20","author":"Scalzitti","year":"2018","journal-title":"Int. J. MS Care"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Hadouiri, N., Monnet, E., Gouelle, A., Decavel, P., and Sagawa, Y. (2021). Evaluation of prolonged walking in persons with multiple sclerosis: Reliability of the spatio-temporal walking variables during the 6-minute walk test. Sensors, 21.","DOI":"10.3390\/s21093075"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1913","DOI":"10.1177\/1352458513488233","article-title":"Risk factors for falls in multiple sclerosis: An observational study","volume":"19","author":"Gunn","year":"2013","journal-title":"Mult. Scler. J."},{"key":"ref_40","first-page":"649390","article-title":"Leg spasticity and ambulation in multiple sclerosis","volume":"2014","author":"Balantrapu","year":"2014","journal-title":"Mult. Scler. Int."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e1799","DOI":"10.1002\/pri.1799","article-title":"Spasticity, gait, and balance in patients with multiple sclerosis: A cross-sectional study","volume":"25","author":"Norbye","year":"2020","journal-title":"Physiother. Res. Int."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2897","DOI":"10.1007\/s00415-020-09928-8","article-title":"Wearable sensors can reliably quantify gait alterations associated with disability in people with progressive multiple sclerosis in a clinical setting","volume":"267","author":"Angelini","year":"2020","journal-title":"J. Neurol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3723","DOI":"10.1007\/s00415-022-10998-z","article-title":"Sensor-based gait analyses of the six-minute walk test identify qualitative improvement in gait parameters of people with multiple sclerosis after rehabilitation","volume":"269","author":"Moen","year":"2022","journal-title":"J. Neurol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1109\/TBME.2020.3025908","article-title":"Photoplethysmographic waveform analysis for autonomic reactivity assessment in depression","volume":"68","author":"Kontaxis","year":"2020","journal-title":"IEEE. Trans. Biomed. Eng."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Findling, O., Hauer, L., Pezawas, T., Rommer, P.S., Struhal, W., and Sellner, J. (2020). Cardiac autonomic dysfunction in multiple sclerosis: A systematic review of current knowledge and impact of immunotherapies. J. Clin. Med., 9.","DOI":"10.3390\/jcm9020335"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1145818","DOI":"10.3389\/fphys.2023.1145818","article-title":"Autonomic response to walk tests is useful for assessing outcome measures in people with multiple sclerosis","volume":"14","author":"Kontaxis","year":"2023","journal-title":"Front. Physiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3233\/NRE-182498","article-title":"Energetic cost of walking and spasticity in persons with multiple sclerosis with moderate disability","volume":"43","author":"Jeng","year":"2018","journal-title":"NeuroRehabilitation"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1007\/s00421-019-04295-3","article-title":"Comfortable walking speed and energy cost of locomotion in patients with multiple sclerosis","volume":"120","author":"Morelli","year":"2020","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"706545","DOI":"10.3389\/fphys.2021.706545","article-title":"Detection of walk tests in free-living activities using a wrist-worn device","volume":"12","author":"Sokas","year":"2021","journal-title":"Front. Physiol."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/13\/6017\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:03:27Z","timestamp":1760126607000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/13\/6017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,29]]},"references-count":49,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["s23136017"],"URL":"https:\/\/doi.org\/10.3390\/s23136017","relation":{},"ISSN":["1424-8220"],"issn-type":[{"type":"electronic","value":"1424-8220"}],"subject":[],"published":{"date-parts":[[2023,6,29]]}}}