Consensus based framework for digital mobility monitoring

Digital mobility assessment using wearable sensor systems has the potential to capture walking performance in a patient9s natural environment. It enables the monitoring of health status and disease progression and outcome evaluation of interventions in real-world situations. In contrast to laboratory settings, real-world walking occurs in non-conventional environments and under unconstrained and uncontrolled conditions. Despite the general understanding, there is a lack of agreed definitions about what constitutes real-world walking, impeding the comparison and interpretation of the acquired data across systems and studies. Hence, there is a need for a terminological framework for the guidance of further algorithmic implementation of digital measures for gait assessment. We used an objective methodology based on an adapted Delphi process to obtain consensus on specific terminology related to real-world walking by asking a diverse panel of clinical, scientific, and industrial stakeholders. Six constituents ("real-world", "walking", "purposeful", "walking bout", "walking speed", "turning") have successfully been defined in two feedback rounds. The identification of a consented set of real-world walking definitions has important implications for the development of assessment and analysis protocols, as well as for the reporting and comparison of digital mobility outcomes across studies and systems. The definitions will serve as a common framework for implementing digital and mobile technologies for gait assessment.