CASE REPORT article
Front. Sports Act. Living
Sec. Biomechanics and Control of Human Movement
Volume 7 - 2025 | doi: 10.3389/fspor.2025.1637831
Case Report: A 1-YearProgression of Mediolateral Gait Instability During Tandem Walking in FXTAS
Provisionally accepted
Jonathan S. Lee-Confer1,2,3*
Dian Baker4,5
Randi Jenssen Hagerman5
Nell Maltman6
Megan Kobel6Rodney Imamura3- 1Department of Physical Therapy, University of Arizona, Tucson, United States
- 2Department of Physiology, The University of Arizona, Tucson, United States
- 3Department of Kinesiology, California State University Sacramento, Sacramento, United States
- 4Department of Nursing, California State University Sacramento, Sacramento, United States
- 5University of California Davis MIND Institute, Sacramento, United States
- 6Department of Speech Language and Hearing Sciences, The University of Arizona, Tucson, United States
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Fragile X-associated Tremor/Ataxia Syndrome (FXTAS) is a late-onset neurodegenerative disorder characterized by progressive motor dysfunction, including cerebellar ataxia and gait instability. Although tandem walking is a sensitive clinical marker of cerebellar dysfunction, its utility in tracking longitudinal motor decline in FXTAS remains unexplored and the trajectory of motor decline in FXTAS is not well characterized. Therefore, the purpose of this case report was to determine whether tandem walking performance deteriorates over a one-year period in an individual with FXTAS. A 68-year-old male with genetically confirmed FXTAS completed a 15-second tandem walking trial at baseline and again after one year. Kinematic data were collected using a Vicon motion capture system. Step width was calculated at each heel strike as the distance between the mediolateral position of the left and right heel markers. The mean step width considerably increased from baseline tandem walking of 45.21 ± 33.47 mm (SD) compared to the 1-year follow-up trial step width of 85.79 ± 15.80 mm (SD) indicating potential progressive mediolateral instability. This case report provides preliminary evidence that step width during tandem walking may be a sensitive marker of longitudinal motor decline in FXTAS and declines in gait stability can occur within one year. Larger studies with repeated measures and additional gait metrics are warranted to validate these findings.
Keywords: Fragile X-associated tremor/ataxia syndrome (FXTAS), Gait, Step width, tandemwalking, Longitudinal, follow-up, variability, Balance impairment
Received: 30 May 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Lee-Confer, Baker, Hagerman, Maltman, Kobel and Imamura. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jonathan S. Lee-Confer, leeconfer@arizona.edu
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