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Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors

BACKGROUND: Although it is well-established that osteoarthritis (OA) impairs daily-life gait, objective gait assessments are not part of routine clinical evaluation. Wearable inertial sensors provide an easily accessible and fast way to routinely evaluate gait quality in clinical settings. However,...

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Autores principales: Boekesteijn, Ramon J., Smolders, José M. H., Busch, Vincent J. J. F., Geurts, Alexander C. H., Smulders, Katrijn
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931541/
https://www.ncbi.nlm.nih.gov/pubmed/33658006
http://dx.doi.org/10.1186/s12891-021-04074-2
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author Boekesteijn, Ramon J.
Smolders, José M. H.
Busch, Vincent J. J. F.
Geurts, Alexander C. H.
Smulders, Katrijn
author_facet Boekesteijn, Ramon J.
Smolders, José M. H.
Busch, Vincent J. J. F.
Geurts, Alexander C. H.
Smulders, Katrijn
author_sort Boekesteijn, Ramon J.
collection PubMed
description BACKGROUND: Although it is well-established that osteoarthritis (OA) impairs daily-life gait, objective gait assessments are not part of routine clinical evaluation. Wearable inertial sensors provide an easily accessible and fast way to routinely evaluate gait quality in clinical settings. However, during these assessments, more complex and meaningful aspects of daily-life gait, including turning, dual-task performance, and upper body motion, are often overlooked. The aim of this study was therefore to investigate turning, dual-task performance, and upper body motion in individuals with knee or hip OA in addition to more commonly assessed spatiotemporal gait parameters using wearable sensors. METHODS: Gait was compared between individuals with unilateral knee (n = 25) or hip OA (n = 26) scheduled for joint replacement, and healthy controls (n = 27). For 2 min, participants walked back and forth along a 6-m trajectory making 180° turns, with and without a secondary cognitive task. Gait parameters were collected using 4 inertial measurement units on the feet and trunk. To test if dual-task gait, turning, and upper body motion had added value above spatiotemporal parameters, a factor analysis was conducted. Effect sizes were computed as standardized mean difference between OA groups and healthy controls to identify parameters from these gait domains that were sensitive to knee or hip OA. RESULTS: Four independent domains of gait were obtained: speed-spatial, speed-temporal, dual-task cost, and upper body motion. Turning parameters constituted a gait domain together with cadence. From the domains that were obtained, stride length (speed-spatial) and cadence (speed-temporal) had the strongest effect sizes for both knee and hip OA. Upper body motion (lumbar sagittal range of motion), showed a strong effect size when comparing hip OA with healthy controls. Parameters reflecting dual-task cost were not sensitive to knee or hip OA. CONCLUSIONS: Besides more commonly reported spatiotemporal parameters, only upper body motion provided non-redundant and sensitive parameters representing gait adaptations in individuals with hip OA. Turning parameters were sensitive to knee and hip OA, but were not independent from speed-related gait parameters. Dual-task parameters had limited additional value for evaluating gait in knee and hip OA, although dual-task cost constituted a separate gait domain. Future steps should include testing responsiveness of these gait domains to interventions aiming to improve mobility. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04074-2.
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spelling pubmed-79315412021-03-05 Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors Boekesteijn, Ramon J. Smolders, José M. H. Busch, Vincent J. J. F. Geurts, Alexander C. H. Smulders, Katrijn BMC Musculoskelet Disord Research Article BACKGROUND: Although it is well-established that osteoarthritis (OA) impairs daily-life gait, objective gait assessments are not part of routine clinical evaluation. Wearable inertial sensors provide an easily accessible and fast way to routinely evaluate gait quality in clinical settings. However, during these assessments, more complex and meaningful aspects of daily-life gait, including turning, dual-task performance, and upper body motion, are often overlooked. The aim of this study was therefore to investigate turning, dual-task performance, and upper body motion in individuals with knee or hip OA in addition to more commonly assessed spatiotemporal gait parameters using wearable sensors. METHODS: Gait was compared between individuals with unilateral knee (n = 25) or hip OA (n = 26) scheduled for joint replacement, and healthy controls (n = 27). For 2 min, participants walked back and forth along a 6-m trajectory making 180° turns, with and without a secondary cognitive task. Gait parameters were collected using 4 inertial measurement units on the feet and trunk. To test if dual-task gait, turning, and upper body motion had added value above spatiotemporal parameters, a factor analysis was conducted. Effect sizes were computed as standardized mean difference between OA groups and healthy controls to identify parameters from these gait domains that were sensitive to knee or hip OA. RESULTS: Four independent domains of gait were obtained: speed-spatial, speed-temporal, dual-task cost, and upper body motion. Turning parameters constituted a gait domain together with cadence. From the domains that were obtained, stride length (speed-spatial) and cadence (speed-temporal) had the strongest effect sizes for both knee and hip OA. Upper body motion (lumbar sagittal range of motion), showed a strong effect size when comparing hip OA with healthy controls. Parameters reflecting dual-task cost were not sensitive to knee or hip OA. CONCLUSIONS: Besides more commonly reported spatiotemporal parameters, only upper body motion provided non-redundant and sensitive parameters representing gait adaptations in individuals with hip OA. Turning parameters were sensitive to knee and hip OA, but were not independent from speed-related gait parameters. Dual-task parameters had limited additional value for evaluating gait in knee and hip OA, although dual-task cost constituted a separate gait domain. Future steps should include testing responsiveness of these gait domains to interventions aiming to improve mobility. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12891-021-04074-2. BioMed Central 2021-03-03 /pmc/articles/PMC7931541/ /pubmed/33658006 http://dx.doi.org/10.1186/s12891-021-04074-2 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Boekesteijn, Ramon J.
Smolders, José M. H.
Busch, Vincent J. J. F.
Geurts, Alexander C. H.
Smulders, Katrijn
Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
title Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
title_full Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
title_fullStr Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
title_full_unstemmed Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
title_short Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
title_sort independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931541/
https://www.ncbi.nlm.nih.gov/pubmed/33658006
http://dx.doi.org/10.1186/s12891-021-04074-2
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