1
|
Cortes-Rodríguez A, Alves-Gomes L, Losa-Iglesias ME, Gómez-Salgado J, Becerro-de-Bengoa-Vallejo R, Saavedra-García MÁ, Montiel-Luque A, López-López D, Jiménez-Cebrián AM. Impact of ankylosing spondylitis on foot health and quality of life: an observational case-control study. Front Med (Lausanne) 2024; 11:1355803. [PMID: 38737760 PMCID: PMC11082285 DOI: 10.3389/fmed.2024.1355803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 04/02/2024] [Indexed: 05/14/2024] Open
Abstract
Background Ankylosing spondylitis (AS) is a chronic, inflammatory, and autoimmune disease. This condition primarily affects the axial skeleton and presents direct foot involvement, such as Achilles enthesitis or plantar fascia involvement. Objective This study aimed to investigate the impact of foot health on the quality of life of individuals with AS compared to a control group without AS. Materials and methods A sample of 112 subjects was recruited, with a mean age of 46.80 ± 10.49 years, divided into two groups: 56 individuals with AS (cases) and 56 individuals without AS (controls). Demographic data were collected, and the scores obtained in the Foot Health Status Questionnaire domains were recorded. Results Of the participants, 27.79% (N = 30) were men and 73.21% (N = 82) were women. The mean age in the group was 46.80 ± 10.49. Significant differences (p < 0.05) were found in the domains of foot function, foot pain, footwear, overall foot health, general health-related physical activity, and social capacity between the AS group and the control group. Conclusion Individuals with AS exhibited a decreased quality of life, as indicated by their Foot Health Status Questionnaire scores.
Collapse
Affiliation(s)
- Antonio Cortes-Rodríguez
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Industrial Campus of Ferrol, Ferrol, Spain
| | - Lisa Alves-Gomes
- Nursing School, Nursing Research Centre (CIEnf) of the University of Minho, Portugal; Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Braga, Portugal
| | | | - Juan Gómez-Salgado
- Departamento de Sociología, Trabajo Social y Salud Pública, Universidad de Huelva, Huelva, Spain
- Programa de Posgrado de Seguridad y Salud, Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | | | - Alonso Montiel-Luque
- Health District Costa del Sol, Department of Nursing and Podiatry, Faculty of Health Sciences, Primary Health Care Centre San Miguel (Torremolinos), Málaga, Spain
| | - Daniel López-López
- Research, Health and Podiatry Group, Department of Health Sciences, Faculty of Nursing and Podiatry, Universidade da Coruña, Industrial Campus of Ferrol, Ferrol, Spain
| | - Ana María Jiménez-Cebrián
- Department Nursing and Podiatry, Faculty of Health Sciences, University of Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga, Málaga, Spain
| |
Collapse
|
2
|
Park YG, Goh TS, Kim DS, Jung SJ, Lee JS. Relationships between Clinical Status and Gait Parameters in Ankylosing Spondylitis. Clin Orthop Surg 2023; 15:249-256. [PMID: 37008970 PMCID: PMC10060776 DOI: 10.4055/cios22112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 02/07/2023] Open
Abstract
Background This study aimed to identify the relationship between gait parameters and health-related quality of life (HRQOL) in patients with ankylosing spondylitis (AS). Methods The study group comprised 134 patients with AS and 124 patients were enrolled as controls. All study participants underwent instrumented gait analysis and completed clinical questionnaires. The kinematic parameters of gait were walking speed, step length, cadence, stance phase, single support, double support, phase coordination index (PCI), and gait asymmetry (GA). For each patient, a visual analog scale (VAS; 0-10) score was used to assess back pain, 36-item short form survey (SF-36) questionnaire was administered to evaluate the HRQOL, and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) was calculated. Using kinematic parameters and questionnaires, statistical analyses were done to investigate significant differences between the groups. Relationship of gait kinematic data and questionnaires of clinical outcome was also evaluated. Results Among the 134 patients with AS, 34 were women and 100 were men. In the control group, 26 were women and 98 were men. The patients with AS and control group patients had significant differences in terms of walking speed, step length, single support, PCI, and GA. However, such differences were not observed in cadence, stance phase, and double support (p > 0.05). In correlation analyses, gait kinematic parameters and clinical outcomes were significantly related with each other. In multiple regression analysis performed to identify predictive factors for clinical outcome, walking speed was found to predict VAS, and walking speed and step length were found to predict the BASDAI and SF-36 scores. Conclusions Patients with and without AS had significant differences in the gait parameters. Correlation analysis showed significant correlation between the gait kinematic data and clinical outcomes. In particular, walking speed and step length successfully predicted clinical outcomes in patients with AS.
Collapse
Affiliation(s)
- Yong Geon Park
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Tae Sik Goh
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Dong Suk Kim
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Seok Jin Jung
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Jung Sub Lee
- Biomedical Research Institute, Department of Orthopaedic Surgery, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| |
Collapse
|
3
|
Soulard J, Vaillant J, Baillet A, Gaudin P, Vuillerme N. Gait and Axial Spondyloarthritis: Comparative Gait Analysis Study Using Foot-Worn Inertial Sensors. JMIR Mhealth Uhealth 2021; 9:e27087. [PMID: 34751663 PMCID: PMC8663701 DOI: 10.2196/27087] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/18/2021] [Accepted: 07/23/2021] [Indexed: 12/15/2022] Open
Abstract
Background Axial spondyloarthritis (axSpA) can lead to spinal mobility restrictions associated with restricted lower limb ranges of motion, thoracic kyphosis, spinopelvic ankylosis, or decrease in muscle strength. It is well known that these factors can have consequences on spatiotemporal gait parameters during walking. However, no study has assessed spatiotemporal gait parameters in patients with axSpA. Divergent results have been obtained in the studies assessing spatiotemporal gait parameters in ankylosing spondylitis, a subgroup of axSpA, which could be partly explained by self-reported pain intensity scores at time of assessment. Inertial measurement units (IMUs) are increasingly popular and may facilitate gait assessment in clinical practice. Objective This study compared spatiotemporal gait parameters assessed with foot-worn IMUs in patients with axSpA and matched healthy individuals without and with pain intensity score as a covariate. Methods A total of 30 patients with axSpA and 30 age- and sex-matched healthy controls performed a 10-m walk test at comfortable speed. Various spatiotemporal gait parameters were computed from foot-worn inertial sensors including gait speed in ms–1 (mean walking velocity), cadence in steps/minute (number of steps in a minute), stride length in m (distance between 2 consecutive footprints of the same foot on the ground), swing time in percentage (portion of the cycle during which the foot is in the air), stance time in percentage (portion of the cycle during which part of the foot touches the ground), and double support time in percentage (portion of the cycle where both feet touch the ground). Results Age, height, and weight were not significantly different between groups. Self-reported pain intensity was significantly higher in patients with axSpA than healthy controls (P<.001). Independent sample t tests indicated that patients with axSpA presented lower gait speed (P<.001) and cadence (P=.004), shorter stride length (P<.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than healthy controls. When using pain intensity as a covariate, spatiotemporal gait parameters were still significant with patients with axSpA exhibiting lower gait speed (P<.001), shorter stride length (P=.001) and swing time (P<.001), and longer double support time (P<.001) and stance time (P<.001) than matched healthy controls. Interestingly, there were no longer statistically significant between-group differences observed for the cadence (P=.17). Conclusions Gait was significantly altered in patients with axSpA with reduced speed, cadence, stride length, and swing time and increased double support and stance time. Taken together, these changes in spatiotemporal gait parameters could be interpreted as the adoption of a so-called cautious gait pattern in patients with axSpA. Among factors that may influence gait in patients with axSpA, patient self-reported pain intensity could play a role. Finally, IMUs allowed computation of spatiotemporal gait parameters and are usable to assess gait in patients with axSpA in clinical routine. Trial Registration ClinicalTrials.gov NCT03761212; https://clinicaltrials.gov/ct2/show/NCT03761212 International Registered Report Identifier (IRRID) RR2-10.1007/s00296-019-04396-4
Collapse
Affiliation(s)
- Julie Soulard
- University Grenoble Alpes, AGEIS, La Tronche, France.,Grenoble Alpes University Hospital, Grenoble, France
| | | | - Athan Baillet
- University Grenoble Alpes, CNRS, Grenoble Alpes University Hospital, Grenoble INP, TIMC-IMAG UMR5525, Grenoble, France
| | - Philippe Gaudin
- University Grenoble Alpes, CNRS, Grenoble Alpes University Hospital, Grenoble INP, TIMC-IMAG UMR5525, Grenoble, France
| | - Nicolas Vuillerme
- University Grenoble Alpes, AGEIS, La Tronche, France.,Institut Universitaire de France, Paris, France.,LabCom Telecom4Health, Orange Labs & Univ. Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
| |
Collapse
|
4
|
Soulard J, Vaillant J, Baillet A, Gaudin P, Vuillerme N. The effects of a secondary task on gait in axial spondyloarthritis. Sci Rep 2021; 11:19537. [PMID: 34599222 PMCID: PMC8486771 DOI: 10.1038/s41598-021-98732-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/27/2021] [Indexed: 02/08/2023] Open
Abstract
Studies on the effects of dual tasking in patients with chronic inflammatory rheumatic diseases are limited. The aim of this study was to assess dual tasking while walking in patients with axial spondyloarthritis (axSpA) in comparison to healthy controls. Thirty patients with axSpA and thirty healthy controls underwent a 10-m walk test at a self-selected comfortable walking speed in single- and dual-task conditions. Foot-worn inertial sensors were used to compute spatiotemporal gait parameters. Analysis of spatiotemporal gait parameters showed that the secondary manual task negatively affected walking performance in terms of significantly decreased mean speed (p < 0.001), stride length (p < 0.001) and swing time (p = 0.008) and increased double support (p = 0.002) and stance time (p = 0.008). No significant interaction of group and condition was observed. Both groups showed lower gait performance in dual task condition by reducing speed, swing time and stride length, and increasing double support and stance time. Patients with axSpA were not more affected by the dual task than matched healthy controls, suggesting that the secondary manual task did not require greater attention in patients with axSpA. Increasing the complexity of the walking and/or secondary task may increase the sensitivity of the dual-task design to axial spondyloarthritis.
Collapse
Affiliation(s)
- Julie Soulard
- University Grenoble Alpes, AGEIS, Grenoble, France.
- CHU Grenoble Alpes, Grenoble, France.
| | | | - Athan Baillet
- CHU Grenoble Alpes, Grenoble, France
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, Grenoble, France
| | - Philippe Gaudin
- CHU Grenoble Alpes, Grenoble, France
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, Grenoble, France
| | - Nicolas Vuillerme
- University Grenoble Alpes, AGEIS, Grenoble, France
- Institut Universitaire de France, Paris, France
- LabCom Telecom4Health, Orange Labs & Univ. Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, Grenoble, France
| |
Collapse
|
5
|
Future Challenges and Critical Approach to Metrology in Patients with Axial Spondyloarthritis. Diagnostics (Basel) 2021; 11:diagnostics11091533. [PMID: 34573875 PMCID: PMC8465528 DOI: 10.3390/diagnostics11091533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022] Open
Abstract
Axial spondyloarthritis (axSpA) is a rheumatic inflammatory chronic disease that mainly affects the spine, producing inflammation and structural damage at the vertebral level (erosions, syndesmophytes, and bony bridges) [...].
Collapse
|
6
|
Spatio-temporal gait parameters obtained from foot-worn inertial sensors are reliable in healthy adults in single- and dual-task conditions. Sci Rep 2021; 11:10229. [PMID: 33986307 PMCID: PMC8119721 DOI: 10.1038/s41598-021-88794-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 04/07/2021] [Indexed: 02/07/2023] Open
Abstract
Inertial measurement units (IMUs) are increasingly popular and may be usable in clinical routine to assess gait. However, assessing their intra-session reliability is crucial and has not been tested with foot-worn sensors in healthy participants. The aim of this study was to assess the intra-session reliability of foot-worn IMUs for measuring gait parameters in healthy adults. Twenty healthy participants were enrolled in the study and performed the 10-m walk test in single- and dual-task ('carrying a full cup of water') conditions, three trials per condition. IMUs were used to assess spatiotemporal gait parameters, gait symmetry parameters (symmetry index (SI) and symmetry ratio (SR)), and dual task effects parameters. The relative and the absolute reliability were calculated for each gait parameter. Results showed that spatiotemporal gait parameters measured with foot-worn inertial sensors were reliable; symmetry gait parameters relative reliability was low, and SR showed better absolute reliability than SI; dual task effects were poorly reliable, and taking the mean of the second and the third trials was the most reliable. Foot-worn IMUs are reliable to assess spatiotemporal and symmetry ratio gait parameters but symmetry index and DTE gait parameters reliabilities were low and need to be interpreted with cautious by clinicians and researchers.
Collapse
|
7
|
Soulard J, Vaillant J, Balaguier R, Baillet A, Gaudin P, Vuillerme N. Foot-Worn Inertial Sensors Are Reliable to Assess Spatiotemporal Gait Parameters in Axial Spondyloarthritis under Single and Dual Task Walking in Axial Spondyloarthritis. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6453. [PMID: 33198119 PMCID: PMC7697708 DOI: 10.3390/s20226453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was (1) to evaluate the relative and absolute reliability of gait parameters during walking in single- and dual-task conditions in patients with axial spondyloarthritis (axSpA), (2) to evaluate the absolute and relative reliability of dual task effects (DTE) parameters, and (3) to determine the number of trials required to ensure reliable gait assessment, in patients with axSpA. Twenty patients with axSpa performed a 10-m walk test in single- and dual-task conditions, three times for each condition. Spatiotemporal, symmetry, and DTE gait parameters were calculated from foot-worn inertial sensors. The relative reliability (intraclass correlation coefficients-ICC) and absolute reliability (standard error of measurement-SEM and minimum detectable change-MDC) were calculated for these parameters in each condition. Spatiotemporal gait parameters showed good to excellent reliability in both conditions (0.59 < ICC < 0.90). The reliability of symmetry and DTE parameters was low. ICC, SEM, and MDC were better when using the mean of the second and the third trials. Spatiotemporal gait parameters obtained from foot-worn inertial sensors assessed in patients with axSpA in single- and dual-task conditions are reliable. However, symmetry and DTE parameters seem less reliable and need to be interpreted with caution. Finally, better reliability of gait parameters was found when using the mean of the 2nd and the 3rd trials.
Collapse
Affiliation(s)
- Julie Soulard
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
- CHU Grenoble Alpes, 38000 Grenoble, France
| | - Jacques Vaillant
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
| | - Romain Balaguier
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
| | - Athan Baillet
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, 38000 Grenoble, France; (A.B.); (P.G.)
| | - Philippe Gaudin
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, 38000 Grenoble, France; (A.B.); (P.G.)
| | - Nicolas Vuillerme
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
- Institut Universitaire de France, 75000 Paris, France
- LabCom Telecom4Health, University Grenoble Alpes & Orange Labs, 38000 Grenoble, France
| |
Collapse
|