Reliability of inertial sensor based spatiotemporal gait parameters for short walking bouts in community dwelling older adults

Inertial Sensor Gait Analysis of Trendelenburg Gait in Patients Who Have Hip Osteoarthritis

BACKGROUND

Gait abnormalities such as Trendelenburg gait (TG) in patients who have hip osteoarthritis (OA) have traditionally been evaluated using clinicians' visual assessment. Recent advances in portable inertial gait sensors offer more sensitive, quantitative methods for gait assessment in clinical settings. This study sought to compare sensor-derived metrics in a cohort of hip OA patients when stratified by clinical TG severity.

METHODS

There were 42 patients who had hip OA and were grouped by TG severity (mild, moderate, and severe) through visual assessment by a single arthroplasty surgeon who had > 30 years of experience. After informed consent, wireless inertial sensors placed at the midpoint of the intercristal line collected gait parameters including pelvic shift, support time, toe-off symmetry, impact, and cadence. Clinical data on hip strength, range of motion, and Kellgren-Lawrence grade were collected.

RESULTS

Worsening TG severity had a higher mean Kellgren-Lawrence grade (2.5 versus 3.2 versus 3.4; P = .014) and reduced passive hip abduction (P = .004). Severe TG group demonstrated predominantly contralateral pelvic shift (n = 9 of 10, 90.0%), while ipsilateral shift was more frequently detected in moderate (n = 10 of 18, 55.6%) and mild groups (n = 9 of 14, 64.3%; P = .021). Contralateral single support time bias was greatest in severe TG (35.7% versus 50.0 versus 90.0%; P = .027). Asymmetric toe-off, impact, and support times were observed in all groups.

CONCLUSIONS

Traditional understanding of TG is that truncal shift occurs to the ipsilateral side. Using sensor-based measurements, the present study demonstrates a shift of the weight-bearing axis toward the contralateral side with increasing TG severity, which has not been previously described. Inertial sensors are feasible, quantitative gait measuring tools, and may reveal subtle patterns not readily discernible by traditional methods.

Reliability of waveforms and gait metrics from multiple outdoor wearable inertial sensors collections in adults with knee osteoarthritis

Wearable sensors may allow research to move outside of controlled laboratory settings to be able to collect real-world data in clinical populations, such as older adults with osteoarthritis. However, the reliability of these sensors must be established across multiple out-of-lab data collections. Nine older adults with symptomatic knee arthritis wore wearable inertial sensors on their proximal tibias during an outdoor 6-minute walk test outside of a controlled laboratory setting as part of a pilot study. Reliability of the underlying waveforms, discrete peak outcomes, and spatiotemporal outcomes were assessed over four separate data collections, each approximately 1 week apart. Reliability at a different number of included strides was also assessed at 10, 20, 50, and 100 strides. The underlying waveforms and discrete peak outcome measures had good-to-excellent reliability for all axes, with lower reliability in frontal plane angular velocity axis. Spatiotemporal outcomes demonstrated excellent reliability. The inclusion of additional strides had little to no effect on reliability in most axes, but the confidence intervals generally became smaller across all axes. However, there was improvement in axes with lower (i.e., good) reliability. These data were collected in an out-of-lab setting, and the results are generally consistent with previous in-lab data collections, likely due to its semi-controlled nature. Additional out-of-laboratory research is required to investigate if these trends continue during truly free-living collections. This study provides support for increasing research conducted in out-of-lab data collections, as demonstrated by the good-to-excellent reliability of all axes.

Relationship between static balance and gait parameters in preschool children

BACKGROUND

Postural sway while standing reflects the degree of sensory integration function. The relationship between static balance and gait parameters in preschool children is essential for understanding which component of gait function is linked to the sensory integration function.

RESEARCH QUESTION

We aimed to clarify the relationship between static balance and gait in children, aged 2-6 years, with typical development METHODS: A total of 105 children (48 girls, 57 boys) participated in this study. Static balance parameters were computed using positions at the center of pressure (COP) while standing (COP length, velocity, and sway area). Spatiotemporal parameters during gait were analyzed for stride length, step width, stance time, cadence, coefficient of variation (CV) of step length, and CV of stance time as gait variability. Pearson correlation coefficients were estimated to explore the relationship between age and static balance or gait parameters. Partial correlation analysis controlling for age was also performed to examine the relationship between static balance and gait parameters.

RESULTS

A moderate association between age and static balance parameters and between age and gait parameters was found. Partial correlation analysis revealed that the variability parameters of gait were associated with the static balance parameters. No relationship was found between both spatial and temporal gait parameters and static balance parameters.

SIGNIFICANCE

Among the gait parameters that are considered to develop in early childhood, gait variability was associated with COP sway while standing, whereas stride length with increasing age was independent of any static balance parameters. Of the spatial, temporal, and variability parameters of gait, only gait variability maybe associated with the development of sensory integration function.

Basic gait pattern and impact of fall risk factors on gait among older adults in India

BACKGROUND

An unstable gait pattern is an indicator of an increased risk of falls among older adults. Data on basic gait parameters is useful in the early identification of gait impairment. However, reference gait measurements are not available in low- and middle-income countries.

RESEARCH QUESTION

What are the normative reference values of gait parameters and do fall risk factors such as impaired balance, functional difficulty, and multimorbidity affect the gait patterns of older adults in India?

METHODS

A cross-sectional data of 659 older adults were collected using a semi-structured schedule. Gait parameters were measured using wearable sensors. Descriptive statistics, independent t-test, and one-way ANCOVA were used to determine the significant difference (p < 0.05) in gait parameters across the risk factors.

RESULTS

A mean stride length of 123.00 ± 15.19 cm, stride velocity of 110.57 ± 17.57 cm/s, and a cadence of 106.14 ± 11.44 steps/minute were reported in the study. Functional difficulties and balance impairment were the two major risk factors that affected stride velocity, stride length, and cadence after adjusting for age and height. No difference in gait parameters was observed among participants with and without multimorbidity.

SIGNIFICANCE

This study provides a baseline or reference values of various gait parameters measured on a large sample of population aged 60 and above from India. Assessment of gait patterns and associated risk factors in a clinical setup will help identify the older adults at risk of falls and reduce the enormous burden of fall injuries. Since gait parameters show a large variation across geographical regions, it is important to have region-specific reference values.