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Carvalho A, Vanrenterghem J, Cabral S, Assunção A, Fernandes R, Veloso AP, Moniz-Pereira V. Markerless three-dimensional gait analysis in healthy older adults: test-retest reliability and measurement error. J Biomech 2024; 174:112280. [PMID: 39153296 DOI: 10.1016/j.jbiomech.2024.112280] [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: 12/20/2023] [Revised: 08/02/2024] [Accepted: 08/12/2024] [Indexed: 08/19/2024]
Abstract
In older adults, gait analysis may detect changes that signal early disease states, yet challenges in biomechanical screening limit widespread use in clinical or community settings. Recently, a markerless method from multi-camera video data has become accessible, making screenings less challenging. This study evaluated the test-retest reliability and measurement error of markerless gait kinematics and kinetics in healthy older adults. Twenty-nine healthy older adults performed gait analysis on two occasions, at preferred walking speed, using their everyday clothes. Lower limb angles and moments were averaged from 8 gait cycles. Integrated pointwise indices [Intraclass Correlation Coefficient (ICCA,K) and Standard Error of Measurement (SEM)] were calculated for curve data, as well as ICCA,K, and SEM [95 % confidence intervals] for selected peaks. Generally, kinematic ICCs were good (>0.75) and reasonably stable throughout the gait cycle, except for the hip kinematics during the swing phase in the sagittal plane and pelvis tilt and rotation. The integrated and peaks SEM were <2.4°. The reliability of kinetics was similar (ICC>0.75), except for the transverse hip moment and abduction peak, fluctuating more during the swing than through the stance phase. SEM were < 0.07Nm/Kg. In conclusion, these results showed good overall test-retest reliability for markerless gait kinematics and kinetics for the hip, knee, and ankle joints, moderate for the pelvis angles, and error levels of ≤5°, and SEM%≤5% for the sagittal plane. This supports this method's use in assessing gait in healthy older adults, including kinetics, for which reliability data from markerless systems is difficult to find reported.
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Affiliation(s)
- Andreia Carvalho
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal; Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, Leuven KU, Belgium; Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, 1990-096 Lisboa, Portugal.
| | - Jos Vanrenterghem
- Musculoskeletal Rehabilitation Research Group, Faculty of Movement and Rehabilitation Sciences, Leuven KU, Belgium.
| | - Sílvia Cabral
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | - Ana Assunção
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | - Rita Fernandes
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal; Instituto Politécnico de Setúbal, Escola Superior de Saúde, Campus do Instituto Politécnico de Setúbal, ESCE, Estefanilha, Edifício 2914-503 Setúbal, Portugal; Comprehensive Health Research Centre, Nova Medical School, 1150-190 Lisboa, Portugal.
| | - António P Veloso
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
| | - Vera Moniz-Pereira
- Universidade Lisboa, Faculdade de Motricidade Humana, CIPER, LBMF, P-1499-002 Lisboa, Portugal.
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Kowalski E, Catelli DS, Dervin G, Lamontagne M. Knee biomechanics variability before and after total knee arthroplasty: an equality of variance prospective study. Sci Rep 2024; 14:2673. [PMID: 38302571 PMCID: PMC10834938 DOI: 10.1038/s41598-024-52965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/24/2024] [Indexed: 02/03/2024] Open
Abstract
This study evaluated gait variability in patients before and after total knee arthroplasty (TKA) using the equality of variance method to determine where variability differences occur in the movement cycle. Twenty-eight patients underwent TKA with cruciate-sacrificed implants. Patients underwent motion analysis which measured knee biomechanics as they walked overground at their preferred pace before and 12 months after TKA. Equality of variance results were compared with 14 healthy controls of similar age. Before surgery, patients had reduced knee extension moment variability throughout the early stance phase (4-21% gait cycle, p < 0.05) compared to controls. Knee power variability was lower preoperatively compared to controls for most of the stance phase (0-13% and 17-60% gait cycle, p < 0.05). Sagittal knee moment and power variability further decreased following TKA. Knee extension moment variability was lower postoperatively throughout stance phase compared to preoperatively (4-22% and 36-60% gait cycle, p < 0.05) and compared to controls (4-30% and 45-60% gait cycle, p < 0.05). Knee power variability remained lower following TKA throughout stance phase compared to preoperatively (10-24% and 36-58% gait cycle, p < 0.05) and controls (3-60% gait cycle, p < 0.05). TKA patients may be less stable, and this may be in part due to an unresolved adaptation developed while awaiting TKA surgery and the cruciate sacrificing design of the implants utilized in this study.
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Affiliation(s)
- Erik Kowalski
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Danilo S Catelli
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Geoffrey Dervin
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada
| | - Mario Lamontagne
- Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
- Division of Orthopaedic Surgery, The Ottawa Hospital, Ottawa, ON, Canada.
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