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Wang Y, Li Z, Zhao G, Ding Y, Huan Z, Chen L. Assessment of lumbar disc herniation-impaired gait by using IMU data fusion method. Comput Methods Biomech Biomed Engin 2024:1-12. [PMID: 38940627 DOI: 10.1080/10255842.2024.2370404] [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: 03/21/2024] [Accepted: 06/05/2024] [Indexed: 06/29/2024]
Abstract
The inertial motion unit (IMU) is an effective tool for monitoring and assessing gait impairment in patients with lumbar disc herniation(LDH). However, the current clinical assessment methods for LDH gait focus on patients' subjective scoring indicators and lack the assessment of kinematic ability; at the same time, individual differences in the motor function degradation of the healthy and affected lower limbs of LDH patients are also ignored. To solve this problem, we propose an LDH gait feature model based on multi-source adaptive Kalman data fusion of acceleration and angular velocity. The gait phase is segmented by using an adaptive Kalman data fusion algorithm to estimate the attitude angle, and obtaining gait events through a zero-velocity update technique and a peak detection algorithm. Two IMUs were used to analyze the gait characteristics of lumbar disc patients and healthy gait people, including 12 gait characteristics such as gait spatiotemporal parameters, kinematic parameters, gait variability and stability. Statistical methods were used to analyze the characteristic model and verify the biological differences between the healthy affected side of LDH and healthy subjects. Finally, feature engineering and machine learning technology were used to identify the gait pattern of inertial movement units in patients with lumbar intervertebral disc disease, and achieved a classification accuracy of 95.50%, providing an effective gait feature set and method for clinical evaluation of LDH.
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Affiliation(s)
- Yongsong Wang
- School of Computer Science and Artificial Intelligence, Changzhou University, Changzhou, Jiangsu, China
| | - Zhixin Li
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou, Jiangsu, China
| | - Guohui Zhao
- Department of Orthopedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yin Ding
- Department of Orthopedics, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Zhan Huan
- School of Microelectronics and Control Engineering, Changzhou University, Changzhou, Jiangsu, China
| | - Lin Chen
- School of Computer Science and Artificial Intelligence, Changzhou University, Changzhou, Jiangsu, China
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Ruehr L, Blomé S, Kastrati G, Lagerbäck T, Jonsjö M, Möller H, Skorpil M, Lasselin J, Lalouni M, Gerdhem P, Jensen K. Back morphology and walking patterns mean 13.8 years after surgery for lumbar disk herniation in adolescents. Pain Rep 2024; 9:e1148. [PMID: 38500565 PMCID: PMC10948132 DOI: 10.1097/pr9.0000000000001148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 03/20/2024] Open
Abstract
Introduction In many pain conditions, there is lingering pain despite healed tissue damage. Our previous study shows that individuals who underwent surgery for lumbar disk herniation (LDH) during adolescence have worse health, more pain, and increased disk degeneration mean 13 years after surgery compared with controls. It is unclear if walking patterns segregate surgically treated LDH adolescents and controls at mean 13-year follow-up. Objectives Here, we analyzed the relationship between gait, back morphology and other health outcomes in a cohort of individuals treated surgically because of lumbar disk herniation compared with controls. Methods We analyzed gait during a walking paradigm, back morphology at the site of surgery, and standardized health outcomes, among individuals who received surgery for LDH as adolescents, "cases" (n = 23), compared with "controls" (n = 23). Results There were gait differences in head (P = 0.021) and trunk angle (P = 0.021) between cases and controls in a direction where cases exhibited a posture associated with sickness. The gait variance was explained by subjective pain and exercise habits rather than objective disk degeneration. Conclusion Over a decade after surgery for LDH during adolescence, health among cases is worse compared with controls. The head and trunk angles differ between cases and controls, indicating that the residual pain lingers and may cause changes in movement patterns long after a painful episode in early life. Gait may be a useful target for understanding maintenance of pain and disability among individuals treated surgically for LDH during adolescence.
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Affiliation(s)
- Livia Ruehr
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Max Planck School of Cognition, Leipzig, Germany
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Sebastian Blomé
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Gránit Kastrati
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Tobias Lagerbäck
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden
| | - Martin Jonsjö
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Hans Möller
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden
- Center for Spine Surgery in Stockholm, Stockholm, Sweden
| | - Mikael Skorpil
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden
| | - Julie Lasselin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Osher Center for Integrative Health, Karolinska Institutet, Stockholm, Sweden
| | - Maria Lalouni
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Paul Gerdhem
- Department of Clinical Science, Intervention and Technology, Division of Orthopedics and Biotechnology, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopedics and Hand Surgery, Uppsala University Hospital, Uppsala, Sweden
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Karin Jensen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Chen G, Li LB, Shangguan Z, Wang Z, Liu W, Li J. Clinical Effect of Minimally Invasive Microendoscopic-Assisted Transforaminal Lumbar Interbody Fusion for Single-Level Lumbar Disc Herniation. Orthop Surg 2022; 14:3300-3312. [PMID: 36303440 PMCID: PMC9732619 DOI: 10.1111/os.13443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE This retrospective study aimed to compare the clinical and radiological outcomes of transforaminal lumbar interbody fusion (TLIF) through the Wiltse approach (W-TLIF) vs minimally invasive microendoscopy-assisted transforaminal lumbar interbody fusion (ME-TLIF) in single-segment lumbar disc herniation (LDH). METHODS A retrospective study was conducted to study the differences in specific clinical outcomes between single-segment LDH patients receiving W-TLIF and ME-TLIF. Single-segment LDH patients admitted to the Fujian Medical University Union Hospital from March 2015 to June 2018 were included. All the participants were divided into the ME-TLIF group or the W-TLIF group according to their TLIF surgery types. Demographic characteristics, the visual analog score (VAS), Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scale, blood loss volume, postoperative drainage, ambulated time, initial postoperative back pain, hospitalization duration, expenses, and improvement rates of patients in the two groups were collected for analysis. Radiographic fusion was ultimately assessed via the Bridwell interbody fusion grading system. All selected patients with TLIF were followed up for 1 year. RESULTS Fifty-seven patients were selected, with 26 in the ME-TLIF group and 31 in the W-TLIF group, both of whom were followed up for 1 year. The mean age of the included patients was 53.75 ± 9.313 years, and the sex ratio was indiscrimination. There was no significant difference in demographic data or operating time between the two groups prior to surgery. The blood loss volume (ME-TLIF: 228.5 vs W-TLIF: 681.3), postoperative drainage (ME-TLIF:82.1 ± 23.5 vs W-TLIF: 345.8 ± 65.2), initial postoperative back pain (ME-TLIF: VAS_3 days: 1.96 ± 0.60 VAS_7 days: 1.73 ± 0.53, W-TLIF: VAS_3 days: 2.48 ± 0.51 VAS_7 days: 1.87 ± 0.43), and hospitalization duration (ME-TLIF: 9.04 vs. W-TLIF: 11.29) were all significantly lower in the ME-TILF group (p < 0.05). However, there were no statistical differences between the two groups in VAS, ODI, and JOA at 1 month, 3 months, 6 months, and 1 year postoperatively (p > 0.05). The fusion rates of the two groups showed no notable difference (p > 0.05), while the X-ray exposure time in the ME-TLIF group was significantly longer than in the W-TLIF group (p < 0.05). CONCLUSIONS ME-TLIF surgery was an effective and satisfactory surgical technique to manage LDH. Although ME-TLIF increased the operation time and intraoperative fluoroscopic irradiation volume, it could effectively relieve low back pain from early postoperative onset and promote early postoperative recovery compared with W-TLIF.
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Affiliation(s)
- Gang Chen
- Department of OrthopaedicsFujian Medical University Union HospitalFuzhouChina
- Fujian Medical UniversityFuzhouChina
- Department of Interventional MedicineNingde Municipal Hospital of Ningde Normal UniversityNingdeChina
- Ningde Normal UniversityNingdeChina
| | - Long Biao Li
- Department of OrthopaedicsFujian Medical University Union HospitalFuzhouChina
- Fujian Medical UniversityFuzhouChina
- Department of Interventional MedicineNingde Municipal Hospital of Ningde Normal UniversityNingdeChina
- Ningde Normal UniversityNingdeChina
| | - Zhitao Shangguan
- Department of OrthopaedicsFujian Medical University Union HospitalFuzhouChina
- Fujian Medical UniversityFuzhouChina
- Department of Interventional MedicineNingde Municipal Hospital of Ningde Normal UniversityNingdeChina
- Ningde Normal UniversityNingdeChina
| | - Zhenyu Wang
- Department of OrthopaedicsFujian Medical University Union HospitalFuzhouChina
- Fujian Medical UniversityFuzhouChina
- Department of Interventional MedicineNingde Municipal Hospital of Ningde Normal UniversityNingdeChina
- Ningde Normal UniversityNingdeChina
| | - Wenge Liu
- Department of OrthopaedicsFujian Medical University Union HospitalFuzhouChina
- Fujian Medical UniversityFuzhouChina
- Department of Interventional MedicineNingde Municipal Hospital of Ningde Normal UniversityNingdeChina
- Ningde Normal UniversityNingdeChina
| | - Jiandong Li
- Department of OrthopaedicsFujian Medical University Union HospitalFuzhouChina
- Fujian Medical UniversityFuzhouChina
- Department of Interventional MedicineNingde Municipal Hospital of Ningde Normal UniversityNingdeChina
- Ningde Normal UniversityNingdeChina
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Wang J, Zou Q, Li S, Tang R, Yang X, Zeng J, Shen B, Li K, Nie Y. Gait asymmetry of lower extremities reduced immediately after minimally invasive surgery among patients with lumbar disc herniation. Clin Biomech (Bristol, Avon) 2022; 98:105720. [PMID: 35863143 DOI: 10.1016/j.clinbiomech.2022.105720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 07/06/2022] [Accepted: 07/12/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lumbar disc herniation patients with increased pain exhibit greater gait asymmetry in stance time, swing time and single support time. Percutaneous endoscopic lumbar discectomy, as a minimally invasive surgical procedure has been used to treat patients with lumbar disc herniation. The objective of this study was to evaluate the immediate impact of the percutaneous endoscopic lumbar discectomy on gait asymmetry in spatiotemporal and kinetic parameters among lumbar disc herniation patients. METHODS Marker trajectories and ground reaction forces were measured during walking among 67 lumbar disc herniation patients and 15 healthy controls. Spatiotemporal gait parameters were analyzed via Visual3D. Muscle force and joint contact force were calculated with OpenSim. Gait asymmetry of those parameters were assessed with asymmetry index. FINDINGS After surgery, gait asymmetry in gait cycle time, step length, peak biceps femoris long head, tensor fasciae latae and rectus femoris muscle forces, and peak hip and knee joint contact forces reduced immediately. Postoperatively, increased gait cycle time and decreased step length were found in the affected side. Moreover, decreased peak biceps femoris long head, tensor fasciae latae and rectus femoris muscle forces, and peak hip joint contact force were observed in the contralateral side. INTERPRETATION These results suggested compensation strategy that biceps femoris long head, tensor fasciae latae and rectus femoris in the contralateral side were mainly used to compensate the affected side preoperatively in lumbar disc herniation patients, with less compensation between lower limbs after surgery, which may provide an insight into postoperative rehabilitation.
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Affiliation(s)
- Junqing Wang
- West China Biomedical Big Data Center, Sichuan University West China Hospital, Chengdu, Sichuan Province, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan Province, China
| | - Qiang Zou
- Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China
| | - Shiqi Li
- College of Electrical Engineering, Sichuan University, Chengdu, Sichuan Province, China
| | - Ruoliang Tang
- Sichuan University-Pittsburgh Institute (SCUPI), Sichuan University, Chengdu, Sichuan Province, China
| | - Xi Yang
- Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China
| | - Jiancheng Zeng
- Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China
| | - Bin Shen
- Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China
| | - Kang Li
- West China Biomedical Big Data Center, Sichuan University West China Hospital, Chengdu, Sichuan Province, China.
| | - Yong Nie
- Department of Orthopedics, Orthopedic Research Institute and National Clinical Research Center for Geriatrics, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan Province, China.
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Differences between Systems Using Optical and Capacitive Sensors in Treadmill-Based Spatiotemporal Analysis of Level and Sloping Gait. SENSORS 2022; 22:s22072790. [PMID: 35408404 PMCID: PMC9003327 DOI: 10.3390/s22072790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 03/27/2022] [Accepted: 04/02/2022] [Indexed: 12/10/2022]
Abstract
Modern technology has enabled researchers to analyze gait with great accuracy and in various conditions based on the needs of the trainees. The purpose of the study was to investigate the agreement between systems equipped with optical and capacitive sensors in the analysis of treadmill-based level and sloping gait. The spatiotemporal parameters of gait were measured in 30 healthy college-level students during barefoot walking on 0% (level), -10% and -20% (downhill) and +10% and +20% (uphill) slopes at hiking-related speeds using an optoelectric cell system and an instrumented treadmill. Inter-system agreement was assessed using the Intraclass Correlation Coefficients (ICCs) and the 95% limits of agreement. Our findings revealed excellent ICCs for the temporal and between moderate to excellent ICCs for the spatial parameters of gait. Walking downhill and on a 10% slope demonstrated better inter-system agreement compared to walking uphill and on a 20% slope. Inter-system agreement regarding the duration of gait phases was increased by increasing the number of LEDs used by the optoelectric cell system to detect the contact event. The present study suggests that systems equipped with optical and capacitive sensors can be used interchangeably in the treadmill-based spatiotemporal analysis of level and sloping gait.
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