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Swisser F, Brethe Y, Choquet O, Herteleer M, Bernard N, Laffont I, Bringuier S, Capdevila X. Plantar Compartment Block Improves Enhanced Recovery after Hallux Valgus Surgery: A Randomized, Comparative, Double-blind Study. Anesthesiology 2024; 141:891-903. [PMID: 39102486 DOI: 10.1097/aln.0000000000005180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
BACKGROUND Walking ability is a key factor in enhanced recovery after foot ambulatory surgery. Plantar compartment block offers an analgesic alternative to popliteal sciatic nerve block (PSNB) for hallux valgus surgery. The objective of this study was to compare these two regional anesthesia strategies on patients' ability to recover a painless unaided walk. METHODS This prospective double-blinded (patient; observing anesthesiologist) randomized study compared patients scheduled for hallux valgus surgery receiving PSNB with 1% mepivacaine, then combined plantar and peroneal nerve blocks (plantar compartment block [PCB] group) with ropivacaine 0.5% and dexamethasone, or PSNB with ropivacaine 0.5% and dexamethasone (control group). The primary outcome was the patient's ability to walk unaided 6 h after PSNB. The test was performed on a GAITRite, spatio-temporal gait analysis mat. For 3 days, the number of patient steps, pain levels, rescue analgesics, patient's experience, and adverse events were assessed. RESULTS Sixty patients were included and 59 were analyzed. The number of patients walking unaided on the GAITRite mat was significantly higher in the PCB group (21 of 30, 70%) than in the control group (4 of 29, 13.8%; P < 0.001). Gait quality using the Functional Ambulation Profile score was 63 ± 13.6 in the PCB group and 49.5 ± 4.7 in the control group (P < 0.001). Median time to free ambulation at home was significantly lower in the PCB group (9 h [8.2 to 11.8]) than in the control group (33.5 h [24 to 47]; P < 0.001). Postoperative pain did not differ between the groups (β = -0.41 [-1.78 to 0.95]; P = 0.548). The number of steps on day 3, the time of first rescue analgesic, the number of patients using rescue analgesia, consumption of morphine, and patient's experience did not differ between the groups. CONCLUSIONS PCB decreased the time to return to unaided walking, with improved gait, compared with PSNB, improving effective analgesia and low consumption of rescue analgesics. This innovative regional anesthesia strategy enhanced recovery after surgery. EDITOR’S PERSPECTIVE
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Affiliation(s)
- Fabien Swisser
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Yann Brethe
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Olivier Choquet
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Matthias Herteleer
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France; Department of Anatomy, Lille University School of Medicine, Lille, France
| | - Nathalie Bernard
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France
| | - Isabelle Laffont
- Physical Medicine and Rehabilitation Department, Centre Hospitalo-Universitaire Montpellier, University of Montpellier, Montpellier, France; Euromov, UFR STAPS, University of Montpellier, Montpellier, France
| | - Sophie Bringuier
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France; Department of Medical Statistics, Montpellier University Hospital, Montpellier, France; Desbrest Institute of Epidemiology and Public Health, Univ Montpellier, INSERM, Montpellier, France
| | - Xavier Capdevila
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, Montpellier, France; INSERM Unit 1298 Montpellier NeuroSciences Institute, Montpellier University, Montpellier, France
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Brito AL, Marques AP, Igarashi Y, Oliveira LKR, Sobral LL, Xavier MB, Souza GS, Callegari B. Use of an inertial sensor and a force platform to assess static balance in participants affected by multibacillary leprosy. PLoS Negl Trop Dis 2024; 18:e0012537. [PMID: 39374305 DOI: 10.1371/journal.pntd.0012537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 10/17/2024] [Accepted: 09/13/2024] [Indexed: 10/09/2024] Open
Abstract
INTRODUCTION Leprosy is a chronic, slowly developing infectious disease that affects the peripheral nerves, specifically Schwann cells. Individuals with the multibacillary type exhibit a propensity for developing chronic pain and a decrease in sensitivity in the plantar region, which directly interferes with balance maintenance. The evaluation of static balance in this population is made through the measurement of the center of pressure (COP) oscillations. Therefore, there is a need to investigate the association between postural control and COP oscillations using a force platform and finding accelerations of the center of mass (COM) from inertial sensors for reliable and portable balance assessment in leprosy patients. OBJECTIVE To validate the application of inertial sensors for patients with leprosy by establishing a correlation with the outcomes obtained from a force platform. METHODS This is an observational study with a case-control design, in which 30 participants with leprosy and 30 healthy participants were recruited to evaluate static balance using an inertial sensor and a force platform. Participants underwent balance assessment under two conditions (Eyes Open: OE and Eyes Closed: CE), and data from the platform and sensor were processed using Matlab computational routines. The data were quantified using four parameters: Total Displacement (TD), Area, Antero-Posterior Displacement (APdisp), and Medio-Lateral Displacement (MLdisp). RESULTS The evaluated parameters showed significantly different values between the groups, where the Leprosy group exhibited significantly higher values compared to the control group, both in the OE and CE conditions for all four parameters. The sensor corroborated the differences demonstrated by the platform and followed the same trend for medio-lateral displacements and accelerations. It can be observed that the evaluated parameters exhibited a varied correlation ranging from moderate to large between the platform and the sensor. Among the four variables, MLdisp had the lowest correlation. DISCUSSION The results partially confirmed the first hypothesis of concurrent validation, showing a moderate to large correlation between the force platform and the inertial sensor. The second hypothesis of clinical validation was also partially confirmed, as not all group differences observed in the COP measurements from the force platform were reflected in the COM measurements from the inertial sensor. Specifically, the force platform indicated greater oscillations in participants with multibacillary leprosy compared to controls, a finding statistically confirmed by the sensor for all measures except MLdisp. CONCLUSION This research confirmed the concurrent validity of the inertial sensor with the force platform and its clinical validation, demonstrating that this instrument can be applied in clinical settings due to its low cost and ease of use. The findings may contribute to public health by identifying postural control tools for patients with multibacillary leprosy.
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Affiliation(s)
- Aymee Lobato Brito
- Laboratory of Human Motricity Studies, Federal University of Para, Belém, Pará, Brasil
- Biological Sciences Institute, Federal University of Para, Belém, Pará, Brazil
| | - Amelia Pasqual Marques
- Department of Physiotherapy, Speech Therapy and Occupational Therapy, Faculty of Medicine, University of São Paulo, Cipotânea Street, University City, São Paulo, Brazil
| | - Yuzo Igarashi
- Laboratory of Human Motricity Studies, Federal University of Para, Belém, Pará, Brasil
- Tropical Medicine Center, Federal University of Para, Belém, Pará, Brazil
| | - Luana Karine Resende Oliveira
- Laboratory of Human Motricity Studies, Federal University of Para, Belém, Pará, Brasil
- Association of Social Pioneers, SMHS Neighborhood, Brasília, Distrito Federal, Brazil
| | - Luciane Lobato Sobral
- Center for Biological and Health Sciences, State University of Pará, Belém, Pará, Brazil
| | | | - Givago Silva Souza
- Biological Sciences Institute, Federal University of Para, Belém, Pará, Brazil
- Tropical Medicine Center, Federal University of Para, Belém, Pará, Brazil
| | - Bianca Callegari
- Laboratory of Human Motricity Studies, Federal University of Para, Belém, Pará, Brasil
- Tropical Medicine Center, Federal University of Para, Belém, Pará, Brazil
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Cristia A, Gautheron L, Zhang Z, Schuller B, Scaff C, Rowland C, Räsänen O, Peurey L, Lavechin M, Havard W, Fausey CM, Cychosz M, Bergelson E, Anderson H, Al Futaisi N, Soderstrom M. Establishing the reliability of metrics extracted from long-form recordings using LENA and the ACLEW pipeline. Behav Res Methods 2024:10.3758/s13428-024-02493-2. [PMID: 39304601 DOI: 10.3758/s13428-024-02493-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/31/2024] [Indexed: 09/22/2024]
Abstract
Long-form audio recordings are increasingly used to study individual variation, group differences, and many other topics in theoretical and applied fields of developmental science, particularly for the description of children's language input (typically speech from adults) and children's language output (ranging from babble to sentences). The proprietary LENA software has been available for over a decade, and with it, users have come to rely on derived metrics like adult word count (AWC) and child vocalization counts (CVC), which have also more recently been derived using an open-source alternative, the ACLEW pipeline. Yet, there is relatively little work assessing the reliability of long-form metrics in terms of the stability of individual differences across time. Filling this gap, we analyzed eight spoken-language datasets: four from North American English-learning infants, and one each from British English-, French-, American English-/Spanish-, and Quechua-/Spanish-learning infants. The audio data were analyzed using two types of processing software: LENA and the ACLEW open-source pipeline. When all corpora were included, we found relatively low to moderate reliability (across multiple recordings, intraclass correlation coefficient attributed to the child identity [Child ICC], was < 50% for most metrics). There were few differences between the two pipelines. Exploratory analyses suggested some differences as a function of child age and corpora. These findings suggest that, while reliability is likely sufficient for various group-level analyses, caution is needed when using either LENA or ACLEW tools to study individual variation. We also encourage improvement of extant tools, specifically targeting accurate measurement of individual variation.
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Affiliation(s)
- Alejandrina Cristia
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'Etudes cognitives, ENS, EHESS, CNRS, PSL University, Paris, France.
| | - Lucas Gautheron
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'Etudes cognitives, ENS, EHESS, CNRS, PSL University, Paris, France
- Interdisciplinary Centre for Science and Technology Studies (IZWT) Wuppertal, University of Wuppertal, Nordrhein-Westfalen, Germany
| | - Zixing Zhang
- School of Computer Science and Electronic Engineering, Hunan University, Changsha, Hunan, China
| | - Björn Schuller
- Technische Universität München, Institute for Human-Machine Communication, Munich, Germany
- Imperial College London, GLAM - Group on Language, Audio, & Music, London, UK
| | - Camila Scaff
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'Etudes cognitives, ENS, EHESS, CNRS, PSL University, Paris, France
- Human Ecology group, Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
| | - Caroline Rowland
- Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Okko Räsänen
- Unit of Computing Sciences, Tampere University, Tampere, Finland
| | - Loann Peurey
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'Etudes cognitives, ENS, EHESS, CNRS, PSL University, Paris, France
| | - Marvin Lavechin
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'Etudes cognitives, ENS, EHESS, CNRS, PSL University, Paris, France
| | - William Havard
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'Etudes cognitives, ENS, EHESS, CNRS, PSL University, Paris, France
- LLL, Université d'Orléans, CNRS, Orléans, France
| | | | - Margaret Cychosz
- Department of Hearing and Speech Sciences, University of Maryland at College Park, College Park, MD, USA
| | | | | | - Najla Al Futaisi
- Imperial College London, GLAM - Group on Language, Audio, & Music, London, UK
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Oh J, Loeb GE, Smith BA. The Utility of Calibrating Wearable Sensors before Quantifying Infant Leg Movements. SENSORS (BASEL, SWITZERLAND) 2024; 24:5736. [PMID: 39275650 PMCID: PMC11397996 DOI: 10.3390/s24175736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2024] [Revised: 08/30/2024] [Accepted: 09/02/2024] [Indexed: 09/16/2024]
Abstract
While interest in using wearable sensors to measure infant leg movement is increasing, attention should be paid to the characteristics of the sensors. Specifically, offset error in the measurement of gravitational acceleration (g) is common among commercially available sensors. In this brief report, we demonstrate how we measured the offset and other errors in three different off-the-shelf wearable sensors available to professionals and how they affected a threshold-based movement detection algorithm for the quantification of infant leg movement. We describe how to calibrate and correct for these offsets and how conducting this improves the reproducibility of results across sensors.
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Affiliation(s)
- Jinseok Oh
- Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
| | - Gerald E Loeb
- Alfred E. Mann Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA 90089, USA
| | - Beth A Smith
- Division of Developmental-Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA 90033, USA
- Developmental Neuroscience and Neurogenetics Program, The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
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Suffoletto B, Kim D, Toth C, Mayer W, Glaister S, Cinkowski C, Ashenburg N, Lin M, Losak M. Feasibility of Measuring Smartphone Accelerometry Data During a Weekly Instrumented Timed Up-and-Go Test After Emergency Department Discharge: Prospective Observational Cohort Study. JMIR Aging 2024; 7:e57601. [PMID: 39258924 PMCID: PMC11440574 DOI: 10.2196/57601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/14/2024] [Accepted: 07/11/2024] [Indexed: 09/12/2024] Open
Abstract
Background Older adults discharged from the emergency department (ED) face elevated risk of falls and functional decline. Smartphones might enable remote monitoring of mobility after ED discharge, yet their application in this context remains underexplored. Objective This study aimed to assess the feasibility of having older adults provide weekly accelerometer data from an instrumented Timed Up-and-Go (TUG) test over an 11-week period after ED discharge. Methods This single-center, prospective, observational, cohort study recruited patients aged 60 years and older from an academic ED. Participants downloaded the GaitMate app to their iPhones that recorded accelerometer data during 11 weekly at-home TUG tests. We measured adherence to TUG test completion, quality of transmitted accelerometer data, and participants' perceptions of the app's usability and safety. Results Of the 617 approached patients, 149 (24.1%) consented to participate, and of these 149 participants, 9 (6%) dropped out. Overall, participants completed 55.6% (912/1639) of TUG tests. Data quality was optimal in 31.1% (508/1639) of TUG tests. At 3-month follow-up, 83.2% (99/119) of respondents found the app easy to use, and 95% (114/120) felt safe performing the tasks at home. Barriers to adherence included the need for assistance, technical issues with the app, and forgetfulness. Conclusions The study demonstrates moderate adherence yet high usability and safety for the use of smartphone TUG tests to monitor mobility among older adults after ED discharge. Incomplete TUG test data were common, reflecting challenges in the collection of high-quality longitudinal mobility data in older adults. Identified barriers highlight the need for improvements in user engagement and technology design.
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Affiliation(s)
- Brian Suffoletto
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - David Kim
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Caitlin Toth
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Waverly Mayer
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Sean Glaister
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Chris Cinkowski
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Nick Ashenburg
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Michelle Lin
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
| | - Michael Losak
- Department of Emergency Medicine, Stanford University, 300 Porter Drive, Palo Alto, CA, 94020, United States, 1 650-723-6576, 1 650-723-0121
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Bonato P, Feipel V, Corniani G, Arin-Bal G, Leardini A. Position paper on how technology for human motion analysis and relevant clinical applications have evolved over the past decades: Striking a balance between accuracy and convenience. Gait Posture 2024; 113:191-203. [PMID: 38917666 DOI: 10.1016/j.gaitpost.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/30/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Over the past decades, tremendous technological advances have emerged in human motion analysis (HMA). RESEARCH QUESTION How has technology for analysing human motion evolved over the past decades, and what clinical applications has it enabled? METHODS The literature on HMA has been extensively reviewed, focusing on three main approaches: Fully-Instrumented Gait Analysis (FGA), Wearable Sensor Analysis (WSA), and Deep-Learning Video Analysis (DVA), considering both technical and clinical aspects. RESULTS FGA techniques relying on data collected using stereophotogrammetric systems, force plates, and electromyographic sensors have been dramatically improved providing highly accurate estimates of the biomechanics of motion. WSA techniques have been developed with the advances in data collection at home and in community settings. DVA techniques have emerged through artificial intelligence, which has marked the last decade. Some authors have considered WSA and DVA techniques as alternatives to "traditional" HMA techniques. They have suggested that WSA and DVA techniques are destined to replace FGA. SIGNIFICANCE We argue that FGA, WSA, and DVA complement each other and hence should be accounted as "synergistic" in the context of modern HMA and its clinical applications. We point out that DVA techniques are especially attractive as screening techniques, WSA methods enable data collection in the home and community for extensive periods of time, and FGA does maintain superior accuracy and should be the preferred technique when a complete and highly accurate biomechanical data is required. Accordingly, we envision that future clinical applications of HMA would favour screening patients using DVA in the outpatient setting. If deemed clinically appropriate, then WSA would be used to collect data in the home and community to derive relevant information. If accurate kinetic data is needed, then patients should be referred to specialized centres where an FGA system is available, together with medical imaging and thorough clinical assessments.
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Affiliation(s)
- Paolo Bonato
- Dept of PM&R, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, USA
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Faculty of Motor Sciences, Laboratory of Anatomy, Biomechanics and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Giulia Corniani
- Dept of PM&R, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, USA
| | - Gamze Arin-Bal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey; Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Martelli D, Rahman MM, Gurbuz SZ. Validation of a micro-doppler radar for measuring gait modifications during multidirectional visual perturbations. Gait Posture 2024; 113:504-511. [PMID: 39173440 DOI: 10.1016/j.gaitpost.2024.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 06/12/2024] [Accepted: 08/07/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND Changes in spatio-temporal gait parameters and their variability during balance-challenging tasks are markers of motor performance linked to fall risk. Radio frequency (RF) sensors hold great promise towards achieving continuous remote monitoring of these parameters. RESEARCH QUESTIONS To establish the concurrent validity of RF-based gait metrics extracted using micro-Doppler (µD) signatures and to determine whether these metrics are sensitive to gait modifications created by multidirectional visual perturbations. METHODS Fifteen participants walked overground in a virtual environment (VE) and VE with medio-lateral (ML) and antero-posterior (AP) perturbations. An optoelectronic motion capture system and one RF sensor were used to extract the linear velocity of the trunk and estimate step time (ST), step velocity (SV), step length (SL), and their variability (STV, SVV, and SLV). Intra-class coefficient for consistency (ICC), mean and standard deviation of the differences (MD), 95 % limits of agreement, and Pearson correlation coefficients (r) were used to determine concurrent validity. One-way repeated-measures analysis of variance was used to analyze the main and interaction effects of visual conditions. RESULTS All outcomes showed good to excellent reliability (r>0.795, ICC>0.886). Average gait parameters showed good to excellent agreement, with values obtained with the RF sensor systematically smaller than the values obtained with the markers (MD of 0.001 s, 0.09 m/s, and 0.06 m). Gait variability parameters showed poor to moderate agreement, with values obtained with the RF sensor systematically larger than those obtained with the markers (MD of 1.9 %-3.9 %). Both measurement systems reported decreased SL and SV during ML perturbations, but the gait variability parameters extracted with the radar were not able to detect the higher STV and SLV during this condition. SIGNIFICANCE The radar µD signature is a valid and reliable method for the assessment of average spatio-temporal gait parameters but gait variability measures need to be viewed with caution because of the lower levels of agreement and sensitivity to ML visual perturbations. This work represents an initial investigation for the development of a low-cost system that will facilitate aging-in-place by providing remote monitoring of gait in natural settings.
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Affiliation(s)
- Dario Martelli
- Department of Orthopedics and Sports Medicine, Medstar Health Research Institute, Baltimore, MD, United States.
| | - M Mahbubur Rahman
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, United States.
| | - Sevgi Z Gurbuz
- Department of Electrical and Computer Engineering, University of Alabama, Tuscaloosa, United States.
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Welbourn M, Sheriff P, Tuttle PG, Adamowicz L, Psaltos D, Kelekar A, Selig J, Messere A, Mei W, Caouette D, Ghafoor S, Santamaria M, Zhang H, Demanuele C, Karahanoglu FI, Cai X. In-Clinic and Natural Gait Observations master protocol (I-CAN-GO) to validate gait using a lumbar accelerometer. Sci Rep 2024; 14:20128. [PMID: 39209869 PMCID: PMC11362325 DOI: 10.1038/s41598-024-67675-6] [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] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 07/15/2024] [Indexed: 09/04/2024] Open
Abstract
Traditional measurements of gait are typically performed in clinical or laboratory settings where functional assessments are used to collect episodic data, which may not reflect naturalistic gait and activity patterns. The emergence of digital health technologies has enabled reliable and continuous representation of gait and activity in free-living environments. To provide further evidence for naturalistic gait characterization, we designed a master protocol to validate and evaluate the performance of a method for measuring gait derived from a single lumbar-worn accelerometer with respect to reference methods. This evaluation included distinguishing between participants' self-perceived different gait speed levels, and effects of different floor surfaces such as carpet and tile on walking performance, and performance under different bouts, speed, and duration of walking during a wide range of simulated daily activities. Using data from 20 healthy adult participants, we found different self-paced walking speeds and floor surface effects can be accurately characterized. Furthermore, we showed accurate representation of gait and activity during simulated daily living activities and longer bouts of outside walking. Participants in general found that the devices were comfortable. These results extend our previous validation of the method to more naturalistic setting and increases confidence of implementation at-home.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Xuemei Cai
- Pfizer, Inc, Cambridge, MA, USA.
- Tufts Medical Center, Boston, MA, USA.
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Pîrșcoveanu CI, Oliveira AS, Franch J, Madeleine P. Absolute and Relative Reliability of Spatiotemporal Gait Characteristics Extracted from an Inertial Measurement Unit among Senior Adults Using a Passive Hip Exoskeleton: A Test-Retest Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:5213. [PMID: 39204911 PMCID: PMC11360760 DOI: 10.3390/s24165213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 08/07/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Seniors wearing a passive hip exoskeleton (Exo) show increased walking speed and step length but reduced cadence. We assessed the test-retest reliability of seniors' gait characteristics with Exo. METHODS Twenty seniors walked with and without Exo (noExo) on a 10 m indoor track over two sessions separated by one week. Speed, step length, cadence and step time variability were extracted from one inertial measurement unit (IMU) placed over the L5 vertebra. Relative and absolute reliability were assessed using the intraclass correlation coefficient (ICC), standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS The relative reliability of speed, step length, cadence and step time variability ranged from "almost perfect to substantial" for Exo and noExo with ICC values between 0.75 and 0.87 and 0.60 and 0.92, respectively. The SEM and MDC values for speed, step length cadence and step time variability during Exo and noExo were <0.002 and <0.006 m/s, <0.002 and <0.005 m, <0.30 and <0.83 steps/min and <0.38 s and <1.06 s, respectively. CONCLUSIONS The high test-retest reliability of speed, step length and cadence estimated from IMU suggest a robust extraction of spatiotemporal gait characteristics during exoskeleton use. These findings indicate that IMUs can be used to assess the effects of wearing an exoskeleton on seniors, thus offering the possibility of conducting longitudinal studies.
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Affiliation(s)
- Cristina-Ioana Pîrșcoveanu
- Department of Health Science and Technology, ExerciseTech, Aalborg University, 9260 Gistrup, Denmark; (J.F.); (P.M.)
| | | | - Jesper Franch
- Department of Health Science and Technology, ExerciseTech, Aalborg University, 9260 Gistrup, Denmark; (J.F.); (P.M.)
| | - Pascal Madeleine
- Department of Health Science and Technology, ExerciseTech, Aalborg University, 9260 Gistrup, Denmark; (J.F.); (P.M.)
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Liu W, Bai J. The correlation of gait and muscle activation characteristics with locomotion dysfunction grade in elderly individuals. Front Bioeng Biotechnol 2024; 12:1372757. [PMID: 39161347 PMCID: PMC11331308 DOI: 10.3389/fbioe.2024.1372757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/15/2024] [Indexed: 08/21/2024] Open
Abstract
Objective To investigate the differences and regularity of gait and muscle activation characteristics parameters in the Locomotion Dysfunction Grade (LDG) scale assessment in elderly individuals, and analyse the correlation between objective parameters and scale grading. Thus, to propose a novel detection mode for elderly individuals, which combined the LDG scale with objective detection. It can not only provide quantitative data for intelligent evaluation and rehabilitation, but also provided more accurate reference for the classification of care levels in elderly care policies. Methods Elderly individuals (n = 159) who underwent gait analysis and sEMG at the Chinese Rehabilitation Research Center from January 2019 to September 2023 were included. According to the LDG scale, the elderly individuals were divided into four groups, namely, the LDG4, LDG5, LDG6 groups and the healthy control group. Four indicators, namely, spatiotemporal, kinematic, dynamic gait parameters and muscle activation characteristics data, were collected. Changes in these characteristics of elderly individuals with lower extremity motor dysfunction were evaluated and analysed statistically. Results The spatiotemporal gait parameters were significantly lower in the LDG4, LDG5, LDG6 groups than in the healthy control group. The double support phase was positively correlated with the LDG, while the swing phase, step length and velocity were negatively correlated (P < 0.05). The movement angles of both hips, knees and ankles were significantly limited and negatively correlated with the LDG (P < 0.05). Compared with those in the healthy control group, the centre of pressure (COP) path length were greater, and the average COP velocity was significantly lower (P < 0.05) in the LDG4, LDG5, LDG6 groups. The regularity of muscle activation clearly changed. The root mean square of the gastrocnemius medialis was positively correlated with LDG (P < 0.05), while the tibialis anterior showed no regularity. Conclusion As the LDG increased, the differences in spatiotemporal, kinematic and dynamic gait parameters between elderly individuals with motor dysfunction and the healthy individuals gradually increased. The muscle activation characteristics parameters showed an abnormal activation pattern. These parameters were correlated with the LDG, providing a more comprehensive and objective assessment of lower extremity motor function in elderly individuals, improve assessment accuracy, and help accurate rehabilitation.
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Affiliation(s)
- Wen Liu
- Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- China Rehabilitation Research Center, Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, Beijing, China
| | - Jinzhu Bai
- Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children’s Hospital, Wenzhou Medical University, Wenzhou, China
- China Rehabilitation Research Center, Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, Beijing, China
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
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11
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Ilg W, Milne S, Schmitz-Hübsch T, Alcock L, Beichert L, Bertini E, Mohamed Ibrahim N, Dawes H, Gomez CM, Hanagasi H, Kinnunen KM, Minnerop M, Németh AH, Newman J, Ng YS, Rentz C, Samanci B, Shah VV, Summa S, Vasco G, McNames J, Horak FB. Quantitative Gait and Balance Outcomes for Ataxia Trials: Consensus Recommendations by the Ataxia Global Initiative Working Group on Digital-Motor Biomarkers. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1566-1592. [PMID: 37955812 PMCID: PMC11269489 DOI: 10.1007/s12311-023-01625-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
With disease-modifying drugs on the horizon for degenerative ataxias, ecologically valid, finely granulated, digital health measures are highly warranted to augment clinical and patient-reported outcome measures. Gait and balance disturbances most often present as the first signs of degenerative cerebellar ataxia and are the most reported disabling features in disease progression. Thus, digital gait and balance measures constitute promising and relevant performance outcomes for clinical trials.This narrative review with embedded consensus will describe evidence for the sensitivity of digital gait and balance measures for evaluating ataxia severity and progression, propose a consensus protocol for establishing gait and balance metrics in natural history studies and clinical trials, and discuss relevant issues for their use as performance outcomes.
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Affiliation(s)
- Winfried Ilg
- Section Computational Sensomotorics, Hertie Institute for Clinical Brain Research, Otfried-Müller-Straße 25, 72076, Tübingen, Germany.
- Centre for Integrative Neuroscience (CIN), Tübingen, Germany.
| | - Sarah Milne
- Bruce Lefroy Centre for Genetic Health Research, Murdoch Children's Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Melbourne University, Melbourne, VIC, Australia
- Physiotherapy Department, Monash Health, Clayton, VIC, Australia
- School of Primary and Allied Health Care, Monash University, Frankston, VIC, Australia
| | - Tanja Schmitz-Hübsch
- Experimental and Clinical Research Center, a cooperation of Max-Delbrueck Center for Molecular Medicine and Charité, Universitätsmedizin Berlin, Berlin, Germany
- Neuroscience Clinical Research Center, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lisa Alcock
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Lukas Beichert
- Department of Neurodegenerative Diseases and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Enrico Bertini
- Research Unit of Neuromuscular and Neurodegenerative Disorders, Bambino Gesu' Children's Research Hospital, IRCCS, Rome, Italy
| | | | - Helen Dawes
- NIHR Exeter BRC, College of Medicine and Health, University of Exeter, Exeter, UK
| | | | - Hasmet Hanagasi
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | | | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1)), Research Centre Juelich, Juelich, Germany
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty & University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea H Németh
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Jane Newman
- NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Yi Shiau Ng
- Wellcome Centre for Mitochondrial Research, Newcastle University, Newcastle upon Tyne, UK
| | - Clara Rentz
- Institute of Neuroscience and Medicine (INM-1)), Research Centre Juelich, Juelich, Germany
| | - Bedia Samanci
- Behavioral Neurology and Movement Disorders Unit, Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Vrutangkumar V Shah
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Precision Motion, Clario, Portland, OR, USA
| | - Susanna Summa
- Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Gessica Vasco
- Movement Analysis and Robotics Laboratory (MARLab), Neurorehabilitation Unit, Neurological Science and Neurorehabilitation Area, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - James McNames
- APDM Precision Motion, Clario, Portland, OR, USA
- Department of Electrical and Computer Engineering, Portland State University, Portland, OR, USA
| | - Fay B Horak
- Department of Neurology, Oregon Health & Science University, Portland, OR, USA
- APDM Precision Motion, Clario, Portland, OR, USA
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12
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Cereatti A, Gurchiek R, Mündermann A, Fantozzi S, Horak F, Delp S, Aminian K. ISB recommendations on the definition, estimation, and reporting of joint kinematics in human motion analysis applications using wearable inertial measurement technology. J Biomech 2024; 173:112225. [PMID: 39032224 DOI: 10.1016/j.jbiomech.2024.112225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 06/07/2024] [Accepted: 07/08/2024] [Indexed: 07/23/2024]
Abstract
There is widespread and growing use of inertial measurement technology for human motion analysis in biomechanics and clinical research. Due to advancements in sensor miniaturization, inertial measurement units can be used to obtain a description of human body and joint kinematics both inside and outside the laboratory. While algorithms for data processing continue to improve, a lack of standard reporting guidelines compromises the interpretation and reproducibility of results, which hinders advances in research and development of measurement and intervention tools. To address this need, the International Society of Biomechanics approved our proposal to develop recommendations on the use of inertial measurement units for joint kinematics analysis. A collaborative effort that incorporated feedback from the biomechanics community has produced recommendations in five categories: sensor characteristics and calibration, experimental protocol, definition of a kinematic model and subject-specific calibration, analysis of joint kinematics, and quality assessment. We have avoided an overly prescriptive set of recommendations for algorithms and protocols, and instead offer reporting guidelines to facilitate reproducibility and comparability across studies. In addition to a conceptual framework and reporting guidelines, we provide a checklist to guide the design and review of research using inertial measurement units for joint kinematics.
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Affiliation(s)
- Andrea Cereatti
- Department of Electronics and Telecommunications, Polytechnic University of Torino, Torino, Italy.
| | - Reed Gurchiek
- Department of Bioengineering, Clemson University, Clemson, SC, USA
| | - Annegret Mündermann
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Silvia Fantozzi
- Department of Electric, Electronic and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Italy
| | - Fay Horak
- APDM Precision Motion of Clario, Portland, Oregon, USA; Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
| | - Scott Delp
- Department of Bioengineering, Stanford University, Stanford, CA, USA
| | - Kamiar Aminian
- Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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13
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Benner JL, Boerma-Argelo KDS, Simon-Konijnenburg MD, Hoozemans MJM, Burger BJ. Hoffa's fat pad resection during total knee arthroplasty does not affect functioning and gait: a double-blind randomized clinical trial. Arch Orthop Trauma Surg 2024; 144:3657-3668. [PMID: 39196403 PMCID: PMC11417071 DOI: 10.1007/s00402-024-05503-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/14/2024] [Indexed: 08/29/2024]
Abstract
INTRODUCTION Hoffa's fat pad is considered a source of anterior knee pain and may limit prosthetic knee function. Resection of Hoffa's fat pad in total knee arthroplasty (TKA), however, is controversial, and little is known about the functional outcomes including gait quality. This double-blind randomized controlled trial (i) compared functional recovery between TKAs where Hoffa was resected or preserved, and (ii) compared recovery of self-reported function with objective (gait-related) outcomes. MATERIALS AND METHODS Eighty-five patients (age 66.4 ± 8.0 years, 47% women) scheduled to undergo TKA for primary osteoarthritis were randomly assigned to either fat pad resection or preservation. Subjective measures of functioning were assessed at baseline, 6 weeks, 3 months, and 12 months postoperatively and included the Knee Injury and Osteoarthritis Outcome Score (KOOS), Kujala, and visual analog scale (VAS) for pain. Objective measures of functioning were assessed at baseline, 3 months, and 12 months postoperatively and included instrumented range-of-motion and gait analysis. Longitudinal analyses (generalized estimating equations) were used to compare recovery between groups, and chi-square tests compared attainment of minimal clinical important difference (MCID) and patient acceptable symptom state (PASS). Finally, correlation analyses explored associations between subjective and objective recovery in function. RESULTS Resection patients showed poorer improvement in KOOS quality of life in the first 6 weeks (B=-10.02, 95% confidence interval (CI) [-18.91, -1.12], p = .027), but stronger improvement in knee extension after 3 months (B = 3.02, 95%CI [0.45, 5.60], p = .021) compared to preservation patients. Regarding MCID or PASS, no differences were noted between groups at 3 and 12 months (all p > .05). Subjective function substantially improved in the first 3 months, while objective outcomes improved only between 3 and 12 months. Moderate to strong correlations were identified between changes in knee flexion and gait with Kujala and KOOS in the resection but not in the preservation group. CONCLUSIONS Similar functional outcomes were achieved after TKA with or without resection of Hoffa's fat pad. Hence, removing the fat pad to promote surgical exposure will not affect functional outcomes including gait quality. Functional recovery of objective outcomes was not always consistent with subjective recovery, suggesting that both self-reported as well as objective, gait-related outcomes may provide meaningful information on functional recovery following TKA. TRIAL REGISTRATION This clinical trial was prospectively registered under the Netherlands Trial Registry (# NL3638). This registry has recently been replaced by the Dutch Trial Registry where this study can be accessed via https://onderzoekmetmensen.nl/en/trial/20994 .
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Affiliation(s)
- Joyce L Benner
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research Alkmaar (CORAL), Northwest Clinics, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands.
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands.
| | - Kirsten D S Boerma-Argelo
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research Alkmaar (CORAL), Northwest Clinics, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands
| | - Myrthe D Simon-Konijnenburg
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research Alkmaar (CORAL), Northwest Clinics, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands
| | - Marco J M Hoozemans
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research Alkmaar (CORAL), Northwest Clinics, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands
- Department of Human Movement Sciences, Faculty of Behavioral and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands
| | - Bart J Burger
- Department of Orthopaedic Surgery, Centre for Orthopaedic Research Alkmaar (CORAL), Northwest Clinics, Wilhelminalaan 12, Alkmaar, 1815 JD, The Netherlands
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14
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Piergiovanni S, Terrier P. Effects of metronome walking on long-term attractor divergence and correlation structure of gait: a validation study in older people. Sci Rep 2024; 14:15784. [PMID: 38982219 PMCID: PMC11233570 DOI: 10.1038/s41598-024-65662-5] [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: 12/02/2023] [Accepted: 06/21/2024] [Indexed: 07/11/2024] Open
Abstract
This study investigates the effects of metronome walking on gait dynamics in older adults, focusing on long-range correlation structures and long-range attractor divergence (assessed by maximum Lyapunov exponents). Sixty older adults participated in indoor walking tests with and without metronome cues. Gait parameters were recorded using two triaxial accelerometers attached to the lumbar region and to the foot. We analyzed logarithmic divergence of lumbar acceleration using Rosenstein's algorithm and scaling exponents for stride intervals from foot accelerometers using detrended fluctuation analysis (DFA). Results indicated a concomitant reduction in long-term divergence exponents and scaling exponents during metronome walking, while short-term divergence remained largely unchanged. Furthermore, long-term divergence exponents and scaling exponents were significantly correlated. Reliability analysis revealed moderate intrasession consistency for long-term divergence exponents, but poor reliability for scaling exponents. Our results suggest that long-term divergence exponents could effectively replace scaling exponents for unsupervised gait quality assessment in older adults. This approach may improve the assessment of attentional involvement in gait control and enhance fall risk assessment.
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Affiliation(s)
- Sophia Piergiovanni
- Haute-Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Espace de l'Europe 11, 2000, Neuchâtel, Switzerland
| | - Philippe Terrier
- Haute-Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Espace de l'Europe 11, 2000, Neuchâtel, Switzerland.
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15
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Vun DSY, Bowers R, McGarry A. Vision-based motion capture for the gait analysis of neurodegenerative diseases: A review. Gait Posture 2024; 112:95-107. [PMID: 38754258 DOI: 10.1016/j.gaitpost.2024.04.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/25/2024] [Accepted: 04/26/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Developments in vision-based systems and human pose estimation algorithms have the potential to detect, monitor and intervene early on neurodegenerative diseases through gait analysis. However, the gap between the technology available and actual clinical practice is evident as most clinicians still rely on subjective observational gait analysis or objective marker-based analysis that is time-consuming. RESEARCH QUESTION This paper aims to examine the main developments of vision-based motion capture and how such advances may be integrated into clinical practice. METHODS The literature review was conducted in six online databases using Boolean search terms. A commercial system search was also included. A predetermined methodological criterion was then used to assess the quality of the selected articles. RESULTS A total of seventeen studies were evaluated, with thirteen studies focusing on gait classification systems and four studies on gait measurement systems. Of the gait classification systems, nine studies utilized artificial intelligence-assisted techniques, while four studies employed statistical techniques. The results revealed high correlations of gait features identified by classifier models with existing clinical rating scales. These systems demonstrated generally high classification accuracies and were effective in diagnosing disease severity levels. Gait measurement systems that extract spatiotemporal and kinematic joint information from video data generally found accurate measurements of gait parameters with low mean absolute errors, high intra- and inter-rater reliability. SIGNIFICANCE Low cost, portable vision-based systems can provide proof of concept for the quantification of gait, expansion of gait assessment tools, remote gait analysis of neurodegenerative diseases and a point of care system for orthotic evaluation. However, certain challenges, including small sample sizes, occlusion risks, and selection bias in training models, need to be addressed. Nevertheless, these systems can serve as complementary tools, equipping clinicians with essential gait information to objectively assess disease severity and tailor personalized treatment for enhanced patient care.
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Affiliation(s)
- David Sing Yee Vun
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Robert Bowers
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK
| | - Anthony McGarry
- National Centre for Prosthetics and Orthotics, Department of Biomedical Engineering, University of Strathclyde, Glasgow, UK.
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16
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Fasipe G, Goršič M, Zabre EV, Rammer JR. Inertial Measurement Unit and Heart Rate Monitoring to Assess Cardiovascular Fitness of Manual Wheelchair Users during the Six-Minute Push Test. SENSORS (BASEL, SWITZERLAND) 2024; 24:4172. [PMID: 39000952 PMCID: PMC11243937 DOI: 10.3390/s24134172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 06/21/2024] [Accepted: 06/25/2024] [Indexed: 07/16/2024]
Abstract
Manual wheelchair users (MWUs) are prone to a sedentary life that can negatively affect their physical and cardiovascular health, making regular assessment important to identify appropriate interventions and lifestyle modifications. One mean of assessing MWUs' physical health is the 6 min push test (6MPT), where the user propels themselves as far as they can in six minutes. However, reliance on observer input introduces subjectivity, while limited quantitative data inhibit comprehensive assessment. Incorporating sensors into the 6MPT can address these limitations. Here, ten MWUs performed the 6MPT with additional sensors: two inertial measurement units (IMUs)-one on the wheelchair and one on the wrist together with a heart rate wristwatch. The conventional measurements of distance and laps were recorded by the observer, and the IMU data were used to calculate laps, distance, speed, and cadence. The results demonstrated that the IMU can provide the metrics of the traditional 6MPT with strong significant correlations between calculated laps and observer lap counts (r = 0.947, p < 0.001) and distances (r = 0.970, p < 0.001). Moreover, heart rate during the final minute was significantly correlated with calculated distance (r = 0.762, p = 0.017). Enhanced 6MPT assessment can provide objective, quantitative, and comprehensive data for clinicians to effectively inform interventions in rehabilitation.
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Affiliation(s)
- Grace Fasipe
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Maja Goršič
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
- Department of Biomedical Engineering, Marquette University, Milwaukee, WI 53233, USA
| | - Erika V Zabre
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
| | - Jacob R Rammer
- Department of Biomedical Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA
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Gurbuz SZ, Rahman MM, Bassiri Z, Martelli D. Overview of Radar-Based Gait Parameter Estimation Techniques for Fall Risk Assessment. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2024; 5:735-749. [PMID: 39184960 PMCID: PMC11342925 DOI: 10.1109/ojemb.2024.3408078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/09/2024] [Accepted: 05/27/2024] [Indexed: 08/27/2024] Open
Abstract
Current methods for fall risk assessment rely on Quantitative Gait Analysis (QGA) using costly optical tracking systems, which are often only available at specialized laboratories that may not be easily accessible to rural communities. Radar placed in a home or assisted living facility can acquire continuous ambulatory recordings over extended durations of a subject's natural gait and activity. Thus, radar-based QGA has the potential to capture day-to-day variations in gait, is time efficient and removes the burden for the subject to come to a clinic, providing a more realistic picture of older adults' mobility. Although there has been research on gait-related health monitoring, most of this work focuses on classification-based methods, while only a few consider gait parameter estimation. On the one hand, metrics that are accurately and easily computable from radar data have not been demonstrated to have an established correlation with fall risk or other medical conditions; on the other hand, the accuracy of radar-based estimates of gait parameters that are well-accepted by the medical community as indicators of fall risk have not been adequately validated. This paper provides an overview of emerging radar-based techniques for gait parameter estimation, especially with emphasis on those relevant to fall risk. A pilot study that compares the accuracy of estimating gait parameters from different radar data representations - in particular, the micro-Doppler signature and skeletal point estimates - is conducted based on validation against an 8-camera, marker-based optical tracking system. The results of pilot study are discussed to assess the current state-of-the-art in radar-based QGA and potential directions for future research that can improve radar-based gait parameter estimation accuracy.
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Affiliation(s)
- Sevgi Z. Gurbuz
- Department of Electrical and Computer EngineeringUniversity of AlabamaTuscaloosaAL35487USA
| | | | - Zahra Bassiri
- Center for Motion Analysis in the Division of Orthopedic Surgery at Connecticut Children'sFarmingtonCT06032USA
| | - Dario Martelli
- Department of Orthopedics and Sports MedicineMedStar Health Research InstituteBaltimoreMD21218USA
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18
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Di Bacco VE, Gage WH. Gait variability, fractal dynamics, and statistical regularity of treadmill and overground walking recorded with a smartphone. Gait Posture 2024; 111:53-58. [PMID: 38636334 DOI: 10.1016/j.gaitpost.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 03/20/2024] [Accepted: 04/04/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND The nonlinear variability present during steady-state gait may provide a signature of health and showcase one's walking adaptability. Although treadmills can capture vast amounts of walking data required for estimating variability within a small space, gait patterns may be misrepresented compared to an overground setting. Smartphones may provide a low-cost and user-friendly estimate of gait patterns among a variety of walking settings. However, no study has investigated differences in gait patterns derived from a smartphone between treadmill walking (TW) and overground walking (OW). RESEARCH QUESTION This study implemented a smartphone accelerometer to compare differences in temporal gait variability and gait dynamics between TW and OW. METHODS Sixteen healthy adults (8F; 24.7 ± 3.8 years) visited the laboratory on three separate days and completed three 8-minute OW and three TW trials, at their preferred speed, during each visit. The inter-stride interval was calculated as the time difference between right heel contact events located within the vertical accelerometery signals recorded from a smartphone while placed in participants front right pant pocket during walking trials. The inter-stride interval series was used to calculate stride time standard deviation (SD) and coefficient of variation (COV), statistical persistence (fractal scaling index), and statistical regularity (sample entropy). Two-way analysis of variance compared walking condition and laboratory visits for each measure. RESULTS Compared to TW, OW displayed significantly (p < 0.01) greater stride time SD (0.014 s, 0.020 s), COV (1.26 %, 1.82 %), fractal scaling index (0.70, 0.79) and sample entropy (1.43, 1.63). No differences were found between visits for all measures. SIGNIFICANCE Smartphone-based assessment of gait provides the ability to distinguish between OW and TW conditions, similar to previously established methodologies. Furthermore, smartphones may be a low-cost and user-friendly tool to estimate gait patterns outside the laboratory to improve ecological validity, with implications for free-living monitoring of gait among various populations.
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Affiliation(s)
- Vincenzo E Di Bacco
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
| | - William H Gage
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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19
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Mao Q, Zhang J, Yu L, Zhao Y, Luximon Y, Wang H. Effectiveness of sensor-based interventions in improving gait and balance performance in older adults: systematic review and meta-analysis of randomized controlled trials. J Neuroeng Rehabil 2024; 21:85. [PMID: 38807117 PMCID: PMC11131332 DOI: 10.1186/s12984-024-01375-0] [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: 12/18/2023] [Accepted: 05/10/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Sensor-based interventions (SI) have been suggested as an alternative rehabilitation treatment to improve older adults' functional performance. However, the effectiveness of different sensor technologies in improving gait and balance remains unclear and requires further investigation. METHODS Ten databases (Academic Search Premier; Cumulative Index to Nursing and Allied Health Literature, Complete; Cochrane Central Register of Controlled Trials; MEDLINE; PubMed; Web of Science; OpenDissertations; Open grey; ProQuest; and Grey literature report) were searched for relevant articles published up to December 20, 2022. Conventional functional assessments, including the Timed Up and Go (TUG) test, normal gait speed, Berg Balance Scale (BBS), 6-Minute Walk Test (6MWT), and Falling Efficacy Scale-International (FES-I), were used as the evaluation outcomes reflecting gait and balance performance. We first meta-analyzed the effectiveness of SI, which included optical sensors (OPTS), perception sensors (PCPS), and wearable sensors (WS), compared with control groups, which included non-treatment intervention (NTI) and traditional physical exercise intervention (TPEI). We further conducted sub-group analysis to compare the effectiveness of SI (OPTS, PCPS, and WS) with TPEI groups and compared each SI subtype with control (NTI and TPEI) and TPEI groups. RESULTS We scanned 6255 articles and performed meta-analyses of 58 selected trials (sample size = 2713). The results showed that SI groups were significantly more effective than control or TPEI groups (p < 0.000) in improving gait and balance performance. The subgroup meta-analyses between OPTS groups and TPEI groups revealed clear statistically significant differences in effectiveness for TUG test (mean difference (MD) = - 0.681 s; p < 0.000), normal gait speed (MD = 4.244 cm/s; p < 0.000), BBS (MD = 2.325; p = 0.001), 6MWT (MD = 25.166 m; p < 0.000), and FES-I scores (MD = - 2.036; p = 0.036). PCPS groups also presented statistically significant differences with TPEI groups in gait and balance assessments for normal gait speed (MD = 4.382 cm/s; p = 0.034), BBS (MD = 1.874; p < 0.000), 6MWT (MD = 21.904 m; p < 0.000), and FES-I scores (MD = - 1.161; p < 0.000), except for the TUG test (MD = - 0.226 s; p = 0.106). There were no statistically significant differences in TUG test (MD = - 1.255 s; p = 0.101) or normal gait speed (MD = 6.682 cm/s; p = 0.109) between WS groups and control groups. CONCLUSIONS SI with biofeedback has a positive effect on gait and balance improvement among a mixed population of older adults. Specifically, OPTS and PCPS groups were statistically better than TPEI groups at improving gait and balance performance, whereas only the group comparison in BBS and 6MWT can reach the minimal clinically important difference. Moreover, WS groups showed no statistically or clinically significant positive effect on gait and balance improvement compared with control groups. More studies are recommended to verify the effectiveness of specific SI. Research registration PROSPERO platform: CRD42022362817. Registered on 7/10/2022.
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Affiliation(s)
- Qian Mao
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jiaxin Zhang
- School of System Design and Intelligent Manufacturing, Southern University of Science and Technology, Shenzhen, China
| | - Lisha Yu
- School of Data Science, Lingnan University, Hong Kong, China
| | - Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Yan Luximon
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Hong Kong, China.
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Slattery P, Cofré Lizama LE, Wheat J, Gastin P, Dascombe B, Middleton K. The Agreement between Wearable Sensors and Force Plates for the Analysis of Stride Time Variability. SENSORS (BASEL, SWITZERLAND) 2024; 24:3378. [PMID: 38894183 PMCID: PMC11174954 DOI: 10.3390/s24113378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024]
Abstract
The variability and regularity of stride time may help identify individuals at a greater risk of injury during military load carriage. Wearable sensors could provide a cost-effective, portable solution for recording these measures, but establishing their validity is necessary. This study aimed to determine the agreement of several measures of stride time variability across five wearable sensors (Opal APDM, Vicon Blue Trident, Axivity, Plantiga, Xsens DOT) and force plates during military load carriage. Nineteen Australian Army trainee soldiers (age: 24.8 ± 5.3 years, height: 1.77 ± 0.09 m, body mass: 79.5 ± 15.2 kg, service: 1.7 ± 1.7 years) completed three 12-min walking trials on an instrumented treadmill at 5.5 km/h, carrying 23 kg of an external load. Simultaneously, 512 stride time intervals were identified from treadmill-embedded force plates and each sensor where linear (standard deviation and coefficient of variation) and non-linear (detrended fluctuation analysis and sample entropy) measures were obtained. Sensor and force plate agreement was evaluated using Pearson's r and intraclass correlation coefficients. All sensors had at least moderate agreement (ICC > 0.5) and a strong positive correlation (r > 0.5). These results suggest wearable devices could be employed to quantify linear and non-linear measures of stride time variability during military load carriage.
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Affiliation(s)
- Patrick Slattery
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3083, Australia; (P.S.); (L.E.C.L.); (P.G.)
| | - L. Eduardo Cofré Lizama
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3083, Australia; (P.S.); (L.E.C.L.); (P.G.)
- Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
- Department of Medicine, The University of Melbourne, Parkville, VIC 3050, Australia
| | - Jon Wheat
- Academy of Sport and Physical Activity, Sheffield Hallam University, Sheffield S10 2DN, UK;
- School of Science and Technology, Nottingham Trent University, Nottingham NG11 8NS, UK
| | - Paul Gastin
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3083, Australia; (P.S.); (L.E.C.L.); (P.G.)
| | - Ben Dascombe
- Applied Sport Science and Exercise Testing Laboratory, School of Life and Environmental Sciences, University of Newcastle, Ourimbah, NSW 2258, Australia;
- Sports and Exercise Science, School of Health Sciences, Western Sydney University, Sydney, NSW 2000, Australia
| | - Kane Middleton
- Sport, Performance and Nutrition Research Group, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC 3083, Australia; (P.S.); (L.E.C.L.); (P.G.)
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21
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Jehu DA, Langston R, Sams R, Young L, Hamrick M, Zhu H, Dong Y. The Impact of Dual-Tasks and Disease Severity on Posture, Gait, and Functional Mobility among People Living with Dementia in Residential Care Facilities: A Pilot Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:2691. [PMID: 38732796 PMCID: PMC11086138 DOI: 10.3390/s24092691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/14/2024] [Accepted: 04/19/2024] [Indexed: 05/13/2024]
Abstract
Gait speed and timed-up-and-go (TUG) predict cognitive decline, falls, and mortality. Dual-tasks may be useful in cognitive screening among people living with dementia (PWD), but more evidence is needed. This cross-sectional study aimed to compare single- and dual-task performance and determine the influence of dementia severity on dual-task performance and interference. Thirty PWD in two residential care facilities (Age: 81.3 ± 7.1 years; Montreal Cognitive Assessment: 10.4 ± 6.0 points) completed two trials of single- (feet apart) and dual-task posture (feet apart while counting backward), single- (walk 4 m) and dual-task gait (walk 4m while naming words), and single- (timed-up-and-go (TUG)), and dual-task functional mobility (TUG while completing a category task) with APDM inertial sensors. Dual-tasks resulted in greater sway frequency, jerk, and sway area; slower gait speed; greater double limb support; shorter stride length; reduced mid-swing elevation; longer TUG duration; reduced turn angle; and slower turn velocity than single-tasks (ps < 0.05). Dual-task performance was impacted (reduced double limb support, greater mid-swing elevation), and dual-task interference (greater jerk, faster gait speed) was related to moderate-to-severe compared to mild PWD. Moderate-to-severe PWD had poorer dynamic stability and a reduced ability to appropriately select a cautious gait during dual-tasks than those with mild PWD, indicating the usefulness of dual-tasks for cognitive screening.
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Affiliation(s)
- Deborah A Jehu
- Department of Community & Behavioral Health Sciences, Institute of Public and Preventative Health, Augusta University, Augusta, GA 30912, USA
| | - Ryan Langston
- Department of Community & Behavioral Health Sciences, Institute of Public and Preventative Health, Augusta University, Augusta, GA 30912, USA
| | - Richard Sams
- Georgia War Veterans Nursing Home, Augusta, GA 30901, USA;
| | - Lufei Young
- School of Nursing, University of North Carolina, Charlotte, NC 28081, USA;
| | - Mark Hamrick
- Department of Cellular Biology and Anatomy, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Haidong Zhu
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Yanbin Dong
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
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22
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McClintock FA, Callaway AJ, Clark CJ, Williams JM. Validity and reliability of inertial measurement units used to measure motion of the lumbar spine: A systematic review of individuals with and without low back pain. Med Eng Phys 2024; 126:104146. [PMID: 38621847 DOI: 10.1016/j.medengphy.2024.104146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/22/2023] [Accepted: 03/09/2024] [Indexed: 04/17/2024]
Abstract
Low back pain (LBP) is a leading cause of disability, resulting in aberrant movement. This movement is difficult to measure accurately in clinical practice and gold standard methods, such as optoelectronic systems involve the use of expensive laboratory equipment. Inertial measurement units (IMU) offer an alternative method of quantifying movement that is accessible in most environments. However, there is no consensus around the validity and reliability of IMUs for quantifying lumbar spine movements compared with gold standard measures. The aim of this systematic review was to establish concurrent validity and repeated measures reliability of using IMUs for the measurement of lumbar spine movements in individuals with and without LBP. A systematic search of electronic databases, incorporating PRISMA guidelines was completed, limited to the English language. 503 studies were identified where 15 studies met the inclusion criteria. Overall, 305 individuals were included, and 109 of these individuals had LBP. Weighted synthesis of the results demonstrated root mean squared differences of <2.4° compared to the gold standard and intraclass correlations >0.84 for lumbar spine movements. IMUs offer clinicians and researchers valid and reliable measurement of motion in the lumbar spine, comparable to laboratory methods, such as optoelectronic motion capture for individuals with and without LBP.
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Affiliation(s)
- Frederick A McClintock
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom.
| | - Andrew J Callaway
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom
| | - Carol J Clark
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom
| | - Jonathan M Williams
- Faculty of Health and Social Sciences, Bournemouth University, Fern Barrow, Poole BH12 5BB, United Kingdom
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23
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Krishnakumar S, van Beijnum BJF, Baten CTM, Veltink PH, Buurke JH. Estimation of Kinetics Using IMUs to Monitor and Aid in Clinical Decision-Making during ACL Rehabilitation: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2024; 24:2163. [PMID: 38610374 PMCID: PMC11014074 DOI: 10.3390/s24072163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
After an ACL injury, rehabilitation consists of multiple phases, and progress between these phases is guided by subjective visual assessments of activities such as running, hopping, jump landing, etc. Estimation of objective kinetic measures like knee joint moments and GRF during assessment can help physiotherapists gain insights on knee loading and tailor rehabilitation protocols. Conventional methods deployed to estimate kinetics require complex, expensive systems and are limited to laboratory settings. Alternatively, multiple algorithms have been proposed in the literature to estimate kinetics from kinematics measured using only IMUs. However, the knowledge about their accuracy and generalizability for patient populations is still limited. Therefore, this article aims to identify the available algorithms for the estimation of kinetic parameters using kinematics measured only from IMUs and to evaluate their applicability in ACL rehabilitation through a comprehensive systematic review. The papers identified through the search were categorized based on the modelling techniques and kinetic parameters of interest, and subsequently compared based on the accuracies achieved and applicability for ACL patients during rehabilitation. IMUs have exhibited potential in estimating kinetic parameters with good accuracy, particularly for sagittal movements in healthy cohorts. However, several shortcomings were identified and future directions for improvement have been proposed, including extension of proposed algorithms to accommodate multiplanar movements and validation of the proposed techniques in diverse patient populations and in particular the ACL population.
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Affiliation(s)
- Sanchana Krishnakumar
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
| | - Bert-Jan F. van Beijnum
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
| | - Chris T. M. Baten
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands;
| | - Peter H. Veltink
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
| | - Jaap H. Buurke
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands;
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24
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Kim HS, Ha Y, Lim J, Kim HJ, Kang H, Ryu JS. The Effect of Leg Length Discrepancy on Paraspinal Muscles Activation Using Surface Electromyography. Am J Phys Med Rehabil 2024; 103:208-214. [PMID: 37602547 DOI: 10.1097/phm.0000000000002329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
OBJECTIVE The aim of the study is to assess the effects of leg length discrepancy on paraspinal muscle activity and kinematic variables during gait. DESIGN Thirty-nine healthy participants aged 5-12 yrs performed the 10-m walk test using the surface electromyography and G-walk sensor for the following conditions: (1) non-leg length discrepancy condition (leg length discrepancy 0 cm) and (2) leg length discrepancy condition with an insole on the right leg at three different heights (leg length discrepancy 0.5 cm, 1.0 cm, and 1.5 cm). The root mean square was normalized using maximal voluntary contraction and reference voluntary contraction methods (RMS_MVC and RMS_ref) and compared between the sides. RESULTS The mean RMS_MVC of the 12th thoracic erector spinae on the right side was significantly higher at a leg length discrepancy 0.5 cm and 1 cm. Regarding the 3rd lumbar multifidus, the mean RMS_MVC on the right side was significantly higher at a leg length discrepancy 1.5 cm. The mean RMS_ref exhibited similar patterns. Pelvic obliquity and rotation showed asymmetry at a leg length discrepancy 1.5 cm compared with a leg length discrepancy 0 cm. CONCLUSIONS A small leg length discrepancy significantly affected the asymmetric hyperactivation of the 3rd lumbar multifidus and 12th thoracic erector spinae muscles during gait. Considering the action of these muscles, asymmetric hyperactivation might result in rotation and bending of the lumbar spine and the bending of the thoracolumbar spine.
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Affiliation(s)
- Hee Soo Kim
- From the Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, Republic of Korea (HSK, YH, HJK, JSR); Department of Rehabilitation Medicine, Korea University Ansan Hospital, Ansan, South Korea (JL); and Department of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea (HK)
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25
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Spangler J, Mitjans M, Collimore A, Gomes-Pires A, Levine DM, Tron R, Awad LN. Automation of Functional Mobility Assessments at Home Using a Multimodal Sensor System Integrating Inertial Measurement Units and Computer Vision (IMU-Vision). Phys Ther 2024; 104:pzad184. [PMID: 38159106 PMCID: PMC10851845 DOI: 10.1093/ptj/pzad184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 12/05/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE Functional movement assessments are routinely used to evaluate and track changes in mobility. The objective of this study was to evaluate a multimodal movement monitoring system developed for autonomous, home-based, functional movement assessment. METHODS Fifty frail and prefrail adults were recruited from the Brigham and Women's Hospital at Home program to evaluate the feasibility and accuracy of applying the multimodal movement monitoring system to autonomously recognize and score functional activities collected in the home. Study subjects completed sit-to-stand, standing balance (Romberg, semitandem, and tandem), and walking test activities in likeness to the Short Physical Performance Battery. Test activities were identified and scored manually and by the multimodal movement monitoring system's activity recognition and scoring algorithms, which were previously trained on lab-based biomechanical data to integrate wearable inertial measurement unit (IMU) and external red-blue-green-depth vision data. Feasibility was quantified as the proportion of completed tests that were analyzable. Accuracy was quantified as the degree of agreement between the actual and system-identified activities. In an exploratory analysis of a subset of functional activity data, the accuracy of a preliminary activity-scoring algorithm was also evaluated. RESULTS Activity recognition by the IMU-vision system had good feasibility and high accuracy. Of 271 test activities collected in the home, 217 (80%) were analyzable by the activity-recognition algorithm, which overall correctly identified 206 (95%) of the analyzable activities: 100% of walking, 97% of balance, and 82% of sit-to-stand activities (χ2(2) = 19.9). In the subset of 152 tests suitable for activity scoring, automatic and manual scores showed substantial agreement (Kw = 0.76 [0.69, 0.83]). CONCLUSIONS Autonomous recognition and scoring of home-based functional activities is enabled by a multimodal movement monitoring system that integrates inertial measurement unit and vision data. Further algorithm training with ecologically valid data and a kitted system that is independently usable by patients are needed before fully autonomous, functional movement assessment is realizable. IMPACT Functional movement assessments that can be administered in the home without a clinician present have the potential to democratize these evaluations and improve care access.
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Affiliation(s)
- Johanna Spangler
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA
| | - Marc Mitjans
- Department of Mechanical Engineering, College of Engineering, Boston University, Boston, Massachusetts, USA
| | - Ashley Collimore
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA
| | - Aysha Gomes-Pires
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - David M Levine
- Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Roberto Tron
- Department of Mechanical Engineering, College of Engineering, Boston University, Boston, Massachusetts, USA
| | - Louis N Awad
- Department of Physical Therapy, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, Massachusetts, USA
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26
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Jocham AJ, Laidig D, Guggenberger B, Seel T. Measuring highly accurate foot position and angle trajectories with foot-mounted IMUs in clinical practice. Gait Posture 2024; 108:63-69. [PMID: 37988888 DOI: 10.1016/j.gaitpost.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 10/19/2023] [Accepted: 11/01/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND Gait analysis using foot-mounted IMUs is a promising method to acquire gait parameters outside of laboratory settings and in everyday clinical practice. However, the need for precise sensor attachment or calibration, the requirement of environments with a homogeneous magnetic field, and the limited applicability to pathological gait patterns still pose challenges. Furthermore, in previously published work, the measurement accuracy of such systems is often only validated for specific points in time or in a single plane. RESEARCH QUESTION This study investigates the measurement accuracy of a gait analysis method based on foot-mounted IMUs in the acquisition of the foot motion, i.e., position and angle trajectories of the foot in the sagittal, frontal, and transversal plane over the entire gait cycle. RESULTS A comparison of the proposed method with an optical motion capture system showed an average RMSE of 0.67° for pitch, 0.63° for roll and 1.17° for yaw. For position trajectories, an average RMSE of 0.51 cm for vertical lift and 0.34 cm for lateral shift was found. The measurement error of the IMU-based method is found to be much smaller than the deviations caused by the shoes. SIGNIFICANCE The proposed method is found to be sufficiently accurate for clinical practice. It does not require precise mounting, special calibration movements, or magnetometer data, and shows no difference in measurement accuracy between normal and pathological gait. Therefore, it provides an easy-to-use alternative to optical motion capture and facilitates gait analysis independent of laboratory settings.
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Affiliation(s)
- Andreas J Jocham
- Institute of Physiotherapy, FH JOANNEUM University of Applied Sciences, Graz, Austria.
| | - Daniel Laidig
- Control Systems Group, Technische Universität Berlin, Berlin, Germany
| | - Bernhard Guggenberger
- Institute of Physiotherapy, FH JOANNEUM University of Applied Sciences, Graz, Austria; Department of Orthopaedics and Trauma, Medical University of Graz, Graz, Austria
| | - Thomas Seel
- Institute of Mechatronic Systems, Leibniz Universität Hannover, Hannover, Germany
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Na CH, Siebers HL, Reim J, Eschweiler J, Hildebrand F, Clusmann H, Betsch M. Kinematic movement and balance parameter analysis in neurological gait disorders. J Biol Eng 2024; 18:6. [PMID: 38225612 PMCID: PMC10790442 DOI: 10.1186/s13036-023-00398-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 12/07/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Neurological gait disorders are mainly classified based on clinical observation, and therefore difficult to objectify or quantify. Movement analysis systems provide objective parameters, which may increase diagnostic accuracy and may aid in monitoring the disease course. Despite the increasing wealth of kinematic movement and balance parameter data, the discriminative value for the differentiation of neurological gait disorders is still unclear. We hypothesized that kinematic motion and balance parameter metrics would be differently altered across neurological gait disorders when compared to healthy controls. METHODS Thirty one patients (9 normal pressure hydrocephalus < NPH > , 16 cervical myelopathy < CM > , 6 lumbar stenosis < LST >) and 14 healthy participants were investigated preoperatively in an outpatient setting using an inertial measurement system (MyoMotion) during 3 different walking tasks (normal walking, dual-task walking with simultaneous backward counting, fast walking). In addition, the natural postural sway of participants was measured by pedobarography, with the eyes opened and closed. The range of motion (ROM) in different joint angles, stride time, as well as sway were compared between different groups (between-subject factor), and different task conditions (within-subject factor) by a mixed model ANOVA. RESULTS Kinematic metrics and balance parameters were differently altered across different gait disorders compared to healthy controls. Overall, NPH patients significantly differed from controls in all movement parameters except for stride time, while they differed in balance parameters only with regard to AP movement. LST patients had significantly reduced ROMs of the shoulders, hips, and ankles, with significantly altered balance parameters regarding AP movement and passed center-of-pressure (COP) distance. CM patients differed from controls only in the ROM of the hip and ankle, but were affected in nearly all balance parameters, except for force distribution. CONCLUSION The application of inertial measurement systems and pedobarography is feasible in an outpatient setting in patients with different neurological gait disorders. Rather than defining singular discriminative values, kinematic gait and balance metrics may provide characteristic profiles of movement parameter alterations in the sense of specific ´gait signatures´ for different pathologies, which could improve diagnostic accuracy by defining objective and quantifiable measures for the discrimination of different neurological gait disorders. TRIAL REGISTRATION The study was retrospectively registered on the 27th of March 2023 in the 'Deutsches Register für Klinische Studien' under the number DRKS00031555.
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Affiliation(s)
- Chuh-Hyoun Na
- Department of Neurosurgery, University Hospital RWTH Aachen, Pauwelsstr. 30, Aachen, 52074, Germany.
| | - Hannah Lena Siebers
- Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Julia Reim
- Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Jörg Eschweiler
- Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, University Hospital RWTH Aachen, Pauwelsstr. 30, Aachen, 52074, Germany
| | - Marcel Betsch
- Department of Trauma and Orthopedic Surgery, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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He Y, Chen Y, Tang L, Chen J, Tang J, Yang X, Su S, Zhao C, Xiao N. Accuracy validation of a wearable IMU-based gait analysis in healthy female. BMC Sports Sci Med Rehabil 2024; 16:2. [PMID: 38167148 PMCID: PMC10762813 DOI: 10.1186/s13102-023-00792-3] [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: 09/12/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE The aim of this study was to assess the accuracy and test-retest reliability of a wearable inertial measurement unit (IMU) system for gait analysis in healthy female compared to a gold-standard optoelectronic motion capture (OMC) system. METHODS In our study, we collected data from 5 healthy young females. Participants were attached with markers from both the OMC system and the IMU system simultaneously. Data was collected when participants walked on a 7 m walking path. Each participant performed 50 repetitions of walking on the path. To ensure the collection of complete gait cycle data, a gait cycle was considered valid only if the participant passed through the center of the walking path at the same time that the OMC system detected a valid marker signal. As a result, 5 gait cycles that met the standards of the OMC system were included in the final analysis. The stride length, cadence, velocity, stance phase and swing phase of the spatio-temporal parameters were included in the analysis. A generalized linear mixture model was used to assess the repeatability of the two systems. The Wilcoxon rank-sum test for continuous variables was used to compare the mean differences between the two systems. For evaluating the reliability of the IMU system, we calculated the Intra-class Correlation Coefficient (ICC). Additionally, Bland-Altman plots were used to compare the levels of agreement between the two systems. RESULTS The measurements of Spatio-temporal parameters, including the stance phase (P = 0.78, 0.13, L-R), swing phase (P = 0.78, 0.13, L-R), velocity (P = 0.14, 0.13, L-R), cadence (P = 0.53, 0.22, L-R), stride length (P = 0.05, 0.19, L-R), by the IMU system and OMC system were similar. Which suggested that IMU and OMC systems could be used interchangeably for gait measurements. The intra-rater reliability showed an excellent correlation for the stance phase, swing phase, velocity and cadence (Intraclass Correlation Coefficient, ICC > 0.9) for both systems. However, the correlation of stride length was poor (ICC = 0.36, P = 0.34, L) to medium (ICC = 0.56, P = 0.22, R). Additionally, the measurements of IMU systems were repeatable. CONCLUSIONS The results of IMU system and OMC system shown good repeatability. Wearable IMU system could analyze gait data accurately. In particular, the measurement of stance phase, swing phase, velocity and cadence showed excellent reliability. IMU system provided an alternative measurement to OMC for gait analysis. However, the measurement of stride length by IMU needs further consideration.
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Affiliation(s)
- Yi He
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Yuxia Chen
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing, 400016, China
| | - Li Tang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China
| | - Jing Chen
- Shanqi (Chongqing) Smart Medical Technology Co., Ltd., Chongqing, China
| | - Jing Tang
- Shanqi (Chongqing) Smart Medical Technology Co., Ltd., Chongqing, China
| | - Xiaoxuan Yang
- Shanqi (Chongqing) Smart Medical Technology Co., Ltd., Chongqing, China
| | - Songchuan Su
- Chongqing Orthopedics Hospital of Traditional Chinese Medicine, Chongqing, China
| | - Chen Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
| | - Nong Xiao
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No. 136 Zhongshan 2nd Road, Yuzhong District, Chongqing, 400016, China.
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Olsen S, Rashid U, Barbado D, Suresh P, Alder G, Khan Niazi I, Taylor D. The validity of smartphone-based spatiotemporal gait measurements during walking with and without head turns: Comparison with the GAITRite® system. J Biomech 2024; 162:111899. [PMID: 38128468 DOI: 10.1016/j.jbiomech.2023.111899] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 11/26/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
Smartphone accelerometry has potential to provide clinicians with specialized gait analysis not available in most clinical settings. The Gait&Balance Application (G&B App) uses smartphone accelerometry to assess spatiotemporal gait parameters under two conditions: walking looking straight ahead and walking with horizontal head turns. This study investigated the validity of G&B App gait parameters compared with the GAITRite® pressure-sensitive walkway. Healthy young and older adults (age range 21-85 years) attended a single session where a smartphone was secured over the lumbosacral junction. Data were collected concurrently with the app and GAITRite® systems as participants completed the two walking conditions. Spatiotemporal gait parameters for 54 participants were determined from both systems and agreement evaluated with partial Pearson's correlation coefficients and limits of agreement. The results demonstrated moderate to excellent validity for G&B App measures of step time (rp 0.97, 95 % CI [0.96, 0.98]), walking speed (rp 0.83 [0.78, 0.87]), and step length (rp 0.74, [0.66, 0.80]) when walking looking straight ahead, and results were comparable with head turns. The validity of walking speed and step length measures was influenced by sex and height. G&B App measures of step length variability, step time variability, step length asymmetry, and step time asymmetry had poor validity. The G&B App has potential to provide valid measures of unilateral and bilateral step time, unilateral and bilateral step length, and walking speed, under two walking conditions in healthy young and older adults. Further research should validate this tool in clinical conditions and optimise the algorithm for demographic characteristics.
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Affiliation(s)
- Sharon Olsen
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand.
| | - Usman Rashid
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; Centre for Chiropractic Research, New Zealand College of Chiropractic, PO Box 113-044, Newmarket, Auckland 1149, New Zealand
| | - David Barbado
- Department of Sport Science, Sports Research Centre, Miguel Hernandez University of Elche, Avda. de la Universidad s/n, Elche 03202, Spain; Institute for Health and Biomedical Research (ISABIAL Foundation), Avda. Pintor Baeza, 12 HGUA, Alicante 03550, Spain
| | - Priyadharshini Suresh
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Gemma Alder
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
| | - Imran Khan Niazi
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand; Centre for Chiropractic Research, New Zealand College of Chiropractic, PO Box 113-044, Newmarket, Auckland 1149, New Zealand; Centre for Sensory-Motor Interaction (SMI), Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Denise Taylor
- Rehabilitation Innovation Centre, Health and Rehabilitation Research Institute, Auckland University of Technology, Private Bag 92006, Auckland 1142, New Zealand
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Morikawa T, Mura N, Sato T, Katoh H. Reliability and validity of estimated angles information assessed using inertial measurement unit-based motion sensors. Biomed Mater Eng 2024; 35:439-450. [PMID: 39031336 DOI: 10.3233/bme-240031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
BACKGROUND Inertial measurement unit (IMU)-based motion sensors are affordable, and their use is appropriate for rehabilitation. However, regarding the accuracy of estimated angle information obtained from this sensor, it is reported that it is likely affected by velocity. OBJECTIVE The present study investigated the reliability and validity of the angle information obtained using IMU-based sensors compared with a three-dimensional (3D) motion analyzer. METHODS The Euler angle obtained using the 3D motion analyzer and the angle obtained using the IMU-based sensor (IMU angle) were compared. Reliability was assessed by comparing the Bland-Altman analysis, intra-class correlation coefficient (ICC) (1,1), and cross-correlation function. The root mean square (RMS) error, ICC (2,1), and cross-correlation function were used to compare data on the Euler and IMU angles to evaluate the validity. RESULTS Regarding reliability, the Bland-Atman analysis indicated no fixed or proportional bias in the angle measurements. The measurement errors ranged from 0.2° to 3.2°. In the validity, the RMS error ranged from 0.3° to 2.2°. The ICCs (2,1) were 0.9. The cross-correlation functions were >0.9, which indicated a high degree of agreement. CONCLUSION The IMU-based sensor had a high reliability and validity. The IMU angle may be used in rehabilitation.
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Affiliation(s)
- Taiki Morikawa
- Department of Rehabilitation, Eniwa Hospital, Eniwa-shi, Japan
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata-shi, Japan
| | - Nariyuki Mura
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata-shi, Japan
| | - Toshiaki Sato
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata-shi, Japan
| | - Hiroshi Katoh
- Graduate School, Yamagata Prefectural University of Health Sciences, Yamagata-shi, Japan
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Lin YC, Price K, Carmichael DS, Maniar N, Hickey JT, Timmins RG, Heiderscheit BC, Blemker SS, Opar DA. Validity of Inertial Measurement Units to Measure Lower-Limb Kinematics and Pelvic Orientation at Submaximal and Maximal Effort Running Speeds. SENSORS (BASEL, SWITZERLAND) 2023; 23:9599. [PMID: 38067972 PMCID: PMC10708829 DOI: 10.3390/s23239599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023]
Abstract
Inertial measurement units (IMUs) have been validated for measuring sagittal plane lower-limb kinematics during moderate-speed running, but their accuracy at maximal speeds remains less understood. This study aimed to assess IMU measurement accuracy during high-speed running and maximal effort sprinting on a curved non-motorized treadmill using discrete (Bland-Altman analysis) and continuous (root mean square error [RMSE], normalised RMSE, Pearson correlation, and statistical parametric mapping analysis [SPM]) metrics. The hip, knee, and ankle flexions and the pelvic orientation (tilt, obliquity, and rotation) were captured concurrently from both IMU and optical motion capture systems, as 20 participants ran steadily at 70%, 80%, 90%, and 100% of their maximal effort sprinting speed (5.36 ± 0.55, 6.02 ± 0.60, 6.66 ± 0.71, and 7.09 ± 0.73 m/s, respectively). Bland-Altman analysis indicated a systematic bias within ±1° for the peak pelvic tilt, rotation, and lower-limb kinematics and -3.3° to -4.1° for the pelvic obliquity. The SPM analysis demonstrated a good agreement in the hip and knee flexion angles for most phases of the stride cycle, albeit with significant differences noted around the ipsilateral toe-off. The RMSE ranged from 4.3° (pelvic obliquity at 70% speed) to 7.8° (hip flexion at 100% speed). Correlation coefficients ranged from 0.44 (pelvic tilt at 90%) to 0.99 (hip and knee flexions at all speeds). Running speed minimally but significantly affected the RMSE for the hip and ankle flexions. The present IMU system is effective for measuring lower-limb kinematics during sprinting, but the pelvic orientation estimation was less accurate.
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Affiliation(s)
- Yi-Chung Lin
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Kara Price
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Declan S. Carmichael
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Nirav Maniar
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Jack T. Hickey
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
- Department of Sport Science and Nutrition, Maynooth University, W23 F2H6 Co. Kildare, Ireland
| | - Ryan G. Timmins
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
| | - Bryan C. Heiderscheit
- Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Silvia S. Blemker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, USA;
- Springbok Analytics, Charlottesville, VA 22902, USA
| | - David A. Opar
- School of Behavioural and Health Sciences, Australian Catholic University, Fitzroy, VIC 3065, Australia; (K.P.); (D.S.C.); (N.M.); (J.T.H.); (R.G.T.); (D.A.O.)
- Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre, Australian Catholic University, Fitzroy, VIC 3065, Australia
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Ruder MC, Masood Z, Kobsar D. Reliability of waveforms and gait metrics from multiple outdoor wearable inertial sensors collections in adults with knee osteoarthritis. J Biomech 2023; 160:111818. [PMID: 37793202 DOI: 10.1016/j.jbiomech.2023.111818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/06/2023]
Abstract
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.
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Affiliation(s)
- Matthew C Ruder
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
| | - Zaryan Masood
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Dylan Kobsar
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Strongman C, Cavallerio F, Timmis MA, Morrison A. A Scoping Review of the Validity and Reliability of Smartphone Accelerometers When Collecting Kinematic Gait Data. SENSORS (BASEL, SWITZERLAND) 2023; 23:8615. [PMID: 37896708 PMCID: PMC10611257 DOI: 10.3390/s23208615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023]
Abstract
The aim of this scoping review is to evaluate and summarize the existing literature that considers the validity and/or reliability of smartphone accelerometer applications when compared to 'gold standard' kinematic data collection (for example, motion capture). An electronic keyword search was performed on three databases to identify appropriate research. This research was then examined for details of measures and methodology and general study characteristics to identify related themes. No restrictions were placed on the date of publication, type of smartphone, or participant demographics. In total, 21 papers were reviewed to synthesize themes and approaches used and to identify future research priorities. The validity and reliability of smartphone-based accelerometry data have been assessed against motion capture, pressure walkways, and IMUs as 'gold standard' technology and they have been found to be accurate and reliable. This suggests that smartphone accelerometers can provide a cheap and accurate alternative to gather kinematic data, which can be used in ecologically valid environments to potentially increase diversity in research participation. However, some studies suggest that body placement may affect the accuracy of the result, and that position data correlate better than actual acceleration values, which should be considered in any future implementation of smartphone technology. Future research comparing different capture frequencies and resulting noise, and different walking surfaces, would be useful.
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Affiliation(s)
- Clare Strongman
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK; (F.C.); (M.A.T.); (A.M.)
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Feng Y, Liu Y, Fang Y, Chang J, Deng F, Liu J, Xiong Y. Advances in the application of wearable sensors for gait analysis after total knee arthroplasty: a systematic review. ARTHROPLASTY 2023; 5:49. [PMID: 37779198 PMCID: PMC10544450 DOI: 10.1186/s42836-023-00204-4] [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: 05/18/2023] [Accepted: 07/31/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Wearable sensors have become a complementary means for evaluation of body function and gait in lower limb osteoarthritis. This study aimed to review the applications of wearable sensors for gait analysis after total knee arthroplasty (TKA). METHODS Five databases, including Web of Science Core Collection, Embase, Cochrane, Medline, and PubMed, were searched for articles published between January 2010 and March 2023, using predetermined search terms that focused on wearable sensors, TKA, and gait analysis as broad areas of interest. RESULTS A total of 25 articles were identified, involving 823 TKA patients. Methodologies varied widely across the articles, with inconsistencies found in reported patient characteristics, sensor data and experimental protocols. Patient-reported outcome measures (PROMs) and gait variables showed various recovery times from 1 week postoperatively to 5 years postoperatively. Gait analysis using wearable sensors and PROMs showed differences in controlled environments, daily life, and when comparing different surgeries. CONCLUSION Wearable sensors offered the potential to remotely monitor the gait function post-TKA in both controlled environments and patients' daily life, and covered more aspects than PROMs. More cohort longitudinal studies are warranted to further confirm the benefits of this remote technology in clinical practice.
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Affiliation(s)
- Yuguo Feng
- College of Art and Design, Xihua University, Chengdu, 610039, China
| | - Yu Liu
- Chongqing Brace Technology Co., Ltd., Chongqing, 401120, China
| | - Yuan Fang
- Chongqing Brace Technology Co., Ltd., Chongqing, 401120, China
| | - Jin Chang
- Chongqing Brace Technology Co., Ltd., Chongqing, 401120, China
| | - Fei Deng
- Chongqing Brace Technology Co., Ltd., Chongqing, 401120, China
| | - Jin Liu
- Affiliated Experimental School of Sichuan Normal University, Chengdu, 610000, China
| | - Yan Xiong
- Department of Orthopaedics, Daping Hospital, Army Medical University, Chongqing, 400042, China.
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Bi CL, Kurland DB, Ber R, Kondziolka D, Lau D, Pacione D, Frempong-Boadu A, Laufer I, Oermann EK. Digital Biomarkers and the Evolution of Spine Care Outcomes Measures: Smartphones and Wearables. Neurosurgery 2023; 93:745-754. [PMID: 37246874 DOI: 10.1227/neu.0000000000002519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/19/2023] [Indexed: 05/30/2023] Open
Abstract
Over the past generation, outcome measures in spine care have evolved from a reliance on clinician-reported assessment toward recognizing the importance of the patient's perspective and the wide incorporation of patient-reported outcomes (PROs). While patient-reported outcomes are now considered an integral component of outcomes assessments, they cannot wholly capture the state of a patient's functionality. There is a clear need for quantitative and objective patient-centered outcome measures. The pervasiveness of smartphones and wearable devices in modern society, which passively collect data related to health, has ushered in a new era of spine care outcome measurement. The patterns emerging from these data, so-called "digital biomarkers," can accurately describe characteristics of a patient's health, disease, or recovery state. Broadly, the spine care community has thus far concentrated on digital biomarkers related to mobility, although the researcher's toolkit is anticipated to expand in concert with advancements in technology. In this review of the nascent literature, we describe the evolution of spine care outcome measurements, outline how digital biomarkers can supplement current clinician-driven and patient-driven measures, appraise the present and future of the field in the modern era, as well as discuss present limitations and areas for further study, with a focus on smartphones (see Supplemental Digital Content , http://links.lww.com/NEU/D809 , for a similar appraisal of wearable devices).
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Affiliation(s)
- Christina L Bi
- Department of Neurological Surgery, New York University, New York , New York , USA
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Shimamura T, Ishikawa H, Fujii H, Katoh H. Smoothness Evaluation Indices during Sit-to-Stand-to-Sit Motions in Healthy Older Females and after Hip Fracture Using an Accelerometer: A Pilot Study. Geriatrics (Basel) 2023; 8:98. [PMID: 37887971 PMCID: PMC10606243 DOI: 10.3390/geriatrics8050098] [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: 07/04/2023] [Revised: 08/27/2023] [Accepted: 09/29/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND Studies that quantify the quality of sit-to-stand-to-sit (STS) motions, particularly in terms of smoothness, are limited. Thus, this study aimed to investigate the possibility and usefulness of quality evaluation during STS motions. METHODS This cross-sectional study enrolled 36 females aged >60 years, including 18 females each in the healthy and hip fracture groups. Measurements were performed at two different speeds: five STS as fast as possible (STSF) and two seconds for each motion (STS2s). Indices of smoothness, including harmonic ratio (HR) and power spectrum entropy (PSE), were calculated and compared from the measured data in each of the three axial directions. RESULTS HR in the vertical direction was significantly higher in the healthy group (STSF: 3.65 ± 1.74, STS2s: 3.42 ± 1.54) than in the hip fracture group (STSF: 2.67 ± 1.01, STS2s: 2.58 ± 0.83) for STSF and STS2s. Furthermore, PSE for all directions and triaxial composites were significantly lower for STS2s (the healthy group (mediolateral (ML): 7.63 ± 0.31, vertical (VT): 7.46 ± 0.22, anterior-posterior (AP): 7.47 ± 0.15, triaxial: 7.45 ± 0.25), the hip fracture group (ML: 7.82 ± 0.16, VT: 7.63 ± 0.16, AP: 7.61 ± 0.17, triaxial: 7.66 ± 0.17)). CONCLUSIONS This study suggests the usefulness of HR and PSE as quality evaluations for STS motions.
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Affiliation(s)
- Takeshi Shimamura
- Department of Rehabilitation, Kumamoto Health Science University, 325 Izumi-machi, Kita-ku, Kumamoto 861-5598, Japan
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan
| | - Hitoshi Ishikawa
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan
| | - Hiromi Fujii
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan
| | - Hiroshi Katoh
- Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata 990-2212, Japan
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Gigonzac M, Terrier P. Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial. BMC Geriatr 2023; 23:542. [PMID: 37674129 PMCID: PMC10481504 DOI: 10.1186/s12877-023-04255-9] [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: 02/08/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
CONTEXT Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls. RATIONALE Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls. OBJECTIVE The aim is to assess the efficacy of an arm-in-arm gait-training program in older people. DESIGN The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial. PARTICIPANTS We will enroll 66 dyads of older people and their younger "gait instructors". The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry. INTERVENTION Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks. OUTCOMES The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 - week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training. EXPECTED RESULTS Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors. TRIAL REGISTRATION ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
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Affiliation(s)
- Mathilde Gigonzac
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland
| | - Philippe Terrier
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland.
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Mihai EE, Papathanasiou J, Panayotov K, Kashilska Y, Rosulescu E, Foti C, Berteanu M. Conventional physical therapy combined with extracorporeal shock wave leads to positive effects on spasticity in stroke survivors: a prospective observational study. Eur J Transl Myol 2023; 33:11607. [PMID: 37667862 PMCID: PMC10583146 DOI: 10.4081/ejtm.2023.11607] [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: 07/24/2023] [Accepted: 07/31/2023] [Indexed: 09/06/2023] Open
Abstract
The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors.
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Affiliation(s)
- Emanuela Elena Mihai
- Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest.
| | - Jannis Papathanasiou
- Department of Medical Imaging, Allergology and Physiotherapy, Faculty of Dental Medicine, Medical University of Plovdiv, Bulgaria; Department of Kinesitherapy, Faculty of Public Health "Prof. Dr. Tzecomir Vodenicharov, DSc.", Medical University of Sofia.
| | - Kiril Panayotov
- Department of Medical and Clinical Activities, Faculty of Public Health and Healthcare, "Angel Kanchev" University of Ruse.
| | | | - Eugenia Rosulescu
- Department of Physical Therapy and Sports Medicine, Faculty of Physical Education and Sport, University of Craiova.
| | - Calogero Foti
- Physical Medicine and Rehabilitation, Clinical Sciences and Translational Medicine, Tor Vergata University, Rome.
| | - Mihai Berteanu
- Physical and Rehabilitation Medicine Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Physical and Rehabilitation Medicine Department, Elias University Emergency Hospital, Bucharest.
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Rose MJ, Neogi T, Friscia B, Torabian KA, LaValley MP, Gheller M, Adamowicz L, Georgiev P, Viktrup L, Demanuele C, Wacnik PW, Kumar D. Reliability of Wearable Sensors for Assessing Gait and Chair Stand Function at Home in People With Knee Osteoarthritis. Arthritis Care Res (Hoboken) 2023; 75:1939-1948. [PMID: 36734316 PMCID: PMC10397366 DOI: 10.1002/acr.25096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/20/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To assess the reliability of wearable sensors for at-home assessment of walking and chair stand activities in people with knee osteoarthritis (OA). METHODS Baseline data from participants with knee OA (n = 20) enrolled in a clinical trial of an exercise intervention were used. Participants completed an in-person laboratory visit and a video conference-enabled at-home visit. In both visits, participants performed walking and chair stand tasks while fitted with 3 inertial sensors. During the at-home visit, participants self-donned the sensors and completed 2 sets of acquisitions separated by a 15-minute break, when they removed and redonned the sensors. Participants completed a survey on their experience with the at-home visit. During the laboratory visit, researchers placed the sensors on the participants. Spatiotemporal metrics of walking gait and chair stand duration were extracted from the sensor data. We used intraclass correlation coefficients (ICCs) and the Bland-Altman plot for statistical analyses. RESULTS For test-retest reliability during the at-home visit, all ICCs were good to excellent (0.85-0.95). For agreement between at-home and laboratory visits, ICCs were moderate to good (0.59-0.87). Systematic differences were noted between at-home and laboratory data due to faster task speed during the laboratory visits. Participants reported a favorable experience during the at-home visit. CONCLUSION Our method of estimating spatiotemporal gait measures and chair stand duration function remotely was reliable, feasible, and acceptable in people with knee OA. Wearable sensors could be used to remotely assess walking and chair stand in participant's natural environments in future studies.
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Affiliation(s)
- Michael J. Rose
- Department of Physical Therapy & Athletic Training, Boston University, Boston, MA, USA
| | - Tuhina Neogi
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Brian Friscia
- Department of Physical Therapy & Athletic Training, Boston University, Boston, MA, USA
| | - Kaveh A. Torabian
- Department of Physical Therapy & Athletic Training, Boston University, Boston, MA, USA
| | - Michael P. LaValley
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Mary Gheller
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | | | | | - Lars Viktrup
- Neuroscience, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Paul W. Wacnik
- Early Clinical Development, Pfizer Inc., Cambridge, MA, USA
| | - Deepak Kumar
- Department of Physical Therapy & Athletic Training, Boston University, Boston, MA, USA
- Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
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Salisu S, Ruhaiyem NIR, Eisa TAE, Nasser M, Saeed F, Younis HA. Motion Capture Technologies for Ergonomics: A Systematic Literature Review. Diagnostics (Basel) 2023; 13:2593. [PMID: 37568956 PMCID: PMC10416907 DOI: 10.3390/diagnostics13152593] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/25/2023] [Accepted: 08/02/2023] [Indexed: 08/13/2023] Open
Abstract
Muscular skeletal disorder is a difficult challenge faced by the working population. Motion capture (MoCap) is used for recording the movement of people for clinical, ergonomic and rehabilitation solutions. However, knowledge barriers about these MoCap systems have made them difficult to use for many people. Despite this, no state-of-the-art literature review on MoCap systems for human clinical, rehabilitation and ergonomic analysis has been conducted. A medical diagnosis using AI applies machine learning algorithms and motion capture technologies to analyze patient data, enhancing diagnostic accuracy, enabling early disease detection and facilitating personalized treatment plans. It revolutionizes healthcare by harnessing the power of data-driven insights for improved patient outcomes and efficient clinical decision-making. The current review aimed to investigate: (i) the most used MoCap systems for clinical use, ergonomics and rehabilitation, (ii) their application and (iii) the target population. We used preferred reporting items for systematic reviews and meta-analysis guidelines for the review. Google Scholar, PubMed, Scopus and Web of Science were used to search for relevant published articles. The articles obtained were scrutinized by reading the abstracts and titles to determine their inclusion eligibility. Accordingly, articles with insufficient or irrelevant information were excluded from the screening. The search included studies published between 2013 and 2023 (including additional criteria). A total of 40 articles were eligible for review. The selected articles were further categorized in terms of the types of MoCap used, their application and the domain of the experiments. This review will serve as a guide for researchers and organizational management.
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Affiliation(s)
- Sani Salisu
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Malaysia;
- Department of Information Technology, Federal University Dutse, Dutse 720101, Nigeria
| | | | | | - Maged Nasser
- Computer & Information Sciences Department, Universiti Teknologi PETRONAS, Seri Iskandar 32610, Malaysia;
| | - Faisal Saeed
- DAAI Research Group, Department of Computing and Data Science, School of Computing and Digital Technology, Birmingham City University, Birmingham B4 7XG, UK;
| | - Hussain A. Younis
- School of Computer Sciences, Universiti Sains Malaysia, Gelugor 11800, Malaysia;
- College of Education for Women, University of Basrah, Basrah 61004, Iraq
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Rozanski G, Delgado A, Putrino D. Spatiotemporal parameters from remote smartphone-based gait analysis are associated with lower extremity functional scale categories. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1189376. [PMID: 37565184 PMCID: PMC10410151 DOI: 10.3389/fresc.2023.1189376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/12/2023] [Indexed: 08/12/2023]
Abstract
Objective Self-report tools are recommended in research and clinical practice to capture individual perceptions regarding health status; however, only modest correlations are found with performance-based results. The Lower Extremity Functional Scale (LEFS) is one well-validated measure of impairment affecting physical activities that has been compared with objective tests. More recently, mobile gait assessment software can provide comprehensive motion tracking output from ecologically valid environments, but how this data relates to subjective scales is unknown. Therefore, the association between the LEFS and walking variables remotely collected by a smartphone was explored. Methods Proprietary algorithms extracted spatiotemporal parameters detected by a standard integrated inertial measurement unit from 132 subjects enrolled in physical therapy for orthopedic or neurological rehabilitation. Users initiated ambulation recordings and completed questionnaires through the OneStep digital platform. Discrete categories were created based on LEFS score cut-offs and Analysis of Variance was applied to estimate the difference in gait metrics across functional groups (Low-Medium-High). Results The main finding of this cross-sectional retrospective study is that remotely-collected biomechanical walking data are significantly associated with individuals' self-evaluated function as defined by LEFS categorization (n = 132) and many variables differ between groups. Velocity was found to have the strongest effect size. Discussion When patients are classified according to subjective mobility level, there are significant differences in quantitative measures of ambulation analyzed with smartphone-based technology. Capturing real-time information about movement is important to obtain accurate impressions of how individuals perform in daily life while understanding the relationship between enacted activity and relevant clinical outcomes.
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Affiliation(s)
- Gabriela Rozanski
- Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Willwacher S, Robbin J, Eßer T, Mai P. [Motion analysis systems in research and for practicing orthopedists]. ORTHOPADIE (HEIDELBERG, GERMANY) 2023:10.1007/s00132-023-04404-3. [PMID: 37391676 DOI: 10.1007/s00132-023-04404-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Complex biomechanical motion analysis can provide relevant information for a variety of orthopedic problems. When purchasing motion analysis systems, in addition to the classical measurement quality criteria (validity, reliability, objectivity), spatial and temporal conditions, as well as the requirements for the qualification of the measuring personnel should be considered. APPLICATION In complex movement analysis, systems are used to determine kinematics, kinetics and muscle activity (electromyography). This article gives an overview of methods of complex biomechanical motion analysis for use in orthopaedic research or for individual patient care. In addition to the use for pure movement analysis, the use of movement analysis methods in the field of biofeedback training is discussed. ACQUISITION For the specific acquisition of motion analysis systems, it is recommended to contact professional societies (e.g., the German Society for Biomechanics),universities with existing motion analysis facilities or distributors in the field of biomechanics.
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Affiliation(s)
- Steffen Willwacher
- Institute for Advanced Biomechanics and Motion Studies, Hochschule Offenburg, Max-Planck-Str. 1, 77656, Offenburg, Deutschland.
| | - Johanna Robbin
- Institute for Advanced Biomechanics and Motion Studies, Hochschule Offenburg, Max-Planck-Str. 1, 77656, Offenburg, Deutschland
| | - Tanja Eßer
- Institut für Funktionelle Diagnostik, Köln, Deutschland, Im Mediapark 2, 50670
| | - Patrick Mai
- Institute for Advanced Biomechanics and Motion Studies, Hochschule Offenburg, Max-Planck-Str. 1, 77656, Offenburg, Deutschland
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Yeo SS, Koo DK, Ko SY, Park SY. Effect of Balance Training in Sitting Position Using Visual Feedback on Balance and Gait Ability in Chronic Stroke Patients. J Clin Med 2023; 12:4383. [PMID: 37445418 DOI: 10.3390/jcm12134383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 06/26/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023] Open
Abstract
Chronic stroke often results in balance and gait impairments, significantly impacting patients' quality of life. The purpose of this study was to investigate whether the combined effect of unstable surface balance training and visual feedback, based on proprioceptive neuromuscular stimulation in patients with chronic stroke, is effective in restoring balance and gait ability. A total of 39 chronic stroke patients were randomly assigned to a visual feedback combined with unstable surface balance training group (VUSBG), an unstable surface balance training group (USBG), or a conventional physical therapy group (CG). This study was conducted with the Trunk Impairment Scale, the Bug Balance Scale, the Timed Get Up and Go Test, and Gait Analysis. VUSBG and USBG improved function and gait (stride length and hip/knee flexion angle), but there was no significant difference in the CG group. Specific results showed that the stride length in the VUSBG improved by 25% (p < 0.05), and the hip/knee flexion angle improved by 18% (p < 0.05). The post-hoc analysis revealed that VUSBG had a greater impact on the hip/knee flexion angle relative to the other two groups, as well as gait velocity and stride length relative to CG. Visual feedback complex exercise based on the principle of proprioceptive neuromuscular facilitation could be an intervention strategy to improve gait speed, trunk stability, and mobility in chronic stroke patients.
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Affiliation(s)
- Sang-Seok Yeo
- Department of Physical Therapy, College of Health Sciences, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Republic of Korea
| | - Dong-Kyun Koo
- Department of Public Health Sciences, Graduate School, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Republic of Korea
| | - Seong-Young Ko
- Department of Physical Therapy, Graduate School of Health and Welfare, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan-si 31116, Republic of Korea
| | - Seo-Yoon Park
- Department of Physical Therapy, College of Health and Welfare, Woosuk University, 443 Samnye-ro, Samnye-eup, Wanju-gun 55338, Republic of Korea
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Scataglini S, Van Dyck Z, Declercq V, Van Cleemput G, Struyf N, Truijen S. Effect of Music Based Therapy Rhythmic Auditory Stimulation (RAS) Using Wearable Device in Rehabilitation of Neurological Patients: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:5933. [PMID: 37447782 DOI: 10.3390/s23135933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/09/2023] [Accepted: 06/17/2023] [Indexed: 07/15/2023]
Abstract
(1) Background: Even though music therapy is acknowledged to have positive benefits in neurology, there is still a lack of knowledge in the literature about the applicability of music treatments in clinical practice with a neurological population using wearable devices. (2) Methods: a systematic review was conducted following PRISMA 2020 guidelines on the 29 October 2022, searching in five databases: PubMed, PEDro, Medline, Web of Science, and Science Direct. (3) Results: A total of 2964 articles were found, including 413 from PubMed, 248 from Web of Science, 2110 from Science Direct, 163 from Medline, and none from PEDro. Duplicate entries, of which there were 1262, were eliminated. In the first screening phase, 1702 papers were screened for title and abstract. Subsequently, 1667 papers were removed, based on population, duplicate, outcome, and poor study design. Only 15 studies were considered after 35 papers had their full texts verified. Results showed significant values of spatiotemporal gait parameters in music-based therapy rhythmic auditory stimulation (RAS), including speed, stride length, cadence, and ROM. (4) Conclusions: The current findings confirm the value of music-based therapy RAS as a favorable and effective tool to implement in the health care system for the rehabilitation of patients with movement disorders.
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Affiliation(s)
- Sofia Scataglini
- 4D4ALL Lab, Department of Rehabilitation Sciences and Physiotherapy, Center for Health and Technology (CHaT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Zala Van Dyck
- 4D4ALL Lab, Department of Rehabilitation Sciences and Physiotherapy, Center for Health and Technology (CHaT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Véronique Declercq
- 4D4ALL Lab, Department of Rehabilitation Sciences and Physiotherapy, Center for Health and Technology (CHaT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Gitte Van Cleemput
- 4D4ALL Lab, Department of Rehabilitation Sciences and Physiotherapy, Center for Health and Technology (CHaT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Nele Struyf
- 4D4ALL Lab, Department of Rehabilitation Sciences and Physiotherapy, Center for Health and Technology (CHaT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
| | - Steven Truijen
- 4D4ALL Lab, Department of Rehabilitation Sciences and Physiotherapy, Center for Health and Technology (CHaT), Faculty of Medicine and Health Sciences, University of Antwerp, 2000 Antwerpen, Belgium
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Dudarev V, Barral O, Zhang C, Davis G, Enns JT. On the Reliability of Wearable Technology: A Tutorial on Measuring Heart Rate and Heart Rate Variability in the Wild. SENSORS (BASEL, SWITZERLAND) 2023; 23:5863. [PMID: 37447713 DOI: 10.3390/s23135863] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/15/2023]
Abstract
Wearable sensors are quickly making their way into psychophysiological research, as they allow collecting data outside of a laboratory and for an extended period of time. The present tutorial considers fidelity of physiological measurement with wearable sensors, focusing on reliability. We elaborate on why ensuring reliability for wearables is important and offer statistical tools for assessing wearable reliability for between participants and within-participant designs. The framework offered here is illustrated using several brands of commercially available heart rate sensors. Measurement reliability varied across sensors and, more importantly, across the situations tested, and was highest during sleep. Our hope is that by systematically quantifying measurement reliability, researchers will be able to make informed choices about specific wearable devices and measurement procedures that meet their research goals.
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Affiliation(s)
- Veronica Dudarev
- Department of Psychology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- HealthQb Technologies Inc., Vancouver, BC V6K 1B5, Canada
| | - Oswald Barral
- HealthQb Technologies Inc., Vancouver, BC V6K 1B5, Canada
| | - Chuxuan Zhang
- Department of Psychology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Department of Mathematics, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Guy Davis
- HealthQb Technologies Inc., Vancouver, BC V6K 1B5, Canada
| | - James T Enns
- Department of Psychology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
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Schilaty N, Bates N, Holmes B, Nagai T. Group differences and associations between patient-reported outcomes and physical characteristics in chronic low back pain patients and healthy controls. Clin Biomech (Bristol, Avon) 2023; 106:106009. [PMID: 37245281 DOI: 10.1016/j.clinbiomech.2023.106009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 04/11/2023] [Accepted: 05/18/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Patients with chronic low back pain can exhibit altered slower gait, poor balance, and lower strength/power, and psychological dysfunctions such as pain catastrophizing and fear of movement. Few studies have investigated the relationships between physical and psychological dysfunctions. This study examined associations between patient-reported outcomes (pain interference, physical function, central sensitization, and kinesiophobia) and physical characteristics (gait, balance, and trunk sensorimotor characteristics). METHODS Laboratory testing included a 4-m walk, balance, and trunk sensorimotor testing with 18 patients and 15 controls. Gait and balance were collected with inertial measurement units. Isokinetic dynamometry measured trunk sensorimotor characteristics. Patient-reported outcomes included PROMIS Pain Interference / Physical Function, Central Sensitization Inventory, and Tampa Scale of Kinesiophobia. Independent t-tests or Mann-Whitney U tests were used to compare between groups. Additionally, Spearman's rank correlation coefficient (rs) established associations between physical and psychological domains, and Fisher z-tests compared correlation coefficient values between groups (significance P < 0.05). FINDINGS The patient group had worse tandem balance and all patient-reported outcomes (P < 0.05) while no group differences were observed in gait and trunk sensorimotor characteristics. There were significant correlations between worse central sensitization and poor tandem balance (rs = 0.446-0.619, P < 0.05) and lower peak force and rate of force development (rs = -0.429-0.702, P < 0.05). INTERPRETATION Observed group differences in tandem balance agree with previous studies, indicating impaired proprioception. The current findings provide preliminary evidence that balance and trunk sensorimotor characteristics were significantly associated with patient-reported outcomes in patients. Early and period screening could help clinicians further categorize patients and develop objective treatment plans.
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Affiliation(s)
- Nathan Schilaty
- University of South Florida, Tampa, FL, USA; Mayo Clinic, Rochester, MN, USA.
| | - Nathaniel Bates
- Mayo Clinic, Rochester, MN, USA; Ohio State University, Columbus, OH, USA
| | | | - Takashi Nagai
- Mayo Clinic, Rochester, MN, USA; United States Army Research Institute of Environmental Medicine, Natick, MA, USA
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Cibura C, Rosteius T, Brinkemper A, Ull C, Hufnagel S, Jettkant B, Godolias P, Rausch V, Schildhauer TA, Kruppa C. The impact of knee arthrodesis on gait kinematics, muscle activity and patient-reported outcome. Knee 2023; 42:273-280. [PMID: 37119600 DOI: 10.1016/j.knee.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 02/17/2023] [Accepted: 04/03/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND The aim of this retrospective study was to analyze gait kinematicsandoutcome parameters after knee arthrodesis. METHODS Fifteenpatients with a mean follow-up of 5.9 (range0.8-36) years after unilateral knee arthrodesis were included. A 3D gait analysis was performed and compared to a healthy control group of14patients. Comparative electromyography was performed bilaterally at the rectus femoris, vastuslateralis/medialisand tibialis anterior muscles. The assessment further included standardized outcome scores- Lower Extremity Functional Scale (LEFS) andShort Form Health Survey (SF-36). RESULTS The 3D analysis showed a significantly shortened stance phase (p = 0.000), an extended swing phase (p = 0.000), and an increased time per step (p = 0.009) for the operated side compared with thenonoperatedside. There were statistically significant differences in the extent of movement of the hips, knees and ankles among the operated andnonoperatedsides and the control group. For the mean EMG measurement, no significant difference was found between the healthy control group and the patients with arthrodesis.The average LEFSscorewas 27.5 ± 10.6out of a maximum of 80 points,and the mean physical total scale and mean emotional total scale scores for the SF-36 were 27.9 ± 8.5and 52.9 ± 9.9, respectively. CONCLUSIONS Arthrodesis of the knee joint causes significant kinematic changes in gait pattern,and patients achieve poor results in subjective and functional outcomes(SF- 36, LEFS).Arthrodesis ensures that the extremities are preserved and can enable walking, but it must be viewed as a severe handicap for the patient.
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Affiliation(s)
- Charlotte Cibura
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany.
| | - Thomas Rosteius
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Alexis Brinkemper
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Christopher Ull
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Silvia Hufnagel
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Birger Jettkant
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Periklis Godolias
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Valentin Rausch
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Thomas A Schildhauer
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
| | - Christiane Kruppa
- Department of General and Trauma Surgery, BG-University Hospital Bergmannsheil, Ruhr-University Bochum, Germany
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Blandeau M, Guichard R, Hubaut R, Leteneur S. IMU positioning affects range of motion measurement during squat motion analysis. J Biomech 2023; 153:111598. [PMID: 37120865 DOI: 10.1016/j.jbiomech.2023.111598] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/02/2023]
Abstract
Inertial Measurement Units (IMUs) provides embedded and accessible (financially and technically speaking) motion analysis for sports or clinical applications (rehabilitation, therapy…). Despite being advertised for it ease of use, the very nature of IMU sensor makes it prone to errors which are usually corrected through calibration processes thus adding extra complexity for the users. The main goal of this study is to estimate the effect of sensor positioning on the thigh for a simple assessment of squat motion range of motion (ROM) as could be done in a pragmatic clinical approach (i.e., without prior calibration). Kinematics, squat counts and timing of three IMU sensors along the thigh were recorded during squat motion and compared to an optoelectronic reference system. Results showed concordance coefficients of the IMU system over 0.944 without the need for calibration with a preference for placement on the distal part of the segment regarding kinematics data.
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Affiliation(s)
- Mathias Blandeau
- University Polytechnic Hauts-de-France, CNRS, UMR 8201 LAMIH, F-59313, Valenciennes, France.
| | - Romain Guichard
- University Polytechnic Hauts-de-France, CNRS, UMR 8201 LAMIH, F-59313, Valenciennes, France
| | - Rémy Hubaut
- University Polytechnic Hauts-de-France, CNRS, UMR 8201 LAMIH, F-59313, Valenciennes, France
| | - Sébastien Leteneur
- University Polytechnic Hauts-de-France, CNRS, UMR 8201 LAMIH, F-59313, Valenciennes, France
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Charlton JM, Xia H, Shull PB, Eng JJ, Li LC, Hunt MA. Multi-day monitoring of foot progression angles during unsupervised, real-world walking in people with and without knee osteoarthritis. Clin Biomech (Bristol, Avon) 2023; 105:105957. [PMID: 37084548 DOI: 10.1016/j.clinbiomech.2023.105957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 03/03/2023] [Accepted: 04/13/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Foot progression angle is a biomechanical target in gait modification interventions for knee osteoarthritis. To date, it has only been evaluated within laboratory settings. METHODS Adults with symptomatic knee osteoarthritis (n = 30) and healthy adults (n = 15) completed two conditions: 1) treadmill walking in the laboratory (5-min), and 2) real-world walking outside of the laboratory (1-week). Foot progression angle was estimated via shoe-embedded inertial sensing. We calculated the foot progression angle magnitude (median) and variability (interquartile range, coefficient of variation), and used mixed models to compare outcomes between the conditions, participant groups, and disease severities. Reliability was quantified by the intraclass correlation coefficient, standardized error of the measurement, and the minimum detectable change. FINDINGS Foot progression angle magnitude did not differ between groups or conditions but variability significantly higher in real-world walking (P < 0.001). Structural and symptomatic severity were unrelated to FPA in either walking condition, except for real-world coefficient of variation which was higher for moderate-severe structural osteoarthritis compared to the treadmill for those with mild structural severity (P < 0.034). All real-world outcomes showed excellent reliability including intraclass correlation coefficients above 0.95. The participants recorded a mean (standard deviation) of 298 (33) and 10,447 (5232) steps in the laboratory and real-world walking conditions, respectively. INTERPRETATION This study provides the first characterization of foot progression angles during real-world walking in people with and without symptomatic knee osteoarthritis. These results indicate that foot progression angles can be feasibly and reliably measured in unsupervised real-world walking conditions.
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Affiliation(s)
- Jesse M Charlton
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Graduate Programs in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada.
| | - Haisheng Xia
- Department of Automation, University of Science and Technology of China, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, China
| | - Peter B Shull
- State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Janice J Eng
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
| | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Arthritis Research Canada, Vancouver, Canada
| | - Michael A Hunt
- Department of Physical Therapy, University of British Columbia, Vancouver, Canada; Motion Analysis and Biofeedback Laboratory, University of British Columbia, Vancouver, Canada; Centre for Aging SMART at Vancouver Coastal Health, Vancouver, Canada
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50
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Hafer JF, Mihy JA, Hunt A, Zernicke RF, Johnson RT. Lower Extremity Inverse Kinematics Results Differ Between Inertial Measurement Unit- and Marker-Derived Gait Data. J Appl Biomech 2023; 39:133-142. [PMID: 37024103 DOI: 10.1123/jab.2022-0194] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/30/2022] [Accepted: 02/07/2023] [Indexed: 04/08/2023]
Abstract
In-lab, marker-based gait analyses may not represent real-world gait. Real-world gait analyses may be feasible using inertial measurement units (IMUs) in combination with open-source data processing pipelines (OpenSense). Before using OpenSense to study real-world gait, we must determine whether these methods estimate joint kinematics similarly to traditional marker-based motion capture (MoCap) and differentiate groups with clinically different gait mechanics. Healthy young and older adults and older adults with knee osteoarthritis completed this study. We captured MoCap and IMU data during overground walking at 2 speeds. MoCap and IMU kinematics were computed with OpenSim workflows. We tested whether sagittal kinematics differed between MoCap and IMU, whether tools detected between-group differences similarly, and whether kinematics differed between tools by speed. MoCap showed more anterior pelvic tilt (0%-100% stride) and joint flexion than IMU (hip: 0%-38% and 61%-100% stride; knee: 0%-38%, 58%-89%, and 95%-99% stride; and ankle: 6%-99% stride). There were no significant tool-by-group interactions. We found significant tool-by-speed interactions for all angles. While MoCap- and IMU-derived kinematics differed, the lack of tool-by-group interactions suggests consistent tracking across clinical cohorts. Results of the current study suggest that IMU-derived kinematics with OpenSense may enable reliable evaluation of gait in real-world settings.
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Affiliation(s)
- Jocelyn F Hafer
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE,USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI,USA
| | - Julien A Mihy
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE,USA
| | - Andrew Hunt
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE,USA
| | - Ronald F Zernicke
- School of Kinesiology, University of Michigan, Ann Arbor, MI,USA
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI,USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI,USA
| | - Russell T Johnson
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA,USA
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