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Tsukamoto H, Saito K, Saito H, Kijima H, Akagawa M, Komatsu A, Iwami T, Miyakoshi N. A Novel Classification of Coronal Plane Knee Joint Instability Using Nine-Axis Inertial Measurement Units in Patients with Medial Knee Osteoarthritis. SENSORS (BASEL, SWITZERLAND) 2023; 23:2797. [PMID: 36905001 PMCID: PMC10007345 DOI: 10.3390/s23052797] [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: 01/31/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 06/18/2023]
Abstract
The purpose of this study was to propose a novel classification of varus thrust based on gait analysis with inertial motion sensor units (IMUs) in patients with medial knee osteoarthritis (MKOA). We investigated thigh and shank acceleration using a nine-axis IMU in 69 knees with MKOA and 24 (control) knees. We classified varus thrust into four phenotypes according to the relative medial-lateral acceleration vector patterns of the thigh and shank segments: pattern A (thigh medial, shank medial), pattern B (medial, lateral), pattern C (lateral, medial), and pattern D (lateral, lateral). Quantitative varus thrust was calculated using an extended Kalman filter-based algorithm. We compared the differences between our proposed IMU classification and the Kellgren-Lawrence (KL) grades for quantitative varus thrust and visible varus thrust. Most of the varus thrust was not visually perceptible in early-stage OA. In advanced MKOA, increased proportions of patterns C and D with lateral thigh acceleration were observed. Quantitative varus thrust was significantly increased stepwise from patterns A to D. This novel IMU classification has better clinical utility due to its ability to detect subtle kinematic changes that cannot be captured with conventional motion analysis even in the early stage of MKOA.
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Affiliation(s)
- Hiroaki Tsukamoto
- Department of Orthopedic Surgery, Kita-Akita Municipal Hospital, Shimosugi, Kamishimizusawa 16-29, Kitaakita 018-4221, Japan
- Department of Orthopedic Surgery, Graduate School of Medicine, Akita University, Hondo 1-1-1, Akita 010-8543, Japan
| | - Kimio Saito
- Department of Orthopedic Surgery, Graduate School of Medicine, Akita University, Hondo 1-1-1, Akita 010-8543, Japan
| | - Hidetomo Saito
- Department of Orthopedic Surgery, Graduate School of Medicine, Akita University, Hondo 1-1-1, Akita 010-8543, Japan
| | - Hiroaki Kijima
- Department of Orthopedic Surgery, Graduate School of Medicine, Akita University, Hondo 1-1-1, Akita 010-8543, Japan
| | - Manabu Akagawa
- Department of Orthopedic Surgery, Omagari Kosei Medical Center, Omagari Torimachi 8-65, Senboku 014-0027, Japan
| | - Akira Komatsu
- National Institute of Technology, Sendai College, Natori 981-1239, Japan
| | - Takehiro Iwami
- Department of System Design Engineering, Faculty of Engineering Science, Graduate School of Engineering Science, Akita University, Akita 010-8502, Japan
| | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Graduate School of Medicine, Akita University, Hondo 1-1-1, Akita 010-8543, Japan
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Misu S, Tanaka S, Ishihara K, Asai T, Nishigami T. Applied Assessment Method for Varus Thrust during Walking in Patients with Knee Osteoarthritis Using Acceleration Data Measured by an Inertial Measurement Unit. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22176460. [PMID: 36080919 PMCID: PMC9460931 DOI: 10.3390/s22176460] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/22/2022] [Accepted: 08/26/2022] [Indexed: 05/29/2023]
Abstract
We developed a novel quantitative method to assess varus thrust during walking using acceleration data obtained from an inertial measurement unit (IMU). This study aimed to examine the reliability of the developed index and to evaluate its ability to distinguish patients with knee osteoarthritis (OA) with varus thrust from healthy adults. Overall, 16 patients with knee OA and 16 healthy adults walked on a treadmill with IMUs attached to the tibial tuberosity and lateral femoral condyle. As an index of varus thrust, we used the root mean square (RMS) of acceleration in the mediolateral direction. This value was adjusted by dividing it by swing speed while walking (adjusted RMS, A-RMS) because the RMS of the acceleration was strongly coupled with the speed of motion. The intraclass correlation coefficients of A-RMS of the tibia and femur were 0.85 and 0.73, respectively. Significant differences were observed in the A-RMSs of the tibia and femur, with large effect sizes between the patients with knee OA and healthy adults (Cohen's d: 1.23 and 0.97, respectively). Our results indicate that A-RMS has good test-retest reproducibility and can differentiate patients with varus thrust from healthy adults.
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Affiliation(s)
- Shogo Misu
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women’s University, 6-2-13 Morikita-machi, Higashinada-ku, Kobe 658-0001, Hyogo, Japan
| | - So Tanaka
- Department of Rehabilitation, Fukuoka Orthopedic Hospital, 2-10-50 Yanagochi, Minami-ku, Fukuoka 815-0063, Fukuoka, Japan
| | - Kohei Ishihara
- Department of Orthopedic Surgery, Fukuoka Orthopedic Hospital, 2-10-50 Yanagochi, Minami-ku, Fukuoka 815-0063, Fukuoka, Japan
| | - Tsuyoshi Asai
- Faculty of Rehabilitation, Kansai Medical University, 18-89 Uyamahigashicho, Hirakata 573-1136, Osaka, Japan
| | - Tomohiko Nishigami
- Department of Physical Therapy, Faculty of Health and Welfare, Prefectural University of Hiroshima, 1-1 Gakuen-tyou, Mihara 723-0053, Hiroshima, Japan
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Original article: Validity and reliability of gait metrics derived from researcher-placed and self-placed wearable inertial sensors. J Biomech 2022; 142:111263. [PMID: 36030636 DOI: 10.1016/j.jbiomech.2022.111263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/20/2022]
Abstract
To compare the inter-session placement reliability for researcher-placed and self-placed sensors, and to evaluate the validity and reliability of waveforms and discrete variables from researcher-placed and self-placed sensors following a previously described alignment correction algorithm. Fourteen healthy, pain-free participants underwent gait analysis over two data collection sessions. Participants self-placed an inertial sensor on their left tibia and a researcher placed one on their right tibia, before completing 10 overground walking trials. Following an axis correction from a principal component analysis-based algorithm, validity and reliability were assessed within and between days for each sensor placement type through Euclidean distances, waveforms, and discrete outcomes. The placement location of researcher-placed sensors exhibited good inter-session reliability (ICC = 0.85) in comparison to self-placed sensors (ICC = 0.55). Similarly, waveforms from researcher-placed sensors exhibited excellent validity across all variables (CMC ≥ 0.90), while self-placed sensors saw high validity for most axes with reductions in validity for mediolateral acceleration and frontal plane angular velocity. Discrete outcomes saw good to excellent reliability across both sensor placement types. A simple alignment correction algorithm for inertial sensor gait data demonstrated good to excellent validity and reliability in self-placed sensors with no additional data or measures. This method can be used to align sensors easily and effectively despite sensor placement errors during straight, level walking to improve 3D gait data outcomes in data collected with self-placed sensors.
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