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Azzam I, Rozen N, Eliyahu A, Dabby D, Elbaz A, Mor A, Krasovsky T. The Effect of Total Knee Replacement on Dual-Task Gait Performance in Older Adults. Phys Ther 2024; 104:pzae067. [PMID: 38691445 DOI: 10.1093/ptj/pzae067] [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: 06/16/2023] [Revised: 01/09/2024] [Accepted: 04/22/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Total knee replacement (TKR) is a common solution for patients with advanced knee osteoarthritis (OA). Still, fall rates remain relatively high after surgery. TKR may alter pain and knee function, balance control, and proprioception. However, given the role of complex (dual-task) walking in fall prediction for older adults, it is unknown how TKR alters the attentional demand of walking in older adults. The goal of this study was to examine the effect of TKR on dual-task walking among older adults. METHODS Participants were evaluated 1 month before surgery and 4.5 months after surgery. Participants walked along an instrumented 7-meter path for 1 minute with and without a cognitive task (serial-3 subtraction). Pain and knee function, knee proprioception, dynamic balance, and balance confidence, as well as dual-task costs (DTC) were compared before and after the surgery and factors associated with change in gait DTCs were assessed. RESULTS Thirty-eight participants completed the study (age 72.6 years, SD = 4.9; 11 men). A significant decrease in pain was found following TKR, with no change in balance, balance confidence, or proprioception. There were no differences in gait DTCs before and after the surgery. However, change in dynamic balance, specifically reactive postural control and dynamic gait, predicted changes in gait speed and stride time DTCs. CONCLUSION The absence of an effect of TKR on gait DTCs can potentially underlie increased fall risk after TKR. Results from this study emphasize the significance of balance as a measure and focal point for rehabilitation after TKR. IMPACT This study contributes to our understanding of the attentional cost of walking in people before and after TKR, as well as to factors associated with it. Results from this work can assist formulation of rehabilitation programs for people with knee OA.
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Affiliation(s)
- Ibrahim Azzam
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- AposTherapy Research Group, Herzelyia, Israel
| | - Nimrod Rozen
- Orthopaedic Division, HaEmek Medical Center, Afula, Israel
- Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa, Israel
| | - Amir Eliyahu
- Orthopaedic Division, HaEmek Medical Center, Afula, Israel
| | - Dan Dabby
- Orthopaedic Division, HaEmek Medical Center, Afula, Israel
| | - Avi Elbaz
- AposTherapy Research Group, Herzelyia, Israel
| | - Amit Mor
- AposTherapy Research Group, Herzelyia, Israel
| | - Tal Krasovsky
- Department of Physical Therapy, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
- Pediatric Rehabilitation Department, The Edmond & Lily Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel
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Yarar HA, Narin S, Erduran M, Gurbanov I. The test-retest reliability and concurrent validity of 360° turn test in patients with knee osteoarthritis. Somatosens Mot Res 2024; 41:90-96. [PMID: 36786842 DOI: 10.1080/08990220.2023.2178402] [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: 02/26/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023]
Abstract
PURPOSE The aim of this study is to determine whether the 360° turn test is a reliable and valid evaluator that can be used to assess dynamic balance in patients with early (radiographic grades I and II) and advanced (radiographic grades III and IV) knee osteoarthritis. MATERIALS AND METHODS This study is a methodological research. For the test time and step count of 360° turn test; test-retest reliability were determined by calculating the intraclass correlation coefficient and concurrent validity in patients with knee osteoarthritis was investigated by correlation with the timed up and go test time. RESULTS The final analysis was made on 117 participants. The intraclass correlation coefficient values for the test time and step count of 360° turn test in patients with early knee osteoarthritis are 0.931 and 0.902, respectively, while they are 0.923 and 0.943 in patients with advanced knee osteoarthritis. The Pearson correlation coefficients between the time and step count of 360° turn test and the test time of the timed up and go test in patients with early knee osteoarthritis, respectively; while they are 0.547 and 0.388, the correlation in patients with advanced knee osteoarthritis are 0.697 and 0.700, respectively (p < 0.01). CONCLUSIONS The 360° turn test is a evaluator that has excellent test-retest reliability and moderate to strong concurrent validity in patients with both early and advanced knee osteoarthritis and can be used in the assessment of dynamic balance in this population.
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Affiliation(s)
- Hacı Ahmet Yarar
- Institute of Health Sciences, Dokuz Eylul University, Izmir, Türkiye
- Department of Orthopedic Physiotherapy, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Türkiye
| | - Selnur Narin
- Department of Orthopedic Physiotherapy, Faculty of Physical Therapy and Rehabilitation, Dokuz Eylul University, Izmir, Türkiye
| | - Mehmet Erduran
- Department of Orthopaedics and Traumatology, Faculty of Medicine, Dokuz Eylul University, Izmir, Türkiye
| | - Iftikhar Gurbanov
- Department of Orthopaedics and Traumatology, Okan University Hospital, Istanbul, Türkiye
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3
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Mao Q, Zheng W, Shi M, Yang F. Scientometric Research and Critical Analysis of Gait and Balance in Older Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:3199. [PMID: 38794055 PMCID: PMC11125350 DOI: 10.3390/s24103199] [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: 04/30/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024]
Abstract
Gait and balance have emerged as a critical area of research in health technology. Gait and balance studies have been affected by the researchers' slow follow-up of research advances due to the absence of visual inspection of the study literature across decades. This study uses advanced search methods to analyse the literature on gait and balance in older adults from 1993 to 2022 in the Web of Science (WoS) database to gain a better understanding of the current status and trends in the field for the first time. The study analysed 4484 academic publications including journal articles and conference proceedings on gait and balance in older adults. Bibliometric analysis methods were applied to examine the publication year, number of publications, discipline distribution, journal distribution, research institutions, application fields, test methods, analysis theories, and influencing factors in the field of gait and balance. The results indicate that the publication of relevant research documents has been steadily increasing from 1993 to 2022. The United States (US) exhibits the highest number of publications with 1742 articles. The keyword "elderly person" exhibits a strong citation burst strength of 18.04, indicating a significant focus on research related to the health of older adults. With a burst factor of 20.46, Harvard University has made impressive strides in the subject. The University of Pittsburgh displayed high research skills in the area of gait and balance with a burst factor of 7.7 and a publication count of 103. The research on gait and balance mainly focuses on physical performance evaluation approaches, and the primary study methods include experimental investigations, computational modelling, and observational studies. The field of gait and balance research is increasingly intertwined with computer science and artificial intelligence (AI), paving the way for intelligent monitoring of gait and balance in the elderly. Moving forward, the future of gait and balance research is anticipated to highlight the importance of multidisciplinary collaboration, intelligence-driven approaches, and advanced visualization techniques.
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Affiliation(s)
- Qian Mao
- School of Design, The Hong Kong Polytechnic University, Hong Kong
| | - Wei Zheng
- Department of Computer Science and Technology, Tsinghua University, Beijing 100190, China
| | - Menghan Shi
- Lancaster Imagination Lab, Lancashire, Lancaster LA1 4YD, UK
| | - Fan Yang
- Electrical and Electronic Engineering Department, The Hong Kong Polytechnic University, Hong Kong
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Emami F, Negahban H, Sinaei E, Mostafaee N, Shahtahmassebi B, Ebrahimzadeh MH, Mehravar M. The Effects of Various Cognitive Tasks Including Working Memory, Visuospatial, and Executive Function on Postural Control in Patients With Anterior Cruciate Ligament Injury. Motor Control 2024:1-17. [PMID: 38253046 DOI: 10.1123/mc.2023-0062] [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: 06/25/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024]
Abstract
Anterior cruciate ligament (ACL) rupture can impair balance performance, particularly during cognitive motor dual-tasks. This study aimed to determine the effects of various modalities of cognitive load (working memory, and visuospatial and executive function) on postural control parameters in individuals with ACL injury. Twenty-seven ACL-injured and 27 healthy participants were evaluated doing different cognitive tasks (silent backward counting, Benton's judgment of line orientation, and Stroop color-word test) while standing on a rigid surface or a foam. Each task was repeated three times and then averaged. Center of pressure variables used to measure postural performance included sway area and sway velocity in anterior-posterior and medial-lateral directions. Cognitive performance was also assessed by calculating errors and the score of cognitive tasks. A mixed model analysis of variance for center of pressure parameters indicated that patients had more sways than the healthy group. The interaction of group by postural difficulty by cognitive tasks was statistically significant for cognitive errors (p < .01), and patients with ACL injury indicated more cognitive errors compared to healthy controls while standing on the foam. The main effect of cognitive task was statistically significant for all postural parameters, representing reduced postural sways in both groups with all cognitive tasks. However, ACL-injured patients showed more cognitive errors in difficult postural conditions, suggesting that individuals with ACL injury may prioritize postural control over cognitive task accuracy and adopt the posture-first strategy to maintain balance under dual-task conditions.
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Affiliation(s)
- Fatemeh Emami
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Negahban
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ehsan Sinaei
- Department of Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Neda Mostafaee
- Department of Physical Therapy, School of Paramedical and Rehabilitation Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
- Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behnaz Shahtahmassebi
- Sport Injuries and Corrective Movements Department, Faculty of Sport Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
| | | | - Mohammad Mehravar
- Musculoskeletal Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Choi JY, Yoo T, Burcal CJ, Rosen AB. Dual-task differences in individuals with chronic ankle instability: A systematic review with meta-analysis. Gait Posture 2023; 106:28-33. [PMID: 37639962 DOI: 10.1016/j.gaitpost.2023.08.013] [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: 06/28/2023] [Accepted: 08/22/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND Individuals with Chronic Ankle Instability (CAI) demonstrate altered gait mechanics, impaired proprioception, and decreased postural control. In addition, individuals with CAI have been found to have complex neurophysiological changes, including during dual-task perturbations. However, the results of studies on whether cognitive tasks affect postural control are inconclusive. RESEARCH QUESTION Do individuals with CAI have worse dual-task performance compared to healthy controls? METHODS We searched 4 electronic databases (PubMed, MEDLINE, Cumulative Index of Nursing and Allied Health Literature, and SPORTDiscus) from inception to October 2022. Search terms consisted of: ("dual-task*" OR "dual task*" OR dual-task OR Multitask* OR Multi-task* OR attention OR cognit*) AND (balance OR "postural control" OR "postural sway" OR kinetics OR kinematics OR gait) NOT (concussion OR "traumatic brain injury") combined using the operator "AND" ("ankle sprain" OR "ankle instability" OR CAI). Studies were included if the physical task was postural control or gait, and if they compared control and CAI groups. RESULTS A total of 9 studies were included in the systematic-review portion, 5 of which were included in the meta-analysis. Due to assessing multiple types of dual-tasks, 10 effects were assessed for meta-analysis across postural control studies. A random-effects model for the control group in the mediolateral direction indicated a significant overall Fisher's Z mean effect size (Δ = 0.732, p = 0.029) with high heterogeneity between studies (Q=76.61; I2 = 88.25% P < 0.001). There were no significant differences between dual-tasking in the CAI group individually or when comparing control to CAI groups. SIGNIFICANCE The results of our study indicate that cognitive loading did not affect the postural control except for the control group in the mediolateral direction. Variations in dual-task results may be due to the difficulty of the task as well as the heterogeneity of CAI groups.
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Burton W, Ma Y, Manor B, Hausdorff JM, Kowalski MH, Bain PA, Wayne PM. The impact of neck pain on gait health: a systematic review and meta-analysis. BMC Musculoskelet Disord 2023; 24:618. [PMID: 37516827 PMCID: PMC10385921 DOI: 10.1186/s12891-023-06721-2] [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: 04/17/2023] [Accepted: 07/14/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND Evidence exists demonstrating the negative impacts of chronic musculoskeletal pain on key measures of gait. Despite neck pain being the second most common musculoskeletal pain condition, there is a paucity of evidence exploring the impacts of neck pain specifically on these outcomes. The aims of this work were to systematically review the current evidence of the associations between chronic neck pain and measures of gait health and to conduct meta-analysis for quantitative assessment of the effect sizes under different walking conditions. METHODS Systematic review was conducted following PRISMA guidelines. Databases searched included MEDLINE, Embase, Web of Science, CINAHL, and PEDro. Eligible study designs included observational studies consisting of an exposure group with chronic neck pain and control group without chronic neck pain and primary outcomes relating to gait health. For outcomes amenable to meta-analysis, a random-effects model was used to derive summary estimates of Hedge's g depicted graphically with forest plots. Other gait outcomes were narratively summarized. Risk of bias was also assessed. RESULTS The original search yielded 1918 articles; 12 met final eligibility criteria including 10 cross-sectional studies. Outcomes were grouped first by the five domains of gait: pace, rhythm, asymmetry, variability, and postural control; and second by the tested walking conditions. Meta-analyses for gait speed revealed large effect-sizes indicating that individuals with chronic neck pain had slower measures of gait and lower measures of cadence. Gait outcomes that were narratively summarized supported these findings. CONCLUSION The quantitative and qualitative findings of this systematic review and meta-analysis suggest a negative impact of CNNP on measures of gait health, particularly gait speed, under various walking conditions. However, broad interpretation of these results should be cautious. Testing gait under dual task conditions may be particularly sensitive to the impact of CNNP, and future work is needed to better understand how pain disrupts this important functionality of the locomotor system. Additionally, consideration should be made to assess measures of variability and investigate these relationships in the older adult population.
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Affiliation(s)
- Wren Burton
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA.
- DC. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Yan Ma
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA
- DC. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research, Boston, MA, USA
| | - Jeffrey M Hausdorff
- Center for the Study of Movement Cognition and Mobility, Tel Aviv, Israel
- Sagol School of Neuroscience and Department of Physical Therapy, Sacker School of Medicine Tel Aviv University, Tel Aviv, Israel
- Department of Orthopedic Surgery, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Matthew H Kowalski
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA
| | - Paul A Bain
- Countway Library, Harvard Medical School, Boston, MA, USA
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, 900 Commonwealth Ave, Boston, MA, 02115, USA
- DC. Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Dual-Task Interference Slows Down Proprioception. Motor Control 2023:1-15. [PMID: 36599354 DOI: 10.1123/mc.2022-0075] [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: 06/09/2022] [Revised: 10/28/2022] [Accepted: 10/29/2022] [Indexed: 01/05/2023]
Abstract
It is well-known that multitasking impairs the performance of one or both of the concomitant ongoing tasks. Previous studies have mainly focused on how a secondary task can compromise visual or auditory information processing. However, despite dual tasking being critical to motor performance, the effects of dual-task performance on proprioceptive information processing have not been studied yet. The purpose of the present study was, therefore, to investigate whether sensorimotor task performance would be affected by the dual task and if so, in which phase of the sensorimotor task performance would this negative effect occur. The kinematic variables of passive and active knee movements elicited by the leg drop test were analyzed. Thirteen young adults participated in the study. The dual task consisted of performing serial subtractions. The results showed that the dual task increased both the reaction time to counteract passive knee-joint movements in the leg drop test and the threshold to detect those movements. The dual task did not affect the speed and time during the active knee movement and the absolute angle error between the final and the target knee angles. Furthermore, the results showed that the time to complete the sensorimotor task was prolonged in dual tasking. Our findings suggest that dual tasking reduces motor performance due to slowing down proprioceptive information processing without affecting movement execution.
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Kimura D, Hosokawa T, Ujikawa T, Ito T. Effects of different exercise intensities on prefrontal activity during a dual task. Sci Rep 2022; 12:13008. [PMID: 35906385 PMCID: PMC9338235 DOI: 10.1038/s41598-022-17172-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022] Open
Abstract
The effects of physical exercise on cognitive tasks have been investigated. However, it is unclear how different exercise intensities affect the neural activity. In this study, we investigated the neural activity in the prefrontal cortex (PFC) by varying the exercise intensity while participants performed a dual task (DT). Twenty healthy young adults performed serial subtraction while driving a cycle ergometer. Exercise intensity was set to one of three levels: low, moderate, or high intensity. We did not find any significant change in PFC activity during DT under either the control (no exercise) or low-intensity conditions. In contrast, we observed a significant increase in PFC activity during DT under moderate- and high-intensity conditions. In addition, we observed complex hemodynamics after DT. PFC activity decreased from baseline after DT under the control condition, while it increased under the low-intensity condition. PFC activity remained higher than the baseline level after DT under the moderate-intensity condition but returned to baseline under the high-intensity condition. The results suggest that moderate-intensity exercise with a cognitive load effectively increases PFC activity, and low-intensity exercise may increase PFC activity when combined with a cognitive load.
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Affiliation(s)
- Daisuke Kimura
- Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan. .,Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan.
| | - Takayuki Hosokawa
- Department of Orthoptics, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Takuya Ujikawa
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Tomotaka Ito
- Graduate School of Health Science and Technology, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan.,Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, 288 Matsushima, Kurashiki, Okayama, 701-0193, Japan
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9
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A Comparative study on the assessment of dual task performance in rheumatic diseases. Gait Posture 2022; 93:1-6. [PMID: 35033945 DOI: 10.1016/j.gaitpost.2022.01.003] [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: 06/03/2021] [Revised: 06/28/2021] [Accepted: 01/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND In task-oriented studies showed that the chronic pain is effective on dual tasks. Chronic pain is the main health problem that prevents mobility restriction and participation in most rheumatic diseases. RESEARCH QUESTION Do rheumatic diseases have an effect on dual task gait performance? METHODS This comparative-descriptive study included 75 individuals who aged 18-65 years and divided in two groups as Rheumatic Disease Group (RG; 23 women, 14 men) and Control Group (CG; 20 women, 18 men). The individuals have a chronic pain (> 3.4 cm according to Visual Analogue Scale, VAS) and Standardized Mini Mental State Examination score above 24 were included in this study as the RG. The individuals who were did not have any known disease were included in the CG. The health status of RG was evaluated with the Arthritis Impact Measurement Scale 2 (AIMS-2). The 10-meter Walk Test was applied under single and dual task conditions (dual task cognitive, DTcognitive; dual task motor, DTmotor) for assessing gait performance. RESULTS AND SIGNIFICANCE The mean age of the individuals in the study was 40.6 ± 11.34 years (RG=43.08 ± 11.30; CG=38.18 ± 11.00). There was a significant difference in favor of CG between the groups both in terms of gait speed in DTcognitive and its cost (p < 0.05). VAS scores correlate with single and DTcognitive and DTmotor gait parameters (p < 0.05). Many subdivisions of AIMS-2 were associated with single, DTcognitive and DTmotor gait parameters (p < 0.05). This study concluded that rheumatic diseases may reduce gait performance in concurrent motor-cognitive dual task conditions due to chronic pain. Single and dual task gait parameters may be related with psychosocial factors. Therefore, applications including pain control and biopsychosocial approach may be beneficial in the management gait disturbances and falls due to a rheumatic disease.
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Boekesteijn RJ, Smolders JMH, Busch VJJF, Geurts ACH, Smulders K. Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors. BMC Musculoskelet Disord 2021; 22:242. [PMID: 33658006 PMCID: PMC7931541 DOI: 10.1186/s12891-021-04074-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/09/2021] [Indexed: 11/30/2022] Open
Abstract
Background Although it is well-established that osteoarthritis (OA) impairs daily-life gait, objective gait assessments are not part of routine clinical evaluation. Wearable inertial sensors provide an easily accessible and fast way to routinely evaluate gait quality in clinical settings. However, during these assessments, more complex and meaningful aspects of daily-life gait, including turning, dual-task performance, and upper body motion, are often overlooked. The aim of this study was therefore to investigate turning, dual-task performance, and upper body motion in individuals with knee or hip OA in addition to more commonly assessed spatiotemporal gait parameters using wearable sensors. Methods Gait was compared between individuals with unilateral knee (n = 25) or hip OA (n = 26) scheduled for joint replacement, and healthy controls (n = 27). For 2 min, participants walked back and forth along a 6-m trajectory making 180° turns, with and without a secondary cognitive task. Gait parameters were collected using 4 inertial measurement units on the feet and trunk. To test if dual-task gait, turning, and upper body motion had added value above spatiotemporal parameters, a factor analysis was conducted. Effect sizes were computed as standardized mean difference between OA groups and healthy controls to identify parameters from these gait domains that were sensitive to knee or hip OA. Results Four independent domains of gait were obtained: speed-spatial, speed-temporal, dual-task cost, and upper body motion. Turning parameters constituted a gait domain together with cadence. From the domains that were obtained, stride length (speed-spatial) and cadence (speed-temporal) had the strongest effect sizes for both knee and hip OA. Upper body motion (lumbar sagittal range of motion), showed a strong effect size when comparing hip OA with healthy controls. Parameters reflecting dual-task cost were not sensitive to knee or hip OA. Conclusions Besides more commonly reported spatiotemporal parameters, only upper body motion provided non-redundant and sensitive parameters representing gait adaptations in individuals with hip OA. Turning parameters were sensitive to knee and hip OA, but were not independent from speed-related gait parameters. Dual-task parameters had limited additional value for evaluating gait in knee and hip OA, although dual-task cost constituted a separate gait domain. Future steps should include testing responsiveness of these gait domains to interventions aiming to improve mobility. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04074-2.
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Affiliation(s)
- Ramon J Boekesteijn
- Department of Research, Sint Maartenskliniek, Hengstdal 3, 6574 NA Ubbergen, Nijmegen, The Netherlands. .,Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
| | - José M H Smolders
- Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Vincent J J F Busch
- Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, The Netherlands
| | - Alexander C H Geurts
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katrijn Smulders
- Department of Research, Sint Maartenskliniek, Hengstdal 3, 6574 NA Ubbergen, Nijmegen, The Netherlands
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Mejía ST, Nielsen KE, Raichur V, Carmichael AG, Tavares E, Jarvis J, Smith J, Gonzalez R. Assessment of Cognitive-Motor Performance Costs, Task Prioritization, and Adaptation to Dishwashing Under Increased Demand in Older Women With Arthritis. Innov Aging 2020; 5:igaa059. [PMID: 33614990 PMCID: PMC7874570 DOI: 10.1093/geroni/igaa059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives Hand arthritis can limit upper-limb instrumental activities of daily living (IADLs) and require the recruitment of additional cognitive and motor resources to support performance. We devised a dual-task protocol for dishwashing to examine cognitive-motor performance costs and prioritizations under increased demands, processes of adaptation, and individual differences in performance costs. Research Design and Methods Sixty women with hand arthritis (aged 60–91) completed a standardized dishwashing protocol. Motor demand was increased via the properties of the soap dispenser. Cognitive demand was increased using audial attention and response inhibition tasks. The protocol was completed twice per lab visit on 3 occasions. Response time and dishwashing time provided measures of cognitive and motor task performance. Prioritization was determined by comparing the magnitude of dual-task cost (DTC) across tasks. Adaptation to the dishwashing protocol and novel dispenser was assessed by change in DTC across lab visits. Individual differences in cognitive and physical ability were assessed with the trail making B test and gait speed. Results Estimates from linear mixed-effects models revealed that response time increased, whereas dishwashing time decreased, during the dual-task study stages. Cognitive-motor prioritization effects were most pronounced among women with lower cognitive and physical ability. Evidence of prioritization and individual differences in DTC diminished across lab visits. Discussion and Implications The pattern of results suggests that older women with arthritis prioritize the motor over cognitive components of dishwashing, a common IADL. Adaptation across lab visits resulted in improved performance, reduced evidence of prioritization, and attenuated differences in DTC across physical and cognitive abilities.
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Affiliation(s)
- Shannon T Mejía
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, Illinois, US
| | - Karen E Nielsen
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, US
| | - Vineet Raichur
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
| | - Alicia G Carmichael
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
| | | | | | - Jacqui Smith
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
| | - Richard Gonzalez
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, US
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Soulard J, Vaillant J, Balaguier R, Baillet A, Gaudin P, Vuillerme N. Foot-Worn Inertial Sensors Are Reliable to Assess Spatiotemporal Gait Parameters in Axial Spondyloarthritis under Single and Dual Task Walking in Axial Spondyloarthritis. SENSORS (BASEL, SWITZERLAND) 2020; 20:E6453. [PMID: 33198119 PMCID: PMC7697708 DOI: 10.3390/s20226453] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 11/06/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
The aim of this study was (1) to evaluate the relative and absolute reliability of gait parameters during walking in single- and dual-task conditions in patients with axial spondyloarthritis (axSpA), (2) to evaluate the absolute and relative reliability of dual task effects (DTE) parameters, and (3) to determine the number of trials required to ensure reliable gait assessment, in patients with axSpA. Twenty patients with axSpa performed a 10-m walk test in single- and dual-task conditions, three times for each condition. Spatiotemporal, symmetry, and DTE gait parameters were calculated from foot-worn inertial sensors. The relative reliability (intraclass correlation coefficients-ICC) and absolute reliability (standard error of measurement-SEM and minimum detectable change-MDC) were calculated for these parameters in each condition. Spatiotemporal gait parameters showed good to excellent reliability in both conditions (0.59 < ICC < 0.90). The reliability of symmetry and DTE parameters was low. ICC, SEM, and MDC were better when using the mean of the second and the third trials. Spatiotemporal gait parameters obtained from foot-worn inertial sensors assessed in patients with axSpA in single- and dual-task conditions are reliable. However, symmetry and DTE parameters seem less reliable and need to be interpreted with caution. Finally, better reliability of gait parameters was found when using the mean of the 2nd and the 3rd trials.
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Affiliation(s)
- Julie Soulard
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
- CHU Grenoble Alpes, 38000 Grenoble, France
| | - Jacques Vaillant
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
| | - Romain Balaguier
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
| | - Athan Baillet
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, 38000 Grenoble, France; (A.B.); (P.G.)
| | - Philippe Gaudin
- University Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG UMR5525, 38000 Grenoble, France; (A.B.); (P.G.)
| | - Nicolas Vuillerme
- University Grenoble Alpes, AGEIS, 38000 Grenoble, France; (J.V.); (R.B.); (N.V.)
- Institut Universitaire de France, 75000 Paris, France
- LabCom Telecom4Health, University Grenoble Alpes & Orange Labs, 38000 Grenoble, France
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