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Voisard C, de l'Escalopier N, Ricard D, Oudre L. Automatic gait events detection with inertial measurement units: healthy subjects and moderate to severe impaired patients. J Neuroeng Rehabil 2024; 21:104. [PMID: 38890696 PMCID: PMC11184826 DOI: 10.1186/s12984-024-01405-x] [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: 04/08/2023] [Accepted: 06/11/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Recently, the use of inertial measurement units (IMUs) in quantitative gait analysis has been widely developed in clinical practice. Numerous methods have been developed for the automatic detection of gait events (GEs). While many of them have achieved high levels of efficiency in healthy subjects, detecting GEs in highly degraded gait from moderate to severely impaired patients remains a challenge. In this paper, we aim to present a method for improving GE detection from IMU recordings in such cases. METHODS We recorded 10-meter gait IMU signals from 13 healthy subjects, 29 patients with multiple sclerosis, and 21 patients with post-stroke equino varus foot. An instrumented mat was used as the gold standard. Our method detects GEs from filtered acceleration free from gravity and gyration signals. Firstly, we use autocorrelation and pattern detection techniques to identify a reference stride pattern. Next, we apply multiparametric Dynamic Time Warping to annotate this pattern from a model stride, in order to detect all GEs in the signal. RESULTS We analyzed 16,819 GEs recorded from healthy subjects and achieved an F1-score of 100%, with a median absolute error of 8 ms (IQR [3-13] ms). In multiple sclerosis and equino varus foot cohorts, we analyzed 6067 and 8951 GEs, respectively, with F1-scores of 99.4% and 96.3%, and median absolute errors of 18 ms (IQR [8-39] ms) and 26 ms (IQR [12-50] ms). CONCLUSIONS Our results are consistent with the state of the art for healthy subjects and demonstrate a good accuracy in GEs detection for pathological patients. Therefore, our proposed method provides an efficient way to detect GEs from IMU signals, even in degraded gaits. However, it should be evaluated in each cohort before being used to ensure its reliability.
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Affiliation(s)
- Cyril Voisard
- Université Paris Saclay, Université Paris Cité, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, Gif-sur-Yvette, France.
- Service de Neurologie, Service de Santé des Armées, HIA Percy, Clamart, France.
| | - Nicolas de l'Escalopier
- Université Paris Cité, Université Paris Saclay, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, Paris, France
- Service de Chirurgie Orthopédique, Traumatologique et Réparatrice des Membres, Service de Santé des Armées, HIA Percy, Clamart, France
| | - Damien Ricard
- Université Paris Cité, Université Paris Saclay, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, Paris, France
- Service de Neurologie, Service de Santé des Armées, HIA Percy, Clamart, France
- Ecole du Val-de-Grâce, Service de Santé des Armées, Paris, France
| | - Laurent Oudre
- Université Paris Saclay, Université Paris Cité, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, Gif-sur-Yvette, France
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Kvist A, Tinmark F, Bezuidenhout L, Reimeringer M, Conradsson DM, Franzén E. Validation of algorithms for calculating spatiotemporal gait parameters during continuous turning using lumbar and foot mounted inertial measurement units. J Biomech 2024; 162:111907. [PMID: 38134464 DOI: 10.1016/j.jbiomech.2023.111907] [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: 07/12/2023] [Revised: 12/07/2023] [Accepted: 12/13/2023] [Indexed: 12/24/2023]
Abstract
Spatiotemporal gait parameters such as step time and walking speed can be used to quantify gait performance and determine physical function. Inertial measurement units (IMUs) allow for the measurement of spatiotemporal gait parameters in unconstrained environments but must be validated against a gold standard. While many IMU systems and algorithms have been validated during treadmill walking and overground walking in a straight line, fewer studies have validated algorithms during more complex walking conditions such as continuous turning in different directions. This study explored the concurrent validity in a population of healthy adults (range 26-52 years) of three different algorithms using lumbar and foot mounted IMUs to calculate spatiotemporal gait parameters: two methods utilizing an inverted pendulum model, and one method based on strapdown integration. IMU data was compared to a Vicon twelve-camera optoelectronic system, using data collected from 9 participants performing straight walking and continuous walking trials at different speeds, resulting in 162 walking trials in total. Intraclass correlation coefficients (ICCA,1) for absolute agreement were calculated between the algorithm outputs and Vicon output. Temporal parameters were comparable in all methods and ranged from moderate to excellent, except double support time which was poor. Strapdown integration performed better for estimating spatial parameters than pendulum models during straight walking, but worse during turning. Selecting the most appropriate model should take into consideration both speed and walking condition.
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Affiliation(s)
- Alexander Kvist
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
| | - Fredrik Tinmark
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Physiology, Nutrition and Biomechanics, The Swedish School of Sport and Health Sciences, Sweden
| | - Lucian Bezuidenhout
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Reimeringer
- Karolinska University Hospital, Motion Analysis Laboratory, Stockholm, Sweden
| | - David Moulaee Conradsson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Medical Unit Occupational Therapy & Physiotherapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Erika Franzén
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Medical Unit Occupational Therapy & Physiotherapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.
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Ricciardi C, Pisani N, Donisi L, Abate F, Amboni M, Barone P, Picillo M, Cesarelli M, Amato F. Agreement between Optoelectronic System and Wearable Sensors for the Evaluation of Gait Spatiotemporal Parameters in Progressive Supranuclear Palsy. SENSORS (BASEL, SWITZERLAND) 2023; 23:9859. [PMID: 38139705 PMCID: PMC10747970 DOI: 10.3390/s23249859] [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: 11/14/2023] [Revised: 12/12/2023] [Accepted: 12/14/2023] [Indexed: 12/24/2023]
Abstract
The use of wearable sensors for calculating gait parameters has become increasingly popular as an alternative to optoelectronic systems, currently recognized as the gold standard. The objective of the study was to evaluate the agreement between the wearable Opal system and the optoelectronic BTS SMART DX system for assessing spatiotemporal gait parameters. Fifteen subjects with progressive supranuclear palsy walked at their self-selected speed on a straight path, and six spatiotemporal parameters were compared between the two measurement systems. The agreement was carried out through paired data test, Passing Bablok regression, and Bland-Altman Analysis. The results showed a perfect agreement for speed, a very close agreement for cadence and cycle duration, while, in the other cases, Opal system either under- or over-estimated the measurement of the BTS system. Some suggestions about these misalignments are proposed in the paper, considering that Opal system is widely used in the clinical context.
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Affiliation(s)
- Carlo Ricciardi
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
| | - Noemi Pisani
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
| | - Leandro Donisi
- Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy
| | - Filomena Abate
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy
| | - Marianna Amboni
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy
| | - Paolo Barone
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy
| | - Marina Picillo
- Center for Neurodegenerative Diseases (CEMAND), Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, 84131 Salerno, Italy
| | - Mario Cesarelli
- Department of Engineering, University of Sannio, 82100 Benevento, Italy
| | - Francesco Amato
- Department of Electrical Engineering and Information Technology, University of Naples Federico II, 80125 Naples, Italy
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Weng X, Mei C, Gao F, Wu X, Zhang Q, Liu G. A gait stability evaluation method based on wearable acceleration sensors. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:20002-20024. [PMID: 38052634 DOI: 10.3934/mbe.2023886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
In this study, an accurate tool is provided for the evaluation of the effect of joint motion effect on gait stability. This quantitative gait evaluation method relies exclusively on the analysis of data acquired using acceleration sensors. First, the acceleration signal of lower limb motion is collected dynamically in real-time through the acceleration sensor. Second, an algorithm based on improved dynamic time warping (DTW) is proposed and used to calculate the gait stability index of the lower limbs. Finally, the effects of different joint braces on gait stability are analyzed. The experimental results show that the joint brace at the ankle and the knee reduces the range of motions of both ankle and knee joints, and a certain impact is exerted on the gait stability. In comparison to the ankle joint brace, the knee joint brace inflicts increased disturbance on the gait stability. Compared to the joint motion of the braced side, which showed a large deviation, the joint motion of the unbraced side was more similar to that of the normal walking process. In this paper, the quantitative evaluation algorithm based on DTW makes the results more intuitive and has potential application value in the evaluation of lower limb dysfunction, clinical training and rehabilitation.
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Affiliation(s)
- Xuecheng Weng
- School of Artificial Intelligence, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Chang Mei
- School of Artificial Intelligence, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Farong Gao
- School of Artificial Intelligence, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Xudong Wu
- Department of Orthopaedics, Zhoushan Hospital of Traditional Chinese Medicine, Zhoushan 316000, China
| | - Qizhong Zhang
- School of Artificial Intelligence, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Guangyu Liu
- School of Artificial Intelligence, Hangzhou Dianzi University, Hangzhou 310018, China
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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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A Single Wearable Sensor for Gait Analysis in Parkinson’s Disease: A Preliminary Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Movement monitoring in patients with Parkinson’s disease (PD) is critical for quantifying disease progression and assessing how a subject responds to medication administration over time. In this work, we propose a continuous monitoring system based on a single wearable sensor placed on the lower back and an algorithm for gait parameters evaluation. In order to preliminarily validate the proposed system, seven PD subjects took part in an experimental protocol in preparation for a larger randomized controlled study. We validated the feasibility of our algorithm in a constrained environment through a laboratory scenario. Successively, it was tested in an unsupervised environment, such as the home scenario, for a total of almost 12 h of daily living activity data. During all phases of the experimental protocol, videos were shot to document the tasks. The obtained results showed a good accuracy of the proposed algorithm. For all PD subjects in the laboratory scenario, the algorithm for step identification reached a percentage error low of 2%, 99.13% of sensitivity and 100% of specificity. In the home scenario the Bland–Altman plot showed a mean difference of −3.29 and −1 between the algorithm and the video recording for walking bout detection and steps identification, respectively.
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Krokidis MG, Dimitrakopoulos GN, Vrahatis AG, Tzouvelekis C, Drakoulis D, Papavassileiou F, Exarchos TP, Vlamos P. A Sensor-Based Perspective in Early-Stage Parkinson's Disease: Current State and the Need for Machine Learning Processes. SENSORS (BASEL, SWITZERLAND) 2022; 22:409. [PMID: 35062370 PMCID: PMC8777583 DOI: 10.3390/s22020409] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/02/2021] [Accepted: 01/04/2022] [Indexed: 02/04/2023]
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder associated with dysfunction of dopaminergic neurons in the brain, lack of dopamine and the formation of abnormal Lewy body protein particles. PD is an idiopathic disease of the nervous system, characterized by motor and nonmotor manifestations without a discrete onset of symptoms until a substantial loss of neurons has already occurred, enabling early diagnosis very challenging. Sensor-based platforms have gained much attention in clinical practice screening various biological signals simultaneously and allowing researchers to quickly receive a huge number of biomarkers for diagnostic and prognostic purposes. The integration of machine learning into medical systems provides the potential for optimization of data collection, disease prediction through classification of symptoms and can strongly support data-driven clinical decisions. This work attempts to examine some of the facts and current situation of sensor-based approaches in PD diagnosis and discusses ensemble techniques using sensor-based data for developing machine learning models for personalized risk prediction. Additionally, a biosensing platform combined with clinical data processing and appropriate software is proposed in order to implement a complete diagnostic system for PD monitoring.
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Affiliation(s)
- Marios G. Krokidis
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (M.G.K.); (A.G.V.); (C.T.); (T.P.E.)
| | - Georgios N. Dimitrakopoulos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (M.G.K.); (A.G.V.); (C.T.); (T.P.E.)
| | - Aristidis G. Vrahatis
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (M.G.K.); (A.G.V.); (C.T.); (T.P.E.)
| | - Christos Tzouvelekis
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (M.G.K.); (A.G.V.); (C.T.); (T.P.E.)
| | | | | | - Themis P. Exarchos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (M.G.K.); (A.G.V.); (C.T.); (T.P.E.)
| | - Panayiotis Vlamos
- Bioinformatics and Human Electrophysiology Laboratory, Department of Informatics, Ionian University, 49100 Corfu, Greece; (M.G.K.); (A.G.V.); (C.T.); (T.P.E.)
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Celik Y, Stuart S, Woo WL, Godfrey A. Wearable Inertial Gait Algorithms: Impact of Wear Location and Environment in Healthy and Parkinson's Populations. SENSORS 2021; 21:s21196476. [PMID: 34640799 PMCID: PMC8512498 DOI: 10.3390/s21196476] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022]
Abstract
Wearable inertial measurement units (IMUs) are used in gait analysis due to their discrete wearable attachment and long data recording possibilities within indoor and outdoor environments. Previously, lower back and shin/shank-based IMU algorithms detecting initial and final contact events (ICs-FCs) were developed and validated on a limited number of healthy young adults (YA), reporting that both IMU wear locations are suitable to use during indoor and outdoor gait analysis. However, the impact of age (e.g., older adults, OA), pathology (e.g., Parkinson's Disease, PD) and/or environment (e.g., indoor vs. outdoor) on algorithm accuracy have not been fully investigated. Here, we examined IMU gait data from 128 participants (72-YA, 20-OA, and 36-PD) to thoroughly investigate the suitability of ICs-FCs detection algorithms (1 × lower back and 1 × shin/shank-based) for quantifying temporal gait characteristics depending on IMU wear location and walking environment. The level of agreement between algorithms was investigated for different cohorts and walking environments. Although mean temporal characteristics from both algorithms were significantly correlated for all groups and environments, subtle but characteristically nuanced differences were observed between cohorts and environments. The lowest absolute agreement level was observed in PD (ICC2,1 = 0.979, 0.806, 0.730, 0.980) whereas highest in YA (ICC2,1 = 0.987, 0.936, 0.909, 0.989) for mean stride, stance, swing, and step times, respectively. Absolute agreement during treadmill walking (ICC2,1 = 0.975, 0.914, 0.684, 0.945), indoor walking (ICC2,1 = 0.987, 0.936, 0.909, 0.989) and outdoor walking (ICC2,1 = 0.998, 0.940, 0.856, 0.998) was found for mean stride, stance, swing, and step times, respectively. Findings of this study suggest that agreements between algorithms are sensitive to the target cohort and environment. Therefore, researchers/clinicians should be cautious while interpreting temporal parameters that are extracted from inertial sensors-based algorithms especially for those with a neurological condition.
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Affiliation(s)
- Yunus Celik
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Sam Stuart
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
| | - Wai Lok Woo
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
- Correspondence: (W.L.W.); (A.G.); Tel.: +44-0-191-227-3642 (A.G.)
| | - Alan Godfrey
- Department of Computer and Information Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK;
- Correspondence: (W.L.W.); (A.G.); Tel.: +44-0-191-227-3642 (A.G.)
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Comparison of Subjective and Objective Assessments on Improvement in Gait Function after Carotid Endarterectomy. SENSORS 2020; 20:s20226590. [PMID: 33218023 PMCID: PMC7698780 DOI: 10.3390/s20226590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 11/17/2022]
Abstract
The purpose of the present study was to determine whether objective gait test scores obtained using a tri-axial accelerometer can detect subjective improvement in gait as determined by the patient after carotid endarterectomy (CEA). Each patient undergoing CEA for ipsilateral internal carotid artery stenosis determined whether their gait was subjectively improved at six months after CEA when compared with preoperatively. Gait testing using a tri-axial accelerometer was also performed preoperatively and six months postoperatively. Twelve (15%) of 79 patients reported subjectively improved gait. Areas under the receiver operating characteristic curve for differences between pre- and postoperative test values in stride time, cadence, and ground floor reaction for detecting subjectively improved gait were 0.995 (95% confidence interval (CI), 0.945-1.000), 0.958 (95%CI, 0.887-0.990), and 0.851 (95%CI, 0.753-0.921), respectively. Cut-off points for value differences in detecting subjectively improved gait were identical to mean -1.7 standard deviation (SD) for stride time, mean +1.6 SD for cadence, and mean +0.4 SD for ground floor reaction of control values from normal subjects. Objective gait test scores obtained using the tri-axial accelerometer can detect subjective gait improvements after CEA. When determining significant postoperative improvements in gait using a tri-axial accelerometer, optimal cut-off points for each test value can be defined.
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