Test-Retest Reliability of PODOSmart® Gait Analysis Insoles

Validity and Test-Retest Reliability of Spatiotemporal Running Parameter Measurement Using Embedded Inertial Measurement Unit Insoles

Running is the basis of many sports and has highly beneficial effects on health. To increase the understanding of running, DSPro® insoles were developed to collect running parameters during tasks. However, no validation has been carried out for running gait analysis. The aims of this study were to assess the test-retest reliability and criterion validity of running gait parameters from DSPro® insoles compared to a motion-capture system. Equipped with DSPro® insoles, a running gait analysis was performed on 30 healthy participants during overground and treadmill running using a motion-capture system. Using an intraclass correlation coefficient (ICC), the criterion validity and test-retest reliability of spatiotemporal parameters were calculated. The test-retest reliability shows moderate to excellent ICC values (ICC > 0.50) except for propulsion time during overground running at a fast speed with the motion-capture system. The criterion validity highlights a validation of running parameters regardless of speeds (ICC > 0.70). This present study validates the good criterion validity and test-retest reliability of DSPro® insoles for measuring spatiotemporal running gait parameters. Without the constraints of a 3D motion-capture system, such insoles seem to be helpful and relevant for improving the care management of active patients or following running performance in sports contexts.

Empowering sickle cell disease care: the rise of TechnoRehabLab in Sub-Saharan Africa for enhanced patient's perspectives

Sickle-cell Disease (SCD) is a major public health problem in Africa, and there are significant obstacles to its comprehensive management, particularly in terms of access to appropriate healthcare. This calls for inventive approaches to improve patients' prospects. Among the major challenges to be met are the primary and secondary prevention of certain serious complications associated with the disease, such as neurocognitive, motor and respiratory functional disorders. This perspective argues for the rapid creation of specific, cost-effective, technology-supported rehabilitation centres to advance SCD care, identify patients at high risk of stroke and implement tailored rehabilitation strategies. The TechnoRehabLab in Lubumbashi illustrates this shift in thinking by using cutting-edge technologies such as virtual reality (VR), serious games and mobile health to create a comprehensive and easily accessible rehabilitation framework. Diagnostic tools used to perform functional assessment can be used to identify cognitive, balance and walking deficits respectively. Transcranial Doppler enables early detection of sickle cell cerebral vasculopathy, making it possible to provide early and appropriate treatment. VR technology and serious games enable effective rehabilitation and cognitive stimulation, which is particularly advantageous for remote or community-based rehabilitation. In the context of African countries where there is a glaring disparity in access to digital resources, the TechnoRehabLab serves as a tangible example, demonstrating the flexibility and accessibility of technology-assisted rehabilitation. This perspective is an urgent call to governments, non-governmental organisations and the international community to allocate resources to the replication and expansion of similar facilities across Africa.

Overview on wearable sensors for the management of Parkinson's disease

Parkinson's disease (PD) is affecting about 1.2 million patients in Europe with a prevalence that is expected to have an exponential increment, in the next decades. This epidemiological evolution will be challenged by the low number of neurologists able to deliver expert care for PD. As PD is better recognized, there is an increasing demand from patients for rigorous control of their symptoms and for therapeutic education. In addition, the highly variable nature of symtoms between patients and the fluctuations within the same patient requires innovative tools to help doctors and patients monitor the disease in their usual living environment and adapt treatment in a more relevant way. Nowadays, there are various body-worn sensors (BWS) proposed to monitor parkinsonian clinical features, such as motor fluctuations, dyskinesia, tremor, bradykinesia, freezing of gait (FoG) or gait disturbances. BWS have been used as add-on tool for patients' management or research purpose. Here, we propose a practical anthology, summarizing the characteristics of the most used BWS for PD patients in Europe, focusing on their role as tools to improve treatment management. Consideration regarding the use of technology to monitor non-motor features is also included. BWS obviously offer new opportunities for improving management strategy in PD but their precise scope of use in daily routine care should be clarified.

The Use of Embedded IMU Insoles to Assess Gait Parameters: A Validation and Test-Retest Reliability Study

Wireless wearable insoles are interesting tools to collect gait parameters during daily life activities. However, studies have to be performed specifically for each type of insoles on a big data set to validate the measurement in ecological situations. This study aims to assess the criterion validity and test-retest reliability of gait parameters from wearable insoles compared to motion capture system. Gait of 30 healthy participants was recorded using DSPro® insoles and a motion capture system during overground and treadmill walking at three different speeds. Criterion validity and test-retest reliability of spatio-temporal parameters were estimated with an intraclass correlation coefficient (ICC). For both systems, reliability was found higher than 0.70 for all variables (p < 0.001) except for minimum toe clearance (ICC < 0.50) with motion capture system during overground walking. Regardless of speed and condition of walking, Speed, Cadence, Stride Length, Stride Time and Stance Time variables were validated (ICC > 0.90; p < 0.001). During walking on treadmill, loading time was not validated during slow speed (ICC < 0.70). This study highlights good criterion validity and test-retest reliability of spatiotemporal gait parameters measurement using wearable insoles and opens a new possibility to improve care management of patients using clinical gait analysis in daily life activities.

Wireless pressure insoles for measuring ground reaction forces and trajectories of the centre of pressure during functional activities

Wireless pressure insoles may enable the assessment of movement biomechanics in a real-world setting, and thus play an important role in the recommendation of clinical management, but they are not yet a gold standard due to the unknown accuracy and reliability with respect to different functional activities. Here, we compare novel wireless pressure insoles with force plates and examine the test-retest reliability of the insoles for measuring vertical ground reaction forces (vGRFs) and trajectories of the center of pressure (COP). In this observational study, healthy adults underwent two data collection sessions during one day. The Bland-Altman analysis was used to compare the outcomes measured with the two instruments during squats, jumps, and the sit-to-stand test. Test-retest reliability was assessed by the interclass correlation coefficient and the standard error of measurement for the outcomes during squats, jumps, walking, and stair ambulation. Trajectories of the COP in the anterior-posterior direction were comparable between the two systems during all activities. The insoles consistently measured shorter trajectories of the COP in the medial-lateral direction (except jumps) and lower vGRFs than the force plates. Test-retest reliability of the insoles was fair to high or excellent for all outcomes during all activities. In conclusion, the insoles provide reliable measures of vGRFs and trajectories of the COP during multiple functional activities in healthy adults. Although the insoles do not produce identical results to the force plate, the qualitative similarity and consistency between the two systems confirm the insoles can be used to measure these outcomes, based on the purpose and accuracy required.

Gait Analysis, Metabolic Parameters and Adherence to the Mediterranean Diet in Patients with Type 2 Diabetes Mellitus Compared with Healthy Controls: A Pilot Study

BACKGROUND AND PURPOSE

Patients with type 2 diabetes mellitus (T2DM) are prone to developing diabetic peripheral neuropathy (DPN) with an increased risk of injuries while walking, potentially leading to plantar ulcers. We aimed to assess the early gait changes in T2DM patients without clinical signs of DPN in comparison to age-matched healthy controls (HC).

SUBJECTS AND METHODS

One hundred T2DM patients (78 women, mean age: 66.4 ± 11.5 years) and 50 age-matched HC (34 women, mean age 62.1 ± 7.9 years) were evaluated with the PODOSmart® gait analysis device. Anthropometric and biochemical data, as well as dietary habits were collected for all participants. T2DM patients also completed the Diabetes Distress (DS) self-report validated questionnaire.

RESULTS

One patient was excluded from the study due to lack of recent biochemical data. Among the T2DM patients, 88.9% reported little or no DS and 11.1% moderate DS. The T2DM group had higher body mass index, waist circumference, systolic blood pressure, glycated hemoglobin A1c, sodium, white blood cell count, triglycerides and low-density lipoprotein cholesterol, but lower high-density lipoprotein cholesterol than HC (p < 0.05 for all comparisons). The MedDiet score was satisfactory in both groups (p > 0.05). Significant differences were found between the two study groups in gaitline heel off, propulsion speed, foot progression angle, time taligrade phase, stride length, walking speed, angle attack, oscillation speed, pronation-supination toe off and clearance.

CONCLUSIONS

The T2DM patients without self-reported DS or clinical signs of DPN may exhibit significant differences in several gait parameters analyzed with PODOSmart®. Whether gait analysis can be used as an early diagnostic tool of T2DM complications should be further explored.

Validation of Pressure-Sensing Insoles in Patients with Parkinson's Disease during Overground Walking in Single and Cognitive Dual-Task Conditions

There is a need for unobtrusive and valid tools to collect gait parameters in patients with Parkinson's disease (PD). The novel promising tools are pressure-sensing insoles connected to a smartphone app; however, few studies investigated their measurement properties during simple or challenging conditions in PD patients. This study aimed to examine the validity and reliability of gait parameters computed by pressure-sensing insoles (FeetMe^® insoles, Paris, France). Twenty-five PD patients (21 males, mean age: 69 (7) years) completed two walking assessment sessions. In each session, participants walked on an electronic pressure-sensitive walkway (GaitRite^®, CIR System Inc., Franklin, NJ, USA) without other additional instructions (i.e., single-task condition) and while performing a concurrent cognitive task (i.e., dual-task condition). Spatiotemporal gait parameters were measured simultaneously using the pressure-sensing insoles and the electronic walkway. Concurrent validity was assessed by correlation coefficients and Bland-Altman methodology. Test-retest reliability was examined by intraclass correlation coefficients (ICC) and minimal detectable changes (MDC). The validity results showed moderate to excellent correlations and good agreement between the two systems. Concerning test-retest reliability, moderate-to-excellent ICC values and acceptable MDC demonstrated the repeatability of the measured gait parameters. Our findings support the use of these insoles as complementary instruments to conventional tools during single and dual-task conditions.

Impact of Kinesiotherapy and Hydrokinetic Therapy on the Rehabilitation of Balance, Gait and Functional Capacity in Patients with Lower Limb Amputation: A Pilot Study

The purpose of this pilot study was to identify impact differences in the rehabilitation of balance, gait and functional capacity in patients with lower limb amputation performing hydrokinetic therapy and kinesiotherapy programs during the pre-prosthetic and prosthetic phases. The study included 16 male patients aged 40–60 years with amputated lower limbs for 6 to 12 months, which involved transfemoral amputation (TFA), transtibial amputation (TTA), traumatic and vascular amputation, who were divided into the following two groups: the hydrokinetic therapy (HKT) group and the kinesiotherapy (KT) group, named after the content of the rehabilitation programs that were implemented for 2 weeks in the pre-prosthetic and prosthetic periods. The initial and final evaluation of the participants included the following tests: the Berg Scale and the four square test for the evaluation of the balance; the PodoSmart device for gait assessment; through the walking test over 6 min, we evaluated the functional capacity. The results were processed in SPSS 24. Analysis of the results on balance rehabilitation through the Berg Scale highlighted that the progress related to the mean of the total score was 7.62 points, p = 0.00 for the HKT group and 7.50 points, p = 0.00 for the KT group, while in the four square step test, the mean of progress was 6.125 s, p = 0.00 for the HKT group and 6 s, p = 0.000 for the KT group. The PodoSmart gait analysis revealed that the HKT group showed a progress mean of 4.875%, p = 0.00, for the foot symmetry parameter, which was 1.875% less than the score achieved by the KT group whose symmetry progress mean was 6.75%, p = 0.00, while the average progress mean for the cadence parameter was 2.75 steps/min higher for the KT group than the HKT group. The comparative analysis of the impact of these two programs on the patients’ functional capacity indicated that the score recorded by the KT group was a progress mean of 15.12 m, p = 0.00 better than the HKT group for the travelled distance parameter; the implementation of the hydrokinetic therapy program led to better exercise adaptation for the HKT group compared to the KT group at an average HR (HRavg) with 0.50 BPM, p = 0.00. After analyzing the results, it has been found that hydrokinetic therapy programs have a greater impact on balance rehabilitation and exercise adaptation, while kinesiotherapy programs have a greater impact on gait rehabilitation and functional capacity optimization for the travelled distance parameter.