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.
Total knee arthroplasty (TKA) is the primary treatment for knee osteoarthritis. However, TKA is highly likely to result in prolonged chronic postoperative pain. The one-foot-one-step walking style is likely to induce fear of movement because of pain, leading to catastrophic thinking about the actual activity and consequently limiting movement. The aim of this study is to develop a system to induce the sensation of stair climbing through the interaction of the visual and kinesthetic senses. By controlling the amount of movement of the foot and the point of view in virtual space, the system can present a visual image of stair climbing even when the patient steps in a fixed position. This system enables easy motor imagery intervention even for early postoperative patients who have difficulty with the actual stair climbing movement. The clinical intervention experiment confirmed that the smoothness of the knee joint motion during descent was improved by intervening with motor imagery during stair ascent and descent for TKA patients.
This study aimed to assess the association between the degree of varus thrust (VT) assessed by an inertial measurement unit (IMU) and patient-reported outcome measures (PROMs) in patients with knee osteoarthritis. Seventy patients (mean age: 59.8 ± 8.6 years; women: n = 40) were instructed to walk on a treadmill with an IMU attached to the tibial tuberosity. For the index of VT during walking (VT-index), the swing-speed adjusted root mean square of acceleration in the mediolateral direction was calculated. As the PROMs, the Knee Injury and Osteoarthritis Outcome Score were used. Data on age, sex, body mass index, static alignment, central sensitization, and gait speed were collected as potential confounders. After adjusting for potential confounders, multiple linear regression analysis revealed that the VT-index was significantly associated with the pain score (standardized β = −0.295; p = 0.026), symptoms score (standardized β = −0.287; p = 0.026), and activities of the daily living score (standardized β = −0.256; p = 0.028). Our results indicated that larger VT values during gait are associated with worse PROMs, suggesting that an intervention to reduce VT might be an option for clinicians trying to improve PROMs.
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