Current clinical utilisation of wearable motion sensors for the assessment of outcome following knee arthroplasty: a scoping review

Abstract

ObjectivesWearable motion sensors are used with increasing frequency in the evaluation of gait, function and physical activity within orthopaedics and sports medicine. The integration of wearable technology into the clinical pathway offers the ability to improve post-operative patient assessment beyond the scope of current, questionnaire-based patient-reported outcome measures. This scoping review assesses the current methodology and clinical application of accelerometers and inertial measurement units for the evaluation of patient activity and functional recovery following knee arthroplasty.DesignThis is a systematically conducted scoping review following Joanna Briggs Institute methodology for scoping reviews and reported consulting the Preferred Reporting Items for Systematic Review and Meta-Analyses extension for scoping reviews. A protocol for this review is registered with the Open Science Framework (https://osf.io/rzg9q).Data sourcesCINAHL, EMBASE, MEDLINE and Web of Science databases were searched for manuscripts published between 2008 and 2019.Eligibility criteriaWe included clinical studies reporting the use of any combination of accelerometers, pedometers or inertial measurement units for patient assessment at any time point following knee arthroplasty.Data extraction and synthesisData extracted from manuscripts included patient demographics, sensor technology, testing protocol and sensor-based outcome variables.Results45 studies were identified, including 2076 knee arthroplasty patients, 620 patients with end-stage osteoarthritis and 449 healthy controls. Primary aims of the identified studies included functional assessment, physical activity monitoring and evaluation of knee instability. Methodology varied widely between studies, with inconsistency in reported sensor configuration, testing protocol and output variables.ConclusionsThe use of wearable sensors in evaluation of knee arthroplasty procedures is becoming increasingly common and offers the potential to improve clinical understanding of recovery and rehabilitation. While current studies lack consistency, significant opportunity exists for the development of standardised measures and protocols for function and physical activity evaluation.

Smartphone App with an Accelerometer Enhances Patients’ Physical Activity Following Elective Orthopedic Surgery: A Pilot Study

“…Wearable technology is increasingly being used in TKA and THA research, with the assessment of PA, functional parameters, and gait analysis as primary modes of investigation. No standard outcome measure or testing methodology has been established in wearable-based PA monitoring following TKA or THA [45]. Technology, testing protocol and sensor-based outcome variables may vary and may affect the quality and reliability of the data being collected [46][47][48][49].…”

“…Limited research has been conducted on monitoring PA during the early recovery phase following TKA or THA [45]. Eight studies have been performed, with sensor-based outcome variables varying considerably between studies [28,[50][51][52][53][54][55][56].…”

Impact of Reduced Sampling Rate on Accelerometer-based Physical Activity Monitoring and Machine Learning Activity Classification

“…Most recent physical activity studies include protocols where acceleration data is collected at a sampling frequency between 20 and 100 Hz [10,18,19]. It is important to note that reporting of sampling rate used in testing protocols remains a problem in the field of physical activity, with recent reviews finding that 16% to 73% studies failed to report the sampling rate used in their data collection is the author/funder, who has granted medRxiv a license to display the preprint in (which was not certified by peer review) preprint…”

“…The copyright holder for this this version posted October 27, 2020. ; https://doi.org/10.1101/2020.10.22.20217927 doi: medRxiv preprint protocol [10,18]. In an assessment of benchmark datasets, Khan et al [20] have argued that typical accelerometer sampling rates in many human motion studies are up to 57% higher than necessary for adequate data analysis, with optimal sampling rates between 12 and 63Hz depending on body location and model of accelerometer.…”

“…However, in the case of activity monitoring in clinical populations recovering from trauma or a surgical intervention, extended monitoring well beyond a standard seven day protocol may be desired [9]. Extended longitudinal protocols incorporating measurement windows beyond a few weeks requires frequent participant interaction for battery charging, which is burdensome and undesirable [10]. In these cases, a reduction of sampling rate would offer the potential for longer continuous physical activity measurement, while reducing patient and caregiver interactions with the monitoring device.…”