Kinematic changes in patients with severe knee osteoarthritis are a result of reduced walking speed rather than disease severity

Ismailidis, Petros; Egloff, Christian; Hegglin, Lea; Pagenstert, Geert; Kernen, Rolf; Eckardt, Anke; Ilchmann, Thomas; Mündermann, Annegret

doi:10.1016/j.gaitpost.2020.05.008

Cited by 36 publications

(29 citation statements)

References 33 publications

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“…On the downside, an important issue of gait assessment with IMUs is that it typically results in a large number of outcome parameters, with numerous correlated parameters. For example, many gait parameters share covariance with gait speed [11][12][13][14][15]. Hence, for clinical implementation, it is important to identify gait parameters from independent gait domains that best describe the gait adaptations in individuals with knee and hip OA compared to healthy controls.…”

Section: Introductionmentioning

confidence: 99%

Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors

Boekesteijn

Smolders

Busch

et al. 2021

BMC Musculoskelet Disord

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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.

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Section: Introductionmentioning

confidence: 99%

Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors

Boekesteijn

Smolders

Busch

et al. 2021

BMC Musculoskelet Disord

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“…While most studies on OA using inertial sensor systems have focused on knee OA, a few studies performing measurements with inertial sensor systems in patients with hip OA have reported spatiotemporal parameters [6,9,10,17,18], but none of these captured joint kinematics. Among inertial sensor systems, the RehaGait® system has been shown to provide reliable data that are comparable to an instrumented treadmill and camera-based system for measuring spatiotemporal parameters and lower limb kinematics in younger and older healthy subjects as well as in patients with knee OA and lumbar spinal stenosis [19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Measuring gait kinematics in patients with severe hip osteoarthritis using wearable sensors

Ismailidis

Nüesch²,

Kaufmann

et al. 2020

Gait & Posture

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“…Although the treatment focused on the knee, the hip ROM increase during gait was the most noteworthy difference observed. We can conclude that the increase in ROM is effectively related to the treatment, as the speed was relatively constant and joint kinematics are speeddependent during gait [32,33]. Previous studies have also shown that changes in gait mechanics in the knee joint affect the ROM of the ankle and hip joints [34,35], possibly explained by the fact that these three joints operate as a kinetic/kinematic chain during gait [34,36].…”

Section: Discussionmentioning

confidence: 80%

Lower limb kinematics improvement after genicular nerve blockade in patients with knee osteoarthritis: a milestone study using inertial sensors

Lebleu

Fonkoué

Bandolo

et al. 2020

BMC Musculoskelet Disord

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Background Genicular nerve blockade is a possible treatment for patients with knee osteoarthritis. Pain relief and improvement in functioning is expected. This procedure could be of major interest for patients in low-income countries where total knee arthroplasty is not available for the population. This study aims at assessing the immediate benefits on pain, gait, and stairs kinematics after a genicular nerve blockade in patients suffering from knee osteoarthritis in Cameroun. Methods A prospective study was carried out on 26 subjects in Cameroun. A genicular nerve blockade was performed on 14 women with painful knee osteoarthritis grade 2–4. Lower limb joint angles were recorded with inertial sensors before and 1 h after injection. Patient-reported outcomes of pain and perceived difficulty were collected, as well as 10 m and 6 min walking tests. A reliability analysis of inertial sensors was performed on a sample of 12 healthy subjects by calculating the intraclass correlation coefficient and the standard error of measurement. Results Pain and perceived difficulty decreased significantly (p < 0.001). Cadence increased significantly in stairs climbing (upstairs: + 7.7 steps/min; downstairs: + 7.6 steps/min). There was an improvement for hip sagittal range of motion during gait (+ 9.3°) and pelvis transverse range of motion in walking upstairs (− 3.3°). Angular speed range of the knee in the sagittal plane and of the hip in the frontal plane increased significantly in stairs descent (+ 53.7°/s, + 94.5°/s). Conclusions This study quantified improvement of gait and stair climbing immediately after a genicular nerve blockade in patients suffering from knee OA in Cameroon. This is the first study objectifying this effect, through wearable sensors. Trial registration Pan African Clinical Trial Registry, PACTR202004822698484. Registered 28 March 2020 - Retrospectively registered.

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Kinematic changes in patients with severe knee osteoarthritis are a result of reduced walking speed rather than disease severity

Abstract: Foundation and Deutsche Arthrose-Hilfe e.V. The funding sources had no involvement in any aspect of the study.

Cited by 36 publications

References 33 publications

Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors

Independent and sensitive gait parameters for objective evaluation in knee and hip osteoarthritis using wearable sensors

Measuring gait kinematics in patients with severe hip osteoarthritis using wearable sensors

Lower limb kinematics improvement after genicular nerve blockade in patients with knee osteoarthritis: a milestone study using inertial sensors

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