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

Ismailidis, Petros; Nüesch, Corina; Kaufmann, Mara; Clauss, Martin; Pagenstert, Geert; Eckardt, Anke; Ilchmann, Thomas

doi:10.1016/j.gaitpost.2020.07.004

Cited by 22 publications

(19 citation statements)

References 28 publications

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“…Only a few studies on gait in hip OA reported data for the ankle or knee. Of these, some reported no significant differences in knee ROM [ 6 ], while others described a reduction in knee flexion ROM [ 22 , 27 , 36 , 40 , 44 , 45 ] and greater [ 6 , 22 , 45 ] or comparable [ 27 ] peak ankle dorsiflexion in the affected leg in patients with hip OA compared to controls.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 29 had unilateral knee OA and were scheduled to undergo total knee arthroplasty, 30 had unilateral hip OA and were scheduled total hip arthroplasty, and 54 were age-matched asymptomatic persons ( Table 1 ). Subsets of data have been published previously in studies focusing on differences in gait kinematics between limbs in patients with knee OA and compared to healthy controls [ 21 , 23 ] and on differences in gait kinematics between limbs in patients with hip OA and compared to healthy controls [ 22 , 24 ]. For the current analysis, we expanded all groups of participants and focused on detecting differences in joint kinematics between patients with knee OA and patients with hip OA.…”

Section: Methodsmentioning

confidence: 99%

“…The required number of subjects was calculated based on group differences in discrete parameters reported in the literature [ 16 , 37 ] and based on previous comparisons between patients with knee OA [ 21 ] or patients with hip OA [ 22 ] versus asymptomatic controls. Sample size estimation revealed that 14 participants were required to detect an expected difference in knee ROM with an effect size of at least 1.12 with 80% power at a 5% significance level.…”

Section: Methodsmentioning

confidence: 99%

“…For instance, for patients with knee OA, differences in stride duration, knee flexion range of motion (ROM) in swing and stance have been assessed using the GaitWalk system [ 18 ], kinematic differences at the hip, knee and ankle in the sagittal plane using the H-Gait system [ 19 ], and thigh and shank sagittal and coronal, knee sagittal kinematics as well as temporal gait parameters using the GaitSmart TM system [ 20 ]. In a series of studies, Ismailidis et al have shown that known differences in joint kinematics between patients with knee OA [ 21 ] or patients with hip OA [ 22 ] and healthy controls can be measured using the RehaGait ® system, reported kinematic differences not only for the index joint but also to adjacent joints, and confirmed that some of these differences depend on walking speed [ 23 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

Nüesch

Ismailidis

Koch

et al. 2021

Sensors

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There is a great need for quantitative outcomes reflecting the functional status in patients with knee or hip osteoarthritis (OA) to advance the development and investigation of interventions for OA. The purpose of this study was to determine if gait kinematics specific to the disease—i.e., knee versus hip OA—can be identified using wearable sensors and statistical parametric mapping (SPM) and whether disease-related gait deviations are associated with patient reported outcome measures. 113 participants (N = 29 unilateral knee OA; N = 30 unilateral hip OA; N = 54 age-matched asymptomatic persons) completed gait analysis with wearable sensors and the Knee/Hip Osteoarthritis Outcome Score (KOOS/HOOS). Data were analyzed using SPM. Knee and hip kinematics differed between patients with knee OA and patients with hip OA (up to 14°, p < 0.001 for knee and 8°, p = 0.003 for hip kinematics), and differences from controls were more pronounced in the affected than unaffected leg of patients. The observed deviations in ankle, knee and hip kinematic trajectories from controls were associated with KOOS/HOOS in both groups. Capturing gait kinematics using wearables has a large potential for application as outcome in clinical trials and for monitoring treatment success in patients with knee or hip OA and in large cohorts representing a major advancement in research on musculoskeletal diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

Nüesch

Ismailidis

Koch

et al. 2021

Sensors

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“…Musculoskeletal disorders outside of the spine involved in walking, such as knee and hip osteoarthritis, also result in poor kinematic parameters including reduction in walking speed [ 22 , 23 ]. Given the known association of walking quality with functional disability, and the additional association of walking quality with disease-specific disability scores in the present study, the SMoS may also be used to guide functional intervention by occupational and physiotherapy.…”

Section: Discussionmentioning

confidence: 99%

Proposed objective scoring algorithm for walking performance, based on relevant gait metrics: the Simplified Mobility Score (SMoS™)—observational study

Betteridge

Mobbs

2021

J Orthop Surg Res

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Background Walking is a fundamental part of living, and its importance is not limited by age or medical status. Reduced walking speed (WS), or gait velocity, is a sign of advancing age, various disease states, cognitive impairment, mental illness and early mortality. Activity levels, as defined in the literature as “daily step count” (DSC), is also a relevant measure of health status. A deterioration in our walking metrics, such as reduced WS and DSC, is associated with poor health outcomes. These objective measures are of such importance, that walking speed has been dubbed “the 6th vital sign”. We report a new objective measure that scores walking using the relevant metrics of walking speed and daily step count, into an easy-to-understand score from 0 (nil mobility) to 100 (excellent mobility), termed the Simplified Mobility Score (SMoS™). We have provided equal weighting to walking speed and daily step count, using a simple algorithm to score each metric out of 50. Methods Gait data was collected from 182 patients presenting to a tertiary hospital spinal unit with complaints of pain and reduced mobility. Walking speed was measured from a timed walk along an unobstructed pathway. Daily step count information was obtained from patients who had enabled step count tracking on their devices. The SMoS of the sample group were compared to expected population values calculated from the literature using 2-tailed Z tests. Results There were significantly reduced SMoS in patients who presented to the spinal unit than those expected at each age group for both genders, except for the 50–59 age bracket where no statistically significant reduction was observed. Even lower scores were present in those that went on to have surgical management. There was a significant correlation of SMoS scores with subjective disability scores such as the Oswestry Disability Index (ODI) and Visual Analogue Scale (VAS) in this cohort. Conclusions The SMoS is a simple and effective scoring tool which is demonstrably altered in spinal patients across age and gender brackets and correlates well with subjective disability scores. The SMoS has the potential to be used as a screening tool in primary and specialised care settings.

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Functional assessment of total hip arthroplasty using inertial measurement units: Improvement in gait kinematics and association with patient‐reported outcome measures

Kaufmann

Nüesch

Clauss

et al. 2022

Journal Orthopaedic Research

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Inertial measurement units (IMUs) are commonly used for gait assessment, yet their potential for quantifying improvements in gait function and patterns after total hip arthroplasty (THA) has not been fully explored. The primary aim of this study was to compare spatiotemporal parameters and sagittal plane kinematic patterns of patients with hip osteoarthritis (OA) before and after THA, and to asymptomatic controls.The secondary aim was to assess the association between dynamic hip range of motion (ROM) during walking and the Hip Osteoarthritis Outcome Scores (HOOS).Twenty-four patients with hip OA and 24 matched asymptomatic controls completed gait analyses using the RehaGait ® sensor system. Patients were evaluated pre-and 1 year postoperatively, controls in a single visit. Differences in kinematic data were analyzed using statistical parametric mapping, and correlations between dynamic hip ROM and HOOS were calculated. Walking speed and stride length significantly increased (+0.08 m/s, p = 0.019; +0.06 m, p = 0.048) after THA but did not reach the level of asymptomatic controls (−0.11 m/s, p = 0.028; −0.14 m, p = 0.001). Preoperative hip and knee kinematics differed significantly from controls.After THA, they improved significantly and did not differ from controls. Dynamic hip flexion-extension ROM correlated positively with all HOOS subscores (r > 0.417; p ≤ 0.001). The change in HOOS symptoms in patients was explained by the combination of baseline HOOS symptoms and change in dynamic hip ROM (r 2 = 0.748) suggesting that the additional information gained with IMU gait analysis helps to complement and objectify patient-reported outcome measures pre-and postoperatively and monitor treatment-related improvements.

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

Cited by 22 publications

References 28 publications

Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

Proposed objective scoring algorithm for walking performance, based on relevant gait metrics: the Simplified Mobility Score (SMoS™)—observational study

Functional assessment of total hip arthroplasty using inertial measurement units: Improvement in gait kinematics and association with patient‐reported outcome measures

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