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September 17, 2021Open Access

Patients with hip or knee osteoarthritis demonstrated significantly more asymmetrical gait patterns compared to asymptomatic controls (mean difference in vertical step regularity 0.13, p<0.001 for hip OA).

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Why the study?

To evaluate which trunk-worn IMU movement quality parameters distinguish gait in hip or knee osteoarthritis vs controls, their sensitivity to gait changes after TKA, and correlation with patient-reported outcomes.

Does total knee arthroplasty improve movement quality parameters measured by a single trunk-worn IMU in patients with knee osteoarthritis compared to baseline and asymptomatic controls?

Population

20 people with hip OA, 18 with knee OA, and 20 asymptomatic controls

Comparison

Hip OA vs knee OA vs controls, and pre- vs post-TKA timepoints

Design

Prospective cohort study

Follow-up

12 months

Key result

Patients with hip or knee osteoarthritis demonstrated significantly more asymmetrical gait patterns compared to asymptomatic controls (mean difference in vertical step regularity 0.13, p<0.001 for hip OA).

Authors

JEJill EmmerzaalKCKristoff CortenRSRob van der Straaten

Discussion

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Overview

Objective IMU gait measures detect asymmetry in hip/knee osteoarthritis; hypothesis-generating for tracking arthroplasty response but should not yet change practice.

Study Design

Type

Cohort (n=58)

Multicenter

Yes

Structured PICO

Does total knee arthroplasty improve movement quality parameters measured by a single trunk-worn IMU in patients with knee osteoarthritis compared to baseline and asymptomatic controls?

P
Population
58 adults aged 50-75 years, comprising 38 patients with end-stage hip or knee osteoarthritis and 20 asymptomatic controls, evaluated for gait movement quality with knee OA patients followed for 12 months post-arthroplasty.
E
Exposure
Total knee arthroplasty (TKA) with longitudinal follow-up using a single trunk-worn Inertial Measurement Unit (IMU) during gait.
C
Comparator
Asymptomatic controls (for cross-sectional comparison) and pre-operative baseline (for longitudinal comparison).
O
Outcome
Movement quality parameters (symmetry, complexity, smoothness, and dynamic stability) calculated from raw 3D acceleration signals during a 10m walk at self-selected speed.surrogate

Main Result

Mean Difference: 0.13

Absolute Event Rate: 0.64% vs 0.78%

p-value: p=<0.001

A single lower back IMU can objectively characterize gait movement quality before and after total joint arthroplasty, and these biomechanical improvements correlate with patient-reported outcomes.

Limitations

  • Sample entropy and maximum Lyapunov Exponent are sensitive to the number of data points used, and the study used fewer samples than recommended thresholds.
  • Straight line walking within a controlled lab-based setting may not reflect more complex daily life activities.
  • Limited number of subjects, leaving the study slightly underpowered for some parameters.

Cite This Study

Emmerzaal et al. (2021) conducted a cohort in Hip or knee osteoarthritis (n=58). Osteoarthritis and Total Knee Arthroplasty vs. Asymptomatic controls was evaluated on Step regularity in the vertical (VT) direction (MD 0.13, p=<0.001). Patients with hip or knee osteoarthritis demonstrated significantly more asymmetrical gait patterns compared to asymptomatic controls (mean difference in vertical step regularity 0.13, p<0.001 for hip OA).

synapsesocial.com/papers/6a943a3df55298cb2cfed481https://doi.org/10.21203/rs.3.rs-832370/v1
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