Analysis of characteristics required for gait evaluation of patients with knee osteoarthritis using a wireless accelerometer

Abstract

BackgroundKnee osteoarthritis (KOA) is associated with reduced quality of life due to knee pain and gait disturbance. However, the evaluation of KOA is mainly based on images and patient-reported outcome measures (PROMs), which are said to be insufficient for functional evaluation. Recently, gait analysis using an accelerometer has been used for functional evaluation of KOA patients. Nevertheless, evaluation of the entire body motion is insufficient. The aim of this study was to clarify the gait characteristics of KOA patients using the distribution of scalar products and the interval time of heel contact during spontaneous walking and to compare them with healthy subjects. MethodsParticipants wore a three-axis accelerometer sensor on the third lumbar vertebra and walked for 6 min on a flat path at a free walking speed. The sum of a composite vector (CV) scalar product and a histogram for distribution were used for body motion evaluation. The CV consisted of a synthesis of acceleration data from three axes. In addition to the summation of the CV, a histogram can be created to evaluate in detail the magnitude of the waves. The amount of variation was measured in the left–right and front–back directions. Variability was evaluated from the distribution of heel contact duration between both feet measured from the vertical acceleration. ResultsKOA patients showed a smaller sum of CV that converged to small acceleration in the distribution when compared with healthy subjects. In the KOA group, the amount of variation in the forward and backward directions was greater than that in the forward direction. The variability of heel–ground interval time was greater in the KOA group than in healthy subjects. ConclusionKOA patients walked with less overall body movement, with limited movable range of the knee joint and pain-avoiding motion. The gait of the KOA group was considered unstable, with long time intervals between peaks. The increase in the amount of forward variation was thought to be due to the effect of trunk forward bending during walking. The clinical relevance of this study is that it was possible to evaluate KOA patients’ gait quantitatively and qualitatively.