Abstract
Body-fixed sensor (BFS) technology offers portable, low-cost and easy-to-use alternatives to laboratory-bound equipment for analyzing an individual’s gait. Psychometric properties of single BFS systems for gait analysis in older adults who require a rollator for walking are, however, unknown. The study’s aim was to evaluate the concurrent validity, test-retest-reliability, and sensitivity to change of a BFS (DynaPort MoveTest; McRoberts B.V., The Hague, The Netherlands) for measuring gait parameters during rollator-assisted walking. Fifty-eight acutely hospitalized older patients equipped with the BFS at the lower back completed a 10 m walkway using a rollator. Concurrent validity was assessed against the Mobility Lab (APDM Inc.; Portland, OR, USA), test-retest reliability over two trials within a 15 min period, and sensitivity to change in patients with improved, stable and worsened 4 m usual gait speed over hospital stay. Bland–Altman plots and intraclass correlation coefficients (ICC) for gait speed, cadence, step length, step time, and walk ratio indicate good to excellent agreement between the BFS and the Mobility Lab (ICC2,1 = 0.87–0.99) and the repeated trials (ICC2,1 = 0.83–0.92). Moderate to large standardized response means were observed in improved (gait speed, cadence, step length, walk ratio: 0.62–0.99) and worsened patients (gait speed, cadence, step time: −0.52 to −0.85), while those in stable patients were trivial to small (all gait parameters: −0.04–0.40). The BFS appears to be a valid, reliable and sensitive instrument for measuring spatio-temporal gait parameters during rollator-assisted walking in geriatric patients.
Highlights
Gait disorders are prevalent in older adults [1,2], and have been associated with a higher risk of adverse outcomes such as falls, disability, institutionalization, and mortality [2,3,4,5]
body-fixed sensor (BFS) systems have already been used for gait analysis in older adults during walking with a rollator, there is limited evidence on their psychometric properties for quantifying spatio-temporal gait parameters under this walking condition
Moderate to large standardized response means (SRM) values (−0.85 to −0.52), were observed for deteriorations in gait speed, cadence, and step time among the worsened subgroup; these negative changes missed the level of significance, which might have been related to the small number of patients in this subgroup. These results suggest that the DynaPort MT was more sensitive to improvements than to deteriorations in gait performance
Summary
Gait disorders are prevalent in older adults [1,2], and have been associated with a higher risk of adverse outcomes such as falls, disability, institutionalization, and mortality [2,3,4,5]. Recent advances in wearable sensor technology provide clinicians and researchers with more affordable, easy-to-use and highly portable alternatives for measuring an individual’s spatio-temporal gait parameters during walking [19,20,21,22] Such wearable or body-fixed sensor (BFS) systems for quantitative gait analysis most frequently incorporate miniaturized inertial measurement units (IMUs), which consist of tri-axial accelerometers, gyroscopes and, in some cases, magnetometers [23,24]. Some of these BFS systems are based on multiple IMUs (e.g., APDM Mobility Lab, BioSensics LEGSys) attached to various parts of an individual’s body (e.g., feet, knees, thighs or waist), while others only include a single IMU to collect gait data (e.g., DynaPort MoveTest [MT]). BFS systems have already been used for gait analysis in older adults during walking with a rollator (for review see, [35]), there is limited evidence on their psychometric properties for quantifying spatio-temporal gait parameters (e.g., gait speed, cadence, step time, or step length) under this walking condition
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