Use of a Single Wearable Sensor to Evaluate the Effects of Gait and Pelvis Asymmetries on the Components of the Timed Up and Go Test, in Persons with Unilateral Lower Limb Amputation.

Maria Stella Valle,Matteo Cioni,Sara Lanza,Antonino Casabona,Alessandro Vagnini,Luca Laudani,Ilenia Sapienza

doi:10.3390/s22010095

Abstract

The Timed Up and Go (TUG) test quantifies physical mobility by measuring the total performance time. In this study, we quantified the single TUG subcomponents and, for the first time, explored the effects of gait cycle and pelvis asymmetries on them. Transfemoral (TF) and transtibial (TT) amputees were compared with a control group. A single wearable inertial sensor, applied to the back, captured kinematic data from the body and pelvis during the 10-m walk test and the TUG test. From these data, two categories of symmetry indexes (SI) were computed: One SI captured the differences between the antero-posterior accelerations of the two sides during the gait cycle, while another set of SI quantified the symmetry over the three-dimensional pelvis motions. Moreover, the total time of the TUG test, the time of each subcomponent, and the velocity of the turning subcomponents were measured. Only the TF amputees showed significant reductions in each SI category when compared to the controls. During the TUG test, the TF group showed a longer duration and velocity reduction mainly over the turning subtasks. However, for all the amputees there were significant correlations between the level of asymmetries and the velocity during the turning tasks. Overall, gait cycle and pelvis asymmetries had a specific detrimental effect on the turning performance instead of on linear walking.

Highlights

Motor deficit due to unilateral amputation of a lower limb can lead to functional limitations over almost all the activities of daily living
The effects of asymmetries in amputees have typically been studied during linear walking and, as reported by Devan et al [9], most of the movement asymmetry studies in lower limb amputation have focused on local gait features, such as weight transfer during stance, generation of ground reaction forces, step time, and step length
There were significant differences across the groups for symmetry indexes (SI) evaluated for gait cycle The indices of gait cycle and pelvis symmetries were lower in the participants with (H2 = 12.02, p < 0.001, ε2= 0.86), pelvis tilt (H2 = 9.62, p = 0.002, ε2= 0.69), pelvis obliquity

Summary

Introduction

Motor deficit due to unilateral amputation of a lower limb can lead to functional limitations over almost all the activities of daily living. The effects of asymmetries in amputees have typically been studied during linear walking and, as reported by Devan et al [9], most of the movement asymmetry studies in lower limb amputation have focused on local gait features, such as weight transfer during stance, generation of ground reaction forces, step time, and step length. The asymmetries concerning trunk and pelvic segments have received less attention, with the consequences of neglecting the effects of asymmetries on the mobility of daily living motor tasks, such as standing up, sitting down, or walking along a curved path

Results

Discussion

Conclusion