A clinical application of gait quality patterns in osteoarthritis

IF 2.2 3区医学 Q3 NEUROSCIENCES Gait & posture Pub Date : 2024-10-01 DOI:10.1016/j.gaitpost.2024.10.011

Alan Castro Mejia , Philipp Gulde , Consuelo González Salinas

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Abstract

Aim

To investigate whether a smartphone-based gait analysis tool can reliably output gait quality parameters that can be cross-analyzed to establish individual & disease-based changes in gait quality patterns.

Methods

A cross-sectional study made up of a 48-patients undergoing disability certification at the “Dr. José Castro Villagrana” or the “Dr. David Fragoso Lizalde” Health Centers in Mexico City, Mexico. Their sensorimotor performance was evaluated through an in-house smartphone/IMU based digital tool. Gait was analyzed by means of frequency analysis of the acceleration of the body mass measured at the sternum. A composite gait quality score was determined through principal component analysis based primarily on the explainability and uniformity of gait. Quality independence against demographic variables (age & weight) was tested through ANCOVA. The association between gait quality and gait parameters was analyzed by using multiple linear regression.

Results

A multiple regression model developed with a limited set of gait quality parameters successfully predicted gait smoothness with a 97.05 % accuracy with a mean square error of 0.085 between predicted and actual quality scores. The model demonstrates different predictive capacities across disease groups, with Osteoarthrosis + Osteoporosis having the highest R² at 0.98 (p < 0.001) and Coxarthrosis having the lowest explained R² at 0.79 (p < 0.001).

Conclusions

The assessment of gait quality, in family medicine, with low-cost digital tools is an area of opportunity yet to be explored. This tool can potentially disrupt the current disability workflow between primary and specialty care to have an objective method of assessing gait within a clinical consult. Individual patient-level benchmarking can give us insights into the patient's disease status, develop practical intervention strategies, and control the cost and quality of medical care by predicting an individualized course of disability or rehabilitation. Further studies are needed to validate digital gait assessments as clinical decision support tools for day-to-day clinical operations.

MeSH

Gait Analysis, Smartphone, Primary Health Care, Osteoarthrosis

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骨关节炎步态质量模式的临床应用。

目的：研究基于智能手机的步态分析工具能否可靠地输出步态质量参数，并通过交叉分析确定步态质量模式的个体和疾病变化：这项横断面研究由墨西哥墨西哥城 "何塞-卡斯特罗-比利亚格拉纳博士 "或 "大卫-弗拉戈索-利萨尔德博士 "健康中心的 48 名接受残疾认证的患者组成。他们的感知运动表现通过基于智能手机/IMU 的内部数字工具进行评估。通过对胸骨处测得的体质量加速度进行频率分析，对步态进行了分析。主要根据步态的可解释性和一致性，通过主成分分析确定综合步态质量得分。通过方差分析检验了步态质量与人口统计学变量（年龄和体重）之间的独立性。采用多元线性回归分析步态质量与步态参数之间的关联：结果：利用有限的一组步态质量参数建立的多元回归模型成功预测了步态平稳性，准确率为 97.05%，预测质量得分与实际质量得分之间的均方误差为 0.085。该模型对不同疾病组的预测能力不同，其中骨关节病+骨质疏松症的R2最高，为0.98（p < 0.001），而髋关节病的解释R2最低，为0.79（p < 0.001）：在全科医学中，利用低成本数字工具评估步态质量是一个尚待开发的领域。该工具有可能打破目前初级医疗和专科医疗之间的残疾工作流程，在临床会诊中使用客观的方法评估步态。患者个人层面的基准可以让我们深入了解患者的疾病状况，制定切实可行的干预策略，并通过预测个性化的残疾或康复过程来控制医疗护理的成本和质量。要验证数字步态评估作为临床决策支持工具在日常临床操作中的有效性，还需要进一步的研究。MESH：步态分析、智能手机、初级卫生保健、骨关节病。

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.