Schulze M, Calliess T, Gietzelt M, Wolf K H, Liu T H, Seehaus F, Bocklage R, Windhagen H, Marschollek M
Peter L. Reichertz Institute for Medical Informatics, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Annu Int Conf IEEE Eng Med Biol Soc. 2012;2012:1968-71. doi: 10.1109/EMBC.2012.6346341.
Patients suffering from end-stage knee osteoarthritis are often treated with total knee arthroplasty, improving their functional mobility. A number of patients, however, report continued difficulty with stair ascent and descent or sportive activity after surgery and are not completely satisfied with the outcome. State-of-the-art analyses to evaluate the outcome and mobility after knee replacement are conducted under supervised settings in specialized gait labs and thus can only reflect a short period of time. A number of external factors may lead to artificial gait patterns in patients. Moreover, clinically relevant situations are difficult to simulate in a stationary gait lab. In contrast to this, inertial sensors may be used additionally for unobtrusive gait monitoring. However, recent notable approaches found in literature concerning knee function analysis have so far not been applied in a clinical context and have therefore not yet been validated in a clinical setting. The aim of this paper is to present a system for unsupervised long-term monitoring of human gait with a focus on knee joint function, which is applicable in patients' everyday lives and to report on the validation of this system gathered during walking with reference to state-of-the-art gait lab data using a vision system (VICON Motion System). The system KINEMATICWEAR - developed in close collaboration of computer scientists and physicians performing knee arthroplasty - consists of two sensor nodes with combined tri-axial accelerometer, gyroscope and magnetometer to be worn under normal trousers. Reliability of the system is shown in the results. An overall correlation of 0.99 (with an overall RMSE of 2.72) compared to the state-of-the-art reference system indicates a sound quality and a high degree of correspondence. KINEMATICWEAR enables ambulatory, unconstrained measurements of knee function outside a supervised lab inspection.
患有终末期膝关节骨关节炎的患者通常接受全膝关节置换术治疗，以改善其功能活动能力。然而，许多患者术后仍报告在上下楼梯或进行体育活动时持续存在困难，并且对手术效果不完全满意。目前用于评估膝关节置换术后效果和活动能力的先进分析是在专业步态实验室的监督环境下进行的，因此只能反映短时间内的情况。许多外部因素可能导致患者出现人为的步态模式。此外，临床相关情况在静态步态实验室中难以模拟。与此相反，惯性传感器可额外用于进行不引人注意的步态监测。然而，文献中发现的有关膝关节功能分析的近期显著方法迄今尚未应用于临床环境，因此尚未在临床环境中得到验证。本文的目的是提出一种用于无监督长期监测人类步态的系统，重点关注膝关节功能，该系统适用于患者的日常生活，并报告使用视觉系统（VICON运动系统）在行走过程中收集的该系统相对于先进步态实验室数据的验证情况。KINEMATICWEAR系统——由计算机科学家和进行膝关节置换术的医生密切合作开发——由两个传感器节点组成，带有组合式三轴加速度计、陀螺仪和磁力计，可穿在普通裤子下。结果显示了该系统的可靠性。与先进的参考系统相比，总体相关性为0.99（总体均方根误差为2.72），表明其质量良好且高度一致。KINEMATICWEAR能够在无监督的实验室检查之外对膝关节功能进行动态、无约束的测量。
