Wiedmann Isabella, Grassi Marcello, Duran Ibrahim, Lavrador Ricardo, Alberg Evelyn, Daumer Martin, Schoenau Eckhard, Rittweger Jörn
Center of Prevention and Rehabilitation, University of Cologne, Cologne, Germany.
Department of Muscle and Bone Metabolism, German Aerospace Center, Institute of Aerospace Medicine, Cologne, Germany.
Front Pediatr. 2021 Jan 28;8:574443. doi: 10.3389/fped.2020.574443. eCollection 2020.
To assess children's acceptance to wear a 3D-accelerometer which is attached to the waist under real-world conditions, and also to compare gait speed during supervised testing with the non-supervised gait speed in every-day life. In a controlled observational, cross sectional study thirty subjects with cerebral palsy (CP), with level I&II of the Gross Motor Function Classification System (GMFCS) and 30 healthy control children (Ctrl), aged 3-12 years, were asked to perform a 1-min-walking test (1 mwt) under laboratory conditions, and to wear an accelerometric device for a 1-week wearing home measurement (1 WHM). Acceptance was measured wearing time, and by a questionnaire in which subjects rated restrictions in their daily living and wearing comfort. In addition, validity of 3D-accelerometric gait speed was checked through gold standard assessment of gait speed with a mobile perambulator. Wearing time amounted to 10.3 (SD 3.4) hours per day, which was comparable between groups ( = 1.10, = 0.3). Mode for wearing comfort [CP 1, Range (1,4), Ctrl 1, Range (1,6)] and restriction of daily living [CP 1, Range (1,3), Ctrl 1, Range (1,4)] was comparable between groups. Under laboratory conditions, Ctrl walked faster in the 1 mwt than CP (Ctrl 1.72 ± 0.29 m/s, CP 1.48 ± 0.41 m/s, = 0.018). Similarly, a statistically significant difference was found when comparing real-world walking speed and laboratory walking speed (CP: 1 mwt 1.48 ± 0.41 m/s, 1 WHM 0.89 ± 0.09 m/s, = 0.012; Ctrl: 1mwt 1.72 ± 0.29, 1 WHM 0.97 ± 0.06, < 0.001). 3D-accelerometry is well-enough accepted in a pediatric population of patients with CP and a Ctrl group to allow valid assessments. Assessment outside the laboratory environment yields information about real world activity that was not captured by routine clinical tests. This suggests that assessment of habitual activities by wearable devices reflects the functioning of children in their home environment. This novel information constitutes an important goal for rehabilitation medicine. The study is registered at the German Register of Clinical Trials with the title "Acceptance and Validity of 3D Accelerometric Gait Analysis in Pediatric Patients" (AVAPed; DRKS00011919).
评估儿童在现实生活条件下对佩戴附着于腰部的三维加速度计的接受程度，并比较在监督测试中的步态速度与日常生活中无监督情况下的步态速度。在一项对照观察性横断面研究中，30名患有脑瘫（CP）、粗大运动功能分类系统（GMFCS）为I&II级的3至12岁儿童以及30名健康对照儿童（Ctrl）被要求在实验室条件下进行1分钟步行测试（1 mwt），并佩戴加速度测量设备进行为期1周的居家测量（1 WHM）。通过佩戴时间以及一份问卷来测量接受程度，问卷中受试者对日常生活中的限制和佩戴舒适度进行评分。此外，通过使用移动婴儿车对步态速度进行金标准评估来检查三维加速度计步态速度的有效性。佩戴时间为每天10.3（标准差3.4）小时，两组之间具有可比性（t = 1.10，p = 0.3）。佩戴舒适度[CP组为1，范围（1,4），Ctrl组为1，范围（1,6）]和日常生活限制[CP组为1，范围（1,3），Ctrl组为1，范围（1,4）]在两组之间具有可比性。在实验室条件下，Ctrl组在1 mwt中的步行速度比CP组快（Ctrl组为1.72±0.29 m/s，CP组为1.48±0.41 m/s，p = 0.018）。同样，在比较现实世界步行速度和实验室步行速度时发现了统计学上的显著差异（CP组：1 mwt为1.48±0.41 m/s，1 WHM为0.89±0.09 m/s，p = 0.012；Ctrl组：1 mwt为1.72±0.29，1 WHM为0.97±0.06，p < 0.001）。三维加速度计在CP患儿群体和Ctrl组中得到了足够的接受，从而能够进行有效的评估。在实验室环境之外的评估产生了常规临床测试未捕捉到的关于现实世界活动的信息。这表明通过可穿戴设备对习惯性活动的评估反映了儿童在家庭环境中的功能状况。这一新颖信息构成了康复医学的一个重要目标。该研究已在德国临床试验注册中心注册，标题为“儿科患者三维加速度计步态分析的接受度和有效性”（AVAPed；DRKS00011919）。
