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下肢创伤后电子增强步态异常评估

Electronically augmented gait abnormality assessment following lower extremity trauma.

作者信息

Swart Eric, Peindl Richard, Zheng Nigel, Habet Nahir, Churchill Christine, Ruder John Adam, Seymour Rachel, Karunakar Madhav, Kellam James, Sims Stephen

机构信息

Atrium Health Musculoskeletal Institute, Department of Orthopaedic Surgery.

University of North Carolina at Charlotte, Charlotte, NC.

出版信息

OTA Int. 2019 May 14;2(4):e032. doi: 10.1097/OI9.0000000000000032. eCollection 2019 Dec.

Abstract

BACKGROUND

Objective evaluation of patient outcomes has become an essential component of patient management. Along with patient-reported outcomes, performance-based measures (PBMs) such as gait analysis are an important part of this evaluation. The purpose of this study was to evaluate the validity of utilizing a wearable inertial measurement unit (IMU) in an outpatient clinic setting to assess its ability to provide clinically relevant data in patients with altered gait resulting from lower extremity trauma.

METHODS

Five orthopaedic trauma patients with varying degrees of gait pathologies were compared to 5 healthy control subjects. Kinematic data were simultaneously recorded by the IMU and a gold standard Vicon video motion analysis system (Vicon Motion Systems Ltd, Oxford, UK) during a modified 10-m walk test. Raw data captured by the IMU were directly compared to Vicon data. Additionally, 5 objective gait parameters were compared for controls and the 5 trauma patients.

RESULTS

The IMU data streams strongly correlated with Vicon data for measured variables used in the subsequent gait analysis: vertical acceleration, vertical displacement, pitch angular velocity, and roll angular velocity (Pearson -value > 0.9 for all correlations). Quantitative kinematic data in post-trauma patients significantly differed from control data and correlated with observed gait pathology.

CONCLUSIONS

When compared to the gold standard motion capture reference system (Vicon), an IMU can reliably and accurately measure clinically relevant gait parameters and differentiate between normal and pathologic gait patterns. This technology is easily integrated into clinical settings, requires minimal time, and represents a performance-based method for quantifiably assessing gait outcomes.

LEVEL OF EVIDENCE

.

摘要

背景

对患者预后进行客观评估已成为患者管理的重要组成部分。除了患者报告的预后指标外,基于表现的测量方法(PBMs),如步态分析,也是该评估的重要组成部分。本研究的目的是评估在门诊环境中使用可穿戴惯性测量单元(IMU)的有效性,以评估其为下肢创伤导致步态改变的患者提供临床相关数据的能力。

方法

将5例不同程度步态病变的骨科创伤患者与5例健康对照者进行比较。在改良的10米步行测试中,IMU和金标准Vicon视频运动分析系统(英国牛津Vicon运动系统有限公司)同时记录运动学数据。将IMU采集的原始数据直接与Vicon数据进行比较。此外,还比较了对照组和5例创伤患者的5个客观步态参数。

结果

在后续步态分析中使用的测量变量方面,IMU数据流与Vicon数据高度相关:垂直加速度、垂直位移、俯仰角速度和横滚角速度(所有相关性的Pearson值>0.9)。创伤后患者的定量运动学数据与对照数据有显著差异,且与观察到的步态病变相关。

结论

与金标准运动捕捉参考系统(Vicon)相比,IMU能够可靠且准确地测量临床相关的步态参数,并区分正常和病理步态模式。该技术易于整合到临床环境中,所需时间最少,是一种基于表现的可量化评估步态结果的方法。

证据水平

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbeb/7997086/8add03b5553f/oi9-2-e032-g002.jpg

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