Betteridge Callum, Mobbs Ralph J, Fonseka R Dineth, Natarajan Pragadesh, Ho Daniel, Choy Wen Jie, Sy Luke W, Pell Nina
Faculty of Medicine, University of New South Wales, Sydney, Australia.
NeuroSpine Surgery Research Group, Sydney, Australia.
J Spine Surg. 2021 Sep;7(3):254-268. doi: 10.21037/jss-21-16.
Wearable accelerometer-containing devices have become a mainstay in clinical studies which attempt to classify the gait patterns in various diseases. A gait profile for lumbar spinal stenosis (LSS) has not been developed, and no study has validated a simple wearable system for the clinical assessment of gait in lumbar stenosis. This study identifies the changes to gait patterns that occur in LSS to create a preliminary disease-specific gait profile. In addition, this study compares a chest-based wearable sensor, the MetaMotionC device and inertial measurement unit python script (MMC/IMUPY) system, against a reference-standard, videography, to preliminarily assess its accuracy in measuring the gait features of patients with LSS.
We conduct a cross-sectional observational study examining the walking patterns of 25 LSS patients and 33 healthy controls. To construct a preliminary disease-specific gait profile for LSS, the gait patterns of the 25 LSS patients and 25 healthy controls with similar ages were compared. To assess the accuracy of the MMC/IMUPY system in measuring the gait features of patients with LSS, its results were compared with videography for the 21 LSS and 33 healthy controls whose walking bouts exceeded 30 m.
Patients suffering from LSS walked significantly slower, with shorter, less frequent steps and higher asymmetry compared to healthy controls. The MMC/IMUPY system had >90% agreement with videography for all spatiotemporal gait metrics that both methods could measure.
The MMC/IMUPY system is a simple and feasible system for the construction of a preliminary disease-specific gait profile for LSS. Before clinical application in everyday living conditions is possible, further studies involving the construction of a more detailed disease-specific gait profile for LSS by disease severity, and the validation of the MMC/IMUPY system in the home environment, are required.
含可穿戴加速度计的设备已成为临床研究的主要手段,这些研究试图对各种疾病的步态模式进行分类。尚未建立腰椎管狭窄症(LSS)的步态特征描述,也没有研究验证过用于临床评估腰椎管狭窄症步态的简单可穿戴系统。本研究确定LSS患者步态模式的变化,以创建初步的疾病特异性步态特征描述。此外,本研究将基于胸部的可穿戴传感器、MetaMotionC设备和惯性测量单元Python脚本(MMC/IMUPY)系统与参考标准——摄像进行比较,以初步评估其测量LSS患者步态特征的准确性。
我们进行了一项横断面观察性研究,检查25例LSS患者和33名健康对照者的行走模式。为构建LSS的初步疾病特异性步态特征描述,比较了25例LSS患者和25名年龄相近的健康对照者的步态模式。为评估MMC/IMUPY系统测量LSS患者步态特征的准确性,将其结果与21例LSS患者和33名健康对照者(行走距离超过30米)的摄像结果进行了比较。
与健康对照者相比,LSS患者行走速度明显较慢,步幅更短、频率更低,不对称性更高。对于两种方法都能测量的所有时空步态指标,MMC/IMUPY系统与摄像的一致性超过90%。
MMC/IMUPY系统是构建LSS初步疾病特异性步态特征描述的简单可行系统。在可能应用于日常生活条件的临床应用之前,需要进一步开展研究,包括根据疾病严重程度构建更详细的LSS疾病特异性步态特征描述,以及在家庭环境中验证MMC/IMUPY系统。