Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Dynamic Metrics Limited, Codicote, United Kingdom.
PLoS One. 2022 Mar 23;17(3):e0265883. doi: 10.1371/journal.pone.0265883. eCollection 2022.
There are multiple measures for assessment of physical function in knee osteoarthritis (OA), but each has its strengths and limitations. The GaitSmart® system, which uses inertial measurement units (IMUs), might be a user-friendly and objective method to assess function. This study evaluates the validity and responsiveness of GaitSmart® motion analysis as a function measurement in knee OA and compares this to Knee Injury and Osteoarthritis Outcome Score (KOOS), Short Form 36 Health Survey (SF-36), 30s chair stand test, and 40m self-paced walk test.
The 2-year Innovative Medicines Initiative-Applied Public-Private Research enabling OsteoArthritis Clinical Headway (IMI-APPROACH) knee OA cohort was conducted between January 2018 and April 2021. For this study, available baseline and 6 months follow-up data (n = 262) was used. Principal component analysis was used to investigate whether above mentioned function instruments could represent one or more function domains. Subsequently, linear regression was used to explore the association between GaitSmart® parameters and those function domains. In addition, standardized response means, effect sizes and t-tests were calculated to evaluate the ability of GaitSmart® to differentiate between good and poor general health (based on SF-36). Lastly, the responsiveness of GaitSmart® to detect changes in function was determined.
KOOS, SF-36, 30s chair test and 40m self-paced walk test were first combined into one function domain (total function). Thereafter, two function domains were substracted related to either performance based (objective function) or self-reported (subjective function) function. Linear regression resulted in the highest R2 for the total function domain: 0.314 (R2 for objective and subjective function were 0.252 and 0.142, respectively.). Furthermore, GaitSmart® was able to distinguish a difference in general health status, and is responsive to changes in the different aspects of objective function (Standardized response mean (SRMs) up to 0.74).
GaitSmart® analysis can reflect performance based and self-reported function and may be of value in the evaluation of function in knee OA. Future studies are warranted to validate whether GaitSmart® can be used as clinical outcome measure in OA research and clinical practice.
有多种评估膝骨关节炎(OA)患者身体功能的方法,但每种方法都有其优缺点。步态智能系统(GaitSmart®)是一种使用惯性测量单元(IMU)的用户友好型、客观的功能评估方法。本研究评估了 GaitSmart®运动分析作为膝骨关节炎功能测量的有效性和反应性,并将其与膝关节损伤和骨关节炎结果评分(KOOS)、36 项简明健康调查(SF-36)、30 秒椅站测试和 40m 自我计时步行测试进行比较。
为期两年的创新性药物倡议-应用公私合作研究促进骨关节炎临床进展(IMI-APPROACH)膝骨关节炎队列研究于 2018 年 1 月至 2021 年 4 月进行。本研究使用了可用的基线和 6 个月随访数据(n=262)。主成分分析用于研究上述功能指标是否可以代表一个或多个功能领域。随后,线性回归用于探索 GaitSmart®参数与这些功能领域之间的关联。此外,还计算了标准化反应均值、效应大小和 t 检验,以评估 GaitSmart®区分良好和较差总体健康状况(基于 SF-36)的能力。最后,确定了 GaitSmart®检测功能变化的反应能力。
首先,KOOS、SF-36、30 秒椅测试和 40m 自我计时步行测试被组合成一个功能领域(总功能)。然后,减去与基于表现的(客观功能)或自我报告的(主观功能)功能相关的两个功能领域。线性回归得到了总功能领域的最高 R2 值:0.314(客观和主观功能的 R2 值分别为 0.252 和 0.142)。此外,GaitSmart®能够区分总体健康状况的差异,并且对客观功能的不同方面的变化具有反应性(标准化反应均值(SRM)高达 0.74)。
GaitSmart®分析可以反映基于表现的和自我报告的功能,可能对评估膝骨关节炎患者的功能具有价值。需要进一步的研究来验证 GaitSmart®是否可用于 OA 研究和临床实践中的临床结局测量。