Department of Research, Sint Maartenskliniek, Nijmegen, the Netherlands; Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Orthopedic Surgery, Sint Maartenskliniek, Nijmegen, the Netherlands.
Gait Posture. 2022 Oct;98:109-120. doi: 10.1016/j.gaitpost.2022.09.002. Epub 2022 Sep 6.
Objective assessment of gait using inertial sensors has shown promising results for functional evaluations in individuals with knee osteoarthritis (OA). However, the large number of possible outcome measures calls for a systematic evaluation of most relevant parameters to be used for scientific and clinical purposes.
This systematic review and meta-analysis aimed to identify gait parameters derived from inertial sensors that reflect gait deviations in individuals with knee OA compared to healthy control subjects (HC).
A systematic search was conducted in five electronic databases (Medline, Embase, Web of Science, CINAHL, IEEE) to identify eligible articles. Risk of bias was assessed using a modified version of the Downs and Black scale. Data regarding study population, experimental procedures, and biomechanical outcomes were extracted. When a gait parameter was reported by a sufficient number of studies, a random-effects meta-analysis was conducted using the inverse variance method.
Twenty-three articles comparing gait between 411 individuals with knee OA and 507 HC were included. Individuals with knee OA had a lower gait speed than HC (standardized mean difference = -1.65), driven by smaller strides with a longer duration. Stride time variability was slightly higher in individuals with knee OA than in HC. Individuals with knee OA walked with a lower range of motion of the knee during the swing phase, less lumbar motion in the coronal plane, and a lower foot strike and toe-off angle compared to HC.
This review shows that inertial sensors can detect gait impairments in individuals with knee OA. Large standardized mean differences found on spatiotemporal parameters support their applicability as sensitive endpoints for mobility in individuals with knee OA. More advanced measures, including kinematics of knee and trunk, may reveal gait adaptations that are more specific to knee OA, but compelling evidence was lacking.
使用惯性传感器对步态进行客观评估已显示出在膝关节骨关节炎（OA）患者的功能评估方面具有广阔的前景。然而，由于可能的结果指标数量众多，因此需要对最相关的参数进行系统评估，以便用于科学和临床目的。
本系统评价和荟萃分析旨在确定从惯性传感器得出的反映膝关节 OA 患者与健康对照组（HC）之间步态偏差的步态参数。
在五个电子数据库（Medline、Embase、Web of Science、CINAHL、IEEE）中进行系统搜索，以确定合格的文章。使用 Downs 和 Black 量表的修订版评估偏倚风险。提取有关研究人群、实验程序和生物力学结果的数据。当某个步态参数被足够数量的研究报告时，使用逆方差法进行随机效应荟萃分析。
纳入了 23 篇比较 411 名膝关节 OA 患者和 507 名 HC 之间步态的文章。膝关节 OA 患者的步速低于 HC（标准化均数差=-1.65），这是由于步幅较小且持续时间较长所致。膝关节 OA 患者的步幅时间变异性略高于 HC。膝关节 OA 患者在摆动阶段膝关节的活动范围较小，冠状面腰椎运动较少，与 HC 相比，足部着地和脚趾离地角度较低。
本综述表明，惯性传感器可以检测膝关节 OA 患者的步态障碍。在时空参数上发现的较大标准化均数差异支持它们作为膝关节 OA 患者移动性的敏感终点的适用性。更先进的措施，包括膝关节和躯干的运动学，可能会揭示更特定于膝关节 OA 的步态适应，但缺乏有力的证据。
