Tsai Zhi-Ren, Kuo Chin-Chi, Wang Cheng-Jui, Tsai Jeffrey J P, Chou Hsin-Hsu
Department of Computer Science & Information Engineering, Asia University, Taichung 41354, Taiwan.
Department of Medical Research, China Medical University Hospital, Taichung 404327, Taiwan.
J Pers Med. 2023 Jul 24;13(7):1181. doi: 10.3390/jpm13071181.
Muscle dysfunction, skeletal muscle fibrosis, and disability are associated with weakness in patients with end-stage renal disease. The main purpose of this study was to validate the effectiveness of a proposed system for gait monitoring on short-distance 1.5 m walkways in a dialysis center. Gaits with reduced speed and stride length, long sit-to-stand time (SST), two forward angles, and two unbalanced gait regions are defined in the proposed Kinect v3 gait measurement and analysis system (K3S) and have been considered clinical features in end-stage renal disease (ESRD) associated with poor dialysis outcomes. The stride and pace calibrations of the Kinect v3 system are based on the Zeno Walkway. Its single rating intraclass correlation (ICC) for the stride is 0.990, and its single rating ICC for the pace is 0.920. The SST calibration of Kinect v3 is based on a pressure insole; its single rating ICC for the SST is 0.871. A total of 75 patients on chronic dialysis underwent gait measurement and analysis during walking and weighing actions. After dialysis, patients demonstrated a smaller stride ( < 0.001) and longer SST ( < 0.001). The results demonstrate that patients' physical fitness was greatly reduced after dialysis. This study ensures patients' adequate physical gait strength to cope with the dialysis-associated physical exhaustion risk by tracing gait outliers. As decreased stride and pace are associated with an increased risk of falls, further studies are warranted to evaluate the clinical benefits of monitoring gait with the proposed reliable and valid system in order to reduce fall risk in hemodialysis patients.
肌肉功能障碍、骨骼肌纤维化和残疾与终末期肾病患者的虚弱有关。本研究的主要目的是验证一种提议的步态监测系统在透析中心1.5米短距离走道上的有效性。在提议的Kinect v3步态测量与分析系统（K3S）中定义了速度和步幅降低、从坐到站时间（SST）长、两个前向角度以及两个步态不平衡区域的步态，这些已被视为与透析效果不佳相关的终末期肾病（ESRD）的临床特征。Kinect v3系统的步幅和步频校准基于芝诺走道。其步幅的单评级组内相关系数（ICC）为0.990，步频的单评级ICC为0.920。Kinect v3的SST校准基于压力鞋垫；其SST的单评级ICC为0.871。共有75名接受慢性透析的患者在行走和称重过程中进行了步态测量与分析。透析后，患者的步幅更小（<0.001），SST更长（<|0.001）。结果表明，透析后患者的体能大幅下降。本研究通过追踪步态异常值确保患者有足够的身体步态强度来应对与透析相关的身体疲劳风险。由于步幅和步频降低与跌倒风险增加相关，有必要进一步研究以评估使用该提议的可靠且有效的系统监测步态的临床益处，以降低血液透析患者的跌倒风险。
