Epworth Foundation, Richmond, VIC 3121, Australia.
Department of Orthopaedics, Western Hospital, Melbourne, VIC 3011, Australia.
Sensors (Basel). 2023 Jul 20;23(14):6538. doi: 10.3390/s23146538.
Gait quality parameters have been used to measure recovery from total hip arthroplasty (THA) but are time-intensive and previously could only be performed in a lab. Smartphone sensor data and algorithmic advances presently allow for the passive collection of qualitative gait metrics. The purpose of this prospective study was to observe the recovery of physical function following THA by assessing passively collected pre- and post-operative gait quality metrics. This was a multicenter, prospective cohort study. From six weeks pre-operative through to a minimum 24 weeks post-operative, 612 patients used a digital care management application that collected gait metrics. Average weekly walking speed, step length, timing asymmetry, and double limb support percentage pre- and post-operative values were compared with a paired-sample -test. Recovery was defined as the post-operative week when the respective gait metric was no longer statistically inferior to the pre-operative value. To control for multiple comparison error, significance was set at < 0.002. Walking speeds and step length were lowest, and timing asymmetry and double support percentage were greatest at week two post-post-operative ( < 0.001). Walking speed (1.00 ± 0.14 m/s, = 0.04), step length (0.58 ± 0.06 m/s, = 0.02), asymmetry (14.5 ± 19.4%, = 0.046), and double support percentage (31.6 ± 1.5%, = 0.0089) recovered at 9, 8, 7, and 10 weeks post-operative, respectively. Walking speed, step length, asymmetry, and double support all recovered beyond pre-operative values at 13, 17, 10, and 18 weeks, respectively ( < 0.002). Functional recovery following THA can be measured via passively collected gait quality metrics using a digital care management platform. The data suggest that metrics of gait quality are most negatively affected two weeks post-operative; recovery to pre-operative levels occurs at approximately 10 weeks following primary THA, and follows a slower trajectory compared to previously reported step count recovery trajectories.
步态质量参数已被用于衡量全髋关节置换术 (THA) 后的恢复情况，但这些参数耗时且此前只能在实验室中进行。智能手机传感器数据和算法的进步目前允许被动收集定性步态指标。本前瞻性研究的目的是通过评估被动收集的术前和术后步态质量指标来观察 THA 后的身体功能恢复情况。这是一项多中心前瞻性队列研究。从术前六周到术后至少 24 周，612 名患者使用了一个数字护理管理应用程序来收集步态指标。使用配对样本 t 检验比较术前和术后平均每周步行速度、步长、时间不对称和双下肢支撑百分比的每周变化。恢复定义为相应步态指标不再明显低于术前值的术后周数。为了控制多重比较错误，显著性水平设置为 < 0.002。术后第二周，步行速度和步长最低，时间不对称和双支撑百分比最大 ( < 0.001)。步行速度（1.00 ± 0.14 m/s， = 0.04）、步长（0.58 ± 0.06 m/s， = 0.02）、不对称（14.5 ± 19.4%， = 0.046）和双支撑百分比（31.6 ± 1.5%， = 0.0089）分别在术后 9、8、7 和 10 周恢复。步行速度、步长、不对称和双支撑在术后 13、17、10 和 18 周分别恢复到术前水平以上（ < 0.002）。通过数字护理管理平台使用被动收集的步态质量指标可以测量 THA 后的功能恢复情况。数据表明，步态质量指标在术后两周内受到的影响最大；初次 THA 后大约 10 周恢复到术前水平，与之前报告的步数恢复轨迹相比，恢复速度较慢。
