Bandara Anuradhi, Shimizu Hiroki, Watanabe Daiki, Misa Toyota, Suzuki Shota, Tanigawa Kyoma, Nagai-Tanima Momoko, Aoyama Tomoki
Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Sci Rep. 2025 Mar 7;15(1):8026. doi: 10.1038/s41598-025-91617-5.
Knee osteoarthritis (KOA) significantly impairs mobility in older adults. Understanding its impact on gait dynamics throughout the day is crucial for optimizing management strategies. This study aimed to explore diurnal variations in gait parameters among older adults with KOA using an in-shoe motion sensor (IMS) system equipped with accelerometers and gyroscopes. In this cross-sectional observational study, 19 older adults clinically diagnosed with early-stage KOA (Kellgren-Lawrence grades 1 or 2) participated. Key gait parameters were measured using an IMS system during morning (6:00 AM-11:59 AM) and afternoon (12:00 PM-5:00 PM) sessions. The IMS, placed bilaterally in the participants' shoes, continuously collected gait data during normal daily activities over a 24-hour period. Participants were instructed to walk for at least 10 min in each session. Data were analyzed using descriptive statistics, and paired t-tests or Wilcoxon signed-rank tests were applied to identify significant differences between sessions. Statistical significance was set at p < 0.05. The study included 19 participants (11 females, 8 males) with an average age of 71.4 ± 4.2 years. Walking speed decreased significantly from 1.06 ± 0.14 m/s in the morning to 0.99 ± 0.16 m/s in the afternoon (p = 0.028). Similarly, the maximum dorsiflexion angle decreased from 20.34° ± 2.98° to 18.80° ± 3.01° (p = 0.024), and the maximum plantar flexion angle decreased from 63.40° ± 5.84° to 60.79° ± 5.77° (p = 0.017) in the afternoon. Other parameters such as foot height, peak swing angular velocity, and maximum speed during the swing phase also showed significant reductions in the afternoon. Conversely, the roll angle of heel contact increased from 4.60° ± 2.62° to 5.53° ± 3.12° (p = 0.026), and stance time and pushing time increased significantly in the afternoon. Significant diurnal variations in gait parameters among older adults with KOA highlight the importance of considering time of day when evaluating gait and planning interventions. Wearable sensor technology enables continuous, objective gait monitoring in real-world settings, facilitating personalized and time-sensitive approaches for managing KOA.
膝关节骨关节炎（KOA）严重损害老年人的行动能力。了解其对全天步态动力学的影响对于优化管理策略至关重要。本研究旨在使用配备加速度计和陀螺仪的鞋内运动传感器（IMS）系统，探索KOA老年患者步态参数的昼夜变化。在这项横断面观察性研究中，19名临床诊断为早期KOA（Kellgren-Lawrence分级为1或2级）的老年人参与其中。在上午（上午6:00 - 11:59）和下午（下午12:00 - 5:00）时段，使用IMS系统测量关键步态参数。IMS双侧放置在参与者的鞋子中，在24小时的正常日常活动中持续收集步态数据。要求参与者在每个时段至少步行10分钟。使用描述性统计分析数据，并应用配对t检验或Wilcoxon符号秩检验来确定各时段之间的显著差异。统计学显著性设定为p < 0.05。该研究纳入了19名参与者（11名女性，8名男性），平均年龄为71.4 ± 4.2岁。步行速度从上午的1.06 ± 0.14米/秒显著下降至下午的0.99 ± 0.16米/秒（p = 0.028）。同样，最大背屈角度从20.34° ± 2.98°降至下午的18.80° ± 3.01°（p = 0.024），最大跖屈角度从63.40° ± 5.84°降至下午的60.79° ± 5.77°（p = 0.017）。下午，其他参数如足高、摆动峰值角速度和摆动期最大速度也显著降低。相反，足跟触地时的滚动角度从4.60° ± 2.62°增加到5.53° ± 3.12°（p = 0.026），下午站立时间和推蹬时间显著增加。KOA老年患者步态参数存在显著的昼夜变化，这突出了在评估步态和规划干预措施时考虑时间因素的重要性。可穿戴传感器技术能够在现实环境中进行连续、客观的步态监测，有助于采用个性化和对时间敏感的方法来管理KOA。
