基于地面反作用力的新参数用于监测胫骨骨折后的康复及评估严重改变的步态

New Parameters Based on Ground Reaction Forces for Monitoring Rehabilitation Following Tibial Fractures and Assessment of Heavily Altered Gait.

作者信息

Wolff Christian, Warmerdam Elke, Dahmen Tim, Pohlemann Tim, Slusallek Philipp, Ganse Bergita

机构信息

Agents and Simulated Reality, German Research Center for Artificial Intelligence (DFKI), 66123 Saarbrücken, Germany.

Saarbrücken Graduate School of Computer Science, Saarland University, 66123 Saarbrücken, Germany.

出版信息

Sensors (Basel). 2025 Apr 15;25(8):2475. doi: 10.3390/s25082475.

Abstract

Instrumented insoles have created opportunities for patient monitoring via long-term recordings of ground reaction forces (GRFs). As the GRF curve is altered in patients after lower-extremity fracture, parameters defined on established curve landmarks often cannot be used to monitor the early rehabilitation process. We aimed to screen several new GRF curve-based parameters for suitability and hypothesized an interrelation with days after surgery. In an observational longitudinal study, data were collected from 13 patients with tibial fractures during straight walking at hospital visits using instrumented insoles. Parametrized curves were fitted and regression analyses conducted to determine the best fit, reflected in the highest R-value and lowest fitting error. A Wald Test with t-distribution was employed for statistical analysis. Strides were classified as regular or non-regular, and changes in this proportion were analyzed. Among the 12 parameters analyzed, those with the highest R-values were the mean force between inflection points (R = 0.715, < 0.001, t = 9.89), the absolute time between inflection points (R = 0.707, < 0.001, t = 9.83), and the highest overall force (R = 0.722, < 0.001, t = 10.05). There was a significant increase in regular strides on both injured (R = 0.427, < 0.001, t = 5.83) and healthy (R = 0.506, < 0.001, t = 6.89) sides. The proposed parameters and assessment of the regular stride ratio enable new options for analyses and monitoring during rehabilitation after tibial shaft fractures. They are robust to pathologic GRF curves, can be determined independently from spatiotemporal coherence, and thus might provide advantages over established methods.

摘要

仪器化鞋垫通过长期记录地面反作用力(GRF)为患者监测创造了机会。由于下肢骨折患者的GRF曲线会发生改变,基于既定曲线特征定义的参数往往无法用于监测早期康复过程。我们旨在筛选几个基于GRF曲线的新参数是否合适,并假设其与术后天数存在相互关系。在一项观察性纵向研究中,使用仪器化鞋垫在医院就诊时收集了13例胫骨骨折患者直走时的数据。拟合参数化曲线并进行回归分析以确定最佳拟合,以最高R值和最低拟合误差来体现。采用具有t分布的Wald检验进行统计分析。将步幅分为规则或不规则,并分析该比例的变化。在所分析的12个参数中,R值最高的参数是拐点之间的平均力(R = 0.715,<0.001,t = 9.89)、拐点之间的绝对时间(R = 0.707,<0.001,t = 9.83)以及最高总力(R = 0.722,<0.001,t = 10.05)。受伤侧(R = 0.427,<0.001,t = 5.83)和健康侧(R = 0.506,<0.001,t = 6.89)的规则步幅均显著增加。所提出的参数和规则步幅比评估为胫骨干骨折后的康复分析和监测提供了新的选择。它们对病理性GRF曲线具有鲁棒性,可以独立于时空连贯性来确定,因此可能比现有方法具有优势。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/327d/12031479/8a1cb7129bd9/sensors-25-02475-g001.jpg

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