Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

There is a great need for quantitative outcomes reflecting the functional status in patients with knee or hip osteoarthritis (OA) to advance the development and investigation of interventions for OA. The purpose of this study was to determine if gait kinematics specific to the disease—i.e., knee versus hip OA—can be identified using wearable sensors and statistical parametric mapping (SPM) and whether disease-related gait deviations are associated with patient reported outcome measures. 113 participants (N = 29 unilateral knee OA; N = 30 unilateral hip OA; N = 54 age-matched asymptomatic persons) completed gait analysis with wearable sensors and the Knee/Hip Osteoarthritis Outcome Score (KOOS/HOOS). Data were analyzed using SPM. Knee and hip kinematics differed between patients with knee OA and patients with hip OA (up to 14°, p < 0.001 for knee and 8°, p = 0.003 for hip kinematics), and differences from controls were more pronounced in the affected than unaffected leg of patients. The observed deviations in ankle, knee and hip kinematic trajectories from controls were associated with KOOS/HOOS in both groups. Capturing gait kinematics using wearables has a large potential for application as outcome in clinical trials and for monitoring treatment success in patients with knee or hip OA and in large cohorts representing a major advancement in research on musculoskeletal diseases.

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Correlation Between Patient-Reported Outcome Measures and Health Insurance Provider Types in Patients with Hip Osteoarthritis

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.20.02246 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Brady D. Greene ◽

Jeffrey K. Lange ◽

Marilyn Heng ◽

Christopher M. Melnic ◽

Jeremy T. Smith

Keyword(s):

Health Insurance ◽

Outcome Measures ◽

Hip Osteoarthritis ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Patient Reported ◽

Health Insurance Provider

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Movement Quality Parameters During Gait Assessed by a Single Accelerometer in Subjects with Osteoarthritis and Following Total Joint Arthroplasty

10.21203/rs.3.rs-832370/v1 ◽

2021 ◽

Author(s):

Jill Emmerzaal ◽

Kristoff Corten ◽

Rob van der Straaten ◽

Liesbet De Baets ◽

Sam Van Rossom ◽

...

Keyword(s):

Outcome Measures ◽

Patient Reported Outcome Measures ◽

Gait Pattern ◽

Patient Reported Outcome ◽

Quality Parameters ◽

Joint Arthroplasty ◽

Movement Quality ◽

Knee Oa ◽

Patient Reported ◽

Total Knee

Abstract Background: This study aimed to evaluate which of movement quality parameters measured with a single trunk worn Inertial Measurement Unit (IMU) can distinguish the gait pattern of people with hip or knee osteoarthritis (OA) compared to asymptomatic controls. Secondly, we evaluated the sensitivity of these parameters to capture gait changes at 6 weeks, 3, 6, and 12 months following total knee arthroplasty (TKA). Thirdly, we investigated whether observed changes in movement quality from 6 weeks and 12 months following total knee arthroplasty were related to changes in patient-reported outcome measures.Methods: Twenty people with hip OA, 18 people with knee OA, and 20 asymptomatic controls participated in this study. Seventeen people with knee OA were treated with a TKA and additionally followed for one year postoperatively. The participants were equipped with a single trunk-worn IMU and were instructed to walk back and forth along a 10m walkway at a self-selected speed. The movement quality parameters (quantified by symmetry—step/stride regularity; complexity—Sample entropy; smoothness—Log Dimensionless Jerk; and dynamic stability—maximum Lyapunov Exponent) were calculated from the raw 3D acceleration signal. Comparisons were made between groups and between timepoints in the TKA patients. Finally, changes in movement quality were correlated with patient-reported outcomes in the TKA group.Results: We found significant group differences in movement symmetry and stability pre-operatively. Post-TKA, all parameters, except movement smoothness, reflected an initial decrease in movement quality at 6 weeks post-TKA, but all except movement complexity, normalised after 6 months. Moreover, improved movement quality (6 weeks-12 months post-TKA) related to improvements in patient-reported outcome measures.Conclusions: A single lower back IMU can characterise movement quality before and after a total joint arthroplasty. Most symmetry measures recovered but a more unstable, less complex gait pattern was observed at follow-up. The correlation between these parameters and patient-reported outcome measures shows the potential to monitor movement quality in a clinical setting to inform objective data driven personalised rehabilitation of quantified gait symmetry, stability, complexity, and smoothness.

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Patient Acceptable Symptom State in Knee Osteoarthritis Patients Succeeds Across Different Patient-reported Outcome Measures Assessing Physical Function, But Fails Across Other Dimensions and Rheumatic Diseases

The Journal of Rheumatology ◽

10.3899/jrheum.170181 ◽

2017 ◽

Vol 45 (1) ◽

pp. 122-127 ◽

Cited By ~ 4

Author(s):

Elien A.M. Mahler ◽

Nadine Boers ◽

Johannes W.J. Bijlsma ◽

Frank H.J. van den Hoogen ◽

Alfons A. den Broeder ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Physical Function ◽

Outcome Measures ◽

Rheumatic Diseases ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Knee Oa ◽

Cutoff Values ◽

Patient Reported ◽

Patient Acceptable Symptom State

Objective.The aims of this study are (1) to establish the Patient Acceptable Symptom State (PASS) cutoff values of different patient-reported outcome measures (PROM) assessing physical function in patients with knee osteoarthritis (OA), and (2) to assess the influence of sex, age, duration of symptoms, and presence of depressive feelings on being in PASS.Methods.Patients fulfilling the clinical American College of Rheumatology knee OA criteria received standardized nonsurgical treatment and completed different questionnaires at baseline and 3 months assessing physical function: Knee Injury and Osteoarthritis Outcome Score, Lequesne Algofunctional Index, Lower Extremity Functional Scale, numerical rating scale, and the physical function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index. PASS values were defined as the 75th percentile of the score of questionnaires for those patients who consider their state acceptable.Results.Of the 161 included patients, 62% were women with a mean age of 59 years (SD 9) and body mass index of 30 kg/m2 (SD 5). Standardized PASS values (95% CI) for different questionnaires for physical function varied between 48 (44–54) and 54 (50–56). Female patients and patients feeling depressed were found to have a lower probability to be in PASS for physical function, with OR (95% CI) varying from 0.45 (0.23–0.91) to 0.50 (0.26–0.97) and from 0.27 (0.14–0.55) to 0.38 (0.19–0.77), respectively.Conclusion.PASS cutoff values for physical function are robust across different PROM in patients with knee OA. Our results indicate that PASS values are not consistent across dimensions and rheumatic diseases, and that the use of a generic PASS value for patients with OA or even patients with other rheumatic diseases might not be justifiable.

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