Gait Variability to Phenotype Common Orthopedic Gait Impairments Using Wearable Sensors. 2022

Junichi Kushioka, and Ruopeng Sun, and Wei Zhang, and Amir Muaremi, and Heike Leutheuser, and Charles A Odonkor, and Matthew Smuck
Department of Orthopaedic Surgery, Stanford University, Stanford, CA 94305, USA.

Mobility impairments are a common symptom of age-related degenerative diseases. Gait features can discriminate those with mobility disorders from healthy individuals, yet phenotyping specific pathologies remains challenging. This study aims to identify if gait parameters derived from two foot-mounted inertial measurement units (IMU) during the 6 min walk test (6MWT) can phenotype mobility impairment from different pathologies (Lumbar spinal stenosis (LSS)-neurogenic diseases, and knee osteoarthritis (KOA)-structural joint disease). Bilateral foot-mounted IMU data during the 6MWT were collected from patients with LSS and KOA and matched healthy controls (N = 30, 10 for each group). Eleven gait parameters representing four domains (pace, rhythm, asymmetry, variability) were derived for each minute of the 6MWT. In the entire 6MWT, gait parameters in all four domains distinguished between controls and both disease groups; however, the disease groups demonstrated no statistical differences, with a trend toward higher stride length variability in the LSS group (p = 0.057). Additional minute-by-minute comparisons identified stride length variability as a statistically significant marker between disease groups during the middle portion of 6WMT (3rd min: p ≤ 0.05; 4th min: p = 0.06). These findings demonstrate that gait variability measures are a potential biomarker to phenotype mobility impairment from different pathologies. Increased gait variability indicates loss of gait rhythmicity, a common feature in neurologic impairment of locomotor control, thus reflecting the underlying mechanism for the gait impairment in LSS. Findings from this work also identify the middle portion of the 6MWT as a potential window to detect subtle gait differences between individuals with different origins of gait impairment.

UI MeSH Term Description Entries
D005528 Foot The distal extremity of the leg in vertebrates, consisting of the tarsus (ANKLE); METATARSUS; phalanges; and the soft tissues surrounding these bones. Feet
D005684 Gait Manner or style of walking. Gaits
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000070857 Walk Test A measure of endurance tests that show how far and fast an individual can walk without stopping within a certain period of time. 6-Min Walk Test,Six-Minute Walk Test,6-Minute Walk Test,Endurance Shuttle Walk Test,Incremental Shuttle Walk Test,6 Min Walk Test,6 Minute Walk Test,6-Min Walk Tests,6-Minute Walk Tests,Six Minute Walk Test,Six-Minute Walk Tests,Test, 6-Min Walk,Test, 6-Minute Walk,Test, Six-Minute Walk,Test, Walk,Tests, 6-Min Walk,Tests, 6-Minute Walk,Tests, Six-Minute Walk,Tests, Walk,Walk Test, 6-Min,Walk Test, 6-Minute,Walk Test, Six-Minute,Walk Tests,Walk Tests, 6-Min,Walk Tests, 6-Minute,Walk Tests, Six-Minute
D020370 Osteoarthritis, Knee Noninflammatory degenerative disease of the knee joint consisting of three large categories: conditions that block normal synchronous movement, conditions that produce abnormal pathways of motion, and conditions that cause stress concentration resulting in changes to articular cartilage. (Crenshaw, Campbell's Operative Orthopaedics, 8th ed, p2019) Osteoarthritis of Knee,Osteoarthritis of the Knee,Knee Osteoarthritides,Knee Osteoarthritis
D035002 Lower Extremity The region of the lower limb in animals, extending from the gluteal region to the FOOT, and including the BUTTOCKS; HIP; and LEG. Extremity, Lower,Lower Limb,Membrum inferius,Extremities, Lower,Limb, Lower,Limbs, Lower,Lower Extremities,Lower Limbs

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