Wearable-based assessment of anticipatory postural adjustments during step initiation in patients with knee osteoarthritis

PLoS One. 2023 Aug 10;18(8):e0289588. doi: 10.1371/journal.pone.0289588. eCollection 2023.

Abstract

Older adults with moderate to severe knee osteoarthritis (KOA) exhibit adaptive strategy for initiating walking, known as anticipatory postural adjustments (APAs). While video motion kinematics has been the traditional way of measuring APAs, it can be difficult to transport and install, making it impractical for medical settings. Inertial sensors have become a more popular method for evaluating APAs, but no prior research has used accelerometers to measure gait initiation in individuals with KOA. The study aimed to assess the validity and reliability of a wearable accelerometer device for measuring APAs older adults with and without KOA. 25 individuals with KOA and 10 healthy individuals underwent evaluation using a wearable commercially available accelerometer (MetamotionC) and a video motion capture system. Reflective markers were placed on the lumbar vertebra and calcaneus. Participants were asked to initiate a step, and the researchers measured the APAlatency and APAamplitude of each subject. APAlatency showed an very large to almost perfect correlation in both groups (CG:r = 0.82; p = 0.003 and KOA r = 0.98; p < 0.00001) between the instruments, while APAamplitude had a moderate to very large correlation (CG: r = 0.65; p = 0.04and KOA: r = 0.80; p < 0.00001). Overall, the measurements showed fair to high reliability for intraclass correlation for video and accelerometer variables. Significant group effect was found for both variables: APAlatency (F1, 66 = 7.3; p = 0.008) and APAamplitude (F1,66 = 9.5; p = 0.00). The wearable tri-axial accelerometer is a valid and reliable for assessing APAs during gait initiation in individuals with KOA, and this population exhibits lower APAs when initiating a step.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomechanical Phenomena
  • Gait
  • Humans
  • Osteoarthritis, Knee*
  • Postural Balance
  • Reproducibility of Results
  • Walking

Grants and funding

This work was supported by research grants from Brazilian funding agencies: Research Funding and the National Council of Research Development: GS was a CNPq Productivity Fellow (No. 310845/2018–1) and BC is a post-graduation Fellow (No. 102167/2022-2). The sponsors had no role in the study design. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.