Sensor based assessment of turning during instrumented Timed Up and Go Test for quantifying mobility in chronic stroke patients

Functional Mobility Studies in Younger Adults: Instrumented Timed Up and Go (iTUG) Test Using Inertial Devices

Functional Mobility Assessment (FMA) is a challenging task. One example of an FMA is an instrumented Timed Up and Go test (iTUG). Sensor-based interventions are more effective than traditional interventions that use clinical tests to assess a patient's FMA. Background/Objectives: The aim of this study is to investigate the variability of selected parameters of the instrumented Time Up and Go test using inertial measurements in healthy younger adults. Methods: A total of 73 subjects participated in the study, including 37 women and 36 men. The mean age was 31 years (SD 5.5 years), the mean height [cm] was 176.2 (SD 91), and the mean BMI [kg/m2] was 26.6 (SD 3.1). The Noraxon MyoMotion Research 18 motion analysis system was used to record raw spatial data. Results: The mean total time to complete the iTUG test was 13.1 ± 1.9 s with a low coefficient of variation (CV), suggesting consistent performance between participants. The recorded spatial and temporal parameters of the gait variables, as well as the kinematic variables of the iTUG test of the studied group of healthy adults, show low variability, except for the mean double support ratio (R - L)/(R + L), which was 4.1 ± 11.0% with a CV of 271.5%, indicating a very high variability. Conclusions: The low variability observed in key parameters, such as total time and percentage of posture, suggests that the iTUG test provides reliable, objective, and reproducible measurements that can serve as normative benchmarks for healthy adults.

Mim-pong: a serious game for assessment and treatment of the lower limb in hemiparetic stroke patients

Introduction

The motor impairment evidenced post-stroke results in limitations to performing activities of daily living (ADL), especially when it involves locomotion. The Serious Games (SG) are an interesting therapeutic option, as they allow the performance of exercises according to stroke treatment guidelines. However, there is little research exploring the evaluation potential of SG. This study aimed to evaluate the possible metric properties of the mim-pong SG in addition to the therapeutic effects.

Methods

Twenty-four hemiparetic stroke patients were divided into two non-randomized groups: the experimental group (EG) (n = 16) and the control group (CG) (n = 8). Participants were evaluated in terms of motor impairment (lower limb), muscle strength (MS), motor control, and functional mobility.

Results

The significant correlations observed between the score generated by the SG and clinical variables in both groups are highlighted, especially with MS (rho = 0.62-0.66; p = 0.000, and rho = 0.67-0.71; p = 0.002-0.005, for the experimental and CGs, respectively) and motor function of the lower limb for the EG (rho = 0.41, p = 0.018). In addition, the results indicated improvements in all variables in the EG, with superiority over the CG.

Conclusions

This study showed that the mim-pong serious game could be considered a potential resource for the assessment and treatment of hemiparetic stroke patients.

Validity of Wearable Gait Analysis System for Measuring Lower-Limb Kinematics during Timed Up and Go Test

Few studies have reported on the validity of a sensor-based lower-limb kinematics evaluation during the timed up and go (TUG) test. This study aimed to determine the validity of a wearable gait sensor system for measuring lower-limb kinematics during the TUG test. Ten young healthy participants were enrolled, and lower-limb kinematics during the TUG test were assessed using a wearable gait sensor system and a standard optical motion analysis system. The angular velocities of the hip, knee, and ankle joints in sit-to-stand and turn-to-sit phases were significantly correlated between the two motion analysis systems (R = 0.612-0.937). The peak angles and ranges of motion of hip, knee, and ankle joints in the walking-out and walking-in phases were also correlated in both systems (R = 0.528-0.924). These results indicate that the wearable gait sensor system is useful for evaluating lower-limb kinematics not only during gait, but also during the TUG test.

Evaluation of Patients' Levels of Walking Independence Using Inertial Sensors and Neural Networks in an Acute-Care Hospital

This study aimed to evaluate walking independence in acute-care hospital patients using neural networks based on acceleration and angular velocity from two walking tests. Forty patients underwent the 10-m walk test and the Timed Up-and-Go test at normal speed, with or without a cane. Physiotherapists divided the patients into two groups: 24 patients who were monitored or independent while walking with a cane or without aids in the ward, and 16 patients who were not. To classify these groups, the Transformer model analyzes the left gait cycle data from eight inertial sensors. The accuracy using all the sensor data was 0.836. When sensor data from the right ankle, right wrist, and left wrist were excluded, the accuracy decreased the most. When analyzing the data from these three sensors alone, the accuracy was 0.795. Further reducing the number of sensors to only the right ankle and wrist resulted in an accuracy of 0.736. This study demonstrates the potential of a neural network-based analysis of inertial sensor data for clinically assessing a patient's level of walking independence.

A Step Forward Understanding Directional Limitations in Markerless Smartphone-Based Gait Analysis: A Pilot Study

The progress in markerless technologies is providing clinicians with tools to shorten the time of assessment rapidly, but raises questions about the potential trade-off in accuracy compared to traditional marker-based systems. This study evaluated the OpenCap system against a traditional marker-based system-Vicon. Our focus was on its performance in capturing walking both toward and away from two iPhone cameras in the same setting, which allowed capturing the Timed Up and Go (TUG) test. The performance of the OpenCap system was compared to that of a standard marker-based system by comparing spatial-temporal and kinematic parameters in 10 participants. The study focused on identifying potential discrepancies in accuracy and comparing results using correlation analysis. Case examples further explored our results. The OpenCap system demonstrated good accuracy in spatial-temporal parameters but faced challenges in accurately capturing kinematic parameters, especially in the walking direction facing away from the cameras. Notably, the two walking directions observed significant differences in pelvic obliquity, hip abduction, and ankle flexion. Our findings suggest areas for improvement in markerless technologies, highlighting their potential in clinical settings.

Shoulder brace has no detrimental effect on basic spatio-temporal gait parameters and functional mobility after arthroscopic rotator cuff repair

BACKGROUND

The risk of falls in patients undergoing orthopedic procedures is significant in terms of health and socioeconomic effects.

RESEARCH QUESTION

Is there an influence of the shoulder abduction brace (SAB) on gait parameters in patients undergoing arthroscopic rotator cuff repair (ARCR)?

METHODS

Thirty-five patients undergoing ARCR, who used a 15° SAB in the postoperative period, were included in a prospective study. Participants underwent gait analysis preoperatively (T0), 24 h after surgery (T1), 1 week (T2), and 4 weeks after surgery (1 week after SAB removal) (T3) by using a wearable inertial sensor (BTS G-Walk sensor). Gait Parameters (cadence, speed, right (R) and left (L) step length, gait and propulsion-R and L symmetry indices) and functional mobility (agility and balance) were assessed using the 10-meter test (10MWT) and the Timed Up and Go (TUG) test, respectively.

RESULTS

There were 22 men and 13 women with a median age of 56 (IQR 48.0-61.0) years. The right upper limb was involved in 83% of cases. Regarding the 10MWT, speed was significantly higher at T0 than at T1 (p < 0.01) and significantly lower at T1 than at T3 (p < 0.05). Cadence was significantly lower at T1 than at T3 (p < 0.05). Propulsion-R was significantly higher at T3 than at T1 (p < 0.01), whereas propulsion-L was significantly lower at T1 than at T0 (p < 0.05) and significantly higher at T2 and T3 than T1 (p < 0.01 for all). No significant differences were found for R and L step lengths as well as for symmetry index (p > 0.05). Regarding TUG test, the final turning phase was significantly higher at T2 than at T3 (p < 0.01).

SIGNIFICANCE

The results demonstrated that the use of the SAB affected gait speed and propulsion only 24 h after ARCR, but no effects were reported at long-term observations.

Smartphone-based evaluation of static balance and mobility in long-lasting COVID-19 patients

Background

SARS-CoV-2 infection can lead to a variety of persistent sequelae, collectively known as long COVID-19. Deficits in postural balance have been reported in patients several months after COVID-19 infection. The purpose of this study was to evaluate the static balance and balance of individuals with long COVID-19 using inertial sensors in smartphones.

Methods

A total of 73 participants were included in this study, of which 41 had long COVID-19 and 32 served as controls. All participants in the long COVID-19 group reported physical complaints for at least 7 months after SARS-CoV-2 infection. Participants were evaluated using a built-in inertial sensor of a smartphone attached to the low back, which recorded inertial signals during a static balance and mobility task (timed up and go test). The parameters of static balance and mobility obtained from both groups were compared.

Results

The groups were matched for age and BMI. Of the 41 participants in the long COVID-19 group, 22 reported balance impairment and 33 had impaired balance in the Sharpened Romberg test. Static balance assessment revealed that the long COVID-19 group had greater postural instability with both eyes open and closed than the control group. In the TUG test, the long COVID-19 group showed greater acceleration during the sit-to-stand transition compared to the control group.

Conclusion

The smartphone was feasible to identify losses in the balance motor control and mobility of patients with long-lasting symptomatic COVID-19 even after several months or years. Attention to the balance impairment experienced by these patients could help prevent falls and improve their quality of life, and the use of the smartphone can expand this monitoring for a broader population.