GaitSmart motion analysis compared to commonly used function outcome measures in the IMI-APPROACH knee osteoarthritis cohort

PLoS ONE, vol. 17, pp. e0265883

Abstract

BACKGROUND: There are multiple measures for assessment of physical function in knee osteoarthritis (OA), but each has its strengths and limitations. The GaitSmart® system, which uses inertial measurement units (IMUs), might be a user-friendly and objective method to assess function. This study evaluates the validity and responsiveness of GaitSmart® motion analysis as a function measurement in knee OA and compares this to Knee Injury and Osteoarthritis Outcome Score (KOOS), Short Form 36 Health Survey (SF-36), 30s chair stand test, and 40m self-paced walk test. METHODS: The 2-year Innovative Medicines Initiative-Applied Public-Private Research enabling OsteoArthritis Clinical Headway (IMI-APPROACH) knee OA cohort was conducted between January 2018 and April 2021. For this study, available baseline and 6 months follow-up data (n = 262) was used. Principal component analysis was used to investigate whether above mentioned function instruments could represent one or more function domains. Subsequently, linear regression was used to explore the association between GaitSmart® parameters and those function domains. In addition, standardized response means, effect sizes and t-tests were calculated to evaluate the ability of GaitSmart® to differentiate between good and poor general health (based on SF-36). Lastly, the responsiveness of GaitSmart® to detect changes in function was determined. RESULTS: KOOS, SF-36, 30s chair test and 40m self-paced walk test were first combined into one function domain (total function). Thereafter, two function domains were substracted related to either performance based (objective function) or self-reported (subjective function) function. Linear regression resulted in the highest R2 for the total function domain: 0.314 (R2 for objective and subjective function were 0.252 and 0.142, respectively.). Furthermore, GaitSmart® was able to distinguish a difference in general health status, and is responsive to changes in the different aspects of objective function (Standardized response mean (SRMs) up to 0.74). CONCLUSION: GaitSmart® analysis can reflect performance based and self-reported function and may be of value in the evaluation of function in knee OA. Future studies are warranted to validate whether GaitSmart® can be used as clinical outcome measure in OA research and clinical practice.

Authors 10

1. E.M. van Helvoort corresponding

   Utrecht University · University Medical Center Utrecht

   Affiliation as printed

   Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

2. Diana Hodgins
   Affiliation as printed

   Dynamic Metrics Limited, Codicote, United Kingdom

3. S.C. Mastbergen

   Utrecht University · University Medical Center Utrecht

   Affiliation as printed

   Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

4. Anne C. A. Marijnissen

   Utrecht University · University Medical Center Utrecht

   Affiliation as printed

   Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

5. M. Kloppenburg Aachen Department of Clinical Epidemiology Department of Rheumatology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

   Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands

6. Francisco Javier Blanco

   Universidade da Coruña · Instituto de Investigación Biomédica de A Coruña

   Affiliation as printed

   Servicio de Reumatología, INIBIC-Hospital Universitario A Coruña, Grupo de Investigación Reumatologia, Agrupación CICA-INIBIC, Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Universidad de A Coruña, A Coruña, Spain

7. Ida Kristin Haugen

   Diakonhjemmet Hospital

   Affiliation as printed

   Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway

8. Françis Berenbaum

   Inserm · Sorbonne Université · Hôpital Saint-Antoine

   Affiliation as printed

   Sorbonne Université, Institut National de la Santé et de la Recherché Médicale (INSERM), APHP hôpital Saint-Antoine, Paris, France

9. Floris P. J. G. Lafeber

   Utrecht University · University Medical Center Utrecht

   Affiliation as printed

   Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands

10. Paco M J Welsing

    Utrecht University · University Medical Center Utrecht

    Affiliation as printed

    Department of Rheumatology & Clinical Immunology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands