Real-world gait and turning in individuals scheduled for total knee arthroplasty

Abstract

AbstractObjectiveTo compare real-world gait and turning between individuals scheduled for total knee arthroplasty (TKA) and healthy controls, using continuous monitoring with inertial measurement units (IMUs).DesignReal-world gait and turning data were collected for 5-7 days in individuals scheduled for TKA (n=34) and healthy controls in the same age range (n=32) using IMUs on the feet and lower back. Gait and turning parameters were compared between groups using a linear regression model. Data was further analyzed by stratification of gait bouts based on bout length, and turns based on turning angle and turning direction.ResultsDominant real-world gait speed was 0.21 m/s lower in individuals scheduled for TKA compared to healthy controls. The between-group difference in gait speed was -0.10 m/s for bouts containing 0-10 strides and -0.15 m/s for bouts with 160+ strides. Stride time was 0.05 s higher in individuals scheduled for TKA. Step time asymmetry was not different between the groups. Regarding walking activity, individuals scheduled for TKA walked 72 strides/hour less than healthy controls, and maximum bout length was 316 strides shorter. Irrespective of the size of the turn, turning velocity was lower in individuals scheduled for TKA. Turning velocity did not differ between turns over the affected leg compared to the unaffected leg.ConclusionIndividuals scheduled for TKA showed specific walking and turning limitations in the real-world. Parameters derived from IMUs reflected a rich profile of real-world mobility measures indicative of walking limitation of individuals scheduled for TKA, which may provide a relevant outcome dimension for future studies.