Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Jan 11, 2021
Date Accepted: Jul 23, 2021
Patients with axial spondyloarthritis adopt a cautious gait pattern during walking: A comparative gait analysis study using foot-worn inertial sensors
ABSTRACT
Background:
Axial spondyloarthritis (axSpA) can lead to spinal mobility restrictions, associated to restricted lower limb ranges of motion, thoracic kyphosis, spinopelvic ankylosis, or decrease of muscle strength. It is well know that these factors can have consequences on spatio-temporal gait parameters during walking. However, no study assessed spatiotemporal gait parameters in axSpA. Besides, divergent results were obtained in the studies that have assessed spatiotemporal gait parameters in ankylosing spondylitis, a subgroup of axSpA which could be partly explained by self-reported pain intensity scores at time of assessment. Besides, inertial measurement units (IMUs) are increasingly popular and may facilitate gait assessment in clinical practice. However, no study used IMUs to assess gait in ankylosing spondylitis or in axSpA.
Objective:
This study compared spatiotemporal gait parameters assessed with foot-worn IMUs in patients with axSpA and matched healthy individuals without and with pain intensity score as a covariate.
Methods:
Thirty patients with axSpA and thirty age- and sex-matched healthy controls (HC) performed a 10-m walk test at comfortable speed. Spatiotemporal gait parameters were computed from foot-worn inertial sensors.
Results:
Age, height, weight were not significantly different between groups. Self-reported pain intensity was significantly higher in patients with axSpA than HC (P<0.001). Independent sample t-tests indicated that patients with axSpA presented lower gait speed (P<0.001) and cadence (p=0.004), shorter stride length (P<0.001) and swing time (P<0.001), and longer double support time (p<0.001) and stance time (P<0.001) than HC. When using pain intensity as a covariate, spatiotemporal gait parameters were still significant with patients with axSpA exhibiting lower gait speed (P<0.001), shorter stride length (P=0.001) and swing time (P<0.001), and longer double support time (P<0.001) and stance time (P<0.001) than matched HC. Interestingly, there was no longer statistically significant between group differences observed for the cadence (P=0.171).
Conclusions:
Gait was significantly altered in patients with axSpA with reduced speed, cadence, stride length, and swing time and increased double support and stance time. Taken together and looked into as a whole, these changes in spatiotemporal gait parameters could be interpreted as the adoption of a so-called “cautious gait pattern” in patients with axSpA. Among factors that may influence gait in in patients with axSpA, patient self-reported pain intensity could play a role. Finally, IMUs allowed computation of spatiotemporal gait parameters and are usable to assess gait in patients with axSpA in clinical routine. Clinical Trial: ClinicalTrials.gov NCT03761212
Citation
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