Gait analysis is essential during prosthetic rehabilitation of lower limb amputees (LLAs), as it improves gathering information useful in the interpretation of the effects of prosthetic alignment, as well as in monitoring patient’s rehabilitation.
The use of inertial measurement unit (IMU) as gait analysis method could play a key role in monitoring of LLAs, through detection of gait alteration that could guide the interdisciplinary team during rehabilitation, increase patient safety, personalize the prosthetic equipment and the rehabilitation program, and to improve reliability and sensitivity to gait changes.
The validation of an IMU for LLAs gait analysis would be a major advantage for clinicians, affording them not only a tool capable of gathering most of the relevant data for identifying common LLAs gait deviations, but also one that – compared to a gait analysis laboratory - is most importantly, usable in regular clinical practice, and financially more affordable.
PROJECT OBJECTIVES
Our primary objective is to test the hypothesis that data collected with Physilog® sensors during LLA gait analysis are reliable when LLAs walk on flat corridor, on inclined terrain and stairs. Our secondary objective is to test whether clinical experts’ observations are concordant with data obtained by the Physilog® IMU and whether it detects gait abnormalities that visual analysis cannot.
STUDY PROCEDURES AND METHODOLOGY
Patient enrolment took place during spring 2024. We included 16 participants during the weekly interdisciplinary consultation, destinated to LLAs living with a prosthesis. The experts participating in the consultation are the physical medicine and rehabilitation specialist, physiotherapist and prosthetist in charge.
Physilog® wearable sensors (Gait Up SA, EPFL Innovation Park - Bât. C 1015 Lausanne) is an IMU system measuring various spatiotemporal gait parameters.
Procedure for participants: Patients had their usual consultation during which a clinical and functional examination is held including physical tests. They performed usual physical tests, and were asked in addition to walk stairs of 1⁄2 floor and walk back and forth a slightly inclined slope, while the Physilog® sensors were attached to the laces of their shoes. Each gait analysis test was performed 2 times during the same consultation (to assess the reproducibility of the Physilog®).
RESULTS
- Good reliability of Physilog® parameters concerning the 2 minutes walking test, moderate reliability for the Timed Up and Go test, poor reliability for tests on stairs and inclined terrain.
- Moderate correlation between Physilog® parameters and clinical gait analysis parameters.
CONCLUSION
In the long term, we believe that an IMU like Physilog® could be used in routine clinical practice to improve gait assessment in LLAs, on flat terrain. Objecting to use it in various conditions as inclined terrain and stairs, software should be improved in the future. The moderate concordance between the Physilog® results and the experts’ observations confirms the utility of a reliable IMU for gait analysis of LLAs as observation alone lacks sensitivity.