Measurement of Accelerometry-Based Gait Parameters in People With and Without Dementia in the Field. a Technical Feasibility Study.

Measurement of Accelerometry-based Gait Parameters in People with and without Dementia in the Field. A Technical Feasibility Study.

Methods Inf Med. 2013 Jun 28; 52(4):
Gietzelt M, Wolf KH, Kohlmann M, Marschollek M, Haux R

Background: Gait analyses are an important tool to diagnose diseases or to measure the rehabilitation process of patients. In this context, sensor-based systems, and especially accelerometers, gain in importance. They are able to improve objectiveness of gait analyses. In clinical settings, there is usually a supervisor who gives instructions to the patients, but this can have an influence on patients’ gait. It is expected that this effect will be smaller in field studies. Objective: Aim of this study was to capture and evaluate gait parameters measured by a single waist-mounted accelerometer during everyday life of subjects. Methods: Due to missing ground-truth in unsupervised conditions, another external criterion had to be chosen. Subjects of two different groups were considered: patients with dementia (DEM) and active older people (ACT). These groups were chosen, because of the expected difference in gait. The idea was to quantify the expected difference of accelerometric-based gait parameters. Gait parameters were e.g. velocity, step frequency, compensation movements, and variance of the accelerometric signal. Results: Ten subjects were measured in each group. The number of walking episodes captured was 1,187 (DEM) vs. 1,809 (ACT). The compensation and variance parameters showed an AUC value (Area Under the Curve) between 0.88 and 0.92. In contrast, velocity and step frequency performed poorly (AUC values of 0.51 and 0.55). It was possible to classify both groups using these parameters with an accuracy of 89.2%. Conclusion: The results showed a much higher amount of walking episodes in field studies compared to supervised clinical trials. The classification showed a high accuracy in distinguishing between both groups. HubMed – rehab


Long-term subjective outcomes of computer-assisted total knee arthroplasty.

Int Orthop. 2013 Jun 27;
Nakano N, Matsumoto T, Ishida K, Tsumura N, Kuroda R, Kurosaka M

This study aimed to clarify the results of computer-assisted total knee arthroplasty (TKA) after ten years using patient-derived scores.Thirty posterior-stabilised total knee prostheses implanted using a computed tomography-free navigation system were compared with 30 matched total knee prostheses of the same type implanted using a conventional, manual technique. At an average of ten years after surgery, we investigated patient-reported outcomes using the Knee Society’s new scoring system. The results of 27 patients (14 patients in the navigation group and 13 patients in the manual group) were assessed in this study.There was no significant difference between the navigation and manual groups for any section of the questionnaire, which consisted of symptoms, patient satisfaction, patient expectation, walking/standing, standard activities, advanced activities, and discretionary activities.After long-term follow-up, we found no subjective advantages of using a navigation system for patients who undergo TKA though the absolute number of patients was very small. Additional extensive studies are required to validate our result. HubMed – rehab


A Comparison of the EQ-5D-3L and ICECAP-O in an Older Post-Acute Patient Population Relative to the General Population.

Appl Health Econ Health Policy. 2013 Jun 27;
Couzner L, Crotty M, Norman R, Ratcliffe J

The measurement and valuation of quality of life forms a major component of economic evaluation in health care and is a major issue in health services research. However, differing approaches exist in the measurement and valuation of quality of life from a health economics perspective. While some instruments such as the EQ-5D-3L focus on health-related quality of life alone, others assess quality of life in broader terms, for example, the newly developed ICECAP-O.The aim of this study was to utilize two generic preference-based instruments, the EQ-5D-3L and the ICECAP-O, to measure and value the quality of life of older adult patients receiving post-acute care. An additional objective was to compare the values obtained by each instrument with those generated from two community-based general population samples.Data were collected from a clinical patient population of older adults receiving post-acute outpatient rehabilitation or residential transition care and two Australian general population samples of individuals residing in the general community. The individual responses to the ICECAP-O and EQ-5D-3L instruments were scored using recently developed Australian general population algorithms. Empirical comparisons were made of the resulting patient and general population sample values for the total population and dis-aggregated according to age (65-79 and 80+ years) and gender.A total of 1,260 participants aged 65-99 years (n = 86 clinical patient sample, n = 385 EQ-5D-3L general population sample, n = 789 ICECAP-O general population sample) completed one or both of the EQ-5D-3L and ICECAP-O instruments. As expected, the patient group demonstrated lower quality of life than the general population sample as measured by both quality-of-life instruments. The difference in values between the patient and general population groups was found to be far more pronounced for the EQ-5D-3L than for the ICECAP-O. The ICECAP-O was associated with a mean difference in values of 0.04 (patient group mean 0.753, SD 0.18; general population group mean 0.795, SD 0.17, respectively, p = 0.033). In contrast, the EQ-5D-3L was associated with a mean difference in values of 0.19 (patient group mean 0.595, SD 0.20; general population group mean 0.789, SD 0.02, respectively, p ? 0.001).The study findings illustrate the magnitude of the difference in patient and general population values according to the instrument utilized, and highlight the differences in both the theoretical underpinnings and valuation algorithms for the EQ-5D-3L and ICECAP-O instruments. Further empirical work is required in larger samples and alternative patient groups to investigate the generalizability of the findings presented here. HubMed – rehab