Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement

Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement

Booij, M. J. (Vrije Universiteit Amsterdam)
Meinders, E. (Vrije Universiteit Amsterdam)
Sierevelt, I. N. (Spaarne Gasthuis Academy; Specialized Centre of Orthopedic Research and Education (SCORE))
Nolte, P. A. (Spaarne Gasthuis Academy)
Harlaar, J. (TU Delft Biomechatronics & Human-Machine Control; Erasmus MC)
van den Noort, J. C. (Vrije Universiteit Amsterdam)

2021

Background: The assessment of functional recovery of patients after a total knee replacement includes the quantification of gait deviations. Comparisons to comfortable gait of healthy controls may incorrectly suggest biomechanical gait deviations, since the usually lower walking speed of patients already causes biomechanical differences. Moreover, taking peak values as parameter might not be sensitive to actual differences. Therefore, this study investigates the effect of matching walking speed and full-waveform versus discrete analyses. Methods: Gait biomechanics of 25 knee replacement patients were compared to 22 controls in two ways: uncorrected and corrected for walking speed employing principal component analyses, to reconstruct control gait biomechanics at walking speeds matched to the patients. Ankle, knee and hip kinematics and kinetics were compared over the full gait cycle using statistical parametric mapping against using peak values. Findings: All joint kinematics and kinetics gait data were impacted by applying walking speed correction, especially the kinetics of the knee. The lower control walking speeds used for reference generally reduced the magnitude of differences between patient and control gait, however some were enlarged. Full-waveform analysis identified greater deviating gait cycle regions beyond the peaks, but did not make peak value analyses redundant. Interpretation: Matching walking speed of controls affects identification of gait deviations in patients with a total knee replacement, reducing deviations confounded by walking speed and revealing hidden gait deviations related to possible compensations. Full-waveform analysis should be used along peak values for a comprehensive quantification of differences in gait biomechanics.

Biomechanical deviations
Full-waveform analyses
Gait pattern comparison
Gait speed
Match walking velocity

http://resolver.tudelft.nl/uuid:ec79e7d4-14db-4623-bf40-3741852ecbf1

https://doi.org/10.1016/j.clinbiomech.2021.105278

0268-0033

Clinical Biomechanics, 82

Institutional Repository

journal article

© 2021 M. J. Booij, E. Meinders, I. N. Sierevelt, P. A. Nolte, J. Harlaar, J. C. van den Noort