Abstract
Study design
Quantitative cross-sectional study.
Objectives
Evaluate the test–retest reliability and the construct validity of inertial measurement units (IMU) to characterize spatiotemporal gait parameters in individuals with SCI.
Setting
Two SCI rehabilitation centers in Canada.
Methods
Eighteen individuals with SCI participated in two evaluation sessions spaced 2 weeks apart. Fifteen able-bodied individuals were also recruited. Participants walked 20 m overground under five conditions that challenged balance to varying degrees. Five IMU were attached to the lower-extremities and the sacrum to collect the mean and the coefficient of variation of five gait parameters (gait cycle time, double-support percentage, cadence, stride length, stride velocity). Intra-class correlation coefficients (ICC) were used to evaluate the test–retest reliability. Linear mixed-effects models were used to compare the five walking conditions to evaluate known-group validity while Spearman’s correlation coefficients were used to characterize the level of association between gait parameters and the Mini BESTest (MBT).
Results
Cadence was reliable across all walking conditions. Reliability was higher for the mean (ICC = 0.55–0.98) of the parameters compared to their coefficient of variation (ICC = 0.16–0.97). Cadence collected with IMU had construct validity as their values differed across walking conditions and groups of participants. The coefficient of variation was generally better than the mean to show differences across the five walking conditions. The MBT was moderately to strongly associated with mean cadence (ρ ≥ 0.498) and its coefficient of variation (ρ ≤ −0.49) during most walking conditions.
Conclusions
IMU provide reliable and valid measurements of gait parameters in ambulatory individuals with SCI.
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Data availability
The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.
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Funding
JFL was supported by a postdoctoral fellowship grant from the Craig H. Nielsen Foundation, Rick Hansen Institute. AN was supported by Alberta Innovates Graduate Student Scholarship. JU was supported by an Ontario Graduate Scholarship. HR was supported by Canadian Academy of Sports and Exercise Medicine, New Frontiers in Research Fund—Exploration, Alberta Ministry of Economic Development and Trade, Major Innovation Fund, NSERC & Alberta Innovates, Engage-CASBE, American Orthotics and Prosthetics Association Back/Spinal Bracing, IC Impact, Canadian India SCI Innovation Award, AIHS Alberta Innovates – PFIZER, Occupational Health and Safety (OHS) Futures, Research Funding Program, Glenrose Rehabilitation Hospital (Clinical Research Grant, Research and Development Grant), Natural Sciences and Engineering Research Council of Canada (NSERC) (Engage grant, Connect grant, Discovery grant, RTI grant), Faculty of Engineering, University of Alberta (Start-up Grant). KEM was supported by Canadian Institutes of Health Research, Craig H. Nielsen Foundation, Rick Hansen Institute, Ontario Neurotrauma Foundation, Heart and Stroke Foundation, US Department of Defense.
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JFL: Research project—conception, organization, execution; Statistical analysis—design, execution, review and critique; Manuscript—writing of the first draft. AN: Research project—execution; Statistical analysis—design, execution, review and critique; Manuscript—review and critique. JU: Research project—execution; Manuscript—review and critique. DJH: Research project—execution; Manuscript—review and critique. HR: Research project—conception, organization, execution; Statistical analysis—design, execution, review and critique; Manuscript—review and critique; KEM: Research project—conception, organization, execution; Statistical analysis—design, execution, review and critique; Manuscript—review and critique.
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Lemay, JF., Noamani, A., Unger, J. et al. Using wearable sensors to characterize gait after spinal cord injury: evaluation of test–retest reliability and construct validity. Spinal Cord 59, 675–683 (2021). https://doi.org/10.1038/s41393-020-00559-4
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DOI: https://doi.org/10.1038/s41393-020-00559-4
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