Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty
(Background) Inertial Measurement Units (IMUs) provide a low-cost, portable solution to obtain functional measures similar to those captured with three-dimensional gait analysis, including spatiotemporal gait characteristics. The primary aim of this study was to determine the feasibility of a remote...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Sensors |
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| Online Access: | https://www.mdpi.com/1424-8220/21/15/5143 |
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| author | Scott M. Bolam Bruno Batinica Ted C. Yeung Sebastian Weaver Astrid Cantamessa Teresa C. Vanderboor Shasha Yeung Jacob T. Munro Justin W. Fernandez Thor F. Besier Andrew Paul Monk |
| author_facet | Scott M. Bolam Bruno Batinica Ted C. Yeung Sebastian Weaver Astrid Cantamessa Teresa C. Vanderboor Shasha Yeung Jacob T. Munro Justin W. Fernandez Thor F. Besier Andrew Paul Monk |
| author_sort | Scott M. Bolam |
| collection | DOAJ |
| description | (Background) Inertial Measurement Units (IMUs) provide a low-cost, portable solution to obtain functional measures similar to those captured with three-dimensional gait analysis, including spatiotemporal gait characteristics. The primary aim of this study was to determine the feasibility of a remote patient monitoring (RPM) workflow using ankle-worn IMUs measuring impact load, limb impact load asymmetry and knee range of motion in combination with patient-reported outcome measures. (Methods) A pilot cohort of 14 patients undergoing primary knee arthroplasty for osteoarthritis was prospectively enrolled. RPM in the community was performed weekly from 2 up to 6 weeks post-operatively using wearable IMUs. The following data were collected using IMUs: mobility (Bone Stimulus and cumulative impact load), impact load asymmetry and maximum knee flexion angle. In addition, scores from the Oxford Knee Score (OKS), EuroQol Five-dimension (EQ-5D) with EuroQol visual analogue scale (EQ-VAS) and 6 Minute Walk Test were collected. (Results) On average, the Bone Stimulus and cumulative impact load improved 52% (<i>p</i> = 0.002) and 371% (<i>p</i> = 0.035), compared to Post-Op Week 2. The impact load asymmetry value trended (<i>p</i> = 0.372) towards equal impact loading between the operative and non-operative limb. The mean maximum flexion angle achieved was 99.25° at Post-Operative Week 6, but this was not significantly different from pre-operative measurements (<i>p</i> = 0.1563). There were significant improvements in the mean EQ-5D (0.20; <i>p</i> = 0.047) and OKS (10.86; <i>p</i> < 0.001) scores both by 6 weeks after surgery, compared to pre-operative scores. (Conclusions) This pilot study demonstrates the feasibility of a reliable and low-maintenance workflow system to remotely monitor post-operative progress in knee arthroplasty patients. Preliminary data indicate IMU outputs relating to mobility, impact load asymmetry and range of motion can be obtained using commercially available IMU sensors. Further studies are required to directly correlate the IMU sensor outputs with patient outcomes to establish clinical significance. |
| first_indexed | 2024-03-10T09:08:28Z |
| format | Article |
| id | doaj.art-b9c30530430b43dcad677bdd91ce7a90 |
| institution | Directory Open Access Journal |
| issn | 1424-8220 |
| language | English |
| last_indexed | 2024-03-10T09:08:28Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Sensors |
| spelling | doaj.art-b9c30530430b43dcad677bdd91ce7a902023-11-22T06:11:04ZengMDPI AGSensors1424-82202021-07-012115514310.3390/s21155143Remote Patient Monitoring with Wearable Sensors Following Knee ArthroplastyScott M. Bolam0Bruno Batinica1Ted C. Yeung2Sebastian Weaver3Astrid Cantamessa4Teresa C. Vanderboor5Shasha Yeung6Jacob T. Munro7Justin W. Fernandez8Thor F. Besier9Andrew Paul Monk10Department of Orthopaedics, Auckland City Hospital, Auckland 1023, New ZealandDepartment of Surgery, University of Auckland, Auckland 1023, New ZealandAuckland Bioengineering Institute, University of Auckland, Auckland 1010, New ZealandAuckland Bioengineering Institute, University of Auckland, Auckland 1010, New ZealandLaboratory of Biological and Bioinspired Materials, University of Liège, 4000 Liège, BelgiumDepartment of Orthopaedics, Auckland City Hospital, Auckland 1023, New ZealandAuckland Bioengineering Institute, University of Auckland, Auckland 1010, New ZealandDepartment of Orthopaedics, Auckland City Hospital, Auckland 1023, New ZealandAuckland Bioengineering Institute, University of Auckland, Auckland 1010, New ZealandAuckland Bioengineering Institute, University of Auckland, Auckland 1010, New ZealandDepartment of Orthopaedics, Auckland City Hospital, Auckland 1023, New Zealand(Background) Inertial Measurement Units (IMUs) provide a low-cost, portable solution to obtain functional measures similar to those captured with three-dimensional gait analysis, including spatiotemporal gait characteristics. The primary aim of this study was to determine the feasibility of a remote patient monitoring (RPM) workflow using ankle-worn IMUs measuring impact load, limb impact load asymmetry and knee range of motion in combination with patient-reported outcome measures. (Methods) A pilot cohort of 14 patients undergoing primary knee arthroplasty for osteoarthritis was prospectively enrolled. RPM in the community was performed weekly from 2 up to 6 weeks post-operatively using wearable IMUs. The following data were collected using IMUs: mobility (Bone Stimulus and cumulative impact load), impact load asymmetry and maximum knee flexion angle. In addition, scores from the Oxford Knee Score (OKS), EuroQol Five-dimension (EQ-5D) with EuroQol visual analogue scale (EQ-VAS) and 6 Minute Walk Test were collected. (Results) On average, the Bone Stimulus and cumulative impact load improved 52% (<i>p</i> = 0.002) and 371% (<i>p</i> = 0.035), compared to Post-Op Week 2. The impact load asymmetry value trended (<i>p</i> = 0.372) towards equal impact loading between the operative and non-operative limb. The mean maximum flexion angle achieved was 99.25° at Post-Operative Week 6, but this was not significantly different from pre-operative measurements (<i>p</i> = 0.1563). There were significant improvements in the mean EQ-5D (0.20; <i>p</i> = 0.047) and OKS (10.86; <i>p</i> < 0.001) scores both by 6 weeks after surgery, compared to pre-operative scores. (Conclusions) This pilot study demonstrates the feasibility of a reliable and low-maintenance workflow system to remotely monitor post-operative progress in knee arthroplasty patients. Preliminary data indicate IMU outputs relating to mobility, impact load asymmetry and range of motion can be obtained using commercially available IMU sensors. Further studies are required to directly correlate the IMU sensor outputs with patient outcomes to establish clinical significance.https://www.mdpi.com/1424-8220/21/15/5143knee arthroplastywearable sensorinertial measurement unit (IMU)PROMsremote monitoringtelemedicine |
| spellingShingle | Scott M. Bolam Bruno Batinica Ted C. Yeung Sebastian Weaver Astrid Cantamessa Teresa C. Vanderboor Shasha Yeung Jacob T. Munro Justin W. Fernandez Thor F. Besier Andrew Paul Monk Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty Sensors knee arthroplasty wearable sensor inertial measurement unit (IMU) PROMs remote monitoring telemedicine |
| title | Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty |
| title_full | Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty |
| title_fullStr | Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty |
| title_full_unstemmed | Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty |
| title_short | Remote Patient Monitoring with Wearable Sensors Following Knee Arthroplasty |
| title_sort | remote patient monitoring with wearable sensors following knee arthroplasty |
| topic | knee arthroplasty wearable sensor inertial measurement unit (IMU) PROMs remote monitoring telemedicine |
| url | https://www.mdpi.com/1424-8220/21/15/5143 |
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