Test-retest reliability and minimal clinical change determination for 3-dimensional tibial and femoral accelerations during treadmill walking in knee osteoarthritis patients

Katia Turcot, Rachid Aissaoui, Karine Boivin, Nicola Hagemeister, Michel Pelletier, Jacques A de Guise
Archives of Physical Medicine and Rehabilitation 2008, 89 (4): 732-7

OBJECTIVE: To determine the test-retest reliability and the minimal clinical change determination for accelerometric parameters, estimated by a new accelerometric-based method that estimates 3-dimensional (3D) linear accelerations of the tibia and femur during comfortable and fast walking speeds.

DESIGN: Test-retest study.

SETTING: Gait laboratory in a research center.

PARTICIPANTS: Patients (N=25; 6 men, 19 women) with symptomatic knee osteoarthritis (OA).

INTERVENTIONS: Not applicable.

MAIN OUTCOMES MEASURES: Subjects attended 2 walking sessions in which accelerometers were rigidly fixed by means of an exoskeleton to the femoral and tibial segments. In both sessions, 3D accelerations were collected for 25 seconds for each of the walking speeds. Mean accelerometric pattern was calculated using 15 gait cycles. From each mean pattern, maximal, minimal, and range values were extracted from the loading phase period. The root mean square (RMS) value was also calculated for every pattern. Relative and absolute reliability were determined using intraclass correlation (ICC) and standard error (SE) of measurement, respectively. Minimal detectable change was calculated for each parameter as the least significant difference.

RESULTS: Tibial and femoral accelerations showed reliable values across sessions 1 and 2 with ICCs greater than or equal to .75 for 96% and 88% of the parameters at comfortable and fast speeds, respectively. The SE of measurement ranged from .01 to .05g for the RMS value and from .05 to .35g for maximal, minimum, and range point parameters.

CONCLUSIONS: The proposed method is the first to have determined the reliability and the minimal detectable change for tibial and femoral acceleration parameters in knee OA patients during a treadmill walking evaluation. The minimal detectable change determined in this study will be used to determine improvement or deterioration of knee OA patients after rehabilitation.

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