PDF(Pubmed)
Abstract：
BACKGROUND: A distal radius fracture (DRF) is a common initial fragility fracture among women in their early postmenopausal period, which is associated with an increased risk of subsequent fractures. Gait assessments are valuable for evaluating fracture risk; inertial measurement units (IMUs) have been widely used to assess gait under free-living conditions. However, little is known about long-term changes in patients with DRF, especially concerning daily-life gait. We hypothesized that, in the long term, the daily-life gait parameters in patients with DRF could enable us to reveal future risk factors for falls and fractures.
OBJECTIVE: This study assessed the spatiotemporal characteristics of patients with DRF at 4 weeks and 6 months of recovery.
METHODS: We recruited 16 women in their postmenopausal period with DRF as their first fragility fracture (mean age 62.3, SD 7.0 years) and 28 matched healthy controls (mean age 65.6, SD 8.0 years). Daily-life gait assessments and physical assessments, such as hand grip strength (HGS), were performed using an in-shoe IMU sensor. Participants\' results were compared with those of the control group, and their recovery was assessed for 6 months after the fracture.
RESULTS: In the fracture group, at 4 weeks after DRF, lower foot height in the swing phase (P=.049) and higher variability of stride length (P=.03) were observed, which improved gradually. However, the dorsiflexion angle in the fracture group tended to be lower consistently during 6 months (at 4 weeks: P=.06; during 6 months: P=.07). As for the physical assessments, the fracture group showed lower HGS at all time points (at 4 weeks: P<.001; during 6 months: P=.04), despite significant improvement at 6 months (P<.001).
CONCLUSIONS: With an in-shoe IMU sensor, we discovered the recovery of spatiotemporal gait characteristics 6 months after DRF surgery without the participants\' awareness. The consistently unchanged dorsiflexion angle in the swing phase and lower HGS could be associated with fracture risk, implying the high clinical importance of appropriate interventions for patients with DRF to prevent future fractures. These results could be applied to a screening tool for evaluating the risk of falls and fractures, which may contribute to constructing a new health care system using wearable devices in the near future.
OBJECTIVE: This study assessed the spatiotemporal characteristics of patients with DRF at 4 weeks and 6 months of recovery.
METHODS: We recruited 16 women in their postmenopausal period with DRF as their first fragility fracture (mean age 62.3, SD 7.0 years) and 28 matched healthy controls (mean age 65.6, SD 8.0 years). Daily-life gait assessments and physical assessments, such as hand grip strength (HGS), were performed using an in-shoe IMU sensor. Participants\' results were compared with those of the control group, and their recovery was assessed for 6 months after the fracture.
RESULTS: In the fracture group, at 4 weeks after DRF, lower foot height in the swing phase (P=.049) and higher variability of stride length (P=.03) were observed, which improved gradually. However, the dorsiflexion angle in the fracture group tended to be lower consistently during 6 months (at 4 weeks: P=.06; during 6 months: P=.07). As for the physical assessments, the fracture group showed lower HGS at all time points (at 4 weeks: P<.001; during 6 months: P=.04), despite significant improvement at 6 months (P<.001).
CONCLUSIONS: With an in-shoe IMU sensor, we discovered the recovery of spatiotemporal gait characteristics 6 months after DRF surgery without the participants\' awareness. The consistently unchanged dorsiflexion angle in the swing phase and lower HGS could be associated with fracture risk, implying the high clinical importance of appropriate interventions for patients with DRF to prevent future fractures. These results could be applied to a screening tool for evaluating the risk of falls and fractures, which may contribute to constructing a new health care system using wearable devices in the near future.
摘要：
背景：桡骨远端骨折（DRF）是绝经后早期女性常见的初始脆性骨折，这与后续骨折的风险增加有关。步态评估对于评估骨折风险很有价值；惯性测量单元（IMU）已广泛用于评估自由生活条件下的步态。然而,对DRF患者的长期变化知之甚少，尤其是日常生活中的步态.我们假设，从长远来看,DRF患者的日常生活步态参数可以帮助我们揭示未来跌倒和骨折的危险因素.
目的：本研究评估了DRF患者在恢复4周和6个月时的时空特征。
方法：我们招募了16名绝经后女性，DRF作为她们的第一次脆性骨折（平均年龄62.3，SD7.0岁）和28名匹配的健康对照（平均年龄65.6，SD8.0岁）。日常生活步态评估和身体评估，如手握力(HGS)，使用鞋内IMU传感器进行。将参与者的结果与对照组的结果进行比较，并对骨折后6个月的恢复情况进行评估。
结果：在骨折组中，在DRF后4周，较低的脚的高度在摆动阶段（P=0.049）和较高的变异性步幅（P=0.03）观察到，逐渐改善。然而,骨折组的背屈角在6个月内趋于持续降低(4周时:P=.06;6个月时:P=.07).至于身体评估，骨折组在所有时间点显示较低的HGS（4周：P<.001；6个月：P=.04），尽管在6个月时有显著改善(P<.001)。
结论：使用鞋内IMU传感器，我们发现在DRF手术后6个月,参与者没有意识的情况下,时空步态特征的恢复.在摆动阶段持续不变的背屈角度和较低的HGS可能与骨折风险有关。这意味着对DRF患者进行适当干预以预防未来骨折的临床重要性。这些结果可以应用于评估跌倒和骨折风险的筛查工具，这可能有助于在不久的将来使用可穿戴设备构建新的医疗保健系统。
目的：本研究评估了DRF患者在恢复4周和6个月时的时空特征。
方法：我们招募了16名绝经后女性，DRF作为她们的第一次脆性骨折（平均年龄62.3，SD7.0岁）和28名匹配的健康对照（平均年龄65.6，SD8.0岁）。日常生活步态评估和身体评估，如手握力(HGS)，使用鞋内IMU传感器进行。将参与者的结果与对照组的结果进行比较，并对骨折后6个月的恢复情况进行评估。
结果：在骨折组中，在DRF后4周，较低的脚的高度在摆动阶段（P=0.049）和较高的变异性步幅（P=0.03）观察到，逐渐改善。然而,骨折组的背屈角在6个月内趋于持续降低(4周时:P=.06;6个月时:P=.07).至于身体评估，骨折组在所有时间点显示较低的HGS（4周：P<.001；6个月：P=.04），尽管在6个月时有显著改善(P<.001)。
结论：使用鞋内IMU传感器，我们发现在DRF手术后6个月,参与者没有意识的情况下,时空步态特征的恢复.在摆动阶段持续不变的背屈角度和较低的HGS可能与骨折风险有关。这意味着对DRF患者进行适当干预以预防未来骨折的临床重要性。这些结果可以应用于评估跌倒和骨折风险的筛查工具，这可能有助于在不久的将来使用可穿戴设备构建新的医疗保健系统。
