Chayanin Angthong, MD, PhD Foot & Ankle Surgery Department of Orthopaedics, Faculty of Medicine Thammasat University, Pathum Thani, Thailand

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1 The relationships between patient-reported outcome, quality of life, and gait characteristics using a wearable foot inertial-sensor assessment in patients with foot and ankle conditions Chayanin Angthong, MD, PhD Foot & Ankle Surgery Department of Orthopaedics, Faculty of Medicine Thammasat University, Pathum Thani, Thailand

2 CONFLICT TO DISCLOSE The relationships between patient-reported outcome, quality of life, and gait characteristics using a wearable foot inertialsensor assessment in patients with foot and ankle conditions Chayanin Angthong, M.D., Ph.D. I have potential conflicts out of this presentation due to: financial supports to attend the meetings from Device Innovation Company (Thailand), Phoenix Company (Thailand), and Smith & Nephew Company.

3 PURPOSE The purpose of this study was to report the relationships between validated patient-reported outcome, health-related quality of life, and gait characteristics using a wearable foot inertial-sensor assessment in patients with footankle conditions. The inter-metrics correlations were analyzed to determine the relationships between each spatiotemporal or gait parameter.

4 METHODS (1) Fifty-three patients with foot-ankle conditions (38 female/15 male, the mean age was 51.9 (± 13.7) years (range: years) were collected for this study. Clinical assessments, including evaluations with validated patient-reported outcomes using the visual analogue scale foot and ankle (VAS-FA) score, and health-related quality of life using the validated Short Form-36 (SF-36), were performed and recorded in each patient.

5 METHODS (2) Gait characteristics assessment were performed in all patients using a Foot Pod (Garmin Ltd.) wearable device with Micro-electro-mechanical systems (MEMS) inertial-sensor technology during patients' walking-trial for a distance of 10-meter at their selfselected speeds. Pearson s correlation coefficient r and Analysis-of-variance (ANOVA) tests were mainly used to analyze the data.

6 DEMOGRAPHIC DATA

7 PATIENTS SCORES AND GAIT PARAMETERS

8 VAS-FA SCORES VS GAIT PARAMETERS No significant correlation between VAS- FA scores and gait parameters was shown by Pearson s correlation analysis.

9 SF-36 SCORES VS GAIT PARAMETERS Negative correlation between physical component summary (PCS) and maximal cadence only showed a significant value at Pearson s correlation coefficient (r) = 0.308, P = In addition, the correlation between VAS-FA and SF-36 scores was high, as Pearson s correlation coefficient r = 0.858, P <

10 RESULTS: INTER-METRICS CORRELATIONS Positive correlations (r) were found between mean walking speed and mean cadence (r = 0.776, P < 0.001) and between maximal walking speed and mean step length (r = 0.498, P < 0.001). Negative correlations (r) were found between mean cadence and mean step length (r = 0.491, P < 0.001) and between maximal cadence and mean step length (r = 0.355, P = 0.009).

11 DISCUSSION & CONCLUSION walking speed = step length cadence Regarding relationships among several spatiotemporal parameters and patient-reported outcome measures, cadence is the only parameter that was significantly negatively related with PCS in health-related quality of life. Regarding Tudor-Locke C and Rowe DA, Cadence also significantly positively correlated with walking intensity; patients with increased cadence need more energy during walking. Based on inter-metrics relationships, increased cadence might be used to maintain walking speed as a compensatory mechanism in patients with foot-ankle conditions.

12 REFERENCES 1. Angthong C. Validity and reliability of Thai version of the Foot and Ankle Outcome Score in patients with arthritis of the foot and an kle. Foot Ankle Surg 2016; 22: SooHoo NF, Shuler M, Fleming LL, American Orthopaedic Foot and Ankle Society. Evaluation of the validity of the AOFAS clinical rating systems by correlation to the SF-36. Foot Ankle Int 2003; 24: Richter M, Zech S, Geerling J, Frink M, Knobloch K, Krettek C. A new foot and ankle outcome score: questionnaire based, subjective, Visual - Analogue-Scale, validated and computerized. Foot Ankle Surg 2006; 12: American Orthopaedic Foot and Ankle Society (AOFAS) 1ASMHHSCJJ2, editor. Symposium X outcomes assessment in foot and ankle surgery what instrument should we use? Rosenlund S, Holsgaard-Larsen A, Overgaard S, Jensen C. The Gait Deviation Index Is Associated with Hip Muscle Strength and Patient -Reported Outcome in Patients with Severe Hip Osteoarthritis-A Cross-Sectional Study. PLoS One 2016; 11: e van der Linden ML, Hooper JE, Cowan P, Weller BB, Mercer TH. Habitual functional electrical stimulation therapy improves gait kinematics and walking performance, but not patient-reported functional outcomes, of people with multiple sclerosis who present with foot -drop. PLoS One 2014; 9: e van Hoeve S, de Vos J, Verbruggen JP, Willems P, Meijer K, Poeze M. Gait Analysis and Functional Outcome After Calcaneal Fracture. J Bone Joint Surg Am 2015; 97: Angthong C, Chernchujit B, Suntharapa T, Harnroongroj T. Visual analogue scale foot and ankle: validity and reliability of Thai version of the new outcome score in subjective form. J Med Assoc Thai 2011; 94: Jirarattanaphochai K, Jung S, Sumananont C, Saengnipanthkul S. Reliability of the medical outcomes study short-form survey version 2.0 (Thai version) for the evaluation of low back pain patients. J Med Assoc Thai 2005; 88: Maenaka K. MEMS inertial sensors and their applications, th International Conference on Networked Sensing Systems, Kanazawa, 20 08: Schmitt D, Vap A, Queen RM. Effect of end-stage hip, knee, and ankle osteoarthritis on walking mechanics. Gait Posture 2015; 42: Tudor-Locke C, Rowe DA. Using cadence to study free-living ambulatory behaviour. Sports Med 2012; 42: Aguilar-Ferrándiz ME, Moreno-Lorenzo C, Matarán-Peñarrocha GA, García-Muro F, García-Ríos MC, Castro-Sánchez AM. Effect of a mixed kinesio taping-compression technique on quality of life and clinical and gait parameters in postmenopausal women with chronic venous ins ufficiency: double-blinded, randomized controlled trial. Arch Phys Med Rehabil 2014; 95: Schroeder JB. Case 2: A gait to remember. Paediatr Child Health 2009; 14: Cadenas-Sanchez C, Arellano R, Vanrenterghem J, López-Contreras G. Kinematic Adaptations of Forward And Backward Walking on Land and in Water. J Hum Kinet 2015; 49: Bayle N, Patel AS, Crisan D, Guo LJ, Hutin E, Weisz DJ, et al. Contribution of Step Length to Increase Walking and Turning Speed as a Marker of Parkinson s Disease Progression. PLoS One 2016; 11: e

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