Gait-based evaluation of early rehabilitation after ACL reconstruction
- Project Number: LSC18_018
- Project Lead: Andrea Zauner-Dungl, Karl Landsteiner University of Health Sciences / Institute of Physiotherapy and Rehabilitation (University Hospital Krems)
- Project Partner: FH St. Pölten / Institute of Health Sciences, Karl Landsteiner University of Health Sciences / Division Biomechanics
- Duration: 36 months starting from 15.01.2020
A postsurgical treatment after ACL reconstruction is necessary for early return-to-sport as well as to minimize the occurrence of long-term complications. However, the required amount of postsurgical physiotherapeutic supervision remains unclear, as studies concerning less supervision (home-based program) showed sufficient clinical outcomes in home-based groups. Gait plays a major role in rehabilitation process, therefore affordable and simple applicable devices are needed for clinical practice, as 3D gait analysis (gold standard) is expensive. Wearable systems like IMUs (Inertial Measurement Unit) are already used for clinical investigation. Still, there is a lack of appropriate methods and scores for gait assessment, concerning rehabilitation after ACL reconstruction. The aim of the current study is the gait-based assessment of the early rehabilitation progress after ACLre construction.
For this purpose, a specific ACL rehabilitation score is developed, including multiple aspects of gait as well as clinical parameters. The quality of the score derived by data of a simple, clinically applicable, IMU-based gait analysis device (G-Walk) is evaluated in comparison to a standard 3D gait analysis system. Based on the developed score, the outcome of two different ACL rehabilitation programs (home-based versus standardized) will be determined. Therefore, a clinical study is conducted. Two groups of patients with different postsurgical treatment after ACL reconstruction will be formed. Gait assessments will be carried out 6-7 weeks, 9-10 weeks and 12-13 weeks postsurgical using a simple IMU-based gait analysis system (G-Walk) as well as standard 3D gait analysis system for validation purpose. Pre-existing gait data of healthy people will serve as a control. A new ACL habilitation score will be developed, including clinical parameters (e.g. range of motion, IKDC, Lysholm), standard gait parameters (regarding kinematics, kinetics and spatiotemporal characteristics) as well as more sophisticated gait parameters like symmetry, variability, complexity or local stability. Statistical analysis will be performed to determine the influence of the rehabilitation programs and the adequacy of the score determined from IMU data compared to 3D gait analysis data. The results of the proposed study will not only give information about the impact of physiotherapeutic supervision on the early normalization of gait and if home-based programs can confidently be recommended for specific patients. It will also provide a clinically applicable method for gait assessment which can be integrated in the routinely follow-up procedure after ACL reconstruction and used to answer related scientific questions. Furthermore, the proposed method can lay the basis for the development of similar scores in different fields of rehabilitation or therapy assessment.