Foot characteristics of the daily-life gait in postmenopausal females with distal radius fractures: a cross-sectional study

Abstract

Background Gait decline in older adults is related to falling risk, some of which contribute to injurious falls requiring medical attention or restriction of activity of daily living. Among injurious falls, distal radius fracture (DRF) is a common initial fragility fracture associated with the subsequent fracture risk in postmenopausal females. The recent invention of an inertial measurement unit (IMU) facilitates the assessment of free-living gait; however, little is known about the daily gait characteristics related to the risk of subsequent fractures. We hypothesized that females with DRF might have early changes in foot kinematics in daily gait. The aim of this study was to evaluate the daily-life gait characteristics related to the risk of falls and fracture. Methods In this cross-sectional study, we recruited 27 postmenopausal females with DRF as their first fragility fracture and 28 age-matched females without a history of fragility fractures. The participants underwent daily gait assessments for several weeks using in-shoe IMU sensors. Eight gait parameters and each coefficient of variance were calculated. Some physical tests, such as hand grip strength and Timed Up and Go tests, were performed to check the baseline functional ability. Results The fracture group showed lower foot angles of dorsiflexion and plantarflexion in the swing phase. The receiver operating characteristic curve analyses revealed that a total foot movement angle (TFMA) < 99.0 degrees was the risk of subsequent fracture. Conclusions We extracted the daily-life gait characteristics of patients with DRF using in-shoe IMU sensors. A lower foot angle in the swing phase, TFMA, may be associated with the risk of subsequent fractures, which may be effective in evaluating future fracture risk. Further studies to predict and prevent subsequent fractures from daily-life gait are warranted.

Using In-Shoe Inertial Measurement Unit Sensors to Understand Daily-Life Gait Characteristics in Patients With Distal Radius Fractures During 6 Months of Recovery: Cross-Sectional Study

“…We previously found out that in-shoe IMU sensors were effective in the assessment of daily-life gait in patients with an initial DRF [ 7 ]. We hypothesized that, in the long term, it could enable us to identify future risk factors for secondary fractures by spatiotemporally following daily-life gait parameters using IMU sensors.…”

“…Quantitative gait characteristics, such as slower gait speed and shorter stride length, are associated with falls, resulting in fragility fractures [2][3][4]. Recently, inertial measurement units (IMUs) have been widely used to assess gait under free-living conditions owing to their convenience, low cost, small size, and high accuracy [5][6][7]. The shank and foot are the preferred placements [8,9], and foot kinematics is an important factor related to falls and physical ability [4].…”