Exploring the utility of individualised IMU-based movement analysis in people with chronic knee pain to inform physiotherapy practice

Abuzinadah, Riham 2023. Exploring the utility of individualised IMU-based movement analysis in people with chronic knee pain to inform physiotherapy practice. PhD Thesis, Cardiff University. Item availability restricted.

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Abstract

Background: This study aims to explore kinematic differences in individuals with chronic knee pain (CKP) compared to healthy individuals and test the usability of an inertial measurement unit (IMU) movement analysis reporting tool for physiotherapists treating CKP. Methods: In Part 1, kinematic movement patterns were measured using IMUs and compared within CKP and healthy individuals for the hip, knee, and ankle joints in the sagittal and frontal planes during a variety of tasks. The waveform data for each participant was analysed descriptively, with common trends being identified using a standardised reporting template that provides a structured clinical interpretation (SCI) of waveform data. Alongside this, a standard quantitative analysis (SQA) of discrete time points for all activities in both the frontal and sagittal planes was investigated for the lower limb joint angle. For the knee pain group, the painful limb (KPPL) was compared to the non-painful limb (KPNPL), and for the healthy group, the dominant limb (HDL) was compared to the non-dominant limb (HNDL). In Part 2, a quantitative evaluation of the usability of an electronic movement analysis reporting tool for IMU data was tested via the think-aloud (TA) method and the system usability scale questionnaire (SUS). Physiotherapists interacted with the electronic reporting tool virtually and were asked to interpret movement analysis reports. The system’s usability was measured using six usability metrics: efficiency, effectiveness, memorability, problems, errors, and overall ease of use. Results: In Part 1, altered kinematic movement strategies were highlighted in both groups. The SCI revealed the complexity and individual variation of altered movement patterns, with additional information regarding the timing, nature, and amount of the alteration within the waveform graphs across joints for all activities and planes. Using gait as an example, in the sagittal plane, the SCI of gait waveforms for the hip, knee and ankle depicted 17 different movement patterns in the KPPL compared to the KPNPL and 19 in the HDL compared to the HNDL across individuals. Among both SCI and SQA, alterations related to the ankle were identified within CKP individuals and the healthy group. CKP individuals displayed reduced knee flexion during the stance phase and limited ankle plantarflexion during the swing phase. Notably, there were considerable individual variations within the CKP group. In the frontal plane, the SCI of gait waveforms for the hip, knee and ankle depicted 31 lower-limb movement alterations in the KPPL compared to the KPNPL and 33 in the HDL compared to the HNDL. Among both SCI and SQA, diverse movement alterations were observed in both CKP and healthy participants, with no significant II differences identified either within the CKP group or between CKP and healthy individuals. Averaged data revealed a notable decrease in the knee adduction angle at heel strike between the KPPL of the CKP group and the HDL in the healthy group. In part 2, the mean time spent completing the usability evaluation was 33.31 minutes. The gait report had the highest completion rate (95%) and was the most effective and efficient report. Regarding errors, a total of 76 errors were made while interpreting the reports. The system demonstrated good memorability between reports with less time spent on the repeated task (01:53 minutes for the repeated task vs. 04:04 minutes for the first time). The overall system usability was 63.33%, indicating borderline to good usability. Conclusion: Using the standardised template, movement alterations were identified across the hip, knee, and ankle joints in the sagittal and frontal planes over a range of activities. This provided additional information at the individual level compared to that gained through the discrete analysis. Therefore, it might be advantageous to provide physiotherapists with waveform kinematic data to inform therapeutic exercise prescription, movement re-education, and monitoring progress. The results of the usability study informed modifications to the online kinematic reporting tool to reduce problems and errors using the reporting tool and improve its use for physiotherapists treating CKP individuals.

Item Type:	Thesis (PhD)
Status:	Unpublished
Schools:	Healthcare Sciences
Date of First Compliant Deposit:	14 August 2024
Last Modified:	14 Aug 2024 09:25
URI:	https://orca.cardiff.ac.uk/id/eprint/171387

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