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Identifier

000372547

Title

Καταγραφή και ανάλυση κινησιομετρικών χαρακτηριστικών με στόχο την εκτίμηση του μυοσκελετικού συστήματος των αθλητών

Alternative Title

Recording and analysis of gait features for the evaluation of the musculoskeletal system of athletes.

Author

Τσιβγούλη, Στυλιανού Δ

Thesis advisor

Κατώνης, Παύλος

Reviewer

Κοντάκης, Γεώργιος
Καμπάνης Νικόλαος

Abstract

Aim: Development and evaluation of a new method based on theory of statistical entropy. The new method is going to permit an objective and quantitative evaluation of the gait characteristics in healthy male soccer athletes in correlation with their body features. It will also permit an objective and quantitative evaluation of the gait variability of patients with acute and isolated Anterior Cruciate Ligament (ACL) rupture and will be useful for the evaluation of responses to surgical treatment in these subjects. Methods: Prior to gait measurement, there was a history complementation form and a clinical evaluation form to be filled. A tri-axial accelerometer sensor was used for the gait measurement and entropy algorithm was used for accelerometer data analysis. The measurement device measured the approximate gait acceleration of the centre of gravity (COG) of the subject body. All subjects were instructed to walk along a 40 m straight hospital level walkway at a self-selected walking speed. The group participated at the first study was consisted of 175 healthy soccer atheletes which participated in their athletic club obligations. There were excluded subjects with musculoskeletal and/or neurological problems. At the end 133 subjects were included in the study. Basic somatometric features as well as the level of their training were recorded. The objective of the second study was to compare the gait variability of patients with excessive anterior cruciate ligament (ACL) deficiency (experimental group) with that of healthy individuals (control group) using the proposed method. The experimental group consisted of 20 men with an ACL tear and the control group consisted of 20 healthy men without any neurological and/or musculoskeletal pathology or injury. A receiver operating characteristic (ROC) analysis was used to assess the diagnostic value of the method. The objective of the third study was to assess the gait variability of acl deficient patients and to evaluate quantitatively its postoperative progression. 119 The same group were measured before and after surgery. Preoperative measurements were performed 2 days before surgery. Postoperative measurements were performed 6 months after surgery. Repeated measures analysis of variance (ANOVA) was used to test whether there was a significant surgery effect on entropy at 6 months postoperatively. In the case of a statistically significant finding, post hoc Bonferroni adjusted tests were needed to pinpoint differences. Results: For the first study, the method was sufficient for evaluating healthy soccer subjects concerning their body parameters. There was a correlation between entropy in vertical axis and hours of training per week, between entropy of anteroposterior axis and height, entropy of mediolateral axis and difference of thigh circumference, entropy of anteroposterior axis and circumference of tibia (right and left) and finally for the subgroup having flatfoot with genou varous there was a correlation with the vertical axis. In the second study, the entropy index of the experimental group in the medio–lateral axis, but not the anterior–posterior axis, was statistically significantly higher (P&λτ0.0001) than that of the control group. For the medio– lateral axis, the ROC analysis estimated a 90% probability for the correct identification of patients (sensitivity) and an 85% probability for the correct identification of healthy subjects (specificity). According to the ROC analysis, the entropy index had a 95.6% probability for distinguishing between ACL patients and healthy subjects. The positive likelihood ratio (PLR) was 6.0 and the negative likelihood ratio (NLR) was 0.17. Thus, the LR values of gait variability suggested that the method has strong diagnostic value for using the medio–lateral axis data. In the third study, repeated measures ANOVA revealed that there was a statistical significant surgery effect (p΄&λτ0.001). The preoperative and postoperative measurements of the acl patients’ comparison indicated a statistically significant decrease in entropy for each patient. Post hoc Bonferroni adjusted tests yield that there was a statistically significant 120 reduction in gait variability postoperatively. Te same improvement postoperatively was observed concerning the VAS, Oswestry and IKDC scores. Conclusions: The proposed method permits an objective and quantitative evaluation of the gait characteristics in healthy soccer subjects. It also permits objective and quantitative evaluation of the gait characteristics in patients with ACL rupture and evaluation of responses to surgical treatment in these subjects. The proposed method is also painless, low-cost, non-invasive, requires no radiation or chemicals and the objective index that corresponds to gait irregularity may be computed instantly.

Language

Greek

Subject

Accelerometry

Anterior cruciate ligament

Biodignal

Gait analysis

Gait variability

Musculoskeletal system

Soccer athletes

Somatometric features

Training