Mobile monitoring of joint loading profiles in persons with degenerative hip and knee problems
Aandoening(en):
Specialist(en): Prof. Dr. Johan Bellemans, Prof. Dr. Kristoff Corten
Mobile monitoring of health-related parameters is a hype but is currently underexploited by healthcare practitioners and researchers to evaluate the efficacy of patients’ treatment programs. Although several cell phone applications are available to track activity parameters like heart rate, number of steps and hours of activity and rest, their use for monitoring functional activity level in patients with orthopedic disorders of the lower limb has not yet been introduced and validated in clinical practice. Furthermore, mechanical loading, a known contributing factor to the onset and progression of degenerative joint disease and artificial implant wear, can now be determined using advanced biomechanical analyses. Therefore, mobile monitoring of the evolution of a patient’s total loading profile, i.e. his functional status based on an extended analysis of the activity profile and joint loading, seems feasible, relevant and conceptually within reach. These parameters seem highly relevant for health care practitioners to monitor the rehabilitation status and the functional outcomes in patients with musculoskeletal disorders. In this project, the added value of mobile monitoring of joint loading and functionality profiles in subjects with degenerative hip and knee problems prior to and after surgical interventions will be evaluated in the context of optimizing rehabilitation strategies.
State-of-the-art biomechanical modelling tools allow quantifying joint loading based upon integrated 3D motion capture in a laboratory setting (proof of concept). This can only be done in a limited patient cohort since lab systems suffer from complexity and expensiveness. Portable sensors and sensors included in a smartphone on the other hand still lack the ability to directly calculate joint loading in an accurate way. The challenge in the current project is to quantify the loading profile of patients monitored with portable technology during activities of daily living, independent of a lab-based set-up (innovation). This will allow monitoring a large cohort of patients. Furthermore, it will create a new outcome tool available for thousands of health care practitioners who do not have access to complex gait analysis tools and complex biomechanical analyses. In the first phase of the project, portable sensors will be used to acquire the motion characteristics of healthy subjects and patients with degenerative hip and knee disease. This information will be related to a database of loading profiles. To create this database, the motion characteristics and joint loading of subjects will be mapped and monitored in the lab for a set of activities of daily living. In the second phase, a loading profile will be defined based on the portable sensor data, therefore allowing to monitor joint loading in subjects using portable technology (innovation). To do so, the movement characteristics measured with portable sensors will be calibrated and related to the lab-based loading profile from the different activities. The joint loading profiles will be compiled based upon the patient’s loading profile combined with the time spent on different activities, as derived from the portable sensors. This joint loading profile will then be used by the health practitioner to evaluate the patient's functional status with respect to healthy subjects or to his pre-treatment status. This methodology will provide quantitative information to health care practitioners to monitor their patients’ rehabilitation status and adjust the treatment plan on an individual basis. Throughout the project, the use of mobile monitoring of the joint loading profile for clinical and research purposes will be implemented in a prospective follow-up of patients with osteoarthritic hip and knee disease.
