Watson, Fraye;
(2022)
Towards measuring dynamic spinal balance with wearable activity trackers in children with Adolescent Idiopathic Scoliosis.
Doctoral thesis (Ph.D), UCL (University College London).
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Abstract
I carried out a narrative and systematic review on gait metrics in Adolescent Idiopathic Scoliosis (AIS) and the use of the Margin of Stability (MoS) in pathological populations. I used a motion capture system to measure the MoS in healthy adults simulating scoliosis. Subsequently, I measured the MoS and used a commercially available wearable motion sensor (Notch® Inertial Measurement Unit [IMU]) to generate an adapted MoS measure, Dynamic Postural Stability (DPS). I compared the MoS and DPS in girls with AIS to typically developing girls. The systematic review showed the MoS is a clinically useful measure in pathological populations. Affected populations increased their mediolateral MoS (MoSML) compared to control populations, possibly due to a conservative gait strategy. Healthy adults simulating scoliosis using a custom orthosis increased their MoSML at left heel strike compared to control conditions (p=0.018; n=10). In girls with AIS (n=3), anterior-posterior MoS (MoSAP) was significantly increased at left and right heel strike (p=0.038 and p=0.041, respectively), and the MoSML was decreased at left heel strike compared to controls (n=4), which approached significance. MoSAP increased (r2=0.687 [p=0.054] and r2=0.634 [p=0.067] at left and right heel strike, respectively) and MoSML decreased (r2=-0.912 [p=0.002] and r2=-0.779 [p=0.026] at left and right heel strike, respectively) with increasing Cobb angle. All measurements were made using a motion capture system using reflective markers in a gait laboratory. I found agreement of +0.09m (SD=0.28m, 95% CI[-0.46m–0.63m] between the Notch® IMU and motion capture system. A novel method to use the Notch® IMU to generate the DPS was designed and tested using modified motion capture data and data from the Notch® IMU. The modified motion capture data showed poor agreement with the MoS for measuring DPSAP (+0.08m (SD=0.22m, 95% CI[-0.34m–0.51m]), but reasonable agreement for DPSML (+0.02m (SD=0.01m, 95% CI[0.00m–0.03m]), which was mirrored when the Notch® IMU was used. 6 The MoSAP/ML and DPSML could be used to objectively clinically monitor girls with AIS as an adjunct to radiography and subjective clinical assessment.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Towards measuring dynamic spinal balance with wearable activity trackers in children with Adolescent Idiopathic Scoliosis |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2022. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10161480 |
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