Spatiotemporal parameters and gait variability in people with psoriatic arthritis (PsA): a cross-sectional study

Roua Walha, Nathaly Gaudreault, Pierre Dagenais, Patrick Boissy, Roua Walha, Nathaly Gaudreault, Pierre Dagenais, Patrick Boissy

Abstract

Background: Foot involvement is a major manifestation of psoriatic arthritis (PsA) and can lead to severe levels of foot pain and disability and impaired functional mobility and quality of life. Gait spatiotemporal parameters (STPs) and gait variability, used as a clinical index of gait stability, have been associated with several adverse health outcomes, including risk of falling, functional decline, and mortality in a wide range of populations. Previous studies showed some alterations in STPs in people with PsA. However, gait variability and the relationships between STPs, gait variability and self-reported foot pain and disability have never been studied in these populations. Body-worn inertial measurement units (IMUs) are gaining interest in measuring gait parameters in clinical settings.

Objectives: To assess STPs and gait variability in people with PsA using IMUs, to explore their relationship with self-reported foot pain and function and to investigate the feasibility of using IMUs to discriminate patient groups based on gait speed-critical values.

Methods: Twenty-one participants with PsA (age: 53.9 ± 8.9 yrs.; median disease duration: 6 yrs) and 21 age- and sex-matched healthy participants (age 54.23 ± 9.3 yrs) were recruited. All the participants performed three 10-m walk test trials at their comfortable speed. STPs and gait variability were recorded and calculated using six body-worn IMUs and Mobility Lab software (APDM®). Foot pain and disability were assessed in participants with PsA using the foot function index (FFI).

Results: Cadence, gait speed, stride length, and swing phase were significantly lower, while double support was significantly higher, in the PsA group (p < 0.006). Strong correlations between STPs and the FFI total score were demonstrated (|r| > 0.57, p < 0.006). Gait variability was significantly increased in the PsA group, but it was not correlated with foot pain or function (p < 0.006). Using the IMUs, three subgroups of participants with PsA with clinically meaningful differences in self-reported foot pain and disability were discriminated.

Conclusion: STPs were significantly altered in participants with PsA, which could be associated with self-reported foot pain and disability. Future studies are required to confirm the increased gait variability highlighted in this study and its potential underlying causes. Using IMUs has been useful to objectively assess foot function in people with PsA.

Trial registration: ClinicalTrials.gov , NCT05075343 , Retrospectively registered on 29 September 2021.

Keywords: Foot function; Foot pain; Gait analysis; Gait variability; Psoriatic arthritis; Spatiotemporal parameters.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
A The gait cycle phases taken from an open access article [40]; B 10 m walk test (10MWT); C The Mobility Lab sensors placement
Fig. 2
Fig. 2
Correlation matrix of the relationships between spatiotemporal parameters, stride time variability and the foot function index
Fig. 3
Fig. 3
Scatter plots of the relationships between gait speed and the foot function index for PsA subgroups. PsA1 Participants with gait speed below 1.0 m/s, PsA2 participants with gait speed comprised between 1.0 and 1.2 m/s and PsA3 participants with gait speed higher than 1.2 m/s, FFI Foot function index. Δ1 Difference in the FFI total score between PsA2 and PsA3. Δ2 Difference in the FFI total score between PsA1 and PsA2

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