Orthotic and assistive devices such as knee ankle foot orthoses (KAFO), come in a variety of forms and fits, with several levels of available features that could help users perform daily activities more naturally. However, objective data on the actual use of these devices outside of the research lab is usually not obtained. Such data could enhance traditional lab-based outcome measures and inform clinical decision-making when prescribing new orthotic and assistive technology. Here, we link data from a GPS unit and an accelerometer mounted on the orthotic device to quantify its usage in the community and examine the correlations with clinical metrics. We collected data from 14 individuals over a period of 2 months as they used their personal KAFO first, and then a novel research KAFO; for each device we quantified number of steps, cadence, time spent at community locations and time wearing the KAFO at those locations. Sensor-derived metrics showed that mobility patterns differed widely between participants (mean steps: 591.3, SD =704.2). The novel KAFO generally enabled participants to walk faster during clinical tests ( Δ6\Delta 6 Minute-Walk-Test=71.5m, p=0.006). However, some participants wore the novel device less often despite improved performance on these clinical measures, leading to poor correlation between changes in clinical outcome measures and changes in community mobility ( Δ6\Delta 6 Minute-Walk-Test – Δ\Delta Community Steps: r=0.09, p=0.76). Our results suggest that some traditional clinical outcome measures may not be associated with the actual wear time of an assistive device in the community, and obtaining personalized data from real-world use through wearable technology is valuable.

中文翻译：

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结合加速度计和 GPS 功能来评估膝踝足矫形器 (KAFO) 用户的社区活动能力


膝踝足矫形器 (KAFO) 等矫形器和辅助装置有多种形式和适合度，具有多个级别的可用功能，可以帮助用户更自然地进行日常活动。然而，通常无法获得研究实验室之外这些设备实际使用的客观数据。这些数据可以增强传统的基于实验室的结果测量，并在处方新的矫形器和辅助技术时为临床决策提供信息。在这里，我们将来自 GPS 单元和安装在矫形设备上的加速度计的数据链接起来，以量化其在社区中的使用情况并检查与临床指标的相关性。我们在 2 个月内收集了 14 个人的数据，他们首先使用个人 KAFO，然后使用新颖的研究 KAFO；对于每台设备，我们量化了步数、节奏、在社区地点花费的时间以及在这些地点佩戴 KAFO 的时间。传感器导出的指标显示参与者之间的移动模式差异很大（平均步数：591.3，SD = 704.2）。新颖的 KAFO 通常使参与者在临床测试期间走得更快（Δ6\Delta 6 分钟步行测试=71.5m，p=0.006）。然而，尽管这些临床指标的表现有所提高，但一些参与者佩戴新型设备的频率较低，导致临床结果指标的变化与社区流动性的变化之间的相关性较差（Δ6\Delta 6 分钟步行测试 – Δ\Delta 社区步骤： r=0.09，p=0.76）。我们的结果表明，一些传统的临床结果测量可能与社区辅助设备的实际佩戴时间无关，通过可穿戴技术从现实世界的使用中获取个性化数据是有价值的。