Gait quality assessed by trunk accelerometry after total knee arthroplasty and its association with patient related outcome measures

Bas L. Fransen*, Nina M.C. Mathijssen, Karin Slot, Nicole H.H. de Esch, Hennie Verburg, Olivier P.P. Temmerman, Marco J.M. Hoozemans, Jaap H. van Dieën

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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Background: With an increasingly younger population and more active patients, assessment of functional outcome is more important than ever in patients undergoing total knee arthroplasty. Accelerometers have been used successfully to objectively evaluate gait quality in other fields. The aim of this study was to assess gait quality with accelerometers before and after surgery, and to assess added value of resulting parameters to patient reported outcome measures scores. Methods: Sixty-five patients (mean age 65 years (range 41–75)) who underwent primary total knee arthroplasty were evaluated using a tri-axial trunk accelerometer preoperatively and 1 year after surgery. Gait quality parameters derived from the accelerometry data were evaluated in three dimensions at both time points. Factor analysis was performed on all outcome variables and changes from before to 1 year after surgery in the most representative variable for each factor were studied. Findings: Factor analysis identified three separate gait quality factors, with questionnaire and gait quality parameters loading on different factors. Both gait quality factor scores and questionnaire factor scores improved significantly 1 year after surgery. As expected based on the factor analysis, only weak to moderate associations were found between patient reported outcome measures and gait quality before surgery, after surgery and in change scores. Interpretation: The independence of patient reported outcome measures and gait quality parameters measured with trunk accelerometry indicates that gait quality parameters provide additional information on functional outcome after total knee arthroplasty. Providing caretakers with objectively measurable targets using accelerometry could help improve outcome of these patients.

Original languageEnglish
Pages (from-to)192-196
Number of pages5
JournalClinical Biomechanics
Early online date18 Oct 2019
Publication statusPublished - Dec 2019


  • Accelerometer
  • Functional outcome
  • Gait analysis
  • Patient reported outcome measures
  • Total knee arthroplasty


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