Feasibility of movement retraining in a natural environment for self-management of hip osteoarthritis

Suboptimal mechanical loading contributes to hip osteoarthritis (OA) progression. Articular loading is necessary for cartilage remodelling, though abnormal loading (insufficient, excessive, or concentrated) can drive cartilage degeneration. We have previously proven that abnormal hip loading is a key marker of hip OA severity and can be improved with laboratorybased movement retraining. To make this intervention accessible outside the lab, we developed Smarti-Shorts. Smarti-Shorts is a wearable garment we co-designed with consumers that monitors hip loading during daily activities in a natural environment. In this proof-of-concept study, we assessed the validity of Smarti-Shorts to measure hip biomechanics when people with hip OA walked using nine walking modifications.

To achieve our aim, we used Smarti-Shorts in combination with artificial intelligence (neural network) to estimate hip biomechanics and compared its accuracy to gold-standard laboratory measurement and modelling methods. A female participant with hip OA attended two laboratory sessions where they walked on an instrumented treadmill wearing custom Smarti-Shorts. The shorts were equipped with sensors (textile electrodes and inertial measurement units) embedded in the shorts’ fabric. The participant walked using nine gait modifications while receiving real-time visual biofeedback of a personalised target to a monitor in front of the treadmill.