Wearable sensor-based gait parameters in patients with heart failure with reduced ejection fraction: associations with clinical and physical outcomes

Abstract

Background: Gait parameters provided by wearable inertial sensors remain significant gaps in understanding their clinical and physical implication in patients with heart failure with reduced ejection fraction (HFrEF). Objectives: To analyse gait parameters using a wearable inertial sensor and to assess the relationships between clinical and physical outcomes in patients with HFrEF. Methods: This cross-sectional study recruited 70 HFrEF patients and 32 apparently healthy individuals. Gait parameters were evaluated using a wearable gait analysis system during an 8-meter walk and a 6-minute walk test (6MWT). Functional class, dyspnea, and frailty were evaluated using the New York Heart Association (NYHA) classification, the Modified Medical Research Council Scale (mMRCS), and the Fried Frailty Phenotype. Pulmonary function, respiratory muscle strength and quadriceps muscle strength, functional capacity, physical activity, and dynamic balance were assessed. Results: Age, gender, and body mass index were similar between patients with HFrEF and apparently healthy controls (p>0.05). Gait speed, cadence, and stride length obtained from both the 8-meter walk and 6MWT were significantly different between the groups (p<0.05). Gait speed and stride length obtained from both the 8-meter walk and the 6MWT were moderately to strongly correlated with NYHA functional class, mMRCS, frailty, and six-minute walk distance (6MWD) (p<0.05). Cadence obtained from both the 8-meter walk and 6MWT was moderately to strongly correlated with six-minute walk distance (p<0.05). Conclusions: This study indicates that gait parameters are affected in patients with HFrEF. Altered gait parameters are associated with worsened clinical and physical outcomes in patients with HFrEF.