{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:22:48Z","timestamp":1784647368892,"version":"3.55.0"},"reference-count":30,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Medical University, Pleven, Bulgaria","award":["5\/2023"],"award-info":[{"award-number":["5\/2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Accurate gait assessment is essential for managing pathological locomotion, especially in elderly patients recovering from hip joint surgeries. Inertial measurement units (IMUs) provide real-time, objective data in clinical settings. This study examined pelvic oscillations in sagittal, frontal, and transverse planes using a wearable IMU system in two groups: Group A (n = 15, osteosynthesis metallica) and Group B (n = 34, arthroplasty), all over age 65. Gait analysis was conducted during assisted and unassisted walking. In the frontal plane, both groups showed statistically significant improvements: Group A from 46.4% to 75.2% (p = 0.001) and Group B from 52.6% to 72.2% (p = 0.001), reflecting enhanced lateral stability. In the transverse plane, Group A improved significantly from 47.7% to 80.2% (p = 0.001), while Group B showed a non-significant increase from 73.0% to 80.5% (p = 0.068). Sagittal plane changes were not statistically significant (Group A: 68.8% to 71.1%, p = 0.313; Group B: 76.4% to 69.1%, p = 0.065). These improvements correspond to better pelvic symmetry and postural control, which are critical for a safe and stable gait. Improvements were more pronounced during unassisted walking, indicating better pelvic control. These results confirm the clinical utility of IMUs in capturing subtle gait asymmetries and monitoring recovery progress. The findings support their use in tailoring rehabilitation strategies, particularly for enhancing frontal and transverse pelvic stability in elderly orthopedic patients.<\/jats:p>","DOI":"10.3390\/s25144435","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T15:48:22Z","timestamp":1752680902000},"page":"4435","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Kinesiological Analysis Using Inertial Sensor Systems: Methodological Framework and Clinical Applications in Pathological Gait"],"prefix":"10.3390","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9820-8579","authenticated-orcid":false,"given":"Danelina Emilova","family":"Vacheva","sequence":"first","affiliation":[{"name":"Department of Physical Medicine, Rehabilitation, Occupational Therapy and Sports, Medical University\u2014Pleven, 1, Saint Kliment Ohridski Street, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2102-9117","authenticated-orcid":false,"given":"Atanas Kostadinov","family":"Drumev","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine, Rehabilitation, Occupational Therapy and Sports, Medical University\u2014Pleven, 1, Saint Kliment Ohridski Street, 5800 Pleven, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.3897\/jbcr.e139155","article-title":"Researching the Recovery of Locomotor Activity after Traumatic Conditions of the Lower Limb","volume":"18","author":"Drumev","year":"2025","journal-title":"J. Biomed. Clin. Res."},{"key":"ref_2","unstructured":"Neumann, D.A. (2017). Kinesiology of Gait, Elsevier. [3rd ed.]."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.1016\/j.kjms.2011.08.004","article-title":"Biomechanics of human movement and its clinical applications","volume":"28","author":"Lu","year":"2012","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_4","unstructured":"Hall, S.J. (2021). Basic Biomechanics, McGraw-Hill. [9th ed.]."},{"key":"ref_5","unstructured":"Vacheva, D. (2022). Medical Rehabilitation in Neurological and Psychiatric Disorders, Publishing Center of the Medical University. (In Bulgarian)."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3362","DOI":"10.3390\/s140203362","article-title":"Gait Analysis Methods: An Overview of Wearable and Non-Wearable Systems, Highlighting Clinical Applications","volume":"14","year":"2014","journal-title":"Sensors"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1016\/j.medengphy.2008.09.005","article-title":"Direct measurement of human movement by accelerometry","volume":"30","author":"Godfrey","year":"2008","journal-title":"Med. Eng. Phys."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Hulleck, A.A., Mohan, D.M., Abdallah, N., El Rich, M., and Khalaf, K. (2022). Present and Future of Gait Assessment in Clinical Practice: Towards the Application of Novel Trends and Technologies. Front. Med. Technol., 4.","DOI":"10.3389\/fmedt.2022.901331"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Vargas, V., Ramos, P., Orbe, E.A., Zapata, M., and Valencia-Arag\u00f3n, K. (2024). Low-Cost Non-Wearable Fall Detection System Implemented on a Single Board Computer for People in Need of Care. Sensors, 24.","DOI":"10.3390\/s24175592"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1016\/j.jbiomech.2010.01.031","article-title":"Walking speed estimation using a shank-mounted inertial measurement unit","volume":"43","author":"Li","year":"2010","journal-title":"J. Biomech."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"872","DOI":"10.5535\/arm.2018.42.6.872","article-title":"Evaluation of validity and reliability of inertial measurement unit-based gait analysis systems","volume":"42","author":"Cho","year":"2020","journal-title":"Ann. Rehabil. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1016\/j.gaitpost.2011.02.023","article-title":"Inertial Sensor-Based Reference Gait Data for Healthy Subjects","volume":"33","author":"Schwesig","year":"2011","journal-title":"Gait Posture"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/S0966-6362(01)00203-X","article-title":"Reference Data for Normal Subjects Obtained with an Accelerometric Device","volume":"16","author":"Auvinet","year":"2002","journal-title":"Gait Posture"},{"key":"ref_14","first-page":"S122","article-title":"System to Measure the Range of Motion of the Joints of the Human Hand","volume":"66","year":"2014","journal-title":"Rev. Investig. Clin."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.gaitpost.2023.02.007","article-title":"The Influence of Wearing an Ultrasound Device on Gait in Children with Cerebral Palsy and Typically Developing Children","volume":"101","author":"Mooijekind","year":"2023","journal-title":"Gait Posture"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.jbmt.2019.12.002","article-title":"Impact of Electrodiagnostic (EMG\/NCS) Tests on Clinical Decision-Making and Patient Perceived Benefit in the Outpatient Physical Therapy Practice","volume":"24","author":"Rawat","year":"2020","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.medengphy.2009.10.014","article-title":"Inertial gait phase detection for control of a drop foot stimulator: Inertial sensing for gait phase detection","volume":"32","author":"Kotiadis","year":"2010","journal-title":"Med. Eng. Phys."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"van Melzen, R., Haveman, M.E., Schuurmann, R.C.L., Struys, M.M.R.F., and de Vries, J.-P.P.M. (2023). Implementing Wearable Sensors for Clinical Application at a Surgical Ward: Points to Consider before Starting. Sensors, 23.","DOI":"10.3390\/s23156736"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Valle, M.S., Casabona, A., Sapienza, I., Laudani, L., Vagnini, A., Lanza, S., and Cioni, M. (2022). Use of a Single Wearable Sensor to Evaluate the Effects of Gait and Pelvis Asymmetries on the Components of the Timed Up and Go Test, in Persons with Unilateral Lower Limb Amputation. Sensors, 22.","DOI":"10.3390\/s22010095"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Prasanth, H., Caban, M., Keller, U., Courtine, G., Ijspeert, A., Vallery, H., and von Zitzewitz, J. (2021). Wearable Sensor-Based Real-Time Gait Detection: A Systematic Review. Sensors, 21.","DOI":"10.3390\/s21082727"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Hafer, J.F., Vitali, R., Gurchiek, R., Curtze, C., Shull, P., and Cain, S.M. (2023). Challenges and Advances in the Use of Wearable Sensors for Lower Extremity Biomechanics. J. Biomech., 157.","DOI":"10.1016\/j.jbiomech.2023.111714"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.3390\/s120202255","article-title":"Gait Analysis Using Wearable Sensors","volume":"12","author":"Tao","year":"2012","journal-title":"Sensors"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1002\/acn3.51509","article-title":"Wearable Sensors Detect Impaired Gait and Coordination in LBSL during Remote Assessments","volume":"9","author":"Kaufman","year":"2022","journal-title":"Ann. Clin. Transl. Neurol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Fern\u00e1ndez-Gorgojo, M., Salas-G\u00f3mez, D., S\u00e1nchez-Juan, P., Barbado, D., Laguna-Bercero, E., and P\u00e9rez-N\u00fa\u00f1ez, M.I. (2022). Clinical-Functional Evaluation and Test-Retest Reliability of the G-WALK Sensor in Subjects with Bimalleolar Ankle Fractures 6 Months after Surgery. Sensors, 22.","DOI":"10.3390\/s22083050"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Kristoffersson, A., and Lind\u00e9n, M. (2022). A Systematic Review of Wearable Sensors for Monitoring Physical Activity. Sensors, 22.","DOI":"10.3390\/s22020573"},{"key":"ref_26","first-page":"81","article-title":"Pelvic motion during walking: Differences in individuals with total hip arthroplasty and healthy controls","volume":"32","author":"Lewek","year":"2010","journal-title":"Gait Posture"},{"key":"ref_27","unstructured":"Riener, R., Rabuffetti, M., and Leardini, A. (2021). Quantifying compensatory pelvic kinematics in patients with hip and knee impairments. Clin. Biomech., 85."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1186\/1743-0003-9-21","article-title":"A review of wearable sensors and systems with application in rehabilitation","volume":"9","author":"Patel","year":"2012","journal-title":"J. NeuroEng. Rehabil."},{"key":"ref_29","first-page":"1154","article-title":"Machine learning methods for classifying human physical activity from on-body accelerometers","volume":"12","author":"Mannini","year":"2012","journal-title":"Sensors"},{"key":"ref_30","first-page":"104984","article-title":"Telerehabilitation Approaches for Stroke Patients: Systematic Review and Meta-analysis of Randomized Controlled Trials","volume":"29","author":"Chen","year":"2020","journal-title":"J. Stroke Cerebrovasc. Dis."}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/14\/4435\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:10:58Z","timestamp":1760033458000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/25\/14\/4435"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,16]]},"references-count":30,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["s25144435"],"URL":"https:\/\/doi.org\/10.3390\/s25144435","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,16]]}}}