# Integrating Wearable Sensors and Clinical Tools for Assessing Pelvic Gait Symmetry During ACL Recovery

## TL;DR

This study shows how combining wearable sensors and clinical tools can help track gait symmetry and recovery after ACL surgery.

## Contribution

The novel integration of IMU sensors with clinical assessments provides objective, real-time monitoring of pelvic gait symmetry during ACL recovery.

## Key findings

- Pelvic gait symmetry improved across all planes during early post-operative recovery.
- Objective digital biomarkers from IMUs captured subtle kinematic changes and asymmetries.
- Early recovery showed reduced pain and swelling but persistent thigh hypotrophy and sagittal-plane deficits.

## Abstract

What are the main findings?
Integration of wearable inertial sensors with standardized clinical assessments captured objective pelvic gait asymmetries and subtle kinematic changes, enabling precise monitoring of gait symmetry across patients.Early post-operative recovery showed measurable improvements in joint mobility, pain, and swelling, though mild sagittal-plane deficits and thigh hypotrophy persisted, illustrating inter-individual variability.

Integration of wearable inertial sensors with standardized clinical assessments captured objective pelvic gait asymmetries and subtle kinematic changes, enabling precise monitoring of gait symmetry across patients.

Early post-operative recovery showed measurable improvements in joint mobility, pain, and swelling, though mild sagittal-plane deficits and thigh hypotrophy persisted, illustrating inter-individual variability.

What is the implication of the main finding?
Combining wearable inertial measurement unit sensors with standard clinical tools provides a rich, objective dataset for evaluating pelvic gait symmetry and functional status, allowing clinicians to monitor recovery trajectories and support individualized clinical evaluation and informed decision-making without requiring a control group or long-term follow-up.

Combining wearable inertial measurement unit sensors with standard clinical tools provides a rich, objective dataset for evaluating pelvic gait symmetry and functional status, allowing clinicians to monitor recovery trajectories and support individualized clinical evaluation and informed decision-making without requiring a control group or long-term follow-up.

Anterior cruciate ligament (ACL) injuries frequently lead to persistent gait asymmetries, posing challenges for early rehabilitation and functional status. Comprehensive monitoring of pelvic gait symmetry during rehabilitation remains underexplored. This study evaluated post-operative functional status using an integrated monitoring approach combining pelvic-mounted inertial measurement unit (IMU) sensors with standardized clinical assessments in 32 individuals (9 women, 23 men; aged 19–64) following ACL reconstruction with patellar tendon autografts. IMU recordings captured pelvic oscillations in the sagittal, frontal, and transverse planes during standardized 10 m walking tests, providing objective digital biomarkers of gait symmetry. Clinical assessments included knee range of motion, thigh circumference, swelling, and pain using a modified 0–20 visual analogue scale (VAS). Across the early rehabilitation period, VAS scores decreased from 13.6 to 3.0, knee swelling from 2.88 cm to 1.09 cm, knee extension deficit from −9.38° to −2.03°, and knee flexion improved from 61.56° to 98.75°. Thigh hypotrophy increased from 1.13 cm to 2.53 cm. Pelvic oscillations improved in all planes (sagittal: 36.2 to 49.2; frontal: 71.9 to 92.2; transverse: 73.4 to 90.9), reflecting progressive restoration of gait control as patients transitioned from crutch-assisted to independent walking. The integration of wearable sensor data with clinical metrics enabled sensitive tracking of pelvic gait symmetry and functional status, demonstrating the utility of technology-supported monitoring to support individualized clinical assessment and early-phase monitoring following ACL reconstruction.