Digital technologies for step counting: between promises of reliability and risks of reductionism

Step counting is among the fundamental features of wearable technology, as it grounds several uses of wearables in biomedical research and clinical care, is at the center of emerging public health interventions and recommendations, and is gaining increasing scientific and political importance. This paper provides a perspective of step counting in wearable technology, identifying some limitations to the ways in which wearable technology measures steps and indicating caution in current uses of step counting as a proxy for physical activity. Based on an overview of the current state of the art of technologies and approaches to step counting in digital wearable technologies, we discuss limitations that are methodological as well as epistemic and ethical—limitations to the use of step counting as a basis to build scientific knowledge on physical activity (epistemic limitations) as well as limitations to the accessibility and representativity of these tools (ethical limitations). As such, using step counting as a proxy for physical activity should be considered a form of reductionism. This is not per se problematic, but there is a need for critical appreciation and awareness of the limitations of reductionistic approaches. Perspective research should focus on holistic approaches for better representation of physical activity levels and inclusivity of different user populations

Biometric walk recognizer. Research and results on wearable sensor-based gait recognition

Gait is a biometric trait that can allow user authentication, though being classified as a "soft" one due to a certain lack in permanence, and to sensibility to specific conditions. The earliest research relies on computer vision-based approaches, especially applied in video surveillance. More recently, the spread of wearable sensors, especially those embedded in mobile devices, which are able to capture the dynamics of the walking pattern through simpler 1D signals, has spurred a different research line. This capture modality can avoid some problems related to computer vision-based techniques, but suffers from specific limitations. Related research is still in a less advanced phase with respect to other biometric traits. However, the promising results achieved so far, the increasing accuracy of sensors, the ubiquitous presence of mobile devices, and the low cost of related techniques, make this biometrics attractive and suggest to continue the investigations in this field. The first Chapters of this thesis deal with an introduction to biometrics, and more specifically to gait trait. A comprehensive review of technologies, approaches and strategies exploited by gait recognition proposals in the state-of-the-art is also provided. After such introduction, the contributions of this work are presented in details. Summarizing, it improves preceding result achieved during my Master Degree in Computer Science course of Biometrics and extended in my following Master Degree Thesis. The research deals with different strategies, including preprocessing and recognition techniques, applied to the gait biometrics, in order to allow both an automatic recognition and an improvement of the system accuracy

Addressing the challenges posed by human machine interfaces based on force sensitive resistors for powered prostheses

Despite the advancements in the mechatronics aspect of prosthetic devices, prostheses control still lacks an interface that satisfies the needs of the majority of users. The research community has put great effort into the advancements of prostheses control techniques to address users’ needs. However, most of these efforts are focused on the development and assessment of technologies in the controlled environments of laboratories. Such findings do not fully transfer to the daily application of prosthetic systems. The objectives of this thesis focus on factors that affect the use of Force Myography (FMG) controlled prostheses in practical scenarios. The first objective of this thesis assessed the use of FMG as an alternative or synergist Human Machine Interface (HMI) to the more traditional HMI, i.e. surface Electromyography (sEMG). The assessment for this study was conducted in conditions that are relatively close to the real use case of prosthetic applications. The HMI was embedded in the custom prosthetic prototype that was developed for the pilot participant of the study using an off-the-shelf prosthetic end effector. Moreover, prostheses control was assessed as the user moved their limb in a dynamic protocol.The results of the aforementioned study motivated the second objective of this thesis: to investigate the possibility of reducing the complexity of high density FMG systems without sacrificing classification accuracies. This was achieved through a design method that uses a high density FMG apparatus and feature selection to determine the number and location of sensors that can be eliminated without significantly sacrificing the system’s performance. The third objective of this thesis investigated two of the factors that contribute to increased errors in force sensitive resistor (FSR) signals used in FMG controlled prostheses: bending of force sensors and variations in the volume of the residual limb. Two studies were conducted that proposed solutions to mitigate the negative impact of these factors. The incorporation of these solutions into prosthetic devices is discussed in these studies.It was demonstrated that FMG is a promising HMI for prostheses control. The facilitation of pattern recognition with FMG showed potential for intuitive prosthetic control. Moreover, a method for the design of a system that can determine the required number of sensors and their locations on each individual to achieve a simpler system with comparable performance to high density FMG systems was proposed and tested. The effects of the two factors considered in the third objective were determined. It was also demonstrated that the proposed solutions in the studies conducted for this objective can be used to increase the accuracy of signals that are commonly used in FMG controlled prostheses

Assessment of Foot Signature Using Wearable Sensors for Clinical Gait Analysis and Real-Time Activity Recognition

Locomotion is one of the most important abilities of humans. Actually, gait locomotion provides mobility, and symbolizes freedom and independence. However, gait can be affected by several pathologies, due to aging, neurodegenerative disease, or trauma. The evaluation and treatment of mobility diseases thus requires clinical gait assessment, which is commonly done by using either qualitative analysis based on subjective observations and questionnaires, or expensive analysis established in complex motion laboratories settings. This thesis presents a new wearable system and algorithmic methods for gait assessment in natural conditions, addressing the limitations of existing methods. The proposed system provides quantitative assessment of gait performance through simple and precise outcome measures. The system includes wireless inertial sensors worn on the foot, that record data unobtrusively over long periods of time without interfering with subject's walking. Signal processing algorithms are presented for the automatic calibration and online virtual alignment of sensor signals, the detection of temporal parameters and gait phases, and the estimation of 3D foot kinematics during gait based on fusion methods and biomechanical assumptions. The resulting 3D foot trajectory during one gait cycle is defined as Foot Signature, by analogy with hand-written signature. Spatio-temporal parameters of interest in clinical assessment are derived from foot signature, including commonly parameters, such as stride velocity and gait cycle time, as well as original parameters describing inner-stance phases of gait, foot clearance, and turning. Algorithms based on expert and machine learning methods have been also adapted and implemented in real-time to provide input features to recognize locomotion activities including level walking, stairs, and ramp locomotion. Technical validation of the presented methods against gold standard systems was carried out using experimental protocols on subjects with normal and abnormal gait. Temporal aspects and quantitative estimation of foot-flat were evaluated against pressure insoles in subjects with ankle treatments during long-term gait. Furthermore, spatial parameters and foot clearance were compared in young and elderly persons to data obtained from an optical motion capture system during forward gait trials at various speeds. Finally, turning was evaluated in children with cerebral palsy and people with Parkinson's disease against optical motion capture data captured during timed up and go and figure-of-8 tests. Overall, the results demonstrated that the presently proposed system and methods were precise and accurate, and showed agreement with reference systems as well as with clinical evaluations of subjects' mobility disease using classical scores. Currently, no other methods based on wearable sensors have been validated with such precision to measure foot signature and subsequent parameters during unconstrained walking. Finally, we have used the proposed system in a large-scale clinical application involving more than 1800 subjects from age 7 to 77. This analysis provides reference data of common and original gait parameters, as well as their relationship with walking speed, and allows comparisons between different groups of subjects with normal and abnormal gait. Since the presented methods can be used with any foot-worn inertial sensors, or even combined with other systems, we believe our work to open the door to objective and quantitative routine gait evaluations in clinical settings for supporting diagnosis. Furthermore, the present studies have high potential for further research related to rehabilitation based on real-time devices, the investigation of new parameters' significance and their association with various mobility diseases, as well as for the evaluation of clinical interventions

Development and validation of a neural network for adaptive gait cycle detection from kinematic data

(1) Background: Instrumented gait analysis is a tool for quantification of the different aspects of the locomotor system. Gait analysis technology has substantially evolved over the last decade and most modern systems provide real-time capability. The ability to calculate joint angles with low delays paves the way for new applications such as real-time movement feedback, like control of functional electrical stimulation in the rehabilitation of individuals with gait disorders. For any kind of therapeutic application, the timely determination of different gait phases such as stance or swing is crucial. Gait phases are usually estimated based on heuristics of joint angles or time points of certain gait events. Such heuristic approaches often do not work properly in people with gait disorders due to the greater variability of their pathological gait pattern. To improve the current state-ofthe- art, this thesis aims to introduce a data-driven approach for real-time determination of gait phases from kinematic variables based on long short-term memory recurrent neural networks (LSTM RNNs). (2) Methods: In this thesis, 56 measurements with gait data of 11 healthy subjects, 13 individuals with incomplete spinal cord injury and 10 stroke survivors with walking speeds ranging from 0.2 m s up to 1 m s were used to train the networks. Each measurement contained kinematic data from the corresponding subject walking on a treadmill for 90 seconds. Kinematic data was obtained by measuring the positions of reflective markers on body landmarks (Helen Hayes marker set) with a sample rate of 60Hz. For constructing a ground truth, gait data was annotated manually by three raters. Two approaches, direct regression of gait phases and estimation via detection of the gait events Initial Contact and Final Contact were implemented for evaluation of the performance of LSTM RNNs. For comparison of performance, the frequently cited coordinate- and velocity-based event detection approaches of Zeni et al. were used. All aspects of this thesis have been implemented within MATLAB Version 9.6 using the Deep Learning Toolbox. (3) Results: The mean time difference between events annotated by the three raters was −0.07 ± 20.17ms. Correlation coefficients of inter-rater and intra-rater reliability yielded mainly excellent or perfect results. For detection of gait events, the LSTM RNN algorithm covered 97.05% of all events within a scope of 50ms. The overall mean time difference between detected events and ground truth was −11.62 ± 7.01ms. Temporal differences and deviations were consistently small over different walking speeds and gait pathologies. Mean time difference to the ground truth was 13.61 ± 17.88ms for the coordinate-based approach of Zeni et al. and 17.18 ± 15.67ms for the velocity-based approach. For estimation of gait phases, the gait phase was determined as a percentage. Mean squared error to the ground truth was 0.95 ± 0.55% for the proposed algorithm using event detection and 1.50 ± 0.55% for regression. For the approaches of Zeni et al., mean squared error was 2.04±1.23% for the coordinate-based approach and 2.24±1.34% for the velocity-based approach. Regarding mean absolute error to the ground truth, the proposed algorithm achieved a mean absolute error of 1.95±1.10% using event detection and one of 7.25 ± 1.45% using regression. Mean absolute error for the coordinate-based approach of Zeni et al. was 4.08±2.51% and 4.50±2.73% for the velocity-based approach. (4) Conclusion: The newly introduced LSTM RNN algorithm offers a high recognition rate of gait events with a small delay. Its performance outperforms several state-of-theart gait event detection methods while offering the possibility for real-time processing and high generalization of trained gait patterns. Additionally, the proposed algorithm is easy to integrate into existing applications and contains parameters that self-adapt to individuals’ gait behavior to further improve performance. In respect to gait phase estimation, the performance of the proposed algorithm using event detection is in line with current wearable state-of-the-art methods. Compared with conventional methods, performance of direct regression of gait phases is only moderate. Given the results, LSTM RNNs demonstrate feasibility regarding event detection and are applicable for many clinical and research applications. They may be not suitable for the estimation of gait phases via regression. For LSTM RNNs, it can be assumed, that with a more optimal configuration of the networks, a much higher performance is achieved

Smart Sensors for Healthcare and Medical Applications

This book focuses on new sensing technologies, measurement techniques, and their applications in medicine and healthcare. Specifically, the book briefly describes the potential of smart sensors in the aforementioned applications, collecting 24 articles selected and published in the Special Issue “Smart Sensors for Healthcare and Medical Applications”. We proposed this topic, being aware of the pivotal role that smart sensors can play in the improvement of healthcare services in both acute and chronic conditions as well as in prevention for a healthy life and active aging. The articles selected in this book cover a variety of topics related to the design, validation, and application of smart sensors to healthcare

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice

This Special Issue shows a range of potential opportunities for the application of wearable movement sensors in motor rehabilitation. However, the papers surely do not cover the whole field of physical behavior monitoring in motor rehabilitation. Most studies in this Special Issue focused on the technical validation of wearable sensors and the development of algorithms. Clinical validation studies, studies applying wearable sensors for the monitoring of physical behavior in daily life conditions, and papers about the implementation of wearable sensors in motor rehabilitation are under-represented in this Special Issue. Studies investigating the usability and feasibility of wearable movement sensors in clinical populations were lacking. We encourage researchers to investigate the usability, acceptance, feasibility, reliability, and clinical validity of wearable sensors in clinical populations to facilitate the application of wearable movement sensors in motor rehabilitation

Intelligent Biosignal Processing in Wearable and Implantable Sensors

This reprint provides a collection of papers illustrating the state-of-the-art of smart processing of data coming from wearable, implantable or portable sensors. Each paper presents the design, databases used, methodological background, obtained results, and their interpretation for biomedical applications. Revealing examples are brain–machine interfaces for medical rehabilitation, the evaluation of sympathetic nerve activity, a novel automated diagnostic tool based on ECG data to diagnose COVID-19, machine learning-based hypertension risk assessment by means of photoplethysmography and electrocardiography signals, Parkinsonian gait assessment using machine learning tools, thorough analysis of compressive sensing of ECG signals, development of a nanotechnology application for decoding vagus-nerve activity, detection of liver dysfunction using a wearable electronic nose system, prosthetic hand control using surface electromyography, epileptic seizure detection using a CNN, and premature ventricular contraction detection using deep metric learning. Thus, this reprint presents significant clinical applications as well as valuable new research issues, providing current illustrations of this new field of research by addressing the promises, challenges, and hurdles associated with the synergy of biosignal processing and AI through 16 different pertinent studies. Covering a wide range of research and application areas, this book is an excellent resource for researchers, physicians, academics, and PhD or master students working on (bio)signal and image processing, AI, biomaterials, biomechanics, and biotechnology with applications in medicine

Engineering Dynamics and Life Sciences

From Preface: This is the fourteenth time when the conference “Dynamical Systems: Theory and Applications” gathers a numerous group of outstanding scientists and engineers, who deal with widely understood problems of theoretical and applied dynamics. Organization of the conference would not have been possible without a great effort of the staff of the Department of Automation, Biomechanics and Mechatronics. The patronage over the conference has been taken by the Committee of Mechanics of the Polish Academy of Sciences and Ministry of Science and Higher Education of Poland. It is a great pleasure that our invitation has been accepted by recording in the history of our conference number of people, including good colleagues and friends as well as a large group of researchers and scientists, who decided to participate in the conference for the first time. With proud and satisfaction we welcomed over 180 persons from 31 countries all over the world. They decided to share the results of their research and many years experiences in a discipline of dynamical systems by submitting many very interesting papers. This year, the DSTA Conference Proceedings were split into three volumes entitled “Dynamical Systems” with respective subtitles: Vibration, Control and Stability of Dynamical Systems; Mathematical and Numerical Aspects of Dynamical System Analysis and Engineering Dynamics and Life Sciences. Additionally, there will be also published two volumes of Springer Proceedings in Mathematics and Statistics entitled “Dynamical Systems in Theoretical Perspective” and “Dynamical Systems in Applications”