Is the timed-up and go test feasible in mobile devices? A systematic review

The number of older adults is increasing worldwide, and it is expected that by 2050 over 2 billion individuals will be more than 60 years old. Older adults are exposed to numerous pathological problems such as Parkinson’s disease, amyotrophic lateral sclerosis, post-stroke, and orthopedic disturbances. Several physiotherapy methods that involve measurement of movements, such as the Timed-Up and Go test, can be done to support efficient and effective evaluation of pathological symptoms and promotion of health and well-being. In this systematic review, the authors aim to determine how the inertial sensors embedded in mobile devices are employed for the measurement of the different parameters involved in the Timed-Up and Go test. The main contribution of this paper consists of the identification of the different studies that utilize the sensors available in mobile devices for the measurement of the results of the Timed-Up and Go test. The results show that mobile devices embedded motion sensors can be used for these types of studies and the most commonly used sensors are the magnetometer, accelerometer, and gyroscope available in off-the-shelf smartphones. The features analyzed in this paper are categorized as quantitative, quantitative + statistic, dynamic balance, gait properties, state transitions, and raw statistics. These features utilize the accelerometer and gyroscope sensors and facilitate recognition of daily activities, accidents such as falling, some diseases, as well as the measurement of the subject's performance during the test execution.info:eu-repo/semantics/publishedVersio

Static and dynamic accuracy of an innovative miniaturized wearable platform for short range distance measurements for human movement applications

Magneto-inertial measurement units (MIMU) are a suitable solution to assess human motor performance both indoors and outdoors. However, relevant quantities such as step width and base of support, which play an important role in gait stability, cannot be directly measured using MIMU alone. To overcome this limitation, we developed a wearable platform specifically designed for human movement analysis applications, which integrates a MIMU and an Infrared Time-of-Flight proximity sensor (IR-ToF), allowing for the estimate of inter-object distance. We proposed a thorough testing protocol for evaluating the IR-ToF sensor performances under experimental conditions resembling those encountered during gait. In particular, we tested the sensor performance for different (i) target colors; (ii) sensor-target distances (up to 200 mm) and (iii) sensor-target angles of incidence (AoI) (up to 60°). Both static and dynamic conditions were analyzed. A pendulum, simulating the oscillation of a human leg, was used to generate highly repeatable oscillations with a maximum angular velocity of 6 rad/s. Results showed that the IR-ToF proximity sensor was not sensitive to variations of both distance and target color (except for black). Conversely, a relationship between error magnitude and AoI values was found. For AoI equal to 0°, the IR-ToF sensor performed equally well both in static and dynamic acquisitions with a distance mean absolute error <1.5 mm. Errors increased up to 3.6 mm (static) and 11.9 mm (dynamic) for AoI equal to ±30°, and up to 7.8 mm (static) and 25.6 mm (dynamic) for AoI equal to ±60°. In addition, the wearable platform was used during a preliminary experiment for the estimation of the inter-foot distance on a single healthy subject while walking. In conclusion, the combination of magneto-inertial unit and IR-ToF technology represents a valuable alternative solution in terms of accuracy, sampling frequency, dimension and power consumption, compared to existing technologies

Quantifying Variation in Gait Features from Wearable Inertial Sensors Using Mixed Effects Models

The emerging technology of wearable inertial sensors has shown its advantages in collecting continuous longitudinal gait data outside laboratories. This freedom also presents challenges in collecting high-fidelity gait data. In the free-living environment, without constant supervision from researchers, sensor-based gait features are susceptible to variation from confounding factors such as gait speed and mounting uncertainty, which are challenging to control or estimate. This paper is one of the first attempts in the field to tackle such challenges using statistical modeling. By accepting the uncertainties and variation associated with wearable sensor-based gait data, we shift our efforts from detecting and correcting those variations to modeling them statistically. From gait data collected on one healthy, non-elderly subject during 48 full-factorial trials, we identified four major sources of variation, and quantified their impact on one gait outcome—range per cycle—using a random effects model and a fixed effects model. The methodology developed in this paper lays the groundwork for a statistical framework to account for sources of variation in wearable gait data, thus facilitating informative statistical inference for free-living gait analysis

An objective assessment to investigate the impact of turning angle on freezing of gait in Parkinson's disease

Freezing of gait (FoG) is often described in subjects with Parkinson's disease (PD) as a sudden inability to continue the forward walking progression. FoG occurs most often during turning, especially at sharp angles. Here, we investigated 180 and 360 degrees turns in two groups: PD subjects reporting FoG (FoG+), and PD subjects without FoG (FoG-). Forty-three subjects (25 FoG+, 18 FoG-) wore an inertial sensor on their back while walking back and forth continuously for 2 min (reversing direction with a 180° turn), and while turning in place for 1 min (alternating 360° turning in opposite directions). Objective measures (turn duration, peak velocity, jerkiness and range of acceleration) were computed during the turns and compared across FoG+ and FoG-groups. Results showed that FoG+ compared to FoG-took significantly a longer time to complete 360° turns than 180° turns. A significant lower turn peak velocity, higher jerkiness and an increased range of medio-lateral acceleration was also found in FoG+. Significant differences between the two groups across the two turning tasks validated the hypothesis that sharper turns might cause higher instability in FoG+ compared to FoG-

Home detection of freezing of gait using Support Vector Machines through a single waist-worn triaxial accelerometer

Among Parkinson’s disease (PD) symptoms, freezing of gait (FoG) is one of the most debilitating. To assess FoG, current clinical practice mostly employs repeated evaluations over weeks and months based on questionnaires, which may not accurately map the severity of this symptom. The use of a non-invasive system to monitor the activities of daily living (ADL) and the PD symptoms experienced by patients throughout the day could provide a more accurate and objective evaluation of FoG in order to better understand the evolution of the disease and allow for a more informed decision-making process in making adjustments to the patient’s treatment plan. This paper presents a new algorithm to detect FoG with a machine learning approach based on Support Vector Machines (SVM) and a single tri-axial accelerometer worn at the waist. The method is evaluated through the acceleration signals in an outpatient setting gathered from 21 PD patients at their home and evaluated under two different conditions: first, a generic model is tested by using a leave-one-out approach and, second, a personalised model that also uses part of the dataset from each patient. Results show a significant improvement in the accuracy of the personalised model compared to the generic model, showing enhancement in the specificity and sensitivity geometric mean (GM) of 7.2%. Furthermore, the SVM approach adopted has been compared to the most comprehensive FoG detection method currently in use (referred to as MBFA in this paper). Results of our novel generic method provide an enhancement of 11.2% in the GM compared to the MBFA generic model and, in the case of the personalised model, a 10% of improvement with respect to the MBFA personalised model. Thus, our results show that a machine learning approach can be used to monitor FoG during the daily life of PD patients and, furthermore, personalised models for FoG detection can be used to improve monitoring accuracy.Peer ReviewedPostprint (published version

Improving activity recognition using a wearable barometric pressure sensor in mobility-impaired stroke patients.

© 2015 Massé et al.Background: Stroke survivors often suffer from mobility deficits. Current clinical evaluation methods, including questionnaires and motor function tests, cannot provide an objective measure of the patients mobility in daily life. Physical activity performance in daily-life can be assessed using unobtrusive monitoring, for example with a single sensor module fixed on the trunk. Existing approaches based on inertial sensors have limited performance, particularly in detecting transitions between different activities and postures, due to the inherent inter-patient variability of kinematic patterns. To overcome these limitations, one possibility is to use additional information from a barometric pressure (BP) sensor. Methods: Our study aims at integrating BP and inertial sensor data into an activity classifier in order to improve the activity (sitting, standing, walking, lying) recognition and the corresponding body elevation (during climbing stairs or when taking an elevator). Taking into account the trunk elevation changes during postural transitions (sit-to-stand, stand-to-sit), we devised an event-driven activity classifier based on fuzzy-logic. Data were acquired from 12 stroke patients with impaired mobility, using a trunk-worn inertial and BP sensor. Events, including walking and lying periods and potential postural transitions, were first extracted. These events were then fed into a double-stage hierarchical Fuzzy Inference System (H-FIS). The first stage processed the events to infer activities and the second stage improved activity recognition by applying behavioral constraints. Finally, the body elevation was estimated using a pattern-enhancing algorithm applied on BP. The patients were videotaped for reference. The performance of the algorithm was estimated using the Correct Classification Rate (CCR) and F-score. The BP-based classification approach was benchmarked against a previously-published fuzzy-logic classifier (FIS-IMU) and a conventional epoch-based classifier (EPOCH). Results: The algorithm performance for posture/activity detection, in terms of CCR was 90.4 %, with 3.3 % and 5.6 % improvements against FIS-IMU and EPOCH, respectively. The proposed classifier essentially benefits from a better recognition of standing activity (70.3 % versus 61.5 % [FIS-IMU] and 42.5 % [EPOCH]) with 98.2 % CCR for body elevation estimation. Conclusion: The monitoring and recognition of daily activities in mobility-impaired stoke patients can be significantly improved using a trunk-fixed sensor that integrates BP, inertial sensors, and an event-based activity classifier

Human-activity-centered measurement system:challenges from laboratory to the real environment in assistive gait wearable robotics

Assistive gait wearable robots (AGWR) have shown a great advancement in developing intelligent devices to assist human in their activities of daily living (ADLs). The rapid technological advancement in sensory technology, actuators, materials and computational intelligence has sped up this development process towards more practical and smart AGWR. However, most assistive gait wearable robots are still confined to be controlled, assessed indoor and within laboratory environments, limiting any potential to provide a real assistance and rehabilitation required to humans in the real environments. The gait assessment parameters play an important role not only in evaluating the patient progress and assistive device performance but also in controlling smart self-adaptable AGWR in real-time. The self-adaptable wearable robots must interactively conform to the changing environments and between users to provide optimal functionality and comfort. This paper discusses the performance parameters, such as comfortability, safety, adaptability, and energy consumption, which are required for the development of an intelligent AGWR for outdoor environments. The challenges to measuring the parameters using current systems for data collection and analysis using vision capture and wearable sensors are presented and discussed