Real-time human ambulation, activity, and physiological monitoring:taxonomy of issues, techniques, applications, challenges and limitations

Automated methods of real-time, unobtrusive, human ambulation, activity, and wellness monitoring and data analysis using various algorithmic techniques have been subjects of intense research. The general aim is to devise effective means of addressing the demands of assisted living, rehabilitation, and clinical observation and assessment through sensor-based monitoring. The research studies have resulted in a large amount of literature. This paper presents a holistic articulation of the research studies and offers comprehensive insights along four main axes: distribution of existing studies; monitoring device framework and sensor types; data collection, processing and analysis; and applications, limitations and challenges. The aim is to present a systematic and most complete study of literature in the area in order to identify research gaps and prioritize future research directions

3D motion analysis applying intertial sensing

Small inertial sensors like accelerometers and gyroscopes are more and more used in ambulatory motion analysis (Busseral. 1998; Baten et al. 2000; Veltink et al. 2003). Typically, angular orientation of a body segment is determined by integrating the output from the angular rate sensors strapped on the segment

Wearable inertial sensors for human movement analysis

Introduction: The present review aims to provide an overview of the most common uses of wearable inertial sensors in the field of clinical human movement analysis.Areas covered: Six main areas of application are analysed: gait analysis, stabilometry, instrumented clinical tests, upper body mobility assessment, daily-life activity monitoring and tremor assessment. Each area is analyzed both from a methodological and applicative point of view. The focus on the methodological approaches is meant to provide an idea of the computational complexity behind a variable/parameter/index of interest so that the reader is aware of the reliability of the approach. The focus on the application is meant to provide a practical guide for advising clinicians on how inertial sensors can help them in their clinical practice.Expert commentary: Less expensive and more easy to use than other systems used in human movement analysis, wearable sensors have evolved to the point that they can be considered ready for being part of routine clinical routine

Smart Technology for Telerehabilitation: A Smart Device Inertial-sensing Method for Gait Analysis

The aim of this work was to develop and validate an iPod Touch (4th generation) as a potential ambulatory monitoring system for clinical and non-clinical gait analysis. This thesis comprises four interrelated studies, the first overviews the current available literature on wearable accelerometry-based technology (AT) able to assess mobility-related functional activities in subjects with neurological conditions in home and community settings. The second study focuses on the detection of time-accurate and robust gait features from a single inertial measurement unit (IMU) on the lower back, establishing a reference framework in the process. The third study presents a simple step length algorithm for straight-line walking and the fourth and final study addresses the accuracy of an iPod’s inertial-sensing capabilities, more specifically, the validity of an inertial-sensing method (integrated in an iPod) to obtain time-accurate vertical lower trunk displacement measures. The systematic review revealed that present research primarily focuses on the development of accurate methods able to identify and distinguish different functional activities. While these are important aims, much of the conducted work remains in laboratory environments, with relatively little research moving from the “bench to the bedside.” This review only identified a few studies that explored AT’s potential outside of laboratory settings, indicating that clinical and real-world research significantly lags behind its engineering counterpart. In addition, AT methods are largely based on machine-learning algorithms that rely on a feature selection process. However, extracted features depend on the signal output being measured, which is seldom described. It is, therefore, difficult to determine the accuracy of AT methods without characterizing gait signals first. Furthermore, much variability exists among approaches (including the numbers of body-fixed sensors and sensor locations) to obtain useful data to analyze human movement. From an end-user’s perspective, reducing the amount of sensors to one instrument that is attached to a single location on the body would greatly simplify the design and use of the system. With this in mind, the accuracy of formerly identified or gait events from a single IMU attached to the lower trunk was explored. The study’s analysis of the trunk’s vertical and anterior-posterior acceleration pattern (and of their integrands) demonstrates, that a combination of both signals may provide more nuanced information regarding a person’s gait cycle, ultimately permitting more clinically relevant gait features to be extracted. Going one step further, a modified step length algorithm based on a pendulum model of the swing leg was proposed. By incorporating the trunk’s anterior-posterior displacement, more accurate predictions of mean step length can be made in healthy subjects at self-selected walking speeds. Experimental results indicate that the proposed algorithm estimates step length with errors less than 3% (mean error of 0.80 ± 2.01cm). The performance of this algorithm, however, still needs to be verified for those suffering from gait disturbances. Having established a referential framework for the extraction of temporal gait parameters as well as an algorithm for step length estimations from one instrument attached to the lower trunk, the fourth and final study explored the inertial-sensing capabilities of an iPod Touch. With the help of Dr. Ian Sheret and Oxford Brookes’ spin-off company ‘Wildknowledge’, a smart application for the iPod Touch was developed. The study results demonstrate that the proposed inertial-sensing method can reliably derive lower trunk vertical displacement (intraclass correlations ranging from .80 to .96) with similar agreement measurement levels to those gathered by a conventional inertial sensor (small systematic error of 2.2mm and a typical error of 3mm). By incorporating the aforementioned methods, an iPod Touch can potentially serve as a novel ambulatory monitor system capable of assessing gait in clinical and non-clinical environments

IMUs: validation, gait analysis and system’s implementation

Dissertação de mestrado integrado em Engenharia Biomédica (área de especialização em Eletrónica Médica)Falls are a prevalent problem in actual society. The number of falls has been increasing greatly in the last fifteen years. Some falls result in injuries and the cost associated with their treatment is high. However, this is a complex problem that requires several steps in order to be tackled. Namely, it is crucial to develop strategies that recognize the mode of locomotion, indicating the state of the subject in various situations, namely normal gait, step before fall (pre-fall) and fall situation. Thus, this thesis aims to develop a strategy capable of identifying these situations based on a wearable system that collects information and analyses the human gait. The strategy consists, essentially, in the construction and use of Associative Skill Memories (ASMs) as tools for recognizing the locomotion modes. Consequently, at an early stage, the capabilities of the ASMs for the different modes of locomotion were studied. Then, a classifier was developed based on a set of ASMs. Posteriorly, a neural network classifier based on deep learning was used to classify, in a similar way, the same modes of locomotion. Deep learning is a technique actually widely used in data classification. These classifiers were implemented and compared, providing for a tool with a good accuracy in recognizing the modes of locomotion. In order to implement this strategy, it was previously necessary to carry out extremely important support work. An inertial measurement units’ (IMUs) system was chosen due to its extreme potential to monitor outpatient activities in the home environment. This system, which combines inertial and magnetic sensors and is able to perform the monitoring of gait parameters in real time, was validated and calibrated. Posteriorly, this system was used to collect data from healthy subjects that mimicked Fs. Results have shown that the accuracy of the classifiers was quite acceptable, and the neural networks based classifier presented the best results with 92.71% of accuracy. As future work, it is proposed to apply these strategies in real time in order to avoid the occurrence of falls.As quedas são um problema predominante na sociedade atual. O número de quedas tem aumentado bastante nos últimos quinze anos. Algumas quedas resultam em lesões e o custo associado ao seu tratamento é alto. No entanto, trata-se de um problema complexo que requer várias etapas a serem abordadas. Ou seja, é crucial desenvolver estratégias que reconheçam o modo de locomoção, indicando o estado do sujeito em várias situações, nomeadamente, marcha normal, passo antes da queda (pré-queda) e situação de queda. Assim, esta tese tem como objetivo desenvolver uma estratégia capaz de identificar essas situações com base num sistema wearable que colete informações e analise a marcha humana. A estratégia consiste, essencialmente, na construção e utilização de Associative Skill Memories (ASMs) como ferramenta para reconhecimento dos modos de locomoção. Consequentemente, numa fase inicial, foram estudadas as capacidades das ASMs para os diferentes modos de locomoção. Depois, foi desenvolvido um classificador baseado em ASMs. Posteriormente, um classificador de redes neuronais baseado em deep learning foi utilizado para classificar, de forma semelhante, os mesmos modos de locomoção. Deep learning é uma técnica bastante utilizada em classificação de dados. Estes classificadores foram implementados e comparados, fornecendo a uma ferramenta com uma boa precisão no reconhecimento dos modos de locomoção. Para implementar esta estratégia, era necessário realizar previamente um trabalho de suporte extremamente importante. Um sistema de unidades de medição inercial (IMUs), foi escolhido devido ao seu potencial extremo para monitorizar as atividades ambulatórias no ambiente domiciliar. Este sistema que combina sensores inerciais e magnéticos e é capaz de efetuar a monitorização de parâmetros da marcha em tempo real, foi validado e calibrado. Posteriormente, este Sistema foi usado para adquirir dados da marcha de indivíduos saudáveis que imitiram quedas. Os resultados mostraram que a precisão dos classificadores foi bastante aceitável e o classificador baseado em redes neuronais apresentou os melhores resultados com 92.71% de precisão. Como trabalho futuro, propõe-se a aplicação destas estratégias em tempo real de forma a evitar a ocorrência de quedas

Functional Rotation Axis Based Approach for Estimating Hip Joint Angles Using Wearable Inertial Sensors: Comparison to Existing Methods

Wearable sensors are at the heart of the digital health revolution. Integral to the use of these sensors for monitoring conditions impacting balance and mobility are accurate estimates of joint angles. To this end a simple and novel method of estimating hip joint angles from small wearable magnetic and inertial sensors is proposed and its performance is established relative to optical motion capture in a sample of human subjects. Improving upon previous work, this approach does not require precise sensor placement or specific calibration motions, thereby easing deployment outside of the research laboratory. Specific innovations include the determination of sensor to segment rotations based on functionally determined joint centers, and the development of a novel filtering algorithm for estimating the relative orientation of adjacent body segments. Hip joint angles and range of motion determined from the proposed approach and an existing method are compared to those from an optical motion capture system during walking at a variety of speeds and tasks designed to exercise the hip through its full range of motion. Results show that the proposed approach estimates flexion/extension angle more accurately (RMSE from 7.08 to 7.29 deg) than the existing method (RMSE from 11.64 deg to 14.33 deg), with similar performance for the other anatomical axes. Agreement of each method with optical motion capture is further characterized by considering correlation and regression analyses. Mean ranges of motion for the proposed method are not largely different from those reported by motion capture, and showed similar values to the existing method. Results indicate that this algorithm provides a promising approach for estimating hip joint angles using wearable inertial sensors, and would allow for use outside of constrained research laboratories

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