Robust foot clearance estimation based on the integration of foot-mounted IMU acceleration data

This paper introduces a method for the robust estimation of foot clearance during walking, using a single inertial measurement unit (IMU) placed on the subject's foot. The proposed solution is based on double integration and drift cancellation of foot acceleration signals. The method is insensitive to misalignment of IMU axes with respect to foot axes. Details are provided regarding calibration and signal processing procedures. Experimental validation was performed on 10 healthy subjects under three walking conditions: normal, fast and with obstacles. Foot clearance estimation results were compared to measurements from an optical motion capture system. The mean error between them is significantly less than 15 % under the various walking conditions

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

Gait rehabilitation monitor

This work presents a simple wearable, non-intrusive affordable mobile framework that allows remote patient monitoring during gait rehabilitation, by doctors and physiotherapists. The system includes a set of 2 Shimmer3 9DoF Inertial Measurement Units (IMUs), Bluetooth compatible from Shimmer, an Android smartphone for collecting and primary processing of data and persistence in a local database. Low computational load algorithms based on Euler angles and accelerometer, gyroscope and magnetometer signals were developed and used for the classification and identification of several gait disturbances. These algorithms include the alignment of IMUs sensors data by means of a common temporal reference as well as heel strike and stride detection algorithms to help segmentation of the remotely collected signals by the System app to identify gait strides and extract relevant features to feed, train and test a classifier to predict gait abnormalities in gait sessions. A set of drivers from Shimmer manufacturer is used to make the connection between the app and the set of IMUs using Bluetooth. The developed app allows users to collect data and train a classification model for identifying abnormal and normal gait types. The system provides a REST API available in a backend server along with Java and Python libraries and a PostgreSQL database. The machine-learning type is Supervised using Extremely Randomized Trees method. Frequency, time and time-frequency domain features were extracted from the collected and processed signals to train the classifier. To test the framework a set of gait abnormalities and normal gait were used to train a model and test the classifier.Este trabalho apresenta uma estrutura móvel acessível, simples e não intrusiva, que permite a monitorização e a assistência remota de pacientes durante a reabilitação da marcha, por médicos e fisioterapeutas que monitorizam a reabilitação da marcha do paciente. O sistema inclui um conjunto de 2 IMUs (Inertial Mesaurement Units) Shimmer3 da marca Shimmer, compatíveís com Bluetooth, um smartphone Android para recolha, e pré-processamento de dados e armazenamento numa base de dados local. Algoritmos de baixa carga computacional baseados em ângulos Euler e sinais de acelerómetros, giroscópios e magnetómetros foram desenvolvidos e utilizados para a classificação e identificação de diversas perturbações da marcha. Estes algoritmos incluem o alinhamento e sincronização dos dados dos sensores IMUs usando uma referência temporal comum, além de algoritmos de detecção de passos e strides para auxiliar a segmentação dos sinais recolhidos remotamente pelaappdestaframeworke identificar os passos da marcha extraindo as características relevantes para treinar e testar um classificador que faça a predição de deficiências na marcha durante as sessões de monitorização. Um conjunto de drivers do fabricante Shimmer é usado para fazer a conexão entre a app e o conjunto de IMUs através de Bluetooth. A app desenvolvida permite aos utilizadores recolher dados e treinar um modelo de classificação para identificar os tipos de marcha normais e patológicos. O sistema fornece uma REST API disponível num servidor backend recorrendo a bibliotecas Java e Python e a uma base de dados PostgreSQL. O tipo de machine-learning é Supervisionado usando Extremely Randomized Trees. Features no domínio do tempo, da frequência e do tempo-frequência foram extraídas dos sinais recolhidos e processados para treinar o classificador. Para testar a estrutura, um conjunto de marchas patológicas e normais foram utilizadas para treinar um modelo e testar o classificador

Wearable inertial sensors as a tool for quantitative assessment of progress during rehabilitation

Biomechanics analysis is frequently used in both clinical and sporting practice in order to assess human motion and performance of defined tasks. Whilst camera-based motion systems have long been regarded as the ‘Goldstandard’ for quantitative movement-based analysis, their application is not without limitations as regards potential sources of variability in measurements, high costs, and practicality of use for larger patient/subject groups. Another more practical approach, which presents itself as a viable solution to biomechanical motion capture and monitoring in sporting and patient groups, is through the use of small-size low-cost wearable Micro-ElectroMechanical Systems (MEMs)- based inertial sensors. The clinical aim of the present work is to evaluate gait during rehabilitation following knee injuries and to identify gait abnormalities through a wireless inertial sensing system. This system was developed at the Tyndall National Institute to meet clinician-defined needs, and is able to provide a complete biomechanics assessment without the constraints of a motion capture laboratory. The derived motion parameter outcomes can be analyzed by clinicians and sport scientists to study the overall patients’ condition and provide accurate medical feedback as to their rehabilitative progress. Detection of atypical movement characteristics is possible by comparing the performance and variability in motion characteristics in the patient’s affected and unaffected lower-limbs. The work is ongoing, and to date the system has been tested on only one impaired subject, additional clinical trials are currently being planned with an enhanced number of injured subjects. This will provide a more robust statistical analysis of the data in the study. The present feasibility study proved that inertial sensors can be used for a quantitative assessment of knee joint mobility, and gait mechanics during the rehabilitation program of injured subjects and can provide valuable information to clinical experts as regards patient rehabilitation

Physical Behavior in Older Persons during Daily Life: Insights from Instrumented Shoes.

Activity level and gait parameters during daily life are important indicators for clinicians because they can provide critical insights into modifications of mobility and function over time. Wearable activity monitoring has been gaining momentum in daily life health assessment. Consequently, this study seeks to validate an algorithm for the classification of daily life activities and to provide a detailed gait analysis in older adults. A system consisting of an inertial sensor combined with a pressure sensing insole has been developed. Using an algorithm that we previously validated during a semi structured protocol, activities in 10 healthy elderly participants were recorded and compared to a wearable reference system over a 4 h recording period at home. Detailed gait parameters were calculated from inertial sensors. Dynamics of physical behavior were characterized using barcodes that express the measure of behavioral complexity. Activity classification based on the algorithm led to a 93% accuracy in classifying basic activities of daily life, i.e., sitting, standing, and walking. Gait analysis emphasizes the importance of metrics such as foot clearance in daily life assessment. Results also underline that measures of physical behavior and gait performance are complementary, especially since gait parameters were not correlated to complexity. Participants gave positive feedback regarding the use of the instrumented shoes. These results extend previous observations in showing the concurrent validity of the instrumented shoes compared to a body-worn reference system for daily-life physical behavior monitoring in older adults

Automatic detection, extraction and analysis of unrestrained gait using a wearable sensor system

Within this paper we demonstrate thee ffectiveness of a novel body-worn gait monitoring and analysis framework to both accurately and automatically assess gait during ’freeliving’ conditions. Key features of the system include the ability to automatically identify individual steps within specific gait conditions, and the implementation of continuous waveform analysis within an automated system for the generation of temporally normalized data and their statistical comparison across subjects

Identifying Gait Deficits in Stroke Patients Using Inertial Sensors

Falls remain a significant problem for stroke patients. Tripping, the main cause of falls, occurs when there is insufficient clearance between the foot and ground. Based on an individual’s gait deficits, different joint angles and coordination patterns are necessary to achieve adequate foot clearance during walking. However, gait deficits are typically only quantified in a research or clinical setting, and it would be helpful to use wearable devices – such as accelerometers – to quantify gait disorders in real-world situations. Therefore, the objective of this project was to understand gait characteristics that influence the risk of tripping, and to detect these characteristics using accelerometers. Thirty-five participants with a range of walking abilities performed normal walking and attempted to avoid tripping on an unexpected object while gait characteristics were quantified using motion capture techniques and accelerometers. Multiple regression was used to identify the relationship between joint coordination and foot clearance, and multiple analysis of variance was used to determine characteristics of gait that differ between demographic groups, as well as those that enable obstacle avoidance. Machine learning techniques were employed to detect joint angles and the risk of tripping from patterns in accelerometer signals. Measures of foot clearance that represent toe height throughout swing instead of at a single time point are more sensitive to changes in joint coordination, with hip-knee coordination during midswing having the greatest effect. Participants with a history of falls or stroke perform worse than older non-fallers and young adults on many factors related to falls risk, however, there are no differences in the ability to avoid an unexpected obstacle between these groups. Individuals with an inability to avoid an obstacle have lower scores on functional evaluations, exhibit limited sagittal plane joint range of motion during swing, and adopt a conservative walking strategy. Machine learning processes can be used to predict knee range of motion and classify individuals at risk for tripping based on an ankle-worn accelerometer. This work is significant because a portable device that detects gait characteristics relevant to the risk of tripping without expensive motion capture technology may reduce the risk of falls for stroke patients

Inertial sensors-based lower-limb rehabilitation assessment: A comprehensive evaluation of gait, kinematic and statistical metrics

Analysis of biomechanics is frequently used in both clinical and sporting practice in order to assess human motion and their performance of defined tasks. Whilst camera-based motion capture systems have long been regarded as the ‘Gold-standard’ for quantitative movement-based analysis, their application is not without limitations as regards potential sources of variability in measurements, high cost, and practicality of use for larger patient/subject groups. Another more practical approach, which presents itself as a viable solution to biomechanical motion capture and monitoring in sporting and patient groups, is through the use of small-size low-cost wearable Micro-ElectroMechanical Systems (MEMs)-based inertial sensors. The clinical aim of the present work is to evaluate rehabilitation progress following knee injuries, identifying a number of metrics measured via a wireless inertial sensing system. Several metrics in the time-domain have been considered to be reliable for measuring and quantifying patient progress across multiple exercises in different activities. This system was developed at the Tyndall National Institute and is able to provide a complete and accurate biomechanics assessment without the constraints of a motion capture laboratory. The results show that inertial sensors can be used for a quantitative assessment of knee joint mobility, providing valuable information to clinical experts as regards the trend of patient progress over the course of rehabilitation

VALIDATION OF AN IMU-SYSTEM (GAIT-UP) TO IDENTIFY GAIT PARAMETERS IN NORMAL AND INDUCED LIMPING WALKING CONDITIONS

The purpose of this study was to investigate an IMU system (GaitUp) with respect to validity in normal and induced impaired walking by comparing with a state-of-the-art 3D motion capture system. The gait of nine participants was analysed collecting data simultaneously with the GaitUp (Physiolog) placed at each foot and an eight camera motion capture system (Vicon) at 200 Hz each. Participants walked in normal and induced limping (elevation of one shoe) conditions at three walking speeds. For all conditions the two systems yielded similar results regarding the standard gait parameters (gait cycle time, stride length, stride frequency and gait velocity) according to absolute differences and correlation coefficients. GaitUp gathers fairly valid and reliable data in normal and limping walking in a range of walking speed between 0.9 and 2.0 m/s