Moving On:Measuring Movement Remotely after Stroke

Most persons with stroke suffer from motor impairment, which restricts mobility on one side, and affects their independence in daily life activities. Measuring recovery is needed to develop individualized therapies. However, commonly used clinical outcomes suffer from low resolution and subjectivity. Therefore, objective biomechanical metrics should be identified to measure movement quality. However, non-portable laboratory setups are required in order to measure these metrics accurately. Alternatively, minimal wearable systems can be developed to simplify measurements performed at clinic or home to monitor recovery. Thus, the goal of the thesis was ‘To identify metrics that reflect movement quality of upper and lower extremities after stroke and develop wearable minimal systems for tracking the proposed metrics’. Section Upper Extremity First, we systematically reviewed literature ( Chapter II ) to identify metrics used to measure reaching recovery longitudinally post-stroke. Although several metrics were found, it was not clear how they differentiated recovery from compensation strategies. Future studies must address this gap in order to optimize stroke therapy. Next, we assessed a ‘valid’ measure for smoothness of upper paretic limb reaching ( Chapter III ), as this was commonly used to measure movement quality. After a systematic review and simulation analyses, we found that reaching smoothness is best measured using spectral arc length. The studies in this section offer us a better understanding of movement recovery in the upper extremity post-stroke. Section Lower Extremity Although metrics that reflect gait recovery are yet to be identified, in this section we focused on developing minimal solutions to measure gait quality. First, we showed the feasibility of 1D pressure insoles as a lightweight alternative for measuring 3D Ground Reaction Forces (GRF) ( Chapter IV ). In the following chapters, we developed a minimal system; the Portable Gait Lab (PGL) using only three Inertial Measurement Units (IMUs) (one per foot and one on the pelvis). We explored the Centroidal Moment Pivot (CMP) point ( Chapter V ) as a biomechanical constraint that can help with the reduction in sensors. Then, we showed the feasibility of the PGL to track 3D GRF ( Chapters VI-VII ) and relative foot and CoM kinematics ( Chapter VIII-IX ) during variable overground walking by healthy participants. Finally, we performed a limited validation study in persons with chronic stroke ( Chapter X ). This thesis offers knowledge and tools which can help clinicians and researchers understand movement quality and thereby develop individualized therapies post-stroke

Survey of Motion Tracking Methods Based on Inertial Sensors: A Focus on Upper Limb Human Motion

Motion tracking based on commercial inertial measurements units (IMUs) has been widely studied in the latter years as it is a cost-effective enabling technology for those applications in which motion tracking based on optical technologies is unsuitable. This measurement method has a high impact in human performance assessment and human-robot interaction. IMU motion tracking systems are indeed self-contained and wearable, allowing for long-lasting tracking of the user motion in situated environments. After a survey on IMU-based human tracking, five techniques for motion reconstruction were selected and compared to reconstruct a human arm motion. IMU based estimation was matched against motion tracking based on the Vicon marker-based motion tracking system considered as ground truth. Results show that all but one of the selected models perform similarly (about 35 mm average position estimation error)

Automated gait segmentation and tracking using inertial measurement units

Abstract. In this thesis, a methodology is presented to automate the labelling, event detection, segmentation, tracking, and parameter extraction of IMU gait data for sensors placed on the feet and shanks. The algorithms presented were tested using IMU data from three different styles of gait, normal gait, antalgic gait, and limited mobility gait. The algorithms developed were found effective for all of the simulated gait styles without mislabelling or detecting erroneous gait segments. The resultant gait trajectories and parameters were analyzed and were found to accurately depict the differences between each of the different styles of gait. The methodology presented can be used for the rapid and accurate processing of gait data for multiple styles of gait. This quantification of gait data can enable the collection of IMU gait data on a larger scale. This provides an accessible, low-cost option for out-of-laboratory gait data collection

Estimation of Gait Kinematics and Kinetics from Inertial Sensor Data Using Optimal Control of Musculoskeletal Models

Inertial sensing enables field studies of human movement and ambulant assessment of patients. However, the challenge is to obtain a comprehensive analysis from low-quality data and sparse measurements. In this paper, we present a method to estimate gait kinematics and kinetics directly from raw inertial sensor data performing a single dynamic optimization. We formulated an optimal control problem to track accelerometer and gyroscope data with a planar musculoskeletal model. In addition, we minimized muscular effort to ensure a unique solution and to prevent the model from tracking noisy measurements too closely. For evaluation, we recorded data of ten subjects walking and running at six different speeds using seven inertial measurement units (IMUs). Results were compared to a conventional analysis using optical motion capture and a force plate. High correlations were achieved for gait kinematics (rho \u3e= 0.93) and kinetics (rho \u3e= 0.90). In contrast to existing IMU processing methods, a dynamically consistent simulation was obtained and we were able to estimate running kinetics. Besides kinematics and kinetics, further metrics such as muscle activations and metabolic cost can be directly obtained from simulated model movements. In summary, the method is insensitive to sensor noise and drift and provides a detailed analysis solely based on inertial sensor data

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

Kalman-Filter-Based Orientation Determination Using Inertial/Magnetic Sensors: Observability Analysis and Performance Evaluation

In this paper we present a quaternion-based Extended Kalman Filter (EKF) for estimating the three-dimensional orientation of a rigid body. The EKF exploits the measurements from an Inertial Measurement Unit (IMU) that is integrated with a tri-axial magnetic sensor. Magnetic disturbances and gyro bias errors are modeled and compensated by including them in the filter state vector. We employ the observability rank criterion based on Lie derivatives to verify the conditions under which the nonlinear system that describes the process of motion tracking by the IMU is observable, namely it may provide sufficient information for performing the estimation task with bounded estimation errors. The observability conditions are that the magnetic field, perturbed by first-order Gauss-Markov magnetic variations, and the gravity vector are not collinear and that the IMU is subject to some angular motions. Computer simulations and experimental testing are presented to evaluate the algorithm performance, including when the observability conditions are critical