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

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

An automatic wearable multi-sensor based gait analysis system for older adults.

Gait abnormalities in older adults are very common in clinical practice. They lead to serious adverse consequences such as falls and injury resulting in increased care cost. There is therefore a national imperative to address this challenge. Currently gait assessment is done using standardized clinical tools dependent on subjective evaluation. More objective gold standard methods (motion capture systems such as Qualisys and Vicon) to analyse gait rely on access to expensive complex equipment based in gait laboratories. These are not widely available for several reasons including a scarcity of equipment, need for technical staff, need for patients to attend in person, complicated time consuming procedures and overall expense. To broaden the use of accurate quantitative gait monitoring and assessment, the major goal of this thesis is to develop an affordable automatic gait analysis system that will provide comprehensive gait information and allow use in clinic or at home. It will also be able to quantify and visualize gait parameters, identify gait variables and changes, monitor abnormal gait patterns of older people in order to reduce the potential for falling and support falls risk management. A research program based on conducting experiments on volunteers is developed in collaboration with other researchers in Bournemouth University, The Royal Bournemouth Hospital and care homes. This thesis consists of five different studies toward addressing our major goal. Firstly, a study on the effects on sensor output from an Inertial Measurement Unit (IMU) attached to different anatomical foot locations. Placing an IMU over the bony prominence of the first cuboid bone is the best place as it delivers the most accurate data. Secondly, an automatic gait feature extraction method for analysing spatiotemporal gait features which shows that it is possible to extract gait features automatically outside of a gait laboratory. Thirdly, user friendly and easy to interpret visualization approaches are proposed to demonstrate real time spatiotemporal gait information. Four proposed approaches have the potential of helping professionals detect and interpret gait asymmetry. Fourthly, a validation study of spatiotemporal IMU extracted features compared with gold standard Motion Capture System and Treadmill measurements in young and older adults is conducted. The results obtained from three experimental conditions demonstrate that our IMU gait extracted features are highly valid for spatiotemporal gait variables in young and older adults. In the last study, an evaluation system using Procrustes and Euclidean distance matrix analysis is proposed to provide a comprehensive interpretation of shape and form differences between individual gaits. The results show that older gaits are distinguishable from young gaits. A pictorial and numerical system is proposed which indicates whether the assessed gait is normal or abnormal depending on their total feature values. This offers several advantages: 1) it is user friendly and is easy to set up and implement; 2) it does not require complex equipment with segmentation of body parts; 3) it is relatively inexpensive and therefore increases its affordability decreasing health inequality; and 4) its versatility increases its usability at home supporting inclusivity of patients who are home bound. A digital transformation strategy framework is proposed where stakeholders such as patients, health care professionals and industry partners can collaborate through development of new technologies, value creation, structural change, affordability and sustainability to improve the diagnosis and treatment of gait abnormalities

Automatic Posture and Movement Tracking of Infants with Wearable Movement Sensors

Infants' spontaneous and voluntary movements mirror developmental integrity of brain networks since they require coordinated activation of multiple sites in the central nervous system. Accordingly, early detection of infants with atypical motor development holds promise for recognizing those infants who are at risk for a wide range of neurodevelopmental disorders (e.g., cerebral palsy, autism spectrum disorders). Previously, novel wearable technology has shown promise for offering efficient, scalable and automated methods for movement assessment in adults. Here, we describe the development of an infant wearable, a multi-sensor smart jumpsuit that allows mobile accelerometer and gyroscope data collection during movements. Using this suit, we first recorded play sessions of 22 typically developing infants of approximately 7 months of age. These data were manually annotated for infant posture and movement based on video recordings of the sessions, and using a novel annotation scheme specifically designed to assess the overall movement pattern of infants in the given age group. A machine learning algorithm, based on deep convolutional neural networks (CNNs) was then trained for automatic detection of posture and movement classes using the data and annotations. Our experiments show that the setup can be used for quantitative tracking of infant movement activities with a human equivalent accuracy, i.e., it meets the human inter-rater agreement levels in infant posture and movement classification. We also quantify the ambiguity of human observers in analyzing infant movements, and propose a method for utilizing this uncertainty for performance improvements in training of the automated classifier. Comparison of different sensor configurations also shows that four-limb recording leads to the best performance in posture and movement classification.Peer reviewe

Smart Footwear Insole for Recognition of Foot Pronation and Supination Using Neural Networks

Abnormal foot postures during gait are common sources of pain and pathologies of the lower limbs. Measurements of foot plantar pressures in both dynamic and static conditions can detect these abnormal foot postures and prevent possible pathologies. In this work, a plantar pressure measurement system is developed to identify areas with higher or lower pressure load. This system is composed of an embedded system placed in the insole and a user application. The instrumented insole consists of a low-power microcontroller, seven pressure sensors and a low-energy bluetooth module. The user application receives and shows the insole pressure information in real-time and, finally, provides information about the foot posture. In order to identify the different pressure states and obtain the final information of the study with greater accuracy, a Deep Learning neural network system has been integrated into the user application. The neural network can be trained using a stored dataset in order to obtain the classification results in real-time. Results prove that this system provides an accuracy over 90% using a training dataset of 3000+ steps from 6 different users.Ministerio de Economía y Competitividad TEC2016-77785-

Deep Learning Based Abnormal Gait Classification System Study with Heterogeneous Sensor Network

Gait is one of the important biological characteristics of the human body. Abnormal gait is mostly related to the lesion site and has been demonstrated to play a guiding role in clinical research such as medical diagnosis and disease prevention. In order to promote the research of automatic gait pattern recognition, this paper introduces the research status of abnormal gait recognition and systems analysis of the common gait recognition technologies. Based on this, two gait information extraction methods, sensor-based and vision-based, are studied, including wearable system design and deep neural network-based algorithm design. In the sensor-based study, we proposed a lower limb data acquisition system. The experiment was designed to collect acceleration signals and sEMG signals under normal and pathological gaits. Specifically, wearable hardware-based on MSP430 and upper computer software based on Labview is designed. The hardware system consists of EMG foot ring, high-precision IMU and pressure-sensitive intelligent insole. Data of 15 healthy persons and 15 hemiplegic patients during walking were collected. The classification of gait was carried out based on sEMG and the average accuracy rate can reach 92.8% for CNN. For IMU signals five kinds of abnormal gait are trained based on three models: BPNN, LSTM, and CNN. The experimental results show that the system combined with the neural network can classify different pathological gaits well, and the average accuracy rate of the six-classifications task can reach 93%. In vision-based research, by using human keypoint detection technology, we obtain the precise location of the key points through the fusion of thermal mapping and offset, thus extracts the space-time information of the key points. However, the results show that even the state-of-the-art is not good enough for replacing IMU in gait analysis and classification. The good news is the rhythm wave can be observed within 2 m, which proves that the temporal and spatial information of the key points extracted is highly correlated with the acceleration information collected by IMU, which paved the way for the visual-based abnormal gait classification algorithm.步态指人走路时表现出来的姿态，是人体重要生物特征之一。异常步态多与病变部位有关，作为反映人体健康状况和行为能力的重要特征，其被论证在医疗诊断、疾病预防等临床研究中具有指导作用。为了促进步态模式自动识别的研究，本文介绍了异常步态识别的研究现状，系统地分析了常见步态识别技术以及算法，以此为基础研究了基于传感器与基于视觉两种步态信息提取方法，内容包括可穿戴系统设计与基于深度神经网络的算法设计。 在基于传感器的研究中，本工作开发了下肢步态信息采集系统，并利用该信息采集系统设计实验，采集正常与不同病理步态下的加速度信号与肌电信号，搭建深度神经网络完成分类任务。具体的，在系统搭建部分设计了基于MSP430的可穿戴硬件设备以及基于Labview的上位机软件，该硬件系统由肌电脚环，高精度IMU以及压感智能鞋垫组成，该上位机软件接收、解包蓝牙数据并计算出步频步长等常用步态参数。 在基于运动信号与基于表面肌电的研究中，采集了15名健康人与15名偏瘫病人的步态数据，并针对表面肌电信号训练卷积神经网络进行帕金森步态的识别与分类，平均准确率可达92.8%。针对运动信号训练了反向传播神经网络，LSTM以及卷积神经网络三种模型进行五种异常步态的分类任务。实验结果表明，本工作中步态信息采集系统结合神经网络模型，可以很好地对不同病理步态进行分类，六分类平均正确率可达93%。 在基于视觉的研究中，本文利用人体关键点检测技术，首先检测出图片中的一个或多个人，接着对边界框做图像分割，接着采用全卷积resnet对每一个边界框中的人物的主要关节点做热力图并分析偏移量，最后通过热力图与偏移的融合得到关键点的精确定位。通过该算法提取了不同步态下姿态关键点时空信息，为基于视觉的步态分析系统提供了基础条件。但实验结果表明目前最高准确率的人体关键点检测算法不足以替代IMU实现步态分析与分类。但在2m之内可以观察到节律信息，证明了所提取的关键点时空信息与IMU采集的加速度信息呈现较高相关度，为基于视觉的异常步态分类算法铺平了道路

Human Gait Analysis in Neurodegenerative Diseases: a Review

This paper reviews the recent literature on technologies and methodologies for quantitative human gait analysis in the context of neurodegnerative diseases. The use of technological instruments can be of great support in both clinical diagnosis and severity assessment of these pathologies. In this paper, sensors, features and processing methodologies have been reviewed in order to provide a highly consistent work that explores the issues related to gait analysis. First, the phases of the human gait cycle are briefly explained, along with some non-normal gait patterns (gait abnormalities) typical of some neurodegenerative diseases. The work continues with a survey on the publicly available datasets principally used for comparing results. Then the paper reports the most common processing techniques for both feature selection and extraction and for classification and clustering. Finally, a conclusive discussion on current open problems and future directions is outlined

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