Développement et étude de la validité d'une semelle instrumentée pour le comptage de pas

Les semelles instrumentées sont des dispositifs pouvant être utilisées pour la quantification de pas et la reconnaissance des activités. Il existe plusieurs modèles de semelles instrumentées, avec des niveaux de validité variables. Ce mémoire comprend trois objectifs : 1) faire une revue systématique de la littérature sur la validité de critère des semelles instrumentées existantes pour identifier les postures, les types d’activités et compter les pas, 2) développer une semelle instrumentée et 3) étudier sa validité pour le comptage de pas. Pour l’objectif 1, cinq bases de données ont permis de sélectionner 33 articles sur la validité de critère de seize modèles de semelles instrumentées pour la détection de posture, de type d’activités et de pas. Selon les indicateurs utilisés, les validités de critère varient de 65,8% à 100% pour la reconnaissance des activités et des postures et de 96% à 100% pour la détection de pas. En somme, peu d’études ont utilisé les semelles instrumentées pour le comptage de pas bien qu’elles démontrent une très bonne validité. Pour les objectifs 2 et 3, nous avons équipé une semelle commercialisée de cinq capteurs de pression et testé trois méthodes de traitement des signaux de pression pour la quantification de pas. Ces trois méthodes sont basées sur le signal de chaque capteur de pression, la moyenne ou la somme cumulée des cinq signaux de pression. Les résultats ont montré que notre semelle instrumentée détectait le pas avec un taux de succès de 94,8 ± 9,4% à 99,5 ± 0,4% à des vitesses de marche confortable et de 97,0 ± 6,2% à 99,6 ± 0,4% à des vitesses de marche rapide à l’intérieur et à l’extérieur d’un bâtiment avec les trois méthodes. Toutefois, la méthode basée sur la somme cumulée avait les niveaux de précision plus élevés pour le comptage de pasInstrumented insoles are devices which can be used for quantifying steps and recognizing activities. Validity of many instrumented insoles varies from medium to high. This thesis has three objectives: 1) to systematically review the literature on the validity of existing instrumented insoles for posture, type of activities recognition, and step counting, 2) to develop an instrumented insole and 3) to study its criterion validity for step counting. For objective 1, five databases were used to select 33 articles on criterion validity of sixteen insole models for posture and type of activities recognition, and step detection. According to indicators used, validity values vary from 65.8% to 100% for activities and postures recognition and from 96% to 100% for detection of steps. In summary, few studies have used instrumented insoles for steps counting even though they demonstrated a very good validity. For objectives 2 and 3, we equipped a commercialized insole with five pressure sensors and tested three pressure signal processing methods for step quantification. These three methods are based on signal of each pressure sensor, average or cumulative sum of five pressure signals. Results showed that our instrumented insole detected steps with a success rate varying from 94.8 ± 9.4% to 99.5 ± 0.4% at self-selected walking speeds and from 97.0 ± 6.2% to 99.6 ± 0.4% at maximal walking speeds in indoor and outdoor settings with all three processing methods. However, cumulative sum method had the highest levels of accuracy for step counting

Foot Motion-Based Falling Risk Evaluation for Patients with Parkinson’s Disease

Parkinson’s disease (PD) affects motor functionalities, which are closely associated with increased risks of falling and decreased quality of life. However, there is no easy-to-use definitive tools for PD patients to quantify their falling risks at home. To address this, in this dissertation, we develop Monitoring Insoles (MONI) with advanced data processing techniques to score falling risks of PD patients following Falling Risk Questionnaire (FRQ) developed by the U.S. Centers for Disease Control and Prevention (CDC). To achieve this, we extract motion tasks from daily activities and select the most representative features associated with PD that facilitate accurate falling risk scoring. To address the challenge in uncontrolled daily life environments and to identify the most representative features associated with PD and falling risks, the proposed data processing method firstly recognizes foot motions such as walking and toe tapping from continuous movements with stride detection and fast labeling framework, and then extracts time-axis and acceleration-axis features from the motion tasks, at the end provides a score of falling risks using regression. The data processing method can be integrated into a mobile game to be used at home with MONI. The main contributions of this dissertation includes: (i) developing MONI as a low power solution for daily life use; (ii) utilizing stride detection and developing fast labeling framework for motion recognition that improves recognition accuracy for daily life applications; (iii) analyzing two walking and two toe tapping tasks that are close to real life scenarios and identifying important features associated with PD and falling risks; (iv) providing falling scores as quantitative evaluation to PD patients in daily life through simple foot motion tasks and setups

Instrumented shoes for daily activity monitoring in healthy and at risk populations

Daily activity reflects the health status of an individual. Ageing and disease drastically affect all dimensions of mobility, from the number of active bouts to their duration and intensity. Performing less activity leads to muscle deterioration and further weakness that could lead to increased fall risk. Gait performance is also affected by ageing and could be detrimental for daily mobility. Therefore, activity monitoring in older adults and at risk persons is crucial to obtain relevant quantitative information about daily life performance. Activity evaluation has mainly been established through questionnaires or daily logs. These methods are simple but not sufficiently accurate and are prone to errors. With the advent of microelectromechanical systems (MEMS), the availability of wearable sensors has shifted activity analysis towards ambulatory monitoring. In particular, inertial measurement units consisting of accelerometers and gyroscopes have shown to be extremely relevant for characterizing human movement. However, monitoring daily activity requires comfortable and easy to use systems that are strategically placed on the body or integrated in clothing to avoid movement hindrance. Several research based systems have employed multiple sensors placed at different locations, capable of recognizing activity types with high accuracy, but not comfortable for daily use. Single sensor systems have also been used but revealed inaccuracies in activity recognition. To this end, we propose an instrumented shoe system consisting of an inertial measurement unit and a pressure sensing insole with all the sensors placed at the shoe/foot level. By measuring the foot movement and loading, the recognition of locomotion and load bearing activities would be appropriate for activity classification. Furthermore, inertial measurement units placed on the foot can perform detailed gait analysis, providing the possibility of characterizing locomotion. The system and dedicated activity classification algorithms were first designed, tested and validated during the first part of the thesis. Their application to clinical rehabilitation of at risk persons was demonstrated over the second part. In the first part of the thesis, the designed instrumented shoes system was tested in standardized conditions with healthy elderly subjects performing a sequence of structured activities. An algorithm based on movement biomechanics was built to identify each activity, namely sitting, standing, level walking, stairs, ramps, and elevators. The rich array of sensors present in the system included a 3D accelerometer, 3D gyroscope, 8 force sensors, and a barometer allowing the algorithm to reach a high accuracy in classifying different activity types. The tuning parameters of the algorithm were shown to be robust to small changes, demonstrating the suitability of the algorithm to activity classification in older adults. Next, the system was tested in daily life conditions on the same elderly participants. Using a wearable reference system, the concurrent validity of the instrumented shoes in classifying daily activity was shown. Additionally, daily gait metrics were obtained and compared to the literature. Further insight into the relationship between some gait parameters as well as a global activity metric, the activity âcomplexityâ, was discussed. Participants positively rated their comfort while using the system... (Please refer to thesis for full abstract

Identifying Elderly Patients at Risk of Falling using Time-Domain and Cyclostationarity Related Features

Falls are a prevalent and severe health problem in the elderly community, leading to unfortunate and devastating consequences. Some falls can be prevented through interventions, proper management, and extra care. Therefore, studying and identifying elderly people with risk of falls is essential to minimize the falling risk and to minimize the severity of injuries that can occur from these falls. Besides, identifying at-risk patients can profoundly affect public health in a positive way. In this paper, we use classification techniques to identify at-risk patients using pressure signals of the innersoles of 520 elderly people. These people reported whether they had experienced previous falls or not. Two different types of feature sets were used as inputs to the classification models and were compared: The first feature set includes time-domain, physiological, and cyclostationary features, whereas the second includes a subset of those features chosen by Relief-F as the most important features. Our study showed that the use of features from different walking conditions and using Relief-F as a feature selection method significantly improved the model prediction accuracy, i.e. by 5.24% from the best previously existing model. The results also point out that the mean and standard deviation of the stride time, gender, the degree of cyclostationarity were the most important features to include in classification models for the identification of elderly people at risk of falling

Wearables for Movement Analysis in Healthcare

Quantitative movement analysis is widely used in clinical practice and research to investigate movement disorders objectively and in a complete way. Conventionally, body segment kinematic and kinetic parameters are measured in gait laboratories using marker-based optoelectronic systems, force plates, and electromyographic systems. Although movement analyses are considered accurate, the availability of specific laboratories, high costs, and dependency on trained users sometimes limit its use in clinical practice. A variety of compact wearable sensors are available today and have allowed researchers and clinicians to pursue applications in which individuals are monitored in their homes and in community settings within different fields of study, such movement analysis. Wearable sensors may thus contribute to the implementation of quantitative movement analyses even during out-patient use to reduce evaluation times and to provide objective, quantifiable data on the patients’ capabilities, unobtrusively and continuously, for clinical purposes

Development of a Wireless Mobile Computing Platform for Fall Risk Prediction

Falls are a major health risk with which the elderly and disabled must contend. Scientific research on smartphone-based gait detection systems using the Internet of Things (IoT) has recently become an important component in monitoring injuries due to these falls. Analysis of human gait for detecting falls is the subject of many research projects. Progress in these systems, the capabilities of smartphones, and the IoT are enabling the advancement of sophisticated mobile computing applications that detect falls after they have occurred. This detection has been the focus of most fall-related research; however, ensuring preventive measures that predict a fall is the goal of this health monitoring system. By performing a thorough investigation of existing systems and using predictive analytics, we built a novel mobile application/system that uses smartphone and smart-shoe sensors to predict and alert the user of a fall before it happens. The major focus of this dissertation has been to develop and implement this unique system to help predict the risk of falls. We used built-in sensors --accelerometer and gyroscope-- in smartphones and a sensor embedded smart-shoe. The smart-shoe contains four pressure sensors with a Wi-Fi communication module to unobtrusively collect data. The interactions between these sensors and the user resulted in distinct challenges for this research while also creating new performance goals based on the unique characteristics of this system. In addition to providing an exciting new tool for fall prediction, this work makes several contributions to current and future generation mobile computing research

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

Performance of the Intrac Wireless Activity Tracking System for the Afari Assistive Device

Afari is a mobility device that was designed to be more recreational, aesthetic, and functional outside than the typical mobility devices commonly used today such as walkers, crutches, and rollators. The Afari transfers weight from a user through the arm rests and enforces an upright posture while walking with correct adjustments to the arm rest height. In addition to assisting with walking or running, a sensor system fitted to the Afari device has been designed to analyze different aspects of activity tracking such as the dynamic loading applied to the arm rests, spatial-temporal gait parameters, speed, and distance. This includes various sensors, namely, load cells for each arm rest, an inertial measurement unit, and a speed and distance sensor that wirelessly transmit data via Bluetooth Low Energy (BLE) to either a smartphone or computer. The total distance, pitch angle, right and left loading on each armrest can be viewed in real time by the user. An algorithm was created in MATLAB to process all the raw data and compute cadence, stride length, average toe-off and heel strike angle, swing and stance time, and speed over the duration of active use. An Afari user can monitor these different aspects of their activity and adjust accordingly to potentially improve their balance or gait

An Automatic Gait Feature Extraction Method for Identifying Gait Asymmetry Using Wearable Sensors

This paper aims to assess the use of Inertial Measurement Unit (IMU) sensors to identify gait asymmetry by extracting automatic gait features. We design and develop an android app to collect real time synchronous IMU data from legs. The results from our method are validated using a Qualisys Motion Capture System. The data are collected from 10 young and 10 older subjects. Each performed a trial in a straight corridor comprising 15 strides of normal walking, a turn around and another 15 strides. We analyse the data for total distance, total time, total velocity, stride, step, cadence, step ratio, stance, and swing. The accuracy of detecting the stride number using the proposed method is 100% for young and 92.67% for older subjects. The accuracy of estimating travelled distance using the proposed method for young subjects is 97.73% and 98.82% for right and left legs; and for the older, is 88.71% and 89.88% for right and left legs. The average travelled distance is 37.77 (95% CI ± 3.57) meters for young subjects and is 22.50 (95% CI ± 2.34) meters for older subjects. The average travelled time for young subjects is 51.85 (95% CI ± 3.08) seconds and for older subjects is 84.02 (95% CI ± 9.98) seconds. The results show that wearable sensors can be used for identifying gait asymmetry without the requirement and expense of an elaborate laboratory setup. This can serve as a tool in diagnosing gait abnormalities in individuals and opens the possibilities for home based self-gait asymmetry assessment

Real-Time Step Detection Using Unconstrained Smartphone

Nowadays smartphones are carrying more and more sensors among which are inertial sensors. These devices provide information about the movement and forces acting on the device, but they can also provide information about the movement of the user. Step detection is at the core of many smartphone applications such as indoor location, virtual reality, health and activity monitoring, and some of these require high levels of precision. Current state of the art step detection methods rely heavily in the prediction of the movements performed by the user and the smartphone or on methods of activity recognition for parameter tuning. These methods are limited by the number of situations the researchers can predict and do not consider false positive situations which occur in daily living such as jumps or stationary movements, which in turn will contribute to lower performances. In this thesis, a novel unconstrained smartphone step detection method is proposed using Convolutional Neural Networks. The model utilizes the data from the accelerometer and gyroscope of the smartphone for step detection. For the training of the model, a data set containing step and false step situations was built with a total of 4 smartphone placements, 5 step activities and 2 false step activities. The model was tested using the data from a volunteer which it has not previously seen. The proposed model achieved an overall recall of 89.87% and an overall precision of 87.90%, while being able to distinguish step and non-step situations. The model also revealed little difference between the performance in different smartphone placements, indicating a strong capability towards unconstrained use. The proposed solution demonstrates more versatility than state of the art alternatives, by presenting comparable results without the need of parameter tuning or adjustments for the smartphone use case, potentially allowing for better performances in free living scenarios