Using wearable inertial sensors to compare different versions of the dual task paradigm during walking

The dual task paradigm (DTP), where performance of a walking task co-occurs with a cognitive task to assess performance decrement, has been controversially mooted as a more suitable task to test safety from falls in outdoor and urban environments than simple walking in a hospital corridor. There are a variety of different cognitive tasks that have been used in the DTP, and we wanted to assess the use of a secondary task that requires mental tracking (the alternate letter alphabet task) against a more automatic working memory task (counting backward by ones). In this study we validated the x-io x-IMU wearable inertial sensors, used them to record healthy walking, and then used dynamic time warping to assess the elements of the gait cycle. In the timed 25 foot walk (T25FW) the alternate letter alphabet task lengthened the stride time significantly compared to ordinary walking, while counting backward did not. We conclude that adding a mental tracking task in a DTP will elicit performance decrement in healthy volunteers

An Overview of Smart Shoes in the Internet of Health Things: Gait and Mobility Assessment in Health Promotion and Disease Monitoring

New smart technologies and the internet of things increasingly play a key role in healthcare and wellness, contributing to the development of novel healthcare concepts. These technologies enable a comprehensive view of an individual’s movement and mobility, potentially supporting healthy living as well as complementing medical diagnostics and the monitoring of therapeutic outcomes. This overview article specifically addresses smart shoes, which are becoming one such smart technology within the future internet of health things, since the ability to walk defines large aspects of quality of life in a wide range of health and disease conditions. Smart shoes offer the possibility to support prevention, diagnostic work-up, therapeutic decisions, and individual disease monitoring with a continuous assessment of gait and mobility. This overview article provides the technological as well as medical aspects of smart shoes within this rising area of digital health applications, and is designed especially for the novel reader in this specific field. It also stresses the need for closer interdisciplinary interactions between technological and medical experts to bridge the gap between research and practice. Smart shoes can be envisioned to serve as pervasive wearable computing systems that enable innovative solutions and services for the promotion of healthy living and the transformation of health care

Crowdsourcing-Based Fingerprinting for Indoor Location in Multi-Storey Buildings

POCI-01-0247-FEDER-033479The number of available indoor location solutions has been growing, however with insufficient precision, high implementation costs or scalability limitations. As fingerprinting-based methods rely on ubiquitous information in buildings, the need for additional infrastructure is discarded. Still, the time-consuming manual process to acquire fingerprints limits their applicability in most scenarios. This paper proposes an algorithm for the automatic construction of environmental fingerprints on multi-storey buildings, leveraging the information sources available in each scenario. It relies on unlabelled crowdsourced data from users’ smartphones. With only the floor plans as input, a demand for most applications, we apply a multimodal approach that joins inertial data, local magnetic field andWi-Fi signals to construct highly accurate fingerprints. Precise movement estimation is achieved regardless of smartphone usage through Deep Neural Networks, and the transition between floors detected from barometric data. Users’ trajectories obtained with Pedestrian Dead Reckoning techniques are partitioned into clusters with Wi-Fi measurements. Straight sections from the same cluster are then compared with subsequence Dynamic Time Warping to search for similarities. From the identified overlapping sections, a particle filter fits each trajectory into the building’s floor plans. From all successfully mapped routes, fingerprints labelled with physical locations are finally obtained. Experimental results from an office and a university building show that this solution constructs comparable fingerprints to those acquired manually, thus providing a useful tool for fingerprinting-based solutions automatic setup.publishersversionpublishe

Development and clinical validation of inertial sensor-based gait-clustering methods in Parkinson’s disease

Background Gait symptoms and balance impairment are characteristic indicators for the progression in Parkinson’s disease (PD). Current gait assessments mostly focus on straight strides with assumed constant velocity, while acceleration/deceleration and turning strides are often ignored. This is either due to the set up of typical clinical assessments or technical limitations in capture volume. Wearable inertial measurement units are a promising and unobtrusive technology to overcome these limitations. Other gait phases such as initiation, termination, transitioning (between straight walking and turning) and turning might be relevant as well for the evaluation of gait and balance impairments in PD. Method In a cohort of 119 PD patients, we applied unsupervised algorithms to find different gait clusters which potentially include the clinically relevant information from distinct gait phases in the standardized 4x10 m gait test. To clinically validate our approach, we determined the discriminative power in each gait cluster to classify between impaired and unimpaired PD patients and compared it to baseline (analyzing all straight strides). Results As a main result, analyzing only one of the gait clusters constant, non-constant or turning led in each case to a better classification performance in comparison to the baseline (increase of area under the curve (AUC) up to 19% relative to baseline). Furthermore, gait parameters (for turning, constant and non-constant gait) that best predict motor impairment in PD were identified. Conclusions We conclude that a more detailed analysis in terms of different gait clusters of standardized gait tests such as the 4x10 m walk may give more insights about the clinically relevant motor impairment in PD patients

Patient Movement Monitoring Based on IMU and Deep Learning

Osteoarthritis (OA) is the leading cause of disability among the aging population in the United States and is frequently treated by replacing deteriorated joints with metal and plastic components. Developing better quantitative measures of movement quality to track patients longitudinally in their own homes would enable personalized treatment plans and hasten the advancement of promising new interventions. Wearable sensors and machine learning used to quantify patient movement could revolutionize the diagnosis and treatment of movement disorders. The purpose of this dissertation was to overcome technical challenges associated with the use of wearable sensors, specifically Inertial Measurement Units (IMUs), as a diagnostic tool for osteoarthritic (OA) and total knee replacement patients (TKR) through a detailed biomechanical assessment and development of machine learning algorithms. Specifically, the first study developed a relevant dataset consisting of IMU and associated biomechanical parameters of OA and TKR patients performing various activities, created a machine learning-based framework to accurately estimate spatiotemporal movement characteristics from IMU during level ground walking, and defined optimum sensor configuration associated with the patient population and activity. The second study designed a framework to generate synthetic kinematic and associated IMU data as well as investigated the influence of adding synthetic data into training-measured data on deep learning model performance. The third study investigated the kinematic variation between two patient’s population across various activities: stair ascent, stair descent, and gait using principle component analysis PCA. Additionally, PCA-based autoencoders were developed to generate synthetic kinematics data for each patient population and activity. The fourth study investigated the potential use of a universal deep learning model for the estimation of lower extremities’ kinematics across various activities. Therefore, this model can be used as a global model for transfer learning methods in future research. This line of study resulted in a machine-learning framework that can be used to estimate biomechanical movements based on a stream of signals emitted from low-cost and portable IMUs. Eventually, this could lead to a simple clinical tool for tracking patients\u27 movements in their own homes and translating those movements into diagnostic metrics that clinicians will be able to use to tailor treatment to each patient\u27s needs in the future

Gait event detection in controlled and real-life situations: repeated measures from healthy subjects

A benchmark and time-effective computational method is needed to assess human gait events in real-life walking situations using few sensors to be easily reproducible. This paper fosters a reliable gait event detection system that can operate at diverse gait speeds and on diverse real-life terrains by detecting several gait events in real time. This detection only relies on the foot angular velocity measured by a wearable gyroscope mounted in the foot to facilitate its integration for daily and repeated use. To operate as a benchmark tool, the proposed detection system endows an adaptive computational method by applying a finite-state machine based on heuristic decision rules dependent on adaptive thresholds. Repeated measurements from 11 healthy subjects (28.27 +/- 4.17 years) were acquired in controlled situations through a treadmill at different speeds (from 1.5 to 4.5 km/h) and slopes (from 0% to 10%). This validation also includes heterogeneous gait patterns from nine healthy subjects (27 +/- 7.35 years) monitored at three self-selected paces (from 1 +/- 0.2 to 2 +/- 0.18 m/s) during forward walking on flat, rough, and inclined surfaces and climbing staircases. The proposed method was significantly more accurate (p > 0.9925) and time effective ( 0.9314) in a benchmarking analysis with a state-of-the-art method during 5657 steps. Heel strike was the gait event most accurately detected under controlled (accuracy of 100%) and real-life situations (accuracy > 96.98%). Misdetection was more pronounced in middle mid swing (accuracy > 90.12%). The lower computational load, together with an improved performance, makes this detection system suitable for quantitative benchmarking in the locomotor rehabilitation field.This work has been supported in part by the Fundacao para a Ciencia e Tecnologia (FCT) with the Reference Scholarship under Grant SFRH/BD/108309/2015, by the Reference Project under Grant UID/EEA/04436/2013, and part by the FEDER Funds through the COMPETE 2020-Programa Operacional Competitividade e Internacionalizacao (POCI)-with the Reference Project under Grant POCI-01-0145-FEDER-006941, and in part by Spanish Ministry of Economy and Competitiveness Grant RYC-2014-16613

Wearable Sensors in the Evaluation of Gait and Balance in Neurological Disorders

The aging population and the increased prevalence of neurological diseases have raised the issue of gait and balance disorders as a major public concern worldwide. Indeed, gait and balance disorders are responsible for a high healthcare and economic burden on society, thus, requiring new solutions to prevent harmful consequences. Recently, wearable sensors have provided new challenges and opportunities to address this issue through innovative diagnostic and therapeutic strategies. Accordingly, the book “Wearable Sensors in the Evaluation of Gait and Balance in Neurological Disorders” collects the most up-to-date information about the objective evaluation of gait and balance disorders, by means of wearable biosensors, in patients with various types of neurological diseases, including Parkinson’s disease, multiple sclerosis, stroke, traumatic brain injury, and cerebellar ataxia. By adopting wearable technologies, the sixteen original research articles and reviews included in this book offer an updated overview of the most recent approaches for the objective evaluation of gait and balance disorders

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

Validity and Consistency of Concurrent Extraction of Gait Features Using Inertial Measurement Units and Motion Capture System

Conditions causing gait abnormalities are very common and their treatment requires the detailed assessment of gait. Currently such assessments are carried out in gait laboratories and require the use of complex and expensive equipment. To increase availability and use at home and clinics, we design and develop an affordable, user friendly, wireless, portable automatic system to extract spatiotemporal features of gait that can be used indoors and outdoors. This study determines the concurrent validity of extracted gait features from Inertial Measurement Units (IMUs) against ‘gold standard’ Motion Capture System (MoCap) using a hybrid gait features extraction method. The analysis of the proposed method is based on minimum prominence and abrupt transition points in the IMU signals. We also compare the degree of agreement for mean spatiotemporal gait features. The concurrent data from synchronized IMUs and MoCap are collected from 18 subjects. We validate our proposed system using two experiments; 1) IMU and MoCap with self-selected (free) walking and 2) IMU and MoCap at various walking speeds. Interclass correlations, Lin’s concordance correlation coefficients and Pearson’s correlation coefficients (r) are applied to determine the correlation between extracted gait features from IMU and MoCap measurements. Bland-Altman plots are also generated to evaluate any unknown bias between the mean extracted features. The experiments show that spatiotemporal features of gait extracted from IMUs are highly valid. Our methods facilitate gait assessment in clinics and at home including the possibility of self-assessment