Gait Event Detection on Level Ground and Incline Walking Using a Rate Gyroscope

Gyroscopes have been proposed as sensors for ambulatory gait analysis and functional electrical stimulation systems. Accurate determination of the Initial Contact of the foot with the floor (IC) and the final contact or Foot Off (FO) on different terrains is important. This paper describes the evaluation of a gyroscope placed on the shank for determination of IC and FO in subjects walking outdoors on level ground, and up and down an incline. Performance was compared with a reference pressure measurement system. The mean difference between the gyroscope and the reference was less than −25 ms for IC and less than 75 ms for FO for all terrains. Detection success was over 98%. These results provide preliminary evidence supporting the use of the gyroscope for gait event detection on inclines as well as level walking

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

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

Optimal Inertial Sensor Placement and Motion Detection for Epileptic Seizure Patient Monitoring

Use of inertial sensory systems to monitor and detect seizure episodes in patients suffering from epilepsy is investigated via numerical simulations and experiments. Numerical simulations employ a mathematical model that is able to predict human body dynamic responses during a typical epileptic seizure. An optimized inertial sensor placement procedure is developed to address achievement of highest possible sensing resolution in determining angular accelerations with minimal errors. In addition, a joint torque estimation procedure is formulated to assist in the future development of a possible detection scheme. Experimental motion data obtained from an epileptic seizure patient as well as a healthy subject via a cluster of inertial measurement sensors formed a basis for proposing a suitable detection scheme based on non-linear response analysis. In particular, preliminary experimental data analysis has shown that the proposed modified Poincaré Map based scheme can become an effective tool in detecting of seizure via inertial measurements

Analysis of gait and coordination for arthroplasty outcome evaluation using body-fixed sensors

The importance of evaluation of an orthopedic operation such as hip or knee arthroplasty has long been recognized. Many definitions of outcome and scoring questionnaires have been used in the past to assess the outcome of joint replacement. However, these assessments are subjective and not accurate enough. In addition, orthopedic surgeons require now more subtle comparisons between potentially efficacious treatments (e.g. two types of prostheses). Therefore, the use of objective instruments that have a better sensitivity and specificity than traditional scoring systems is needed. Gait analysis is one of the most currently used instrumented techniques in this respect. However, a gait analysis system is accessible only in a few specialized laboratories, as it is complex, expensive, need a lot of room space and fixed devices, and not convenient for the patient. In this thesis, we proposed an ambulatory system based on kinematic sensors attached on the lower limbs to overcome the limitations of the previously mentioned techniques. Technically the device is portable, easily mountable, non-invasive, and capable of continuously recording data in long term without hindrance to natural gait. The goal was to provide gait parameters as a new objective method to assess Total Knee Replacement (TKR). New solutions to fusing the data of accelerometers and gyroscopes were proposed to accurately measure lower limbs orientations and joint angles. The methods propose a minimal sensor configuration with one sensor module mounted on each segment. The models consider anatomical aspects and biomechanical constraints. In the proposed techniques, the angles are found without the need for integration, so absolute angles can be obtained which are free from any source of drift. These data were then used to develop a gait analysis system providing spatio-temporal parameters, kinematic curves, and a visualization tool to animate the motion data as synthetic skeletons performing the same actions as the subjects. Moreover, a new algorithm was proposed for assessing and quantification of inter-joint coordination during gait. The coordination model captures the whole dynamics of the lower limbs movements and shows the kinematic synergies at various walking speeds. The model imposes a relationship among lower limb joint angles (hips and knees) to parameterize the dynamics of locomotion for each individual. It provides a coordination score at various walking speeds which is ranged between 0 and 10. An integration of different analysis tools such as Harmonic Analysis, Principal Component Analysis, and Artificial Neural Network helped overcome high-dimensionality, temporal dependence, and non-linear relationships of the gait patterns. In order to show the effectiveness of the proposed methods in outcome evaluation, we have considered a clinical study where the outcomes of two types of knee prostheses were compared. We conducted a randomized controlled study, including 54 patients, to assess TKR outcome between patients with fixed bearing and mobile bearing tibial plates of implants. The patients were tested preoperatively and postoperatively at 6 weeks, 3 months, 6 months, and 1 year. Various statistical analyses were done to compare the outcomes of the two groups. Finally, we provided objective criteria, using ambulatory gait analysis, for assessing functional recovery following TKR procedure. We showed significant difference between the two groups where the standard clinical evaluation was unable to detect such a difference

Wearable Textile Platform for Assessing Stroke Patient Treatment in Daily Life Conditions

Monitoring physical activities during post-stroke rehabilitation in daily life may help physicians to optimize and tailor the training program for patients. The European research project INTERACTION (FP7-ICT-2011-7-287351) evaluated motor capabilities in stroke patients during the recovery treatment period. We developed wearable sensing platform based on the sensor fusion among inertial, knitted piezoresistive sensors and textile EMG electrodes. The device was conceived in modular form and consists of a separate shirt, trousers, glove, and shoe. Thanks to the novel fusion approach it has been possible to develop a model for the shoulder taking into account the scapulo-thoracic joint of the scapular girdle, considerably improving the estimation of the hand position in reaching activities. In order to minimize the sensor set used to monitor gait, a single inertial sensor fused with a textile goniometer proved to reconstruct the orientation of all the body segments of the leg. Finally, the sensing glove, endowed with three textile goniometers and three force sensors showed good capabilities in the reconstruction of grasping activities and evaluating the interaction of the hand with the environment, according to the project specifications. This paper reports on the design and the technical evaluation of the performance of the sensing platform, tested on healthy subjects

Promoting a healthy ageing workforce: use of Inertial Measurement Units to monitor potentially harmful trunk posture under actual working conditions

Musculoskeletal disorders, particularly those involving the low back, represent a major health concern for workers, and originate significant consequences for the socio-economic system. As the average age of the population is gradually (yet steadily) increasing, such phenomenon directly reflects on labor market raising the need to create the optimal conditions for jobs which must be sustainable for the entire working life of an individual, while constantly ensuring good health and quality of life. In this context, prevention and management of low back disorders (LBDs) should be effective starting from the working environment. To this purpose, quantitative, reliable and accurate tools are needed to assess the main parameters associated to the biomechanical risk. In the last decade, the technology of wearable devices has made available several options that have been proven suitable to monitor the physical engagement of individuals while they perform manual or office working tasks. In particular, the use of miniaturized Inertial Measurement Units (IMUs) which has been already tested for ergonomic applications with encouraging results, could strongly facilitate the data collection process, being less time- and resources-consuming with respect to direct or video observations of the working tasks. Based on these considerations, this research intends to propose a simplified measurement setup based on the use of a single IMUs to assess trunk flexion exposure, during actual shifts, in occupations characterized by significant biomechanical risk. Here, it will be demonstrated that such approach is feasible to monitor large groups of workers at the same time and for a representative duration which can be extended, in principle, to the entire work shift without perceivable discomfort for the worker or alterations of the performed task. Obtained data, which is easy to interpret, can be effectively employed to provide feedback to workers thus improving their working techniques from the point of view of safety. They can also be useful to ergonomists or production engineers regarding potential risks associated with specific tasks, thus supporting decisions or allowing a better planning of actions needed to improve the interaction of the individual with the working environment

Dynamic estimation of human energy expenditure with wearable sensors

&nbsp;This study investigated energy expenditure estimation using inertial measurement units, electromyography and O2 Gas Mask sensors whilst undergoing motion. Further investigations included the precision measurement of IMUs in order to achieve extremely accurate energy estimation calculations using an experimental Dual-Kalman Filter and limb length estimation using entropy based methods .<br /

Present and future of gait assessment in clinical practice: Towards the application of novel trends and technologies

BackgroundDespite being available for more than three decades, quantitative gait analysis remains largely associated with research institutions and not well leveraged in clinical settings. This is mostly due to the high cost/cumbersome equipment and complex protocols and data management/analysis associated with traditional gait labs, as well as the diverse training/experience and preference of clinical teams. Observational gait and qualitative scales continue to be predominantly used in clinics despite evidence of less efficacy of quantifying gait.Research objectiveThis study provides a scoping review of the status of clinical gait assessment, including shedding light on common gait pathologies, clinical parameters, indices, and scales. We also highlight novel state-of-the-art gait characterization and analysis approaches and the integration of commercially available wearable tools and technology and AI-driven computational platforms.MethodsA comprehensive literature search was conducted within PubMed, Web of Science, Medline, and ScienceDirect for all articles published until December 2021 using a set of keywords, including normal and pathological gait, gait parameters, gait assessment, gait analysis, wearable systems, inertial measurement units, accelerometer, gyroscope, magnetometer, insole sensors, electromyography sensors. Original articles that met the selection criteria were included.Results and significanceClinical gait analysis remains highly observational and is hence subjective and largely influenced by the observer's background and experience. Quantitative Instrumented gait analysis (IGA) has the capability of providing clinicians with accurate and reliable gait data for diagnosis and monitoring but is limited in clinical applicability mainly due to logistics. Rapidly emerging smart wearable technology, multi-modality, and sensor fusion approaches, as well as AI-driven computational platforms are increasingly commanding greater attention in gait assessment. These tools promise a paradigm shift in the quantification of gait in the clinic and beyond. On the other hand, standardization of clinical protocols and ensuring their feasibility to map the complex features of human gait and represent them meaningfully remain critical challenges

Design of actuation system and minimization of sensor configuration for gait event detection for Gen 3.0 Portable Powered Ankle-Foot Orthosis (PPAFO)

Powered ankle-foot orthoses (AFOs), which are capable of providing assistive torque at the ankle joint, have significant potential as both assistance and rehabilitation devices. Technology advancements have led to great progression in the development of powered AFOs. Our group had developed the Portable Powered Ankle-Foot Orthosis (PPAFO) that was capable of providing bidirectional assistive torque at the ankle joint. Two generations of the PPAFO were previously developed. Both designs used two different off-the-shelf rotary actuators. This thesis consists of two studies focusing on the development of a new compact higher torque actuation system and the identification of a minimum sensor configuration for gait event detection for a powered AFO. Study 1 presents the design and evaluation of a new actuation system for the PPAFO (Generation 3.0). The actuation system utilized two dual-action linear actuators and a customized gear train. Compared with the previous designs, it generated higher torque and power while providing a thinner lateral profile. The new design had a total weight of (680g) and was capable of generating 32 Nm torque and 110 W power. While running under the same torque and power level as the previous designs, the new design offered better longevity (42.9% and 81.4% increases in normalized run time for test bench emulation and treadmill walking). Although the overall weight of the new actuation system had a 20% increase compared with previous design, it could generate 166.7% more torque and 120% more power, which will enable us to test the system at various torque and power settings. Study 2 investigated the minimum sensor configuration for detecting gait events. Knowledge of the expected orientation and behavior of a limb as related to specific events during the gait cycle (or state timing as a function of the percentage of the gait cycle, % GC) is essential to allow appropriate control of a powered AFO. A total of five sensors were selected (two force sensitive sensors, one ankle angle sensor, and two inertial measurement units (IMU)). The performances of selected sensor configurations were quantified and compared through state-based and event-based approaches in terms of gait state estimation and gait event detection timing, respectively. Gait data were collected from five healthy subjects while walking on a treadmill wearing the Gen 3.0 PPAFO. Results indicated that, while single IMU configurations (located on the shank or foot) both outperformed all other configurations (mean state estimation error: < 2% GC; mean event detection timing error: < 23 ms), the shank IMU was able to detect more gait events than the foot IMU. Since more detectable events could improve the system's robustness (i.e., adjusting to variable speeds) by updating estimation more frequently, a single shank IMU configuration was recommended for powered AFO applications