2D Gait Skeleton Data Normalization for Quantitative Assessment of Movement Disorders from Freehand Single Camera Video Recordings

Overlapping phenotypic features between Early Onset Ataxia (EOA) and Developmental Coordination Disorder (DCD) can complicate the clinical distinction of these disorders. Clinical rating scales are a common way to quantify movement disorders but in children these scales also rely on the observer’s assessment and interpretation. Despite the introduction of inertial measurement units for objective and more precise evaluation, special hardware is still required, restricting their widespread application. Gait video recordings of movement disorder patients are frequently captured in routine clinical settings, but there is presently no suitable quantitative analysis method for these recordings. Owing to advancements in computer vision technology, deep learning pose estimation techniques may soon be ready for convenient and low-cost clinical usage. This study presents a framework based on 2D video recording in the coronal plane and pose estimation for the quantitative assessment of gait in movement disorders. To allow the calculation of distance-based features, seven different methods to normalize 2D skeleton keypoint data derived from pose estimation using deep neural networks applied to freehand video recording of gait were evaluated. In our experiments, 15 children (five EOA, five DCD and five healthy controls) were asked to walk naturally while being videotaped by a single camera in 1280 × 720 resolution at 25 frames per second. The high likelihood of the prediction of keypoint locations (mean = 0.889, standard deviation = 0.02) demonstrates the potential for distance-based features derived from routine video recordings to assist in the clinical evaluation of movement in EOA and DCD. By comparison of mean absolute angle error and mean variance of distance, the normalization methods using the Euclidean (2D) distance of left shoulder and right hip, or the average distance from left shoulder to right hip and from right shoulder to left hip were found to better perform for deriving distance-based features and further quantitative assessment of movement disorders.