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Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis

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A special issue of Sensors (ISSN 1424-8220). This special issue belongs to the section "Wearables".

Deadline for manuscript submissions: closed (20 March 2022) | Viewed by 25257

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Special Issue Editors

Prof. Dr. Jacob Sosnoff

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Guest Editor

School of Health Professions, University of Kansas Medical Center, Rainbow Blvd, Kansas City, KS 66160, USA

Dr. Arnaud Gouelle

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Guest Editor

Laboratory Performance, Santé, Métrologie, Société (PSMS), UFR STAPS, Université Reims Champagne Ardenne, Reims, France
Interests: gait analysis; motion analysis; measurement systems; rehabilitation; motor control; clinical assessment
Special Issues, Collections and Topics in MDPI journals

Dr. Clint Hansen

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Guest Editor

Kiel University, Germany
Interests: biomechanics and motor control

Special Issue Information

Dear Colleagues,

While instrumented human movement analysis has evolved over recent years and sensor-based measurement techniques can objectively and quantitatively describe motor functions, the real question remains about its additional clinical value.

Once the sensors have been technically validated for their use, and under rigorous protocols, all movements can be captured and scrutinized in detail. The real challenge is then to select, amongst a myriad of possible outcomes and mathematical analyses, which ones will bring the most valuable and meaningful insights. Indeed, the critical mission is finally to improve patient’s quality of life by helping clinicians to better assess, describe, monitor, and understand the performance and limitations of sensors. In this regard, the methods and parameters which arise from the technology must echo the theories of motor control and clinical features.

This Special Issue aims to highlight the most recent research regarding sensors and their direct applications into clinical movement analysis and health monitoring, which can be translated into clinically relevant parameters.

We strongly encourage submission of works by multidisciplinary teams, including both engineers, PhD scholars, and medical experts, with emphasis on the clinical utility of the method. Notice that submissions are not only limited to wearable sensors.

The main topics of this Special Issue include the following:

Instrumented gait analysis;

Instrumental motion analysis;

Sensors for physical rehabilitation;

Quantitative assessment of motor function;

Fall risk assessment;

Foot pressure;

State-of-the-art methods for the implementation and integration of sensors in clinical practice

Prof. Dr. Jacob Sosnoff
Dr. Arnaud Gouelle
Dr. Clint Hansen
Guest Editors

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Published Papers (6 papers)

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Research

17 pages, 21716 KiB

Open AccessArticle

Estimation of Walking Speed and Its Spatiotemporal Determinants Using a Single Inertial Sensor Worn on the Thigh: From Healthy to Hemiparetic Walking

by Dheepak Arumukhom Revi, Stefano M. M. De Rossi, Conor J. Walsh and Louis N. Awad

Sensors 2021, 21(21), 6976; https://doi.org/10.3390/s21216976 - 21 Oct 2021

Cited by 13 | Viewed by 4251

Abstract

We present the use of a single inertial measurement unit (IMU) worn on the thigh to produce stride-by-stride estimates of walking speed and its spatiotemporal determinants (i.e., stride time and stride length). Ten healthy and eight post-stroke individuals completed a 6-min walk test with an 18-camera motion capture system used for ground truth measurements. Subject-specific estimation models were trained to estimate walking speed using the polar radius extracted from phase portraits produced from the IMU-measured thigh angular position and velocity. Consecutive flexion peaks in the thigh angular position data were used to define each stride and compute stride times. Stride-by-stride estimates of walking speed and stride time were then used to compute stride length. In both the healthy and post-stroke cohorts, low error and high consistency were observed for the IMU estimates of walking speed (MAE < 0.035 m/s; ICC > 0.98), stride time (MAE < 30 ms; ICC > 0.97), and stride length (MAE < 0.037 m; ICC > 0.96). This study advances the use of a single wearable sensor to accurately estimate walking speed and its spatiotemporal determinants during both healthy and hemiparetic walking. Full article

(This article belongs to the Special Issue Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis)

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15 pages, 2814 KiB

Open AccessArticle

Assessing Site Specificity of Osteoarthritic Gait Kinematics with Wearable Sensors and Their Association with Patient Reported Outcome Measures (PROMs): Knee versus Hip Osteoarthritis

by Corina Nüesch, Petros Ismailidis, David Koch, Geert Pagenstert, Thomas Ilchmann, Anke Eckardt, Karl Stoffel, Christian Egloff and Annegret Mündermann

Sensors 2021, 21(16), 5363; https://doi.org/10.3390/s21165363 - 10 Aug 2021

Cited by 14 | Viewed by 4831

Abstract

There is a great need for quantitative outcomes reflecting the functional status in patients with knee or hip osteoarthritis (OA) to advance the development and investigation of interventions for OA. The purpose of this study was to determine if gait kinematics specific to the disease—i.e., knee versus hip OA—can be identified using wearable sensors and statistical parametric mapping (SPM) and whether disease-related gait deviations are associated with patient reported outcome measures. 113 participants (N = 29 unilateral knee OA; N = 30 unilateral hip OA; N = 54 age-matched asymptomatic persons) completed gait analysis with wearable sensors and the Knee/Hip Osteoarthritis Outcome Score (KOOS/HOOS). Data were analyzed using SPM. Knee and hip kinematics differed between patients with knee OA and patients with hip OA (up to 14°, p < 0.001 for knee and 8°, p = 0.003 for hip kinematics), and differences from controls were more pronounced in the affected than unaffected leg of patients. The observed deviations in ankle, knee and hip kinematic trajectories from controls were associated with KOOS/HOOS in both groups. Capturing gait kinematics using wearables has a large potential for application as outcome in clinical trials and for monitoring treatment success in patients with knee or hip OA and in large cohorts representing a major advancement in research on musculoskeletal diseases. Full article

(This article belongs to the Special Issue Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis)

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11 pages, 877 KiB

Open AccessCommunication

Self-Perception of the Knee Is Associated with Joint Motion during the Loading Response in Individuals with Knee Osteoarthritis: A Pilot Cross-Sectional Study

by Haruki Toda, Tsubasa Maruyama, Koji Fujita, Yuki Yamauchi and Mitsunori Tada

Sensors 2021, 21(12), 4009; https://doi.org/10.3390/s21124009 - 10 Jun 2021

Cited by 7 | Viewed by 3906

Abstract

Small knee flexion motion is a characteristic of gait in individuals with knee osteoarthritis. This study examined the relationship between knee flexion excursion in loading response and knee self-perception in individuals with knee osteoarthritis. Twenty-one individuals with knee osteoarthritis participated in this study. Knee flexion excursions in loading response while walking at a comfortable and a fast-walking speed were measured using an inertial measurement unit-based motion capture system. The degree of knee perceptual impairment was evaluated using the Fremantle Knee Awareness Questionnaire (FreKAQ). The relationships between the FreKAQ score and gait variables and knee function were evaluated by calculating the correlation coefficient. The unique contributions of knee self-perception and muscle strength to knee flexion excursion in loading response were analyzed using hierarchical linear regression. Knee self-perception was significantly correlated with pain during walking, muscle strength and knee flexion excursion at fast speed. In the fast speed condition only, impaired knee self-perception was inversely proportional to knee flexion excursion and accounted for 21.8% of the variance in knee flexion excursion. This result suggests that impaired self-perception of the knee may help to explain the decrease in the knee flexion excursion in the loading response in individuals with knee osteoarthritis. Full article

(This article belongs to the Special Issue Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis)

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11 pages, 399 KiB

Open AccessArticle

Physical Activity during Weekdays and Weekends in Persons with Multiple Sclerosis

by Yoshimasa Sagawa, Eric Watelain, Thierry Moulin and Pierre Decavel

Sensors 2021, 21(11), 3617; https://doi.org/10.3390/s21113617 - 22 May 2021

Cited by 9 | Viewed by 2971

Abstract

The assessment of the functional performance status of persons with multiple sclerosis (PwMS) is a useful tool to optimize healthcare. This concept does not seem to be extensively explored in this population. This study aimed to determine the level of activity of PwMS during weekdays and weekends, and to establish associations between clinical parameters. Forty-one PwMS and 16 healthy persons participated in this study. Their physical activity in real-life conditions was assessed with an accelerometer. For the clinical evaluations, the quality of life, fatigue, gait, and balance were assessed. The level of activity between PwMS for weekdays, weekends, Saturdays, and Sundays was significantly reduced compared with the reference group (p = 0.001–0.00001, d = 0.95–1.76). PwMS had a constant level of activity throughout the week, whereas the reference group increased its level of activity on Saturdays (p = 0.04, d = 0.69). The level of activity was correlated in descending order with multiple sclerosis disability, body mass index, gait velocity, six-minute walk test, and timed up and go test. This study showed that PwMS had a stable level of activity throughout the week, contrary to healthy persons. It could be necessary to develop programs to facilitate physical activity and participation during the weekdays, but especially during weekends. Full article

(This article belongs to the Special Issue Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis)

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10 pages, 4551 KiB

Open AccessArticle

Evaluation of Prolonged Walking in Persons with Multiple Sclerosis: Reliability of the Spatio-Temporal Walking Variables during the 6-Minute Walk Test

by Nawale Hadouiri, Elisabeth Monnet, Arnaud Gouelle, Pierre Decavel and Yoshimasa Sagawa

Sensors 2021, 21(9), 3075; https://doi.org/10.3390/s21093075 - 28 Apr 2021

Cited by 11 | Viewed by 3729

Abstract

Background: Walking disorders represent the most disabling condition in persons with Multiple Sclerosis (PwMS). Several studies showed good reliability of the 6-min walk test (6MWT) (i.e., especially distance traveled), but little is known about the reliability of the Spatio-temporal (ST) variables in the 6MWT. Objective: To evaluate the test-retest reliability of ST variables and perceived exertion during the 6MWT in PwMS and comparable healthy persons. Methods: We explored three 1-min intervals (initial: 0′–1′, middle: 2′30″–3′30″, end: 5′–6′) of the 6MWT. Six ST variables and perceived exertion were measured (respectively, using the GAITRite system and the Borg Scale). These measurements were performed twice, 1 week apart. The test-retest effects were assessed using the intraclass correlation coefficient (ICC) or the weighted kappa. Results: Forty-five PwMS and 24 healthy persons were included. The test-retest reliability of ST variables values was good-to-excellent for PwMS (ICC range: 0.858–0.919) and moderate-to-excellent for healthy persons (ICC range: 0.569–0.946). The test-retest reliability values of perceived exertion were fair for PwMS (weighted kappa range: 0.279–0.376) and substantial for healthy persons (weighted kappa range: 0.734–0.788). Conclusion: The measurement of ST variables during these 6MWT intervals is reliable and applicable in clinical practice and research to adapt rehabilitation care in PwMS. Full article

(This article belongs to the Special Issue Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis)

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18 pages, 3838 KiB

Open AccessArticle

Gauging Gait Disorders with a Method Inspired by Motor Control Theories: A Pilot Study in Friedreich’s Ataxia

by Arnaud Gouelle, Samantha Norman, Bryanna Sharot, Stephanie Salabarria, Sub Subramony and Manuela Corti

Sensors 2021, 21(4), 1144; https://doi.org/10.3390/s21041144 - 6 Feb 2021

Cited by 6 | Viewed by 4216

Abstract

To date, it has been challenging for clinicians and researchers alike to use the multiple outcome measures available to create a meaningful clinical picture and perform effective longitudinal follow-up. It has been found that instrumented gait analysis can provide information associated with a patient’s performance and help to remedy the shortcomings of the currently available outcome measures. The goal of this methodological article is to set the background and justify a new outcome measure inspired by the motor control theories to analyze gait using spatiotemporal parameters. The method is applied in a population of individuals living with Friedreich’s ataxia (FRDA), a neurodegenerative disease. The sample population consisted of 19 subjects, 11 to 65 years of age with FRDA, who either ambulated independently, with a cane, or with a rollator. Three scores based on the distance from healthy normative data were used: Organization Score, Variability Score, and an overall measurement, the Global Ambulation Score. The scores were then compared to the Scale for Assessment and Rating of Ataxia (SARA) Gait Score (SARA-GS), a clinical scale currently being used for gait analysis in FRDA. Organization Scores demonstrated a longitudinal deterioration in the gait characteristics from independent ambulators to those who ambulated with a rollator. Variability Scores mostly reflected dynamic instability, which became greater as the requirement of an ambulation aid or the switch from a cane to a rollator was imminent. The global value given by the Global Ambulation Score, which takes into consideration both the Organization Score, the Variability Score, and the level of assistive device, demonstrated a logarithmic relationship with the SARA-GS. Overall, these results highlight that both components introduced should be analyzed concurrently and suggest that the Global Ambulation Score may be a valuable outcome measure for longitudinal disease progression. Full article

(This article belongs to the Special Issue Bridging the Gap between Sensors’ Data and Clinically Relevant Outcomes in Movement and Gait Analysis)

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