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Sensors for Gait, Posture, and Health Monitoring

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

Deadline for manuscript submissions: closed (30 June 2019) | Viewed by 471725

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School of Biological and Health Systems Engineering, Ira A Fulton Schools of Engineering, Arizona State University, Tempe, AZ, USA
Interests: gait and posture; activity monitoring; fall risk assessment; nonlinear dynamics; biodynamics; wireless inertial sensors; wearables; musculoskeletal and neuro-rehabilitation
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Special Issue Information

Dear Colleagues,

In recent years, many technologies for gait and posture assessments have emerged. Wearable sensors, active and passive in-house monitors, and many combinations thereof all promise to provide accurate measures of gait and posture parameters. Motivated by market projections for wearable technologies and driven by recent technological innovations in wearable sensors (MEMs, electronic textiles, wireless communications, etc.) the wearable health/performance area is growing rapidly and has the potential to transform the future healthcare from disease treatment to disease prevention.

The objective of this Special Issue is to address and disseminate the latest gait and posture monitoring systems as well as various mathematical models/methods characterizing mobility functions. As such, in this special issue we call on those researchers who have used various sensor technologies and methods to assess gait and postural characteristics among varied populations.

This Special Issue focuses on wearable monitoring systems and physical sensors and its mathematical models that can be utilized in varied environments and varied conditions in monitoring health and performance.

Prof. Dr. Thurmon Lockhart
Guest Editor

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Published Papers (71 papers)

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13 pages, 3130 KiB  
Article
Identification of Gait Motion Patterns Using Wearable Inertial Sensor Network
by Kee S. Moon, Sung Q Lee, Yusuf Ozturk, Apoorva Gaidhani and Jeremiah A. Cox
Sensors 2019, 19(22), 5024; https://doi.org/10.3390/s19225024 - 18 Nov 2019
Cited by 11 | Viewed by 4359
Abstract
Gait signifies the walking pattern of an individual. It may be normal or abnormal, depending on the health condition of the individual. This paper considers the development of a gait sensor network system that uses a pair of wireless inertial measurement unit (IMU) [...] Read more.
Gait signifies the walking pattern of an individual. It may be normal or abnormal, depending on the health condition of the individual. This paper considers the development of a gait sensor network system that uses a pair of wireless inertial measurement unit (IMU) sensors to monitor the gait cycle of a user. The sensor information is used for determining the normality of movement of the leg. The sensor system places the IMU sensors on one of the legs to extract the three-dimensional angular motions of the hip and knee joints while walking. The wearable sensor is custom-made at San Diego State University with wireless data transmission capability. The system enables the user to collect gait data at any site, including in a non-laboratory environment. The paper also presents the mathematical calculations to decompose movements experienced by a pair of IMUs into individual and relative three directional hip and knee joint motions. Further, a new approach of gait pattern classification based on the phase difference angles between hip and knee joints is presented. The experimental results show a potential application of the classification method in the areas of smart detection of abnormal gait patterns. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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19 pages, 2754 KiB  
Article
Lower Limb Locomotion Activity Recognition of Healthy Individuals Using Semi-Markov Model and Single Wearable Inertial Sensor
by Haoyu Li, Stéphane Derrode and Wojciech Pieczynski
Sensors 2019, 19(19), 4242; https://doi.org/10.3390/s19194242 - 29 Sep 2019
Cited by 8 | Viewed by 3627
Abstract
Lower limb locomotion activity is of great interest in the field of human activity recognition. In this work, a triplet semi-Markov model-based method is proposed to recognize the locomotion activities of healthy individuals when lower limbs move periodically. In the proposed algorithm, the [...] Read more.
Lower limb locomotion activity is of great interest in the field of human activity recognition. In this work, a triplet semi-Markov model-based method is proposed to recognize the locomotion activities of healthy individuals when lower limbs move periodically. In the proposed algorithm, the gait phases (or leg phases) are introduced into the hidden states, and Gaussian mixture density is introduced to represent the complex conditioned observation density. The introduced sojourn state forms the semi-Markov structure, which naturally replicates the real transition of activity and gait during motion. Then, batch mode and on-line Expectation-Maximization (EM) algorithms are proposed, respectively, for model training and adaptive on-line recognition. The algorithm is tested on two datasets collected from wearable inertial sensors. The batch mode recognition accuracy reaches up to 95.16%, whereas the adaptive on-line recognition gradually obtains high accuracy after the time required for model updating. Experimental results show an improvement in performance compared to the other competitive algorithms. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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20 pages, 7432 KiB  
Article
Preliminary Clinical Application of Textile Insole Sensor for Hemiparetic Gait Pattern Analysis
by Changwon Wang, Young Kim, Hangsik Shin and Se Dong Min
Sensors 2019, 19(18), 3950; https://doi.org/10.3390/s19183950 - 12 Sep 2019
Cited by 29 | Viewed by 4627
Abstract
Post-stroke gait dysfunction occurs at a very high prevalence. A practical method to quantitatively analyze the characteristics of hemiparetic gait is needed in both clinical and community settings. This study developed a 10-channeled textile capacitive pressure sensing insole (TCPSI) with a real-time monitoring [...] Read more.
Post-stroke gait dysfunction occurs at a very high prevalence. A practical method to quantitatively analyze the characteristics of hemiparetic gait is needed in both clinical and community settings. This study developed a 10-channeled textile capacitive pressure sensing insole (TCPSI) with a real-time monitoring system and tested its performance through hemiparetic gait pattern analysis. Thirty-five subjects (18 hemiparetic, 17 healthy) walked down a 40-m long corridor at a comfortable speed while wearing TCPSI inside the shoe. For gait analysis, the percentage of the plantar pressure difference (PPD), the step count, the stride time, the coefficient of variation, and the phase coordination index (PCI) were used. The results of the stroke patients showed a threefold higher PPD, a higher step count (41.61 ± 10.7), a longer average stride time on the affected side, a lower mean plantar pressure on the affected side, higher plantar pressure in the toe area and the lateral side of the foot, and a threefold higher PCI (hemi: 19.50 ± 13.86%, healthy: 5.62 ± 5.05%) compared to healthy subjects. This study confirmed that TCPSI is a promising tool for distinguishing hemiparetic gait patterns and thus may be used as a wearable gait function evaluation tool, the external feedback gait training device, and a simple gait pattern analyzer for both hemiparetic patients and healthy individuals. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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18 pages, 2958 KiB  
Article
Appropriate Mother Wavelets for Continuous Gait Event Detection Based on Time-Frequency Analysis for Hemiplegic and Healthy Individuals
by Ning Ji, Hui Zhou, Kaifeng Guo, Oluwarotimi Williams Samuel, Zhen Huang, Lisheng Xu and Guanglin Li
Sensors 2019, 19(16), 3462; https://doi.org/10.3390/s19163462 - 8 Aug 2019
Cited by 29 | Viewed by 4290
Abstract
Gait event detection is a crucial step towards the effective assessment and rehabilitation of motor dysfunctions. Recently, the continuous wavelet transform (CWT) based methods have been increasingly proposed for gait event detection due to their robustness. However, few investigations on determining the appropriate [...] Read more.
Gait event detection is a crucial step towards the effective assessment and rehabilitation of motor dysfunctions. Recently, the continuous wavelet transform (CWT) based methods have been increasingly proposed for gait event detection due to their robustness. However, few investigations on determining the appropriate mother wavelet with proper selection criteria have been performed, especially for hemiplegic patients. In this study, the performances of commonly used mother wavelets in detecting gait events were systematically investigated. The acceleration signals from the tibialis anterior muscle of both healthy and hemiplegic subjects were recorded during ground walking and the two core gait events of heel strike (HS) and toe off (TO) were detected from the signal recordings by a CWT algorithm with different mother wavelets. Our results showed that the overall performance of the CWT algorithm in detecting the two gait events was significantly different when using various mother wavelets. By using different wavelet selection criteria, we also found that the accuracy criteria based on time-error minimization and F1-score maximization could provide the appropriate mother wavelet for gait event detection. The findings from this study will provide an insight on the selection of an appropriate mother wavelet for gait event detection and facilitate the development of adequate rehabilitation aids. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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14 pages, 1587 KiB  
Article
Reexamination of Accelerometer Calibration with Energy Expenditure as Criterion: VO2net Instead of MET for Age-Equivalent Physical Activity Intensity
by Daniel Arvidsson, Jonatan Fridolfsson, Christoph Buck, Örjan Ekblom, Elin Ekblom-Bak, Lauren Lissner, Monica Hunsberger and Mats Börjesson
Sensors 2019, 19(15), 3377; https://doi.org/10.3390/s19153377 - 1 Aug 2019
Cited by 21 | Viewed by 7132
Abstract
Accelerometer calibration for physical activity (PA) intensity is commonly performed using Metabolic Equivalent of Task (MET) as criterion. However, MET is not an age-equivalent measure of PA intensity, which limits the use of MET-calibrated accelerometers for age-related PA investigations. We investigated calibration using [...] Read more.
Accelerometer calibration for physical activity (PA) intensity is commonly performed using Metabolic Equivalent of Task (MET) as criterion. However, MET is not an age-equivalent measure of PA intensity, which limits the use of MET-calibrated accelerometers for age-related PA investigations. We investigated calibration using VO2net (VO2gross − VO2stand; mL⋅min−1⋅kg−1) as criterion compared to MET (VO2gross/VO2rest) and the effect on assessment of free-living PA in children, adolescents and adults. Oxygen consumption and hip/thigh accelerometer data were collected during rest, stand and treadmill walk and run. Equivalent speed (Speedeq) was used as indicator of the absolute speed (Speedabs) performed with the same effort in individuals of different body size/age. The results showed that VO2net was higher in younger age-groups for Speedabs, but was similar in the three age-groups for Speedeq. MET was lower in younger age-groups for both Speedabs and Speedeq. The same VO2net-values respective MET-values were applied to all age-groups to develop accelerometer PA intensity cut-points. Free-living moderate-and-vigorous PA was 216, 115, 74 and 71 min/d in children, adolescents, younger and older adults with VO2net-calibration, but 140, 83, 74 and 41 min/d with MET-calibration, respectively. In conclusion, VO2net calibration of accelerometers may provide age-equivalent measures of PA intensity/effort for more accurate age-related investigations of PA in epidemiological research. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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15 pages, 1920 KiB  
Article
Neurophysiological Characterization of a Non-Human Primate Model of Traumatic Spinal Cord Injury Utilizing Fine-Wire EMG Electrodes
by Farah Masood, Hussein A. Abdullah, Nitin Seth, Heather Simmons, Kevin Brunner, Ervin Sejdic, Dane R. Schalk, William A. Graham, Amber F. Hoggatt, Douglas L. Rosene, John B. Sledge and Shanker Nesathurai
Sensors 2019, 19(15), 3303; https://doi.org/10.3390/s19153303 - 27 Jul 2019
Cited by 4 | Viewed by 3827
Abstract
This study aims to characterize traumatic spinal cord injury (TSCI) neurophysiologically using an intramuscular fine-wire electromyography (EMG) electrode pair. EMG data were collected from an agonist-antagonist pair of tail muscles of Macaca fasicularis, pre- and post-lesion, and for a treatment and control group. [...] Read more.
This study aims to characterize traumatic spinal cord injury (TSCI) neurophysiologically using an intramuscular fine-wire electromyography (EMG) electrode pair. EMG data were collected from an agonist-antagonist pair of tail muscles of Macaca fasicularis, pre- and post-lesion, and for a treatment and control group. The EMG signals were decomposed into multi-resolution subsets using wavelet transforms (WT), then the relative power (RP) was calculated for each individual reconstructed EMG sub-band. Linear mixed models were developed to test three hypotheses: (i) asymmetrical volitional activity of left and right side tail muscles (ii) the effect of the experimental TSCI on the frequency content of the EMG signal, (iii) and the effect of an experimental treatment. The results from the electrode pair data suggested that there is asymmetry in the EMG response of the left and right side muscles (p-value < 0.001). This is consistent with the construct of limb dominance. The results also suggest that the lesion resulted in clear changes in the EMG frequency distribution in the post-lesion period with a significant increment in the low-frequency sub-bands (D4, D6, and A6) of the left and right side, also a significant reduction in the high-frequency sub-bands (D1 and D2) of the right side (p-value < 0.001). The preliminary results suggest that using the RP of the EMG data, the fine-wire intramuscular EMG electrode pair are a suitable method of monitoring and measuring treatment effects of experimental treatments for spinal cord injury (SCI). Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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17 pages, 2332 KiB  
Article
A Dynamic Time Warping Based Algorithm to Evaluate Kinect-Enabled Home-Based Physical Rehabilitation Exercises for Older People
by Xiaoqun Yu and Shuping Xiong
Sensors 2019, 19(13), 2882; https://doi.org/10.3390/s19132882 - 28 Jun 2019
Cited by 37 | Viewed by 5967
Abstract
Older people face difficulty engaging in conventional rehabilitation exercises for improving physical functions over a long time period due to the passive nature of the conventional exercise, inconvenience, and cost. This study aims to develop and validate a dynamic time warping (DTW) based [...] Read more.
Older people face difficulty engaging in conventional rehabilitation exercises for improving physical functions over a long time period due to the passive nature of the conventional exercise, inconvenience, and cost. This study aims to develop and validate a dynamic time warping (DTW) based algorithm for assessing Kinect-enabled home-based physical rehabilitation exercises, in order to support auto-coaching in a virtual gaming environment. A DTW-based algorithm was first applied to compute motion similarity between two time series from an individual user and a virtual coach. We chose eight bone vectors of the human skeleton and body orientation as the input features and proposed a simple but innovative method to further convert the DTW distance to a meaningful performance score in terms of the percentage (0–100%), without training data and experience of experts. The effectiveness of the proposed algorithm was validated through a follow-up experiment with 21 subjects when playing a Tai Chi exergame. Results showed that the algorithm scores had a strong positive linear relationship (r = 0.86) with experts’ ratings and the calibrated algorithm scores were comparable to the gold standard. These findings suggested that the DTW-based algorithm could be effectively used for automatic performance evaluation of an individual when performing home-based rehabilitation exercises. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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11 pages, 2931 KiB  
Article
A Sensor Array for the Measurement of Relative Motion in Lower Limb Prosthetic Sockets
by Veronika Noll, Sigrid Whitmore, Philipp Beckerle and Stephan Rinderknecht
Sensors 2019, 19(12), 2658; https://doi.org/10.3390/s19122658 - 12 Jun 2019
Cited by 6 | Viewed by 4470
Abstract
The relative motion between residual limb and prosthetic socket could be a relevant factor in quantifying socket fit. The measurement of these movements, particularly in dynamic gait situations, poses a challenging task. This paper presents the realization of a measurement concept based on [...] Read more.
The relative motion between residual limb and prosthetic socket could be a relevant factor in quantifying socket fit. The measurement of these movements, particularly in dynamic gait situations, poses a challenging task. This paper presents the realization of a measurement concept based on multiple optical 2D-motion sensors. The performance of the system was evaluated on a test rig considering accuracy and precision as well as accomplished measurement frequency and reliability of the system. Additionally, results of a pilot study measuring the relative motion between residual limb and prosthetic socket at seven specific locations of one individual with transtibial amputation during straight level walking are presented. The sensor functionality of the array was confirmed and the test rig experiments were comparable to the previously tested functional model ( e r r rel = 0.52 ± 1.87 %). With a sampling frequency of 1.3 kHz to be distributed among the number of sensor units, the developed system is suitable for investigating the relative movement between residual limb and prosthetic socket in dynamic gait situations. Results of the pilot study show the majority of relative motion occurring during the second half of the gait cycle. The measured relative motions show the residual limb sinking deeper into the socket, extending in the Sagittal plane and rotating internally in the Transverse plane during stance phase. Data captured during swing phase indicate a lower limb extension in the Sagittal plane as well as an external rotation in the Transverse plane. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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11 pages, 1206 KiB  
Article
Validity of the Walked Distance Estimated by Wearable Devices in Stroke Individuals
by Maxence Compagnat, Charles Sebiyo Batcho, Romain David, Nicolas Vuillerme, Jean Yves Salle, Jean Christophe Daviet and Stéphane Mandigout
Sensors 2019, 19(11), 2497; https://doi.org/10.3390/s19112497 - 31 May 2019
Cited by 19 | Viewed by 4035
Abstract
Background: Health professionals need valid devices to assess a stroke individual’s ability to walk. The aim was to evaluate the validity of the estimation of the walked distance by wearable devices and the impact of the sensor’s position in stroke individuals. Methods: Post-stroke [...] Read more.
Background: Health professionals need valid devices to assess a stroke individual’s ability to walk. The aim was to evaluate the validity of the estimation of the walked distance by wearable devices and the impact of the sensor’s position in stroke individuals. Methods: Post-stroke patients able to walk without human assistance were equipped with several wearable devices: pedometers, Actigraph, and Sensewear Armband placed according to the manufacturers' recommendations. Participants walked for 6 min at a comfortable speed wearing all sensors at the same time. We analyzed the validity of sensor-estimated distances according to their position using Bland–Altman analysis, root-mean-square error, and coefficient of correlation. Results: In total, 35 individuals were included (mean age = 65 ± 15 years). The best estimations were given by the Actigraph worn on the unaffected ankle (mean bias (MB) = 22.6 ± 32.4 m; p = 0.37) and by the pedometer worn on the unaffected hip (MB = 20.5 ± 24.6 m; p = 0.46). The other sensors and positions provided large estimation errors over 95 m (p < 0.05). Conclusion: This study led to a recommendation of a pedometer worn on the unaffected hip or an Actigraph worn on the unaffected ankle to get a valid estimation of the distance walked by stroke individuals. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 257 KiB  
Article
Electromyographic Evaluation of the Impacts of Different Insoles in the Activity Patterns of the Lower Limb Muscles during Sport Motorcycling: A Cross-Over Trial
by Israel Casado-Hernández, Ricardo Becerro-de-Bengoa-Vallejo, Marta Elena Losa-Iglesias, Daniel López-López, David Rodríguez-Sanz, Eva María Martínez-Jiménez and César Calvo-Lobo
Sensors 2019, 19(10), 2249; https://doi.org/10.3390/s19102249 - 15 May 2019
Cited by 3 | Viewed by 3173
Abstract
Customized foot insoles (CFI) have been recognized to reduce the prevalence of foot disorders in sport. The aim of this study was to evaluate the effect of four types of CFI on the activity patterns of the lower limb muscles (LLM) in healthy [...] Read more.
Customized foot insoles (CFI) have been recognized to reduce the prevalence of foot disorders in sport. The aim of this study was to evaluate the effect of four types of CFI on the activity patterns of the lower limb muscles (LLM) in healthy people during sport motorcycling. Methods: This was a cross-over trial (NCT03734133. Participants were recruited from an outpatient foot specialist clinic. Their mean age was 33 ± 5.14 years. While participants were sport motorcycling in a simulator, the electromyography (EMG) function was registered for LLM via surface electrodes. Participants completed separate tests while wearing one of four types of CFI: (1) only polypropylene (58° Shore D), (2) selective aluminum (60 HB Brinell hardness) in metatarsal and first hallux areas and polypropylene elsewhere (58° Shore D), (3) ethylene vinyl acetate (EVA) (52° Shore A), and (4) standard EVA (25° Shore A) as the control. Results: The activity patterns of the LLM while sport motorcycling showed significantly lower peak amplitude for the selective aluminum CFI than the other types of CFI. Conclusion: EMG amplitude peaks for several LLM were smaller for the hardest CFI (selective aluminum 60 HB Brinell hardness) than the other CFIs (polypropylene 58° Shore D, EVA 52° Shore A, and standard EVA 25° Shore A), except for the fibularis longus in right curves that is increased when the knee touches the road increasing the stability. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
8 pages, 1298 KiB  
Article
Ultrasonography Features of the Plantar Fascia Complex in Patients with Chronic Non-Insertional Achilles Tendinopathy: A Case-Control Study
by Carlos Romero-Morales, Pedro Javier Martín-Llantino, César Calvo-Lobo, Daniel López-López, Rubén Sánchez-Gómez, Blanca De-La-Cruz-Torres and David Rodríguez-Sanz
Sensors 2019, 19(9), 2052; https://doi.org/10.3390/s19092052 - 2 May 2019
Cited by 20 | Viewed by 8938
Abstract
Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy [...] Read more.
Purpose: The goal of the present study was to assess, by ultrasound imaging (USI), the thickness of the plantar fascia (PF) at the insertion of the calcaneus, mid and forefoot fascial locations, and the calcaneal fat pad (CFP) in patients with Achilles tendinopathy (AT). Methods: An observational case-control study. A total sample of 143 individuals from 18 to 55 years was evaluated by USI in the study. The sample was divided into two groups: A group composed of the chronic non-insertional AT (n = 71) and B group comprised by healthy subjects (n = 72). The PF thicknesses at insertion on the calcaneus, midfoot, rearfoot and CFP were evaluated by USI. Results: the CFP and PF at the calcaneus thickness showed statistically significant differences (P < 0.01) with a decrease for the tendinopathy group with respect to the control group. For the PF midfoot and forefoot thickness, no significant differences (P > 0.05) were observed between groups. Conclusion: The thickness of the PF at the insertion and the CPF is reduced in patients with AT measured by USI. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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18 pages, 1997 KiB  
Article
Heel Height as an Etiology of Hallux Abductus Valgus Development: An electromagnetic Static and Dynamic First Metatarsophalangeal Joint Study
by Rubén Sánchez-Gómez, Ricardo Becerro de Bengoa-Vallejo, Marta Elena Losa-Iglesias, César Calvo-Lobo, Carlos Romero-Morales, Eva María Martínez-Jiménez, Patricia Palomo-López and Daniel López-López
Sensors 2019, 19(6), 1328; https://doi.org/10.3390/s19061328 - 16 Mar 2019
Cited by 7 | Viewed by 5253
Abstract
Background: Hallux abductus valgus (HAV) is a forefoot condition produced by extrinsic and intrinsic factors. Shoes with a high heel height and a typical narrow tip toe box can induce deviations in both the proximal phalanx of the hallux (PPH) and the first [...] Read more.
Background: Hallux abductus valgus (HAV) is a forefoot condition produced by extrinsic and intrinsic factors. Shoes with a high heel height and a typical narrow tip toe box can induce deviations in both the proximal phalanx of the hallux (PPH) and the first metatarsal (IMTT) bones. Nevertheless, the isolated role of heel height remains unclear in the development of HAV pathology. Objectives: The goal was to determine if the heel height increase of shoes without a narrow box toe could augment the PPH and IMTT deviation in frontal, sagittal, and transverse planes toward the first metatarsophalangeal joint (MPJ) and the first metatarsocuneiform joint (MCJ), respectively, during static and dynamic conditions in relation to precursor movements of HAV. Methods: Women with an average age of 25.10 ± 4.67 years were recruited in this cross-sectional study to assess the three planes of motion of PPH and IMTT while wearing high heels with heights at 3, 6, 9 cm and unshod conditions via sandals. The measurements used an electromagnetic goniometer device with sensors placed on medial aspects of the PPH and IMTT bones under static and dynamic conditions. Results: Wearing shoes with a 6 cm heel in dynamic condition may increase the PPH valgus and abduction deviation from 3.15 ± 0.10° to 3.46 ± 0.05° (p < 0.05) and from 1.35 ± 0.28° to 1.69 ± 0.30° (p < 0.001), respectively. In addition, a PPH abduction increase from 1.01 ± 0.36° to 1.31 ± 0.46° (p < 0.05) after wearing shoes with a 6 cm heel height was observed under static conditions. Conclusions: Wearing shoes with a heel height of 6 cm without a narrow box toe interference may produce PPH abduction and valgus deviations related to HAV formation. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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21 pages, 3152 KiB  
Article
Feasibility of Home-Based Automated Assessment of Postural Instability and Lower Limb Impairments in Parkinson’s Disease
by Claudia Ferraris, Roberto Nerino, Antonio Chimienti, Giuseppe Pettiti, Nicola Cau, Veronica Cimolin, Corrado Azzaro, Lorenzo Priano and Alessandro Mauro
Sensors 2019, 19(5), 1129; https://doi.org/10.3390/s19051129 - 5 Mar 2019
Cited by 38 | Viewed by 5209
Abstract
A self-managed, home-based system for the automated assessment of a selected set of Parkinson’s disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation [...] Read more.
A self-managed, home-based system for the automated assessment of a selected set of Parkinson’s disease motor symptoms is presented. The system makes use of an optical RGB-Depth device both to implement its gesture-based human computer interface and for the characterization and the evaluation of posture and motor tasks, which are specified according to the Unified Parkinson’s Disease Rating Scale (UPDRS). Posture, lower limb movements and postural instability are characterized by kinematic parameters of the patient movement. During an experimental campaign, the performances of patients affected by Parkinson’s disease were simultaneously scored by neurologists and analyzed by the system. The sets of parameters which best correlated with the UPDRS scores of subjects’ performances were then used to train supervised classifiers for the automated assessment of new instances of the tasks. Results on the system usability and the assessment accuracy, as compared to clinical evaluations, indicate that the system is feasible for an objective and automated assessment of Parkinson’s disease at home, and it could be the basis for the development of neuromonitoring and neurorehabilitation applications in a telemedicine framework. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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14 pages, 1496 KiB  
Article
Effects of Gait Strategy and Speed on Regularity of Locomotion Assessed in Healthy Subjects Using a Multi-Sensor Method
by Marco Rabuffetti, Giovanni Marco Scalera and Maurizio Ferrarin
Sensors 2019, 19(3), 513; https://doi.org/10.3390/s19030513 - 26 Jan 2019
Cited by 17 | Viewed by 5151
Abstract
The regularity of pseudo-periodic human movements, including locomotion, can be assessed by autocorrelation analysis of measurements using inertial sensors. Though sensors are generally placed on the trunk or pelvis, movement regularity can be assessed at any body location. Pathological factors are expected to [...] Read more.
The regularity of pseudo-periodic human movements, including locomotion, can be assessed by autocorrelation analysis of measurements using inertial sensors. Though sensors are generally placed on the trunk or pelvis, movement regularity can be assessed at any body location. Pathological factors are expected to reduce regularity either globally or on specific anatomical subparts. However, other non-pathological factors, including gait strategy (walking and running) and speed, modulate locomotion regularity, thus potentially confounding the identification of the pathological factor. The present study’s objectives were (1) to define a multi-sensor method based on the autocorrelation analysis of the acceleration module (norm of the acceleration vector) to quantify regularity; (2) to conduct an experimental study on healthy adult subjects to quantify the effect on movement regularity of gait strategy (walking and running at the same velocity), gait speed (four speeds, lower three for walking, upper two for running), and sensor location (on four different body parts). Twenty-five healthy adults participated and four triaxial accelerometers were located on the seventh cervical vertebra (C7), pelvis, wrist, and ankle. The results showed that increasing velocity was associated with increasing regularity only for walking, while no difference in regularity was observed between walking and running. Regularity was generally highest at C7 and ankle, and lowest at the wrist. These data confirm and complement previous literature on regularity assessed on the trunk, and will support future analyses on individuals or groups with specific pathologies affecting locomotor functions. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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13 pages, 11014 KiB  
Article
Weight-Bearing Estimation for Cane Users by Using Onboard Sensors
by Joaquin Ballesteros, Alberto Tudela, Juan Rafael Caro-Romero and Cristina Urdiales
Sensors 2019, 19(3), 509; https://doi.org/10.3390/s19030509 - 26 Jan 2019
Cited by 9 | Viewed by 7084
Abstract
Mobility is a fundamental requirement for a healthy, active lifestyle. Gait analysis is widely acknowledged as a clinically useful tool for identifying problems with mobility, as identifying abnormalities within the gait profile is essential to correct them via training, drugs, or surgical intervention. [...] Read more.
Mobility is a fundamental requirement for a healthy, active lifestyle. Gait analysis is widely acknowledged as a clinically useful tool for identifying problems with mobility, as identifying abnormalities within the gait profile is essential to correct them via training, drugs, or surgical intervention. However, continuous gait analysis is difficult to achieve due to technical limitations, namely the need for specific hardware and constraints on time and test environment to acquire reliable data. Wearables may provide a solution if users carry them most of the time they are walking. We propose to add sensors to walking canes to assess user’s mobility. Canes are frequently used by people who cannot completely support their own weight due to pain or balance issues. Furthermore, in absence of neurological disorders, the load on the cane is correlated with the user condition. Sensorized canes already exist, but often rely on expensive sensors and major device modifications are required. Thus, the number of potential users is severely limited. In this work, we propose an affordable module for load monitoring so that it can be widely used as a screening tool. The main advantages of our module are: (i) it can be deployed in any standard cane with minimal changes that do not affect ergonomics; (ii) it can be used every day, anywhere for long-term monitoring. We have validated our prototype with 10 different elderly volunteers that required a cane to walk, either for balance or partial weight bearing. Volunteers were asked to complete a 10 m test and, then, to move freely for an extra minute. The load peaks on the cane, corresponding to maximum support instants during the gait cycle, were measured while they moved. For validation, we calculated their gait speed using a chronometer during the 10 m test, as it is reportedly related to their condition. The correlation between speed (condition) and load results proves that our module provides meaningful information for screening. In conclusion, our module monitors support in a continuous, unsupervised, nonintrusive way during users’ daily routines, plus only mechanical adjustment (cane height) is needed to change from one user to another. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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23 pages, 4102 KiB  
Article
Gradient-Based Multi-Objective Feature Selection for Gait Mode Recognition of Transfemoral Amputees
by Gholamreza Khademi, Hanieh Mohammadi and Dan Simon
Sensors 2019, 19(2), 253; https://doi.org/10.3390/s19020253 - 10 Jan 2019
Cited by 18 | Viewed by 4558
Abstract
One control challenge in prosthetic legs is seamless transition from one gait mode to another. User intent recognition (UIR) is a high-level controller that tells a low-level controller to switch to the identified activity mode, depending on the user’s intent and environment. We [...] Read more.
One control challenge in prosthetic legs is seamless transition from one gait mode to another. User intent recognition (UIR) is a high-level controller that tells a low-level controller to switch to the identified activity mode, depending on the user’s intent and environment. We propose a new framework to design an optimal UIR system with simultaneous maximum performance and minimum complexity for gait mode recognition. We use multi-objective optimization (MOO) to find an optimal feature subset that creates a trade-off between these two conflicting objectives. The main contribution of this paper is two-fold: (1) a new gradient-based multi-objective feature selection (GMOFS) method for optimal UIR design; and (2) the application of advanced evolutionary MOO methods for UIR. GMOFS is an embedded method that simultaneously performs feature selection and classification by incorporating an elastic net in multilayer perceptron neural network training. Experimental data are collected from six subjects, including three able-bodied subjects and three transfemoral amputees. We implement GMOFS and four variants of multi-objective biogeography-based optimization (MOBBO) for optimal feature subset selection, and we compare their performances using normalized hypervolume and relative coverage. GMOFS demonstrates competitive performance compared to the four MOBBO methods. We achieve a mean classification accuracy of 97.14 % ± 1.51 % and 98.45 % ± 1.22 % with the optimal selected subset for able-bodied and amputee subjects, respectively, while using only 23% of the available features. Results thus indicate the potential of advanced optimization methods to simultaneously achieve accurate, reliable, and compact UIR for locomotion mode detection of lower-limb amputees with prostheses. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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10 pages, 3894 KiB  
Article
Validation of an Inertial Sensor Algorithm to Quantify Head and Trunk Movement in Healthy Young Adults and Individuals with Mild Traumatic Brain Injury
by Lucy Parrington, Deborah A. Jehu, Peter C. Fino, Sean Pearson, Mahmoud El-Gohary and Laurie A. King
Sensors 2018, 18(12), 4501; https://doi.org/10.3390/s18124501 - 19 Dec 2018
Cited by 14 | Viewed by 4763
Abstract
Wearable inertial measurement units (IMUs) may provide useful, objective information to clinicians interested in quantifying head movements as patients’ progress through vestibular rehabilitation. The purpose of this study was to validate an IMU-based algorithm against criterion data (motion capture) to estimate average head [...] Read more.
Wearable inertial measurement units (IMUs) may provide useful, objective information to clinicians interested in quantifying head movements as patients’ progress through vestibular rehabilitation. The purpose of this study was to validate an IMU-based algorithm against criterion data (motion capture) to estimate average head and trunk range of motion (ROM) and average peak velocity. Ten participants completed two trials of standing and walking tasks while moving the head with and without moving the trunk. Validity was assessed using a combination of Intra-class Correlation Coefficients (ICC), root mean square error (RMSE), and percent error. Bland-Altman plots were used to assess bias. Excellent agreement was found between the IMU and criterion data for head ROM and peak rotational velocity (average ICC > 0.9). The trunk showed good agreement for most conditions (average ICC > 0.8). Average RMSE for both ROM (head = 2.64°; trunk = 2.48°) and peak rotational velocity (head = 11.76 °/s; trunk = 7.37 °/s) was low. The average percent error was below 5% for head and trunk ROM and peak rotational velocity. No clear pattern of bias was found for any measure across conditions. Findings suggest IMUs may provide a promising solution for estimating head and trunk movement, and a practical solution for tracking progression throughout rehabilitation or home exercise monitoring. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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22 pages, 4771 KiB  
Article
Comparison of Different Algorithms for Calculating Velocity and Stride Length in Running Using Inertial Measurement Units
by Markus Zrenner, Stefan Gradl, Ulf Jensen, Martin Ullrich and Bjoern M. Eskofier
Sensors 2018, 18(12), 4194; https://doi.org/10.3390/s18124194 - 30 Nov 2018
Cited by 39 | Viewed by 7520
Abstract
Running has a positive impact on human health and is an accessible sport for most people. There is high demand for tracking running performance and progress for amateurs and professionals alike. The parameters velocity and distance are thereby of main interest. In this [...] Read more.
Running has a positive impact on human health and is an accessible sport for most people. There is high demand for tracking running performance and progress for amateurs and professionals alike. The parameters velocity and distance are thereby of main interest. In this work, we evaluate the accuracy of four algorithms, which calculate the stride velocity and stride length during running using data of an inertial measurement unit (IMU) placed in the midsole of a running shoe. The four algorithms are based on stride time, foot acceleration, foot trajectory estimation, and deep learning, respectively. They are compared using two studies: a laboratory-based study comprising 2377 strides from 27 subjects with 3D motion tracking as a reference and a field study comprising 12 subjects performing a 3.2-km run in a real-world setup. The results show that the foot trajectory estimation algorithm performs best, achieving a mean error of 0.032 ± 0.274 m/s for the velocity estimation and 0.022 ± 0.157 m for the stride length. An interesting alternative for systems with a low energy budget is the acceleration-based approach. Our results support the implementation decision for running velocity and distance tracking using IMUs embedded in the sole of a running shoe. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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19 pages, 3768 KiB  
Article
Classification of Human Daily Activities Using Ensemble Methods Based on Smartphone Inertial Sensors
by Ku Nurhanim Ku Abd. Rahim, I. Elamvazuthi, Lila Iznita Izhar and Genci Capi
Sensors 2018, 18(12), 4132; https://doi.org/10.3390/s18124132 - 26 Nov 2018
Cited by 47 | Viewed by 6684
Abstract
Increasing interest in analyzing human gait using various wearable sensors, which is known as Human Activity Recognition (HAR), can be found in recent research. Sensors such as accelerometers and gyroscopes are widely used in HAR. Recently, high interest has been shown in the [...] Read more.
Increasing interest in analyzing human gait using various wearable sensors, which is known as Human Activity Recognition (HAR), can be found in recent research. Sensors such as accelerometers and gyroscopes are widely used in HAR. Recently, high interest has been shown in the use of wearable sensors in numerous applications such as rehabilitation, computer games, animation, filmmaking, and biomechanics. In this paper, classification of human daily activities using Ensemble Methods based on data acquired from smartphone inertial sensors involving about 30 subjects with six different activities is discussed. The six daily activities are walking, walking upstairs, walking downstairs, sitting, standing and lying. It involved three stages of activity recognition; namely, data signal processing (filtering and segmentation), feature extraction and classification. Five types of ensemble classifiers utilized are Bagging, Adaboost, Rotation forest, Ensembles of nested dichotomies (END) and Random subspace. These ensemble classifiers employed Support vector machine (SVM) and Random forest (RF) as the base learners of the ensemble classifiers. The data classification is evaluated with the holdout and 10-fold cross-validation evaluation methods. The performance of each human daily activity was measured in terms of precision, recall, F-measure, and receiver operating characteristic (ROC) curve. In addition, the performance is also measured based on the comparison of overall accuracy rate of classification between different ensemble classifiers and base learners. It was observed that overall, SVM produced better accuracy rate with 99.22% compared to RF with 97.91% based on a random subspace ensemble classifier. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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11 pages, 3952 KiB  
Article
A Batteryless, Wireless Strain Sensor Using Resonant Frequency Modulation
by Kyeong Jae Lee, Namsun Chou and Sohee Kim
Sensors 2018, 18(11), 3955; https://doi.org/10.3390/s18113955 - 15 Nov 2018
Cited by 11 | Viewed by 4948
Abstract
In this study, we demonstrated the feasibility of a wireless strain sensor using resonant frequency modulation through tensile impedance test and wireless sensing test. To achieve a high stretchability, the sensor was fabricated by embedding a copper wire with high conductivity in a [...] Read more.
In this study, we demonstrated the feasibility of a wireless strain sensor using resonant frequency modulation through tensile impedance test and wireless sensing test. To achieve a high stretchability, the sensor was fabricated by embedding a copper wire with high conductivity in a silicone rubber with high stretchability, in which the resonant frequency can be modulated according to changes in strain. The characteristics of the sensor and the behavior of wireless sensing were calculated based on equations and simulated using finite element method. As the strain of the sensor increased, the inductance increased, resulting in the modulation of resonant frequency. In experimental measurement, as the strain of the sensor increased from 0% to 110%, its inductance was increased from 192 nH to 220 nH, changed by 14.5%, and the resonant frequency was shifted from 13.56 MHz to 12.72 MHz, decreased by 6.2%. It was demonstrated that using the proposed sensor, strains up to 110% could be detected wirelessly up to a few centimeters. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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25 pages, 3520 KiB  
Article
A Unified Deep-Learning Model for Classifying the Cross-Country Skiing Techniques Using Wearable Gyroscope Sensors
by Jihyeok Jang, Ankit Ankit, Jinhyeok Kim, Young Jae Jang, Hye Young Kim, Jin Hae Kim and Shuping Xiong
Sensors 2018, 18(11), 3819; https://doi.org/10.3390/s18113819 - 7 Nov 2018
Cited by 19 | Viewed by 4706
Abstract
The automatic classification of cross-country (XC) skiing techniques using data from wearable sensors has the potential to provide insights for optimizing the performance of professional skiers. In this paper, we propose a unified deep learning model for classifying eight techniques used in classical [...] Read more.
The automatic classification of cross-country (XC) skiing techniques using data from wearable sensors has the potential to provide insights for optimizing the performance of professional skiers. In this paper, we propose a unified deep learning model for classifying eight techniques used in classical and skating styles XC-skiing and optimize this model for the number of gyroscope sensors by analyzing the results for five different configurations of sensors. We collected data of four professional skiers on outdoor flat and natural courses. The model is first trained over the flat course data of two skiers and tested over the flat and natural course data of a third skier in a leave-one-out fashion, resulting in a mean accuracy of ~80% over three combinations. Secondly, the model is trained over the flat course data of three skiers and tested over flat course and natural course data of one new skier, resulting in a mean accuracy of 87.2% and 95.1% respectively, using the optimal sensor configuration (five gyroscope sensors: both hands, both feet, and the pelvis). High classification accuracy obtained using both approaches indicates that this deep learning model has the potential to be deployed for real-time classification of skiing techniques by professional skiers and coaches. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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14 pages, 3300 KiB  
Article
The Design and Application of Simplified Insole-Based Prototypes with Plantar Pressure Measurement for Fast Screening of Flat-Foot
by Wei-Chun Hsu, Tommy Sugiarto, Jun-Wen Chen and Yi-Jia Lin
Sensors 2018, 18(11), 3617; https://doi.org/10.3390/s18113617 - 25 Oct 2018
Cited by 24 | Viewed by 6577
Abstract
This study aimed to find the correlation between conventional Arch Index (AI) measurements and our prototype of a simplified insole-based plantar pressure measurement system and to find out the effective plantar pressure sensor position. Twenty-one subjects participated in this study, which was divided [...] Read more.
This study aimed to find the correlation between conventional Arch Index (AI) measurements and our prototype of a simplified insole-based plantar pressure measurement system and to find out the effective plantar pressure sensor position. Twenty-one subjects participated in this study, which was divided into two groups: 10 subjects with flatfoot and 11 subjects with normal foot. Five force sensitive resistance sensors were used on this prototype using Arduino as the data acquisition device. Two types of trials, namely static and dynamic, were conducted to validate our system against the ink-type AI measurement as a golden standard. The results showed that in the static trial, there was a high linear correlation with the medial arch sensor configuration, while in the dynamic trial, there was a high linear correlation in the medial arch sensor configuration and sensor 5 configuration. This study showed that both static and dynamic tests using the self-developed device could effectively determine most of the flatfoot subjects and suggests that in the future, it can be applied in clinical applications because of its advantages when compared to the expensive-high tech graphic input board and conventional tools, like ink-type based measurements. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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23 pages, 836 KiB  
Article
Context Impacts in Accelerometer-Based Walk Detection and Step Counting
by Buke Ao, Yongcai Wang, Hongnan Liu, Deying Li, Lei Song and Jianqiang Li
Sensors 2018, 18(11), 3604; https://doi.org/10.3390/s18113604 - 24 Oct 2018
Cited by 9 | Viewed by 4232
Abstract
Walk detection (WD) and step counting (SC) have become popular applications in the recent emergence of wearable devices. These devices monitor user states and process data from MEMS-based accelerometers and optional gyroscope sensors. Various algorithms have been proposed for WD and SC, which [...] Read more.
Walk detection (WD) and step counting (SC) have become popular applications in the recent emergence of wearable devices. These devices monitor user states and process data from MEMS-based accelerometers and optional gyroscope sensors. Various algorithms have been proposed for WD and SC, which are generally sensitive to the contexts of applications, i.e., (1) the locations of sensor placement; (2) the sensor orientations; (3) the user’s walking patterns; (4) the preprocessing window sizes; and (5) the sensor sampling rates. A thorough understanding of how these dynamic factors affect the algorithms’ performances is investigated and compared in this paper. In particular, representative WD and SC algorithms are introduced according to their design methodologies. A series of experiments is designed in consideration of different application contexts to form an experimental dataset. Different algorithms are then implemented and evaluated on the dataset. The evaluation results provide a quantitative performance comparison indicating the advantages and weaknesses of different algorithms under different application scenarios, giving valuable guidance for algorithm selection in practical applications. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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14 pages, 2372 KiB  
Article
Gait Study of Parkinson’s Disease Subjects Using Haptic Cues with A Motorized Walker
by Minhua Zhang, N. Sertac Artan, Huanying Gu, Ziqian Dong, Lyudmila Burina Ganatra, Suzanna Shermon and Ely Rabin
Sensors 2018, 18(10), 3549; https://doi.org/10.3390/s18103549 - 19 Oct 2018
Cited by 20 | Viewed by 5331
Abstract
Gait abnormalities are one of the distinguishing symptoms of patients with Parkinson’s disease (PD) that contribute to fall risk. Our study compares the gait parameters of people with PD when they walk through a predefined course under different haptic speed cue conditions (1) [...] Read more.
Gait abnormalities are one of the distinguishing symptoms of patients with Parkinson’s disease (PD) that contribute to fall risk. Our study compares the gait parameters of people with PD when they walk through a predefined course under different haptic speed cue conditions (1) without assistance, (2) pushing a conventional rolling walker, and (3) holding onto a self-navigating motorized walker under different speed cues. Six people with PD were recruited at the New York Institute of Technology College of Osteopathic Medicine to participate in this study. Spatial posture and gait data of the test subjects were collected via a VICON motion capture system. We developed a framework to process and extract gait features and applied statistical analysis on these features to examine the significance of the findings. The results showed that the motorized walker providing a robust haptic cue significantly improved gait symmetry of PD subjects. Specifically, the asymmetry index of the gait cycle time was reduced from 6.7% when walking without assistance to 0.56% and below when using a walker. Furthermore, the double support time of a gait cycle was reduced by 4.88% compared to walking without assistance. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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22 pages, 3522 KiB  
Article
A Self-Managed System for Automated Assessment of UPDRS Upper Limb Tasks in Parkinson’s Disease
by Claudia Ferraris, Roberto Nerino, Antonio Chimienti, Giuseppe Pettiti, Nicola Cau, Veronica Cimolin, Corrado Azzaro, Giovanni Albani, Lorenzo Priano and Alessandro Mauro
Sensors 2018, 18(10), 3523; https://doi.org/10.3390/s18103523 - 18 Oct 2018
Cited by 39 | Viewed by 4918
Abstract
A home-based, reliable, objective and automated assessment of motor performance of patients affected by Parkinson’s Disease (PD) is important in disease management, both to monitor therapy efficacy and to reduce costs and discomforts. In this context, we have developed a self-managed system for [...] Read more.
A home-based, reliable, objective and automated assessment of motor performance of patients affected by Parkinson’s Disease (PD) is important in disease management, both to monitor therapy efficacy and to reduce costs and discomforts. In this context, we have developed a self-managed system for the automated assessment of the PD upper limb motor tasks as specified by the Unified Parkinson’s Disease Rating Scale (UPDRS). The system is built around a Human Computer Interface (HCI) based on an optical RGB-Depth device and a replicable software. The HCI accuracy and reliability of the hand tracking compares favorably against consumer hand tracking devices as verified by an optoelectronic system as reference. The interface allows gestural interactions with visual feedback, providing a system management suitable for motor impaired users. The system software characterizes hand movements by kinematic parameters of their trajectories. The correlation between selected parameters and clinical UPDRS scores of patient performance is used to assess new task instances by a machine learning approach based on supervised classifiers. The classifiers have been trained by an experimental campaign on cohorts of PD patients. Experimental results show that automated assessments of the system replicate clinical ones, demonstrating its effectiveness in home monitoring of PD. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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14 pages, 4882 KiB  
Article
A Fuzzy Tuned and Second Estimator of the Optimal Quaternion Complementary Filter for Human Motion Measurement with Inertial and Magnetic Sensors
by Xiaoyue Zhang and Wan Xiao
Sensors 2018, 18(10), 3517; https://doi.org/10.3390/s18103517 - 18 Oct 2018
Cited by 8 | Viewed by 3022
Abstract
To accurately measure human motion at high-speed, we proposed a simple structure complementary filter, named the Fuzzy Tuned and Second EStimator of the Optimal Quaternion Complementary Filter (FTECF). The FTECF is applicable to inertial and magnetic sensors, which include tri-axis gyroscopes, tri-axis accelerometers, [...] Read more.
To accurately measure human motion at high-speed, we proposed a simple structure complementary filter, named the Fuzzy Tuned and Second EStimator of the Optimal Quaternion Complementary Filter (FTECF). The FTECF is applicable to inertial and magnetic sensors, which include tri-axis gyroscopes, tri-axis accelerometers, and tri-axis magnetometers. More specifically, the proposed method incorporates three parts, the input quaternion, the reference quaternion, and the fuzzy logic algorithm. At first, the input quaternion was calculated with gyroscopes. Then, the reference quaternion was calculated by applying the Second EStimator of the Optimal Quaternion (ESOQ-2) algorithm on accelerometers and magnetometers. In addition, we added compensation for accelerometers in the ESOQ-2 algorithm so as to eliminate the effects of limb motion acceleration in high-speed human motion measurements. Finally, the fuzzy logic was utilized to calculate the fusion factor for a complementary filter, so as to adaptively fuse the input quaternion with the reference quaternion. Additionally, the overall algorithm design is more simplified than traditional methods. Confirmed by the experiments, using a commercial inertial and magnetic sensors unit and an optical motion capture system, the efficiency of the proposed method was more improved than two well-known methods. The root mean square error (RMSE) of the FTECF was less than 2.2° and the maximum error was less than 5.4°. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 2150 KiB  
Article
Inertial Sensor Angular Velocities Reflect Dynamic Knee Loading during Single Limb Loading in Individuals Following Anterior Cruciate Ligament Reconstruction
by Kristamarie A. Pratt and Susan M. Sigward
Sensors 2018, 18(10), 3460; https://doi.org/10.3390/s18103460 - 15 Oct 2018
Cited by 23 | Viewed by 6634
Abstract
Difficulty quantifying knee loading deficits clinically in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. Expense associated with quantifying knee moments (KMom) and power (KPow) with gold standard techniques precludes their use in the clinic. As segment and joint kinematics [...] Read more.
Difficulty quantifying knee loading deficits clinically in individuals following anterior cruciate ligament reconstruction (ACLr) may underlie their persistence. Expense associated with quantifying knee moments (KMom) and power (KPow) with gold standard techniques precludes their use in the clinic. As segment and joint kinematics are used to calculate moments and power, it is possible that more accessible inertial sensor technology can be used to identify knee loading deficits. However, it is unknown if angular velocities measured with inertial sensors provide meaningful information regarding KMom/KPow during dynamic tasks post-ACLr. Twenty-one individuals 5.1 ± 1.5 months post-ACLr performed a single limb loading task, bilaterally. Data collected concurrently using a marker-based motion system and gyroscopes positioned lateral thighs/shanks. Intraclass correlation coefficients (ICC)(2,k) determined concurrent validity. To determine predictive ability of angular velocities for KMom/KPow, separate stepwise linear regressions performed using peak thigh, shank, and knee angular velocities extracted from gyroscopes. ICCs were greater than 0.947 (p < 0.001) for all variables. Thigh (r = 0.812 and r = 0.585; p < 0.001) and knee (r = 0.806 and r = 0.536; p < 0.001) angular velocities were strongly and moderately correlated to KPow and KMom, respectively. High ICCs indicated strong agreement between measurement systems. Thigh angular velocity (R2 = 0.66; p < 0.001) explained 66% of variance in KPow suggesting gyroscopes provide meaningful information regarding KPow. Less expensive inertial sensors may be helpful in identifying deficits clinically. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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18 pages, 3102 KiB  
Article
Scanning Laser Rangefinders for the Unobtrusive Monitoring of Gait Parameters in Unsupervised Settings
by Sebastian Fudickar, Christian Stolle, Nils Volkening and Andreas Hein
Sensors 2018, 18(10), 3424; https://doi.org/10.3390/s18103424 - 12 Oct 2018
Cited by 8 | Viewed by 4046
Abstract
Since variations in common gait parameters (such as cadence, velocity and stride-length) of elderly people are a reliable indicator of functional and cognitive decline in aging and increased fall risks, such gait parameters have to be monitored continuously to enable preventive interventions as [...] Read more.
Since variations in common gait parameters (such as cadence, velocity and stride-length) of elderly people are a reliable indicator of functional and cognitive decline in aging and increased fall risks, such gait parameters have to be monitored continuously to enable preventive interventions as early as possible. With scanning laser rangefinders (SLR) having been shown to be suitable for standardised (frontal) gait assessments, this article introduces an unobtrusive gait monitoring (UGMO) system for lateral gait monitoring in homes for the elderly. The system has been evaluated in comparison to a GAITRite (as reference system) with 86 participants (ranging from 21 to 82 years) passing the 6-min walk test twice. Within the considered 56,351 steps within an overall 7877 walks and approximately 34 km distance travelled, it has been shown that the SLR Hokuyo UST10-LX is more sensitive than the cheaper URG-04LX version in regard to the correct (automatic) detection of lateral steps (98% compared to 77%) and walks (97% compared to 66%). Furthermore, it has been confirmed that the UGMO (with the SLR UST10-LX) can measure gait parameters such as gait velocity and stride length with sufficient sensitivity to determine age- and disease-related functional (and cognitive) decline. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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17 pages, 2189 KiB  
Article
Multiple-Wearable-Sensor-Based Gait Classification and Analysis in Patients with Neurological Disorders
by Wei-Chun Hsu, Tommy Sugiarto, Yi-Jia Lin, Fu-Chi Yang, Zheng-Yi Lin, Chi-Tien Sun, Chun-Lung Hsu and Kuan-Nien Chou
Sensors 2018, 18(10), 3397; https://doi.org/10.3390/s18103397 - 11 Oct 2018
Cited by 69 | Viewed by 7320
Abstract
The aim of this study was to conduct a comprehensive analysis of the placement of multiple wearable sensors for the purpose of analyzing and classifying the gaits of patients with neurological disorders. Seven inertial measurement unit (IMU) sensors were placed at seven locations: [...] Read more.
The aim of this study was to conduct a comprehensive analysis of the placement of multiple wearable sensors for the purpose of analyzing and classifying the gaits of patients with neurological disorders. Seven inertial measurement unit (IMU) sensors were placed at seven locations: the lower back (L5) and both sides of the thigh, distal tibia (shank), and foot. The 20 subjects selected to participate in this study were separated into two groups: stroke patients (11) and patients with neurological disorders other than stroke (brain concussion, spinal injury, or brain hemorrhage) (9). The temporal parameters of gait were calculated using a wearable device, and various features and sensor configurations were examined to establish the ideal accuracy for classifying different groups. A comparison of the various methods and features for classifying the three groups revealed that a combination of time domain and gait temporal feature-based classification with the Multilayer Perceptron (MLP) algorithm outperformed the other methods of feature-based classification. The classification results of different sensor placements revealed that the sensor placed on the shank achieved higher accuracy than the other sensor placements (L5, foot, and thigh). The placement-based classification of the shank sensor achieved 89.13% testing accuracy with the Decision Tree (DT) classifier algorithm. The results of this study indicate that the wearable IMU device is capable of differentiating between the gait patterns of healthy patients, patients with stroke, and patients with other neurological disorders. Moreover, the most favorable results were reported for the classification that used the combination of time domain and gait temporal features as the model input and the shank location for sensor placement. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 6558 KiB  
Article
Gait Symmetry Assessment with a Low Back 3D Accelerometer in Post-Stroke Patients
by Wei Zhang, Matthew Smuck, Catherine Legault, Ma A. Ith, Amir Muaremi and Kamiar Aminian
Sensors 2018, 18(10), 3322; https://doi.org/10.3390/s18103322 - 3 Oct 2018
Cited by 38 | Viewed by 6779
Abstract
Gait asymmetry is an important marker of mobility impairment post stroke. This study proposes a new gait symmetry index (GSI) to quantify gait symmetry with one 3D accelerometer at L3 (GSIL3). GSIL3 was evaluated with 16 post stroke patients and [...] Read more.
Gait asymmetry is an important marker of mobility impairment post stroke. This study proposes a new gait symmetry index (GSI) to quantify gait symmetry with one 3D accelerometer at L3 (GSIL3). GSIL3 was evaluated with 16 post stroke patients and nine healthy controls in the Six-Minute-Walk-Test (6-MWT). Discriminative power was evaluated with Wilcoxon test and the effect size (ES) was computed with Cliff’s Delta. GSIL3 estimated during the entire 6-MWT and during a short segment straight walk (GSIL3straight) have comparable effect size to one another (ES = 0.89, p < 0.001) and to the symmetry indices derived from feet sensors (|ES| = [0.22, 0.89]). Furthermore, while none of the indices derived from feet sensors showed significant differences between post stroke patients walking with a cane compared to those able to walk without, GSIL3 was able to discriminate between these two groups with a significantly lower value in the group using a cane (ES = 0.70, p = 0.02). In addition, GSIL3 was strongly associated with several symmetry indices measured by feet sensors during the straight walking cycles (Spearman correlation: |ρ| = [0.82, 0.88], p < 0.05). The proposed index can be a reliable and cost-efficient post stroke gait symmetry assessment with implications for research and clinical practice. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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17 pages, 943 KiB  
Article
Towards an Automated Unsupervised Mobility Assessment for Older People Based on Inertial TUG Measurements
by Sandra Hellmers, Babak Izadpanah, Lena Dasenbrock, Rebecca Diekmann, Jürgen M. Bauer, Andreas Hein and Sebastian Fudickar
Sensors 2018, 18(10), 3310; https://doi.org/10.3390/s18103310 - 2 Oct 2018
Cited by 41 | Viewed by 5958
Abstract
One of the most common assessments for the mobility of older people is the Timed Up and Go test (TUG). Due to its sensitivity regarding the indication of Parkinson’s disease (PD) or increased fall risk in elderly people, this assessment test becomes increasingly [...] Read more.
One of the most common assessments for the mobility of older people is the Timed Up and Go test (TUG). Due to its sensitivity regarding the indication of Parkinson’s disease (PD) or increased fall risk in elderly people, this assessment test becomes increasingly relevant, should be automated and should become applicable for unsupervised self-assessments to enable regular examinations of the functional status. With Inertial Measurement Units (IMU) being well suited for automated analyses, we evaluate an IMU-based analysis-system, which automatically detects the TUG execution via machine learning and calculates the test duration. as well as the duration of its single components. The complete TUG was classified with an accuracy of 96% via a rule-based model in a study with 157 participants aged over 70 years. A comparison between the TUG durations determined by IMU and criterion standard measurements (stopwatch and automated/ambient TUG (aTUG) system) showed significant correlations of 0.97 and 0.99, respectively. The classification of the instrumented TUG (iTUG)-components achieved accuracies over 96%, as well. Additionally, the system’s suitability for self-assessments was investigated within a semi-unsupervised situation where a similar movement sequence to the TUG was executed. This preliminary analysis confirmed that the self-selected speed correlates moderately with the speed in the test situation, but differed significantly from each other. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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10 pages, 1480 KiB  
Article
Examination of the Effect of Suitable Size of Shoes under the Second Metatarsal Head and Width of Shoes under the Fifth Metatarsal Head for the Prevention of Callus Formation in Healthy Young Women
by Ryutaro Kase, Ayumi Amemiya, Rena Okonogi, Hiroki Yamakawa, Hisayoshi Sugawara, Yuji L. Tanaka, Masatoshi Komiyama and Taketoshi Mori
Sensors 2018, 18(10), 3269; https://doi.org/10.3390/s18103269 - 28 Sep 2018
Cited by 11 | Viewed by 4174
Abstract
Excessive pressure and shear stress while walking cause a risk of callus formation, which eventually causes foot ulcers in patients with diabetes mellitus. Callus under the second metatarsal head (MTH) has been associated with increased shear stress/pressure ratios (SPR). Callus under the fifth [...] Read more.
Excessive pressure and shear stress while walking cause a risk of callus formation, which eventually causes foot ulcers in patients with diabetes mellitus. Callus under the second metatarsal head (MTH) has been associated with increased shear stress/pressure ratios (SPR). Callus under the fifth MTH has been associated with increased peak shear stress (PSS). The purpose of this study is to examine whether the effect of the suitable size and width of shoes prevents diabetic foot ulcers under the second and fifth MTH. We measured the pressure and shear stress by testing three kinds of sizes and two types of width of shoes. Significant difference was not observed in the SPR under the second MTH among different sizes of shoes. However, the pressure and shear stress were significantly lower when putting on shoes of fit size compared with larger sizes. The PSS under the fifth MTH was significantly smaller when putting on shoes of fit width compared with those of narrow width. Wearing shoes of fit size and width has the potential to prevent callus formation by reducing the pressure and shear stress constituting SPR under the second MTH and PSS under the fifth MTH. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 1738 KiB  
Article
Wearable Sensor Data to Track Subject-Specific Movement Patterns Related to Clinical Outcomes Using a Machine Learning Approach
by Dylan Kobsar and Reed Ferber
Sensors 2018, 18(9), 2828; https://doi.org/10.3390/s18092828 - 27 Aug 2018
Cited by 34 | Viewed by 6349
Abstract
Wearable sensors can provide detailed information on human movement but the clinical impact of this information remains limited. We propose a machine learning approach, using wearable sensor data, to identify subject-specific changes in gait patterns related to improvements in clinical outcomes. Eight patients [...] Read more.
Wearable sensors can provide detailed information on human movement but the clinical impact of this information remains limited. We propose a machine learning approach, using wearable sensor data, to identify subject-specific changes in gait patterns related to improvements in clinical outcomes. Eight patients with knee osteoarthritis (OA) completed two gait trials before and one following an exercise intervention. Wearable sensor data (e.g., 3-dimensional (3D) linear accelerations) were collected from a sensor located near the lower back, lateral thigh and lateral shank during level treadmill walking at a preferred speed. Wearable sensor data from the 2 pre-intervention gait trials were used to define each individual’s typical movement pattern using a one-class support vector machine (OCSVM). The percentage of strides defined as outliers, based on the pre-intervention gait data and the OCSVM, were used to define the overall change in an individual’s movement pattern. The correlation between the change in movement patterns following the intervention (i.e., percentage of outliers) and improvement in self-reported clinical outcomes (e.g., pain and function) was assessed using a Spearman rank correlation. The number of outliers observed post-intervention exhibited a large association (ρ = 0.78) with improvements in self-reported clinical outcomes. These findings demonstrate a proof-of-concept and a novel methodological approach for integrating machine learning and wearable sensor data. This approach provides an objective and evidence-informed way to understand clinically important changes in human movement patterns in response to exercise therapy. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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16 pages, 2044 KiB  
Article
Automatic Classification of Gait Impairments Using a Markerless 2D Video-Based System
by Tanmay T. Verlekar, Luís D. Soares and Paulo L. Correia
Sensors 2018, 18(9), 2743; https://doi.org/10.3390/s18092743 - 21 Aug 2018
Cited by 48 | Viewed by 5079
Abstract
Systemic disorders affecting an individual can cause gait impairments. Successful acquisition and evaluation of features representing such impairments make it possible to estimate the severity of those disorders, which is important information for monitoring patients’ health evolution. However, current state-of-the-art systems perform the [...] Read more.
Systemic disorders affecting an individual can cause gait impairments. Successful acquisition and evaluation of features representing such impairments make it possible to estimate the severity of those disorders, which is important information for monitoring patients’ health evolution. However, current state-of-the-art systems perform the acquisition and evaluation of these features in specially equipped laboratories, typically limiting the periodicity of evaluations. With the objective of making health monitoring easier and more accessible, this paper presents a system that performs automatic detection and classification of gait impairments, based on the acquisition and evaluation of biomechanical gait features using a single 2D video camera. The system relies on two different types of features to perform classification: (i) feet-related features, such as step length, step length symmetry, fraction of foot flat during stance phase, normalized step count, speed; and (ii) body-related features, such as the amount of movement while walking, center of gravity shifts and torso orientation. The proposed system uses a support vector machine to decide whether the observed gait is normal or if it belongs to one of three different impaired gait groups. Results show that the proposed system outperforms existing markerless 2D video-based systems, with a classification accuracy of 98.8%. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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13 pages, 3109 KiB  
Article
A Novel and Safe Approach to Simulate Cutting Movements Using Ground Reaction Forces
by Amelia S. Lanier, Brian A. Knarr, Nicholas Stergiou and Thomas S. Buchanan
Sensors 2018, 18(8), 2631; https://doi.org/10.3390/s18082631 - 11 Aug 2018
Cited by 2 | Viewed by 3419
Abstract
Control of shear ground reaction forces (sGRF) is important in performing running and cutting tasks as poor sGRF control has implications for those with knee injuries, such as anterior cruciate ligament (ACL) ruptures. The goal of this study was to develop a novel [...] Read more.
Control of shear ground reaction forces (sGRF) is important in performing running and cutting tasks as poor sGRF control has implications for those with knee injuries, such as anterior cruciate ligament (ACL) ruptures. The goal of this study was to develop a novel and safe task to evaluate control or accurate modulation of shear ground reaction forces related to those generated during cutting. Our approach utilized a force control task using real-time visual feedback of a subject’s force production and evaluated control capabilities through accuracy and divergence measurements. Ten healthy recreational athletes completed the force control task while force control via accuracy measures and divergence calculations was investigated. Participants were able to accurately control sGRF in multiple directions based on error measurements. Forces generated during the task were equal to or greater than those measured during a number of functional activities. We found no significant difference in the divergence of the force profiles using the Lyapunov Exponent of the sGRF trajectories. Participants using our approach produced high accuracy and low divergence force profiles and functional force magnitudes. Moving forward, we will utilize this task in at-risk populations who are unable to complete a cutting maneuver in early stages of rehabilitation, such as ACL deficient and newly reconstructed individuals, allowing insight into force control not obtainable otherwise. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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19 pages, 1485 KiB  
Article
Using Temporal Covariance of Motion and Geometric Features via Boosting for Human Fall Detection
by Syed Farooq Ali, Reamsha Khan, Arif Mahmood, Malik Tahir Hassan and Moongu Jeon
Sensors 2018, 18(6), 1918; https://doi.org/10.3390/s18061918 - 12 Jun 2018
Cited by 26 | Viewed by 5511
Abstract
Fall induced damages are serious incidences for aged as well as young persons. A real-time automatic and accurate fall detection system can play a vital role in timely medication care which will ultimately help to decrease the damages and complications. In this paper, [...] Read more.
Fall induced damages are serious incidences for aged as well as young persons. A real-time automatic and accurate fall detection system can play a vital role in timely medication care which will ultimately help to decrease the damages and complications. In this paper, we propose a fast and more accurate real-time system which can detect people falling in videos captured by surveillance cameras. Novel temporal and spatial variance-based features are proposed which comprise the discriminatory motion, geometric orientation and location of the person. These features are used along with ensemble learning strategy of boosting with J48 and Adaboost classifiers. Experiments have been conducted on publicly available standard datasets including Multiple Cameras Fall (with 2 classes and 3 classes) and UR Fall Detection achieving percentage accuracies of 99.2, 99.25 and 99.0, respectively. Comparisons with nine state-of-the-art methods demonstrate the effectiveness of the proposed approach on both datasets. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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20 pages, 4322 KiB  
Article
Inertial Sensor-Based Variables Are Indicators of Frailty and Adverse Post-Operative Outcomes in Cardiovascular Disease Patients
by Rahul Soangra and Thurmon E. Lockhart
Sensors 2018, 18(6), 1792; https://doi.org/10.3390/s18061792 - 2 Jun 2018
Cited by 18 | Viewed by 3992
Abstract
Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an [...] Read more.
Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an independent predictor of post-operative morbidity and mortality. However, this guideline by STS has not been studied adequately with a large sample size; rather it is based largely on expert opinions of cardiac surgeons and researchers. Although one’s gait speed is not completely associated with one’s risk of falls, gait speed is a quick robust measure to classify frail/non-frail CVD patients and undoubtedly frail individuals are more prone to falls. Thus, this study examines the effects of inertial sensor-based quick movement variability characteristics in identifying CVD patients likely to have an adverse post-operative outcome. This study establishes a relationship with gait and postural predictor variables with patient’s post-operative adverse outcomes. Accordingly, inertial sensors embedded inside smartphones are indispensable for the assessment of elderly patients in clinical environments and may be necessary for quick objective assessment. Sixteen elderly CVD patients (Age 76.1 ± 3.6 years) who were scheduled for cardiac surgery the next day were recruited for this study. Based on STS recommendation guidelines, eight of the CVD patients were classified as frail (prone to adverse outcomes with gait speed ≤ 0.833 m/s) and the other eight patients as non-frail (gait speed > 0.833 m/s). Smartphone-derived walking velocity was found to be significantly lower in frail patients than that in non-frail patients (p < 0.01). Mean Center of Pressure (COP) radius (p < 0.01), COP Area (p < 0.01), COP path length (p < 0.05) and mean COP velocity (p < 0.05) were found to be significantly higher in frail patients than that in the non-frail patient group. Nonlinear variability measures such as sample entropy were significantly lower in frail participants in anterior-posterior (p < 0.01) and resultant sway direction (p < 0.01) than in the non-frail group. This study identified numerous postural and movement variability parameters that offer insights into predictive inertial sensor-based variables and post-operative adverse outcomes among CVD patients. In future, smartphone-based clinical measurement systems could serve as a clinical decision support system for assessing patients quickly in the perioperative period. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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17 pages, 1888 KiB  
Article
Toward Smart Footwear to Track Frailty Phenotypes—Using Propulsion Performance to Determine Frailty
by Hadi Rahemi, Hung Nguyen, Hyoki Lee and Bijan Najafi
Sensors 2018, 18(6), 1763; https://doi.org/10.3390/s18061763 - 1 Jun 2018
Cited by 16 | Viewed by 5669
Abstract
Frailty assessment is dependent on the availability of trained personnel and it is currently limited to clinic and supervised setting. The growing aging population has made it necessary to find phenotypes of frailty that can be measured in an unsupervised setting for translational [...] Read more.
Frailty assessment is dependent on the availability of trained personnel and it is currently limited to clinic and supervised setting. The growing aging population has made it necessary to find phenotypes of frailty that can be measured in an unsupervised setting for translational application in continuous, remote, and in-place monitoring during daily living activity, such as walking. We analyzed gait performance of 161 older adults using a shin-worn inertial sensor to investigate the feasibility of developing a foot-worn sensor to assess frailty. Sensor-derived gait parameters were extracted and modeled to distinguish different frailty stages, including non-frail, pre-frail, and frail, as determined by Fried Criteria. An artificial neural network model was implemented to evaluate the accuracy of an algorithm using a proposed set of gait parameters in predicting frailty stages. Changes in discriminating power was compared between sensor data extracted from the left and right shin sensor. The aim was to investigate the feasibility of developing a foot-worn sensor to assess frailty. The results yielded a highly accurate model in predicting frailty stages, irrespective of sensor location. The independent predictors of frailty stages were propulsion duration and acceleration, heel-off and toe-off speed, mid stance and mid swing speed, and speed norm. The proposed model enables discriminating different frailty stages with area under curve ranging between 83.2–95.8%. Furthermore, results from the neural network suggest the potential of developing a single-shin worn sensor that would be ideal for unsupervised application and footwear integration for continuous monitoring during walking. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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15 pages, 3759 KiB  
Article
Estimation of Temporal Gait Parameters Using a Human Body Electrostatic Sensing-Based Method
by Mengxuan Li, Pengfei Li, Shanshan Tian, Kai Tang and Xi Chen
Sensors 2018, 18(6), 1737; https://doi.org/10.3390/s18061737 - 28 May 2018
Cited by 20 | Viewed by 4443
Abstract
Accurate estimation of gait parameters is essential for obtaining quantitative information on motor deficits in Parkinson’s disease and other neurodegenerative diseases, which helps determine disease progression and therapeutic interventions. Due to the demand for high accuracy, unobtrusive measurement methods such as optical motion [...] Read more.
Accurate estimation of gait parameters is essential for obtaining quantitative information on motor deficits in Parkinson’s disease and other neurodegenerative diseases, which helps determine disease progression and therapeutic interventions. Due to the demand for high accuracy, unobtrusive measurement methods such as optical motion capture systems, foot pressure plates, and other systems have been commonly used in clinical environments. However, the high cost of existing lab-based methods greatly hinders their wider usage, especially in developing countries. In this study, we present a low-cost, noncontact, and an accurate temporal gait parameters estimation method by sensing and analyzing the electrostatic field generated from human foot stepping. The proposed method achieved an average 97% accuracy on gait phase detection and was further validated by comparison to the foot pressure system in 10 healthy subjects. Two results were compared using the Pearson coefficient r and obtained an excellent consistency (r = 0.99, p < 0.05). The repeatability of the purposed method was calculated between days by intraclass correlation coefficients (ICC), and showed good test-retest reliability (ICC = 0.87, p < 0.01). The proposed method could be an affordable and accurate tool to measure temporal gait parameters in hospital laboratories and in patients’ home environments. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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15 pages, 2927 KiB  
Article
Dynamical Properties of Postural Control in Obese Community-Dwelling Older Adults
by Christopher W. Frames, Rahul Soangra, Thurmon E. Lockhart, John Lach, Dong Sam Ha, Karen A. Roberto and Abraham Lieberman
Sensors 2018, 18(6), 1692; https://doi.org/10.3390/s18061692 - 24 May 2018
Cited by 26 | Viewed by 5258
Abstract
Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric [...] Read more.
Postural control is a key aspect in preventing falls. The aim of this study was to determine if obesity affected balance in community-dwelling older adults and serve as an indicator of fall risk. The participants were randomly assigned to receive a comprehensive geriatric assessment followed by a longitudinal assessment of their fall history. The standing postural balance was measured for 98 participants with a Body Mass Index (BMI) ranging from 18 to 63 kg/m2, using a force plate and an inertial measurement unit affixed at the sternum. Participants’ fall history was recorded over 2 years and participants with at least one fall in the prior year were classified as fallers. The results suggest that body weight/BMI is an additional risk factor for falling in elderly persons and may be an important marker for fall risk. The linear variables of postural analysis suggest that the obese fallers have significantly higher sway area and sway ranges, along with higher root mean square and standard deviation of time series. Additionally, it was found that obese fallers have lower complexity of anterior-posterior center of pressure time series. Future studies should examine more closely the combined effect of aging and obesity on dynamic balance. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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20 pages, 3121 KiB  
Article
Recognition of a Person Wearing Sport Shoes or High Heels through Gait Using Two Types of Sensors
by Marcin Derlatka and Mariusz Bogdan
Sensors 2018, 18(5), 1639; https://doi.org/10.3390/s18051639 - 21 May 2018
Cited by 15 | Viewed by 7029
Abstract
Biometrics is currently an area that is both very interesting as well as rapidly growing. Among various types of biometrics the human gait recognition seems to be one of the most intriguing. However, one of the greatest problems within this field of biometrics [...] Read more.
Biometrics is currently an area that is both very interesting as well as rapidly growing. Among various types of biometrics the human gait recognition seems to be one of the most intriguing. However, one of the greatest problems within this field of biometrics is the change in gait caused by footwear. A change of shoes results in a significant lowering of accuracy in recognition of people. The following work presents a method which uses data gathered by two sensors: force plates and Microsoft Kinect v2 to reduce this problem. Microsoft Kinect is utilized to measure the body height of a person which allows the reduction of the set of recognized people only to those whose height is similar to that which has been measured. The entire process is preceded by identifying the type of footwear which the person is wearing. The research was conducted on data obtained from 99 people (more than 3400 strides) and the proposed method allowed us to reach a Correct Classification Rate (CCR) greater than 88% which, in comparison to earlier methods reaching CCR’s of <80%, is a significant improvement. The work presents advantages as well as limitations of the proposed method. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 1757 KiB  
Article
Biomechanical Gait Variable Estimation Using Wearable Sensors after Unilateral Total Knee Arthroplasty
by Ik-Hyun Youn, Jong-Hoon Youn, Joseph A. Zeni and Brian A. Knarr
Sensors 2018, 18(5), 1577; https://doi.org/10.3390/s18051577 - 15 May 2018
Cited by 20 | Viewed by 5820
Abstract
Total knee arthroplasty is a common surgical treatment for end-stage osteoarthritis of the knee. The majority of existing studies that have explored the relationship between recovery and gait biomechanics have been conducted in laboratory settings. However, seamless gait parameter monitoring in real-world conditions [...] Read more.
Total knee arthroplasty is a common surgical treatment for end-stage osteoarthritis of the knee. The majority of existing studies that have explored the relationship between recovery and gait biomechanics have been conducted in laboratory settings. However, seamless gait parameter monitoring in real-world conditions may provide a better understanding of recovery post-surgery. The purpose of this study was to estimate kinematic and kinetic gait variables using two ankle-worn wearable sensors in individuals after unilateral total knee arthroplasty. Eighteen subjects at least six months post-unilateral total knee arthroplasty participated in this study. Four biomechanical gait variables were measured using an instrumented split-belt treadmill and motion capture systems. Concurrently, eleven inertial gait variables were extracted from two ankle-worn accelerometers. Subsets of the inertial gait variables for each biomechanical gait variable estimation were statistically selected. Then, hierarchical regressions were created to determine the directional contributions of the inertial gait variables for biomechanical gait variable estimations. Selected inertial gait variables significantly predicted trial-averaged biomechanical gait variables. Moreover, strong directionally-aligned relationships were observed. Wearable-based gait monitoring of multiple and sequential kinetic gait variables in daily life could provide a more accurate understanding of the relationships between movement patterns and recovery from total knee arthroplasty. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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21 pages, 1143 KiB  
Article
A Telerehabilitation System for the Selection, Evaluation and Remote Management of Therapies
by David Anton, Idoia Berges, Jesús Bermúdez, Alfredo Goñi and Arantza Illarramendi
Sensors 2018, 18(5), 1459; https://doi.org/10.3390/s18051459 - 8 May 2018
Cited by 63 | Viewed by 10522
Abstract
Telerehabilitation systems that support physical therapy sessions anywhere can help save healthcare costs while also improving the quality of life of the users that need rehabilitation. The main contribution of this paper is to present, as a whole, all the features supported by [...] Read more.
Telerehabilitation systems that support physical therapy sessions anywhere can help save healthcare costs while also improving the quality of life of the users that need rehabilitation. The main contribution of this paper is to present, as a whole, all the features supported by the innovative Kinect-based Telerehabilitation System (KiReS). In addition to the functionalities provided by current systems, it handles two new ones that could be incorporated into them, in order to give a step forward towards a new generation of telerehabilitation systems. The knowledge extraction functionality handles knowledge about the physical therapy record of patients and treatment protocols described in an ontology, named TrhOnt, to select the adequate exercises for the rehabilitation of patients. The teleimmersion functionality provides a convenient, effective and user-friendly experience when performing the telerehabilitation, through a two-way real-time multimedia communication. The ontology contains about 2300 classes and 100 properties, and the system allows a reliable transmission of Kinect video depth, audio and skeleton data, being able to adapt to various network conditions. Moreover, the system has been tested with patients who suffered from shoulder disorders or total hip replacement. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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28 pages, 1504 KiB  
Article
Improving Fall Detection Using an On-Wrist Wearable Accelerometer
by Samad Barri Khojasteh, José R. Villar, Camelia Chira, Víctor M. González and Enrique De la Cal
Sensors 2018, 18(5), 1350; https://doi.org/10.3390/s18051350 - 26 Apr 2018
Cited by 115 | Viewed by 11533
Abstract
Fall detection is a very important challenge that affects both elderly people and the carers. Improvements in fall detection would reduce the aid response time. This research focuses on a method for fall detection with a sensor placed on the wrist. Falls are [...] Read more.
Fall detection is a very important challenge that affects both elderly people and the carers. Improvements in fall detection would reduce the aid response time. This research focuses on a method for fall detection with a sensor placed on the wrist. Falls are detected using a published threshold-based solution, although a study on threshold tuning has been carried out. The feature extraction is extended in order to balance the dataset for the minority class. Alternative models have been analyzed to reduce the computational constraints so the solution can be embedded in smart-phones or smart wristbands. Several published datasets have been used in the Materials and Methods section. Although these datasets do not include data from real falls of elderly people, a complete comparison study of fall-related datasets shows statistical differences between the simulated falls and real falls from participants suffering from impairment diseases. Given the obtained results, the rule-based systems represent a promising research line as they perform similarly to neural networks, but with a reduced computational cost. Furthermore, support vector machines performed with a high specificity. However, further research to validate the proposal in real on-line scenarios is needed. Furthermore, a slight improvement should be made to reduce the number of false alarms. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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17 pages, 692 KiB  
Article
Wearable Sensors and the Assessment of Frailty among Vulnerable Older Adults: An Observational Cohort Study
by Javad Razjouyan, Aanand D. Naik, Molly J. Horstman, Mark E. Kunik, Mona Amirmazaheri, He Zhou, Amir Sharafkhaneh and Bijan Najafi
Sensors 2018, 18(5), 1336; https://doi.org/10.3390/s18051336 - 26 Apr 2018
Cited by 76 | Viewed by 9247
Abstract
Background: The geriatric syndrome of frailty is one of the greatest challenges facing the U.S. aging population. Frailty in older adults is associated with higher adverse outcomes, such as mortality and hospitalization. Identifying precise early indicators of pre-frailty and measures of specific frailty [...] Read more.
Background: The geriatric syndrome of frailty is one of the greatest challenges facing the U.S. aging population. Frailty in older adults is associated with higher adverse outcomes, such as mortality and hospitalization. Identifying precise early indicators of pre-frailty and measures of specific frailty components are of key importance to enable targeted interventions and remediation. We hypothesize that sensor-derived parameters, measured by a pendant accelerometer device in the home setting, are sensitive to identifying pre-frailty. Methods: Using the Fried frailty phenotype criteria, 153 community-dwelling, ambulatory older adults were classified as pre-frail (51%), frail (22%), or non-frail (27%). A pendant sensor was used to monitor the at home physical activity, using a chest acceleration over 48 h. An algorithm was developed to quantify physical activity pattern (PAP), physical activity behavior (PAB), and sleep quality parameters. Statistically significant parameters were selected to discriminate the pre-frail from frail and non-frail adults. Results: The stepping parameters, walking parameters, PAB parameters (sedentary and moderate-to-vigorous activity), and the combined parameters reached and area under the curve of 0.87, 0.85, 0.85, and 0.88, respectively, for identifying pre-frail adults. No sleep parameters discriminated the pre-frail from the rest of the adults. Conclusions: This study demonstrates that a pendant sensor can identify pre-frailty via daily home monitoring. These findings may open new opportunities in order to remotely measure and track frailty via telehealth technologies. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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16 pages, 5358 KiB  
Article
Gait Shear and Plantar Pressure Monitoring: A Non-Invasive OFS Based Solution for e-Health Architectures
by Cátia Tavares, M. Fátima Domingues, Anselmo Frizera-Neto, Tiago Leite, Cátia Leitão, Nélia Alberto, Carlos Marques, Ayman Radwan, Eduardo Rocon, Paulo André and Paulo Antunes
Sensors 2018, 18(5), 1334; https://doi.org/10.3390/s18051334 - 25 Apr 2018
Cited by 48 | Viewed by 6222
Abstract
In an era of unprecedented progress in sensing technology and communication, health services are now able to closely monitor patients and elderly citizens without jeopardizing their daily routines through health applications on their mobile devices in what is known as e-Health. Within this [...] Read more.
In an era of unprecedented progress in sensing technology and communication, health services are now able to closely monitor patients and elderly citizens without jeopardizing their daily routines through health applications on their mobile devices in what is known as e-Health. Within this field, we propose an optical fiber sensor (OFS) based system for the simultaneous monitoring of shear and plantar pressure during gait movement. These parameters are considered to be two key factors in gait analysis that can help in the early diagnosis of multiple anomalies, such as diabetic foot ulcerations or in physical rehabilitation scenarios. The proposed solution is a biaxial OFS based on two in-line fiber Bragg gratings (FBGs), which were inscribed in the same optical fiber and placed individually in two adjacent cavities, forming a small sensing cell. Such design presents a more compact and resilient solution with higher accuracy when compared to the existing electronic systems. The implementation of the proposed elements into an insole is also described, showcasing the compactness of the sensing cells, which can easily be integrated into a non-invasive mobile e-Health solution for continuous remote gait monitoring of patients and elder citizens. The reported results show that the proposed system outperforms existing solutions, in the sense that it is able to dynamically discriminate shear and plantar pressure during gait. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 6864 KiB  
Article
Older Adults with Weaker Muscle Strength Stand up from a Sitting Position with More Dynamic Trunk Use
by Rob C. Van Lummel, Jordi Evers, Martijn Niessen, Peter J. Beek and Jaap H. Van Dieën
Sensors 2018, 18(4), 1235; https://doi.org/10.3390/s18041235 - 17 Apr 2018
Cited by 37 | Viewed by 7531
Abstract
The ability to stand up from a sitting position is essential for older adults to live independently. Body-fixed inertial sensors may provide an approach for quantifying the sit-to-stand (STS) in clinical settings. The aim of this study was to determine whether measurements of [...] Read more.
The ability to stand up from a sitting position is essential for older adults to live independently. Body-fixed inertial sensors may provide an approach for quantifying the sit-to-stand (STS) in clinical settings. The aim of this study was to determine whether measurements of STS movements using body-fixed sensors yield parameters that are informative regarding changes in STS performance in older adults with reduced muscle strength. In twenty-seven healthy older adults, handgrip strength was assessed as a proxy for overall muscle strength. Subjects were asked to stand up from a chair placed at three heights. Trunk movements were measured using an inertial sensor fixed to the back. Duration, angular range, and maximum angular velocity of STS phases, as well as the vertical velocity of the extension phase, were calculated. Backwards elimination using Generalized Estimating Equations was used to determine if handgrip strength predicted the STS durations and trunk kinematics. Weaker subjects (i.e., with lower handgrip strength) were slower during the STS and showed a larger flexion angular range and a larger extension angular range. In addition, weaker subjects showed a greater maximum angular velocity, which increased with lower seat heights. Measurements with a single inertial sensor did reveal that older adults with lower handgrip strength employed a different strategy to stand up from a sitting position, involving more dynamic use of the trunk. This effect was greatest when elevating body mass. Trunk kinematic parameters were more sensitive to reduced muscle strength than durations. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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15 pages, 12633 KiB  
Article
“What Is a Step?” Differences in How a Step Is Detected among Three Popular Activity Monitors That Have Impacted Physical Activity Research
by Dinesh John, Alvin Morton, Diego Arguello, Kate Lyden and David Bassett
Sensors 2018, 18(4), 1206; https://doi.org/10.3390/s18041206 - 15 Apr 2018
Cited by 60 | Viewed by 6197
Abstract
(1) Background: This study compared manually-counted treadmill walking steps from the hip-worn DigiwalkerSW200 and OmronHJ720ITC, and hip and wrist-worn ActiGraph GT3X+ and GT9X; determined brand-specific acceleration amplitude (g) and/or frequency (Hz) step-detection thresholds; and quantified key features of the acceleration signal during walking. [...] Read more.
(1) Background: This study compared manually-counted treadmill walking steps from the hip-worn DigiwalkerSW200 and OmronHJ720ITC, and hip and wrist-worn ActiGraph GT3X+ and GT9X; determined brand-specific acceleration amplitude (g) and/or frequency (Hz) step-detection thresholds; and quantified key features of the acceleration signal during walking. (2) Methods: Twenty participants (Age: 26.7 ± 4.9 years) performed treadmill walking between 0.89-to-1.79 m/s (2–4 mph) while wearing a hip-worn DigiwalkerSW200, OmronHJ720ITC, GT3X+ and GT9X, and a wrist-worn GT3X+ and GT9X. A DigiwalkerSW200 and OmronHJ720ITC underwent shaker testing to determine device-specific frequency and amplitude step-detection thresholds. Simulated signal testing was used to determine thresholds for the ActiGraph step algorithm. Steps during human testing were compared using bias and confidence intervals. (3) Results: The OmronHJ720ITC was most accurate during treadmill walking. Hip and wrist-worn ActiGraph outputs were significantly different from the criterion. The DigiwalkerSW200 records steps for movements with a total acceleration of ≥1.21 g. The OmronHJ720ITC detects a step when movement has an acceleration ≥0.10 g with a dominant frequency of ≥1 Hz. The step-threshold for the ActiLife algorithm is variable based on signal frequency. Acceleration signals at the hip and wrist have distinctive patterns during treadmill walking. (4) Conclusions: Three common research-grade physical activity monitors employ different step-detection strategies, which causes variability in step output. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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29 pages, 23295 KiB  
Article
Analysis of a Smartphone-Based Architecture with Multiple Mobility Sensors for Fall Detection with Supervised Learning
by José Antonio Santoyo-Ramón, Eduardo Casilari and José Manuel Cano-García
Sensors 2018, 18(4), 1155; https://doi.org/10.3390/s18041155 - 10 Apr 2018
Cited by 54 | Viewed by 7775
Abstract
This paper describes a wearable Fall Detection System (FDS) based on a body-area network consisting of four nodes provided with inertial sensors and Bluetooth wireless interfaces. The signals captured by the nodes are sent to a smartphone which simultaneously acts as another sensing [...] Read more.
This paper describes a wearable Fall Detection System (FDS) based on a body-area network consisting of four nodes provided with inertial sensors and Bluetooth wireless interfaces. The signals captured by the nodes are sent to a smartphone which simultaneously acts as another sensing point. In contrast to many FDSs proposed by the literature (which only consider a single sensor), the multisensory nature of the prototype is utilized to investigate the impact of the number and the positions of the sensors on the effectiveness of the production of the fall detection decision. In particular, the study assesses the capability of four popular machine learning algorithms to discriminate the dynamics of the Activities of Daily Living (ADLs) and falls generated by a set of experimental subjects, when the combined use of the sensors located on different parts of the body is considered. Prior to this, the election of the statistics that optimize the characterization of the acceleration signals and the efficacy of the FDS is also investigated. As another important methodological novelty in this field, the statistical significance of all the results (an aspect which is usually neglected by other works) is validated by an analysis of variance (ANOVA). Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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12 pages, 22810 KiB  
Article
Motor Subtypes of Parkinson’s Disease Can Be Identified by Frequency Component of Postural Stability
by Saba Rezvanian, Thurmon Lockhart, Christopher Frames, Rahul Soangra and Abraham Lieberman
Sensors 2018, 18(4), 1102; https://doi.org/10.3390/s18041102 - 5 Apr 2018
Cited by 20 | Viewed by 5568
Abstract
Parkinson’s disease (PD) can be divided into two subtypes based on clinical features—namely tremor dominant (TD) and postural instability and gait difficulty (PIGD). This categorization is important at the early stage of PD, since identifying the subtypes can help to predict the clinical [...] Read more.
Parkinson’s disease (PD) can be divided into two subtypes based on clinical features—namely tremor dominant (TD) and postural instability and gait difficulty (PIGD). This categorization is important at the early stage of PD, since identifying the subtypes can help to predict the clinical progression of the disease. Accordingly, correctly diagnosing subtypes is critical in initiating appropriate early interventions and tracking the progression of the disease. However, as the disease progresses, it becomes increasingly difficult to further distinguish those attributes that are relevant to the subtypes. In this study, we investigated whether a method using the standing center of pressure (COP) time series data can separate two subtypes of PD by looking at the frequency component of COP (i.e., COP position and speed). Thirty-six participants diagnosed with PD were evaluated, with their bare feet on the force platform, and were instructed to stand upright with their arms by their sides for 20 s (with their eyes open and closed), which is consistent with the traditional COP measures. Fast Fourier transform (FFT) and wavelet transform (WT) were performed to distinguish between the motor subtypes using the COP measures. The TD group exhibited larger amplitudes at the frequency range of 3–7 Hz when compared to the PIGD group. Both the FFT and WT methods were able to differentiate the subtypes. COP time series information can be used to differentiate between the two motor subtypes of PD, using the frequency component of postural stability. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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11 pages, 18538 KiB  
Article
The Height-Adaptive Parameterized Step Length Measurement Method and Experiment Based on Motion Parameters
by Yanshun Zhang, Yingyue Li, Chuang Peng, Dong Mou, Ming Li and Wei Wang
Sensors 2018, 18(4), 1039; https://doi.org/10.3390/s18041039 - 30 Mar 2018
Cited by 23 | Viewed by 6060
Abstract
In order to tackle the inaccurate step length measurement of people with different heights and in different motion states, a height-adaptive method of step length measurement based on motion parameters is proposed in this paper. This method takes people’s height, stride frequency, and [...] Read more.
In order to tackle the inaccurate step length measurement of people with different heights and in different motion states, a height-adaptive method of step length measurement based on motion parameters is proposed in this paper. This method takes people’s height, stride frequency, and changing accelerometer output while walking into integrated consideration, and builds a dynamic and parameterized model of their step length. In this study, these parameters were calibrated with thirty sets of experiment data from people with different heights and in different motion states, which were then verified experimentally by motion data of randomly selected subjects, regardless of speed and height. The experiment results indicate that the height-adaptive step length measurement was realized, thus eliminating the influence of height exerted on step length measurement. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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16 pages, 9682 KiB  
Article
Nondestructive Estimation of Muscle Contributions to STS Training with Different Loadings Based on Wearable Sensor System
by Kun Liu, Yong Liu, Jianchao Yan and Zhenyuan Sun
Sensors 2018, 18(4), 971; https://doi.org/10.3390/s18040971 - 25 Mar 2018
Cited by 5 | Viewed by 5424
Abstract
Partial body weight support or loading sit-to-stand (STS) rehabilitation can be useful for persons with lower limb dysfunction to achieve movement again based on the internal residual muscle force and external assistance. To explicate how the muscles contribute to the kinetics and kinematics [...] Read more.
Partial body weight support or loading sit-to-stand (STS) rehabilitation can be useful for persons with lower limb dysfunction to achieve movement again based on the internal residual muscle force and external assistance. To explicate how the muscles contribute to the kinetics and kinematics of STS performance by non-invasive in vitro detection and to nondestructively estimate the muscle contributions to STS training with different loadings, a wearable sensor system was developed with ground reaction force (GRF) platforms, motion capture inertial sensors and electromyography (EMG) sensors. To estimate the internal moments of hip, knee and ankle joints and quantify the contributions of individual muscle and gravity to STS movement, the inverse dynamics analysis on a simplified STS biomechanical model with external loading is proposed. The functional roles of the lower limb individual muscles (rectus femoris (RF), gluteus maximus (GM), vastus lateralis (VL), tibialis anterior (TA) and gastrocnemius (GAST)) during STS motion and the mechanism of the muscles’ synergies to perform STS-specific subtasks were analyzed. The muscle contributions to the biomechanical STS subtasks of vertical propulsion, anteroposterior (AP) braking and propulsion for body balance in the sagittal plane were quantified by experimental studies with EMG, kinematic and kinetic data. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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14 pages, 4169 KiB  
Article
Motor Planning Error: Toward Measuring Cognitive Frailty in Older Adults Using Wearables
by He Zhou, Hyoki Lee, Jessica Lee, Michael Schwenk and Bijan Najafi
Sensors 2018, 18(3), 926; https://doi.org/10.3390/s18030926 - 20 Mar 2018
Cited by 21 | Viewed by 7123
Abstract
Practical tools which can be quickly administered are needed for measuring subtle changes in cognitive–motor performance over time. Frailty together with cognitive impairment, or ‘cognitive frailty’, are shown to be strong and independent predictors of cognitive decline over time. We have developed an [...] Read more.
Practical tools which can be quickly administered are needed for measuring subtle changes in cognitive–motor performance over time. Frailty together with cognitive impairment, or ‘cognitive frailty’, are shown to be strong and independent predictors of cognitive decline over time. We have developed an interactive instrumented trail-making task (iTMT) platform, which allows quantification of motor planning error (MPE) through a series of ankle reaching tasks. In this study, we examined the accuracy of MPE in identifying cognitive frailty in older adults. Thirty-two older adults (age = 77.3 ± 9.1 years, body-mass-index = 25.3 ± 4.7 kg/m2, female = 38%) were recruited. Using either the Mini-Mental State Examination or Montreal Cognitive Assessment (MoCA), 16 subjects were classified as cognitive-intact and 16 were classified as cognitive-impaired. In addition, 12 young-healthy subjects (age = 26.0 ± 5.2 years, body-mass-index = 25.3 ± 3.9 kg/m2, female = 33%) were recruited to establish a healthy benchmark. Subjects completed the iTMT, using an ankle-worn sensor, which transforms ankle motion into navigation of a computer cursor. The iTMT task included reaching five indexed target circles (including numbers 1-to-3 and letters A&B placed in random order) on the computer-screen by moving the ankle-joint while standing. The ankle-sensor quantifies MPE through analysis of the pattern of ankle velocity. MPE was defined as percentage of time deviation between subject’s maximum ankle velocity and the optimal maximum ankle velocity, which is halfway through the reaching pathway. Data from gait tests, including single task and dual task walking, were also collected to determine cognitive–motor performance. The average MPE in young-healthy, elderly cognitive-intact, and elderly cognitive-impaired groups was 11.1 ± 5.7%, 20.3 ± 9.6%, and 34.1 ± 4.2% (p < 0.001), respectively. Large effect sizes (Cohen’s d = 1.17–4.56) were observed for discriminating between groups using MPE. Significant correlations were observed between the MPE and MoCA score (r = −0.670, p < 0.001) as well as between the MPE and dual task stride velocity (r = −0.584, p < 0.001). This study demonstrated feasibility and efficacy of estimating MPE from a practical wearable platform with promising results in identifying cognitive–motor impairment and potential application in assessing cognitive frailty. The proposed platform could be also used as an alternative to dual task walking test, where gait assessment may not be practical. Future studies need to confirm these observations in larger samples. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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29 pages, 5780 KiB  
Article
Inertial Measurement Units for Clinical Movement Analysis: Reliability and Concurrent Validity
by Mohammad Al-Amri, Kevin Nicholas, Kate Button, Valerie Sparkes, Liba Sheeran and Jennifer L Davies
Sensors 2018, 18(3), 719; https://doi.org/10.3390/s18030719 - 28 Feb 2018
Cited by 198 | Viewed by 17850
Abstract
The aim of this study was to investigate the reliability and concurrent validity of a commercially available Xsens MVN BIOMECH inertial-sensor-based motion capture system during clinically relevant functional activities. A clinician with no prior experience of motion capture technologies and an experienced clinical [...] Read more.
The aim of this study was to investigate the reliability and concurrent validity of a commercially available Xsens MVN BIOMECH inertial-sensor-based motion capture system during clinically relevant functional activities. A clinician with no prior experience of motion capture technologies and an experienced clinical movement scientist each assessed 26 healthy participants within each of two sessions using a camera-based motion capture system and the MVN BIOMECH system. Participants performed overground walking, squatting, and jumping. Sessions were separated by 4 ± 3 days. Reliability was evaluated using intraclass correlation coefficient and standard error of measurement, and validity was evaluated using the coefficient of multiple correlation and the linear fit method. Day-to-day reliability was generally fair-to-excellent in all three planes for hip, knee, and ankle joint angles in all three tasks. Within-day (between-rater) reliability was fair-to-excellent in all three planes during walking and squatting, and poor-to-high during jumping. Validity was excellent in the sagittal plane for hip, knee, and ankle joint angles in all three tasks and acceptable in frontal and transverse planes in squat and jump activity across joints. Our results suggest that the MVN BIOMECH system can be used by a clinician to quantify lower-limb joint angles in clinically relevant movements. Full article
(This article belongs to the Special Issue Sensors for Gait, Posture, and Health Monitoring)
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18 pages, 4047 KiB  
Article
An Affordable Insole-Sensor-Based Trans-Femoral Prosthesis for Normal Gait
by Srinivas Pandit, Anoop Kant Godiyal, Amit Kumar Vimal, Upinderpal Singh, Deepak Joshi and Dinesh Kalyanasundaram
Sensors 2018, 18(3), 706; https://doi.org/10.3390/s18030706 - 27 Feb 2018
Cited by 36 | Viewed by 14016
Abstract
This paper proposes a novel and an affordable lower limb prosthesis to enable normal gait kinematics for trans-femoral amputees. The paper details the design of a passive prosthesis with magneto-rheological (MR) damping system and electronic control. A new control approach based on plantar [...] Read more.
This paper proposes a novel and an affordable lower limb prosthesis to enable normal gait kinematics for trans-femoral amputees. The paper details the design of a passive prosthesis with magneto-rheological (MR) damping system and electronic control. A new control approach based on plantar insole feedback was employed here. Strategically placed sensors on the plantar insole provide required information about gait cycle to a finite state controller for suitable action. A proportional integral (PI) based current controller controls the required current for necessary damping during gait. The prosthesis was designed and developed locally in India keeping in view the cost, functionality, socio-economic, and aesthetic requirements. The prototype was experimentally tested on a trans-femoral amputee and the results are presented in this work. The implementation of the proposed design and control scheme in the prototype successfully realizes the notion that normal gait kinematics can be achieved at a low cost comparable to passive prostheses. The incurring cost and power expenditure of the proposed prosthesis are evaluated against passive and active prostheses, respectively. The commercial implications for the prosthesis were explored on the basis of recommendations of ISPO Consensus Conference on Appropriate Prosthetic T