Synchronized Sensor Insoles for Clinical Gait Analysis in Home-Monitoring Applications

AbstractWearable sensor systems are of increasing interest in clinical gait analysis. However, little information about gait dynamics of patients under free living conditions is available, due to the challenges of integrating such systems unobtrusively into a patient’s everyday live. To address this limitation, new, fully integrated low power sensor insoles are proposed, to target applications particularly in home-monitoring scenarios. The insoles combine inertial as well as pressure sensors and feature wireless synchronization to acquire biomechanical data of both feet with a mean timing offset of 15.0 μs. The proposed system was evaluated on 15 patients with mild to severe gait disorders against the GAITRite® system as reference. Gait events based on the insoles’ pressure sensors were manually extracted to calculate temporal gait features such as double support time and double support. Compared to the reference system a mean error of 0.06 s ±0.06 s and 3.89 % ±2.61 % was achieved, respectively. The proposed insoles proved their ability to acquire synchronized gait parameters and address the requirements for home-monitoring scenarios, pushing the boundaries of clinical gait analysis.

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Agreement and consistency of five different clinical gait analysis systems in the assessment of spatiotemporal gait parameters

Gait & Posture ◽

10.1016/j.gaitpost.2021.01.013 ◽

2021 ◽

Vol 85 ◽

pp. 55-64

Author(s):

Julian Rudisch ◽

Thomas Jöllenbeck ◽

Lutz Vogt ◽

Thomas Cordes ◽

Thomas Jürgen Klotzbier ◽

...

Keyword(s):

Gait Analysis ◽

Gait Parameters ◽

Clinical Gait Analysis

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Evaluation of Gait Variable Change over Time as Transtibial Amputees Adapt to a New Prosthesis Foot

BioMed Research International ◽

10.1155/2019/9252368 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

Xueyi Zhang ◽

Goeran Fiedler ◽

Zhicheng Liu

Keyword(s):

Repeated Measurements ◽

Subjective Perception ◽

Double Support ◽

Gait Parameters ◽

Sound Side ◽

Vas Scores ◽

Double Support Time ◽

Transtibial Amputees ◽

The Relationship ◽

Gait Variable

A variety of prescribed accommodation periods have been used in published prosthesis intervention studies that have examined biomechanical outcomes. Few investigators included repeated measurements in their study design, leaving questions as to how measured outcomes change as amputees acclimate to a new prosthesis. This paper is the product of our investigation as to whether measured gait variables were affected by the duration of accommodation period, and to assess the relationship between measured outcomes and the subjective perception of the participants. A sample of transtibial amputees were recruited for this study. Gait data was collected by wearable sensor repeatedly, starting immediately after fitting the interventional foot and extending over a subsequent four days. Participants indicated their perceived accommodation quality on a visual analog scale (VAS). A total of twelve commonly used spatiotemporal gait parameters were analyzed. Friedman tests were used to determine overall differences across time points in both early (one hour) and late (day two through five) accommodation phases, for each gait variable. Statistically significant changes across the early phase were found for variables gait speed χ2(2)=8.000, p=0.018, cadence χ2(2)=7.185, p=0.028, and double support time on the sound side χ2(2)=8.615, p=0.013. Across days two through five, no gait variable significantly changed. VAS scores correlated strongly with step count (r=1.000, p<0.001) and cadence (r=0.857, p=0.014). Longer accommodation periods resulted in less deviations of gait variables for the clinical assessment in the process of prosthetic rehabilitation. Trying out prosthetic interventions for less than one hour has yielded unreliable outcomes.

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Gait performance of the elderly under dual-task conditions: Review of instruments employed and kinematic parameters

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1809-9823.2016.14159 ◽

2016 ◽

Vol 19 (1) ◽

pp. 165-182 ◽

Cited By ~ 6

Author(s):

Gisele de Cássia Gomes ◽

Luci Fuscaldi Teixeira-Salmela ◽

Flávia Alexandra Silveira de Freitas ◽

Maria Luísa Morais Fonseca ◽

Marina de Barros Pinheiro ◽

...

Keyword(s):

The Elderly ◽

Elderly Persons ◽

Step Width ◽

Kinematic Parameters ◽

Time Step ◽

Double Support ◽

Gait Parameters ◽

Task Conditions ◽

Double Support Time ◽

Support Time

Introduction The physiological deterioration associated with ageing exposes elderly persons to greater risks of falls, especially during the performance of simultaneous tasks during gait. Objectives To evaluate the effects of dual tasks (DT) on spatiotemporal gait parameters and to identify the tools and tasks most commonly used to assess the performance of DT among the elderly. Method Searches of the MEDLINE, PsycINFO, CINAHL, and SciELO databases were conducted. Observational studies, which evaluated gait changes during the performance of DT, published up to April 2014, were selected. Results A total of 385 articles were found, of which 28 were selected. Decreases in speed and increases in stride variability, stride time, step width, and double support time were observed under DT conditions. Motion analysis systems, such as the GAITRite walkway(r) system were the mostly commonly used instruments for the analyses of kinematic parameters (16 studies). DT was most commonly assessed by arithmetic calculations in 20 studies, followed by verbal fluency, in nine studies. The gait parameters most commonly assessed were speed (19 studies), followed by stride variability (14 studies). Conclusion The elderly showed changes in spatiotemporal gait parameters under DT conditions. Gait speed and stride variability were often assessed and, together, were considered good indicators of risks of falls.

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THE EFFECTS OF TRAINING ON DIFFERENT SURFACES, ON BALANCE AND GAIT PERFORMANCE IN STROKE HEMIPLEGIA

Revista Brasileira de Medicina do Esporte ◽

10.1590/1517-8692202127062020_0089 ◽

2021 ◽

Vol 27 (6) ◽

pp. 592-596

Author(s):

Hyun-Seung Rhyu ◽

Soung-Yob Rhi

Keyword(s):

Gait Analysis ◽

Cycle Time ◽

Dynamic Balance ◽

Static Balance ◽

Stroke Patients ◽

Elderly Male ◽

Gait Performance ◽

Double Support ◽

Double Support Time ◽

Support Time

ABSTRACT Although many studies have focused on balance exercises for elderly or stroke patients, no comprehensive studies have investigated the use of training on different surfaces (TDS) with analysis of gait performance in elderly male stroke patients. The active properties of balance and subjective reporting of functional gait ability were used to identify the effects of TDS. Static balance (SB), dynamic balance (DB) and gait analysis was measured in 30 elderly stroke patients. The patients were divided into the TDS group (n=15) and a control group (CG, n=15). Fifteen elderly stroke patients underwent TDS five times a week for 12 weeks. The data was analyzed using repeated measures analysis of variance. Significant differences were observed between the two groups (TDS and Control): SB (p < 0.0001), DB (OSI: p < 0.0001, APSI: p < 0.001, MLSI: p < 0.004) and gait analysis (right: temporal step time: p < 0.0001, temporal cycle time: p < 0.001, temporal double support time: p < 0.0001; left: temporal step time: p < 0.0001, temporal cycle time: p < 0.0001, temporal double support time: p < 0.0001). TDS in elderly male stroke patients suggests that the characteristics of gait performance in these patients may be improved by increasing static balance, dynamic balance and gait velocity. It is hoped that the results of this trial will provide new information on the effects of TDS on balance stability and gait ability in stroke patients, through changes in stability of the lower extremities. Level III, Case-control Study.

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FRAILTY ASSESSMENT BASED ON THE QUALITY OF DAILY WALKING

Innovation in Aging ◽

10.1093/geroni/igz038.328 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S85-S85 ◽

Cited By ~ 1

Author(s):

Danya Pradeep Kumar ◽

Nima Toosizadeh ◽

Jane Mohler ◽

Kaveh Laksari

Keyword(s):

Physical Activity ◽

Gait Analysis ◽

Logistic Models ◽

Gait Variability ◽

Geriatric Syndrome ◽

Age Related ◽

Power Spectral ◽

Gait Parameters ◽

Clinical Gait Analysis

Abstract Frailty is an increasingly recognized geriatric syndrome resulting in age-related decline in reserve across multiple physiologic systems. An impaired physical function is a prime indicator of frailty. In this study, we aim to implement a body-worn sensor to characterize the quantity and quality of everyday walking, and establish associations between gait impairment and frailty. Daily physical activity was acquired for 48 hours from 125 older adults (≥65 years; 44 non-frail, 60 pre-frail, and 21 frail based on the Fried gold standard) using a tri-axial accelerometer motion-sensor. Continuous purposeful walks (≥60s) without pauses were identified from time-domain acceleration data. Power spectral density (PSD) analysis was performed to define higher gait variability, which was identified by a shorter and wider PSD peak. Association between frailty and gait parameters was assessed using multivariable nominal logistic models with frailty as the dependent variable, and demographic parameters along with the gait parameters as the independent variables. Stride times, PSD gait variability, and total and maximum continuous purposeful walking duration were significantly different between non-frail and pre-frail/frail groups (p<0.05). Using a step-wise model with the above qualitative and quantitative gait parameters as predictors, the pre-frail/frail group (vs. non-frail) was identified with 71.4% sensitivity and 75.4% specificity. Everyday walking characteristics were found to be accurate determinants of frailty. Along with quantitative measures of physical activity, qualitative measures are critical elements representing the stages of frailty. In-home gait analysis is advantageous over clinical gait analysis as it enables cost- and space-effective continuous monitoring.

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Gait parameters and characteristics associated with increased risk of falls in people with dementia: a systematic review

International Psychogeriatrics ◽

10.1017/s1041610218001783 ◽

2018 ◽

Vol 31 (9) ◽

pp. 1287-1303 ◽

Cited By ~ 6

Author(s):

Shirin Modarresi ◽

Alison Divine ◽

Jessica A. Grahn ◽

Tom J. Overend ◽

Susan W. Hunter

Keyword(s):

Systematic Review ◽

Rating Scale ◽

Future Research ◽

Time Variability ◽

Double Support ◽

People With Dementia ◽

Gait Parameters ◽

Increased Risk ◽

Double Support Time ◽

Support Time

ABSTRACTBackground:People with dementia fall twice as often and have more serious fall-related injuries than healthy older adults. While gait impairment as a generic term is understood as a fall risk factor in this population, a clear elaboration of the specific components of gait that are associated with falls risk is needed for knowledge translation to clinical practice and the development of fall prevention strategies for people with dementia.Objective:To review gait parameters and characteristics associated with falls in people with dementia.Methods:Electronic databases CINAHL, EMBASE, MedLine, PsycINFO, and PubMed were searched (from inception to April 2017) to identify prospective cohort studies evaluating the association between gait and falls in people with dementia.Results:Increased double support time variability, use of mobility aids, walking outdoors, higher scores on the Unified Parkinson’s Disease Rating Scale, and lower average walking bouts were associated with elevated risk of any fall. Increased double support time and step length variability were associated with recurrent falls. The reviewed articles do not support using the Performance Oriented Mobility Assessment and the Timed Up-and-Go tests to predict any fall in this population. There is limited research on the use of dual-task gait assessments for predicting falls in people with dementia.Conclusion:This systematic review shows the specific spatiotemporal gait parameters and features that are associated with falls in people with dementia. Future research is recommended to focus on developing specialized treatment methods for these specific gait impairments in this patient population.

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Wearable Sensors Technology as a Tool for Discriminating Frailty Levels During Instrumented Gait Analysis

10.21203/rs.3.rs-33024/v1 ◽

2020 ◽

Author(s):

Andrius Apsega ◽

Liudvikas Petrauskas ◽

Vidmantas Alekna ◽

Kristina Daunoraviciene ◽

Viktorija Sevcenko ◽

...

Keyword(s):

Gait Analysis ◽

Gait Speed ◽

Stance Phase ◽

Wearable Sensors ◽

Logistic Models ◽

Stride Time ◽

Double Support ◽

Phase Time ◽

Gait Assessment ◽

Gait Parameters

Abstract Background: One of the greatest challenges facing the healthcare of the aging population is frailty. There is growing scientific evidence that gait assessment using wearable sensors could be used for prefrailty and frailty screening. The purpose of this study was to examine the ability of a wearable sensor-based assessment of gait to discriminate between frailty levels (robust, prefrail, and frail).Methods: 133 participants (≥ 60 years) were recruited and frailty was assessed using the Fried criteria. Gait was assessed using wireless inertial sensors attached by straps on the thighs, shins, and feet. Between-group differences in frailty were assessed using analysis of variance. Associations between frailty and gait parameters was assessed using multinomial logistic models with frailty as the dependent variable. We used receiver operating characteristic (ROC) curves to calculate the area under the curve (AUC) to estimate the predictive validity of each parameter. The cut-off values were calculated based on the Youden index.Results: Frailty was identified in 37 (28%) participants, prefrailty in 66 (50%), and no Fried criteria were found in 30 (23%) participants. Gait speed, stance phase time, swing phase time, stride time, double support time, and cadence were able to discriminate frailty from robust, and prefrail from robust. Stride time (AUC = 0.915), stance phase (AUC = 0.923), and cadence (AUC = 0.930) were the most sensitive parameters to separate frail or prefrail from robust. Other gait parameters, such as double support, had poor sensitivity. We determined the value of stride time (1.19s), stance phase time (0.68s), and cadence (101 steps/min) to identify individuals with prefrailty or frailty with sufficient sensitivity and specificity.Conclusions: The results of our study show that gait analysis using wearable sensors could discriminate between frailty levels. We were able to identify several gait indicators apart from gait speed that distinguish frail or prefrail from robust with sufficient sensitivity and specificity. If improved and adapted for everyday use, gait assessment technologies could contribute to frailty screening and monitoring.

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Wearable Sensors Technology as a Tool for Discriminating Frailty Levels During Instrumented Gait Analysis

Applied Sciences ◽

10.3390/app10238451 ◽

2020 ◽

Vol 10 (23) ◽

pp. 8451

Author(s):

Andrius Apsega ◽

Liudvikas Petrauskas ◽

Vidmantas Alekna ◽

Kristina Daunoraviciene ◽

Viktorija Sevcenko ◽

...

Keyword(s):

Gait Analysis ◽

Sensitivity And Specificity ◽

Gait Speed ◽

Stance Phase ◽

Wearable Sensors ◽

Stride Time ◽

Double Support ◽

Phase Time ◽

Gait Assessment ◽

Gait Parameters

Background and objectives: One of the greatest challenges facing the healthcare of the aging population is frailty. There is growing scientific evidence that gait assessment using wearable sensors could be used for prefrailty and frailty screening. The purpose of this study was to examine the ability of a wearable sensor-based assessment of gait to discriminate between frailty levels (robust, prefrail, and frail). Materials and methods: 133 participants (≥60 years) were recruited and frailty was assessed using the Fried criteria. Gait was assessed using wireless inertial sensors attached by straps on the thighs, shins, and feet. Between-group differences in frailty were assessed using analysis of variance. Associations between frailty and gait parameters were assessed using multinomial logistic models with frailty as the dependent variable. We used receiver operating characteristic (ROC) curves to calculate the area under the curve (AUC) to estimate the predictive validity of each parameter. The cut-off values were calculated based on the Youden index. Results: Frailty was identified in 37 (28%) participants, prefrailty in 66 (50%), and no Fried criteria were found in 30 (23%) participants. Gait speed, stance phase time, swing phase time, stride time, double support time, and cadence were able to discriminate frailty from robust, and prefrail from robust. Stride time (AUC = 0.915), stance phase (AUC = 0.923), and cadence (AUC = 0.930) were the most sensitive parameters to separate frail or prefrail from robust. Other gait parameters, such as double support, had poor sensitivity. We determined the value of stride time (1.19 s), stance phase time (0.68 s), and cadence (101 steps/min) to identify individuals with prefrailty or frailty with sufficient sensitivity and specificity. Conclusions: The results of our study show that gait analysis using wearable sensors could discriminate between frailty levels. We were able to identify several gait indicators apart from gait speed that distinguish frail or prefrail from robust with sufficient sensitivity and specificity. If improved and adapted for everyday use, gait assessment technologies could contribute to frailty screening and monitoring.

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Physiological and Cognitive Determinants of Dual-Task Costs for Gait Parameters: The Yishun Study

Gerontology ◽

10.1159/000514171 ◽

2021 ◽

pp. 1-10

Author(s):

Lay Khoon Lau ◽

Jagadish Ullal Mallya ◽

Wei Jun Benedict Pang ◽

Kexun Kenneth Chen ◽

Khalid bin Abdul Jabbar ◽

...

Keyword(s):

Dual Task ◽

Gait Speed ◽

Postural Sway ◽

Step Length ◽

Double Support ◽

Immediate Memory ◽

Gait Parameters ◽

Primary Determinant ◽

Double Support Time ◽

Support Time

Background: Studies indicate that physiological and cognitive aging are causally related and functionally interdependent. However, the relative contribution of physiological factors and cognition to dual-task costs (DTC) of gait parameters has not been well studied. In this cross-sectional study, we examined the trajectory of DTC of gait parameters across the adult age spectrum for both sexes and identified the contributions of physical and cognitive performance to DTC of gait. Methods: A total of 492 community-dwelling adults, aged 21–90 years, were randomly recruited into the study. Participants were divided into 7 age groups, with 10-year age range for each group. Demographic data, height, body mass, education level, and information on comorbidities were recorded. Cognition was measured using the Repeatable Battery for the Assessment of Neuropsychological Status. Physical performance included visual contrast sensitivity, postural sway, hand reaction time, handgrip strength, knee extensor strength, and single-task and dual-task gait assessments. Stepwise multivariable regression was used to examine the association between physical and cognitive performance with DTC of gait parameters. Results: Women were found to have significantly higher DTC of gait speed (p = 0.01), cadence (p < 0.01), and double support time (p < 0.01) than men. However, significant aging effect on DTC of gait speed (p = 0.01), step length (p = 0.01), and double support time (p = 0.01) was observed in men but not in women. Immediate memory was the primary determinant for the DTC of gait speed (β = −0.25, p < 0.01), step length (β = −0.22, p < 0.01), and cadence (β = −0.15, p = 0.03) in men. Besides immediate memory, postural sway (β = −0.13, p = 0.03) and hand reaction (β = 0.14, p = 0.02) were also significantly associated with DTC of step length and cadence, respectively, in women. Conclusion: There were sex differences in the amplitude and trajectories of DTC of gait parameters. The DTC increased with age in men but not in women. Immediate memory was the primary determinant of DTC of gait parameters in men while immediate memory, postural sway, and reaction time were associated with DTC of gait in women. Future studies should investigate the clinical implications of the sex differences in the DTC with fall risks.

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A Clinical Gait Analysis System

Engineering in Medicine ◽

10.1243/emed_jour_1987_016_049_02 ◽

1987 ◽

Vol 16 (4) ◽

pp. 217-220 ◽

Cited By ~ 4

Author(s):

Malcolm Ellis ◽

Adrian Howe

Keyword(s):

Gait Analysis ◽

Telemetry System ◽

System A ◽

Normal Gait ◽

Laboratory Facilities ◽

Contact Data ◽

The Subject ◽

Analysis System ◽

User Friendly ◽

Clinical Gait Analysis

A gait analysis system has been devised that is not only relatively inexpensive, but is also quick to use, requires no expertise to run, and does not need any special laboratory facilities. The system monitors the subject's knee and hip movements during ambulation using electro-goniometers. Foot contact data are obtained using lightweight, flexible, foot switches. The data are sent to a computer via an eight channel telemetry system carried by the subject on a waist belt. The software is designed to simplify analysis and be ‘user friendly’. After a simple calibration routine, the system prompts the operator to ask the subject to walk a number of steps. The computer ignores the initial steps taken as these are not typical of normal gait. It then collects data from the consequent steps, averages the data and then displays them in both graphical and numerical form. A patient can be tested and a printout provided for insertion in the patient's notes within ten minutes. Only one hours training is required to learn to operate the system. A patient can be tested in a physiotherapy department, corridor, or in any area where a few consecutive steps can be taken.

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