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2022 ◽  
pp. 9-18
Author(s):  
Luca Lonini ◽  
Yaejin Moon ◽  
Kyle Embry ◽  
R. James Cotton ◽  
Kelly McKenzie ◽  
...  

Recent advancements in deep learning have produced significant progress in markerless human pose estimation, making it possible to estimate human kinematics from single camera videos without the need for reflective markers and specialized labs equipped with motion capture systems. Such algorithms have the potential to enable the quantification of clinical metrics from videos recorded with a handheld camera. Here we used DeepLabCut, an open-source framework for markerless pose estimation, to fine-tune a deep network to track 5 body keypoints (hip, knee, ankle, heel, and toe) in 82 below-waist videos of 8 patients with stroke performing overground walking during clinical assessments. We trained the pose estimation model by labeling the keypoints in 2 frames per video and then trained a convolutional neural network to estimate 5 clinically relevant gait parameters (cadence, double support time, swing time, stance time, and walking speed) from the trajectory of these keypoints. These results were then compared to those obtained from a clinical system for gait analysis (GAITRite®, CIR Systems). Absolute accuracy (mean error) and precision (standard deviation of error) for swing, stance, and double support time were within 0.04 ± 0.11 s; Pearson’s correlation with the reference system was moderate for swing times (<i>r</i> = 0.4–0.66), but stronger for stance and double support time (<i>r</i> = 0.93–0.95). Cadence mean error was −0.25 steps/min ± 3.9 steps/min (<i>r</i> = 0.97), while walking speed mean error was −0.02 ± 0.11 m/s (<i>r</i> = 0.92). These preliminary results suggest that single camera videos and pose estimation models based on deep networks could be used to quantify clinically relevant gait metrics in individuals poststroke, even while using assistive devices in uncontrolled environments. Such development opens the door to applications for gait analysis both inside and outside of clinical settings, without the need of sophisticated equipment.


Biology ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 36
Author(s):  
Honghao Liu ◽  
Bo Li ◽  
Minjian Zhang ◽  
Chuankai Dai ◽  
Pengcheng Xi ◽  
...  

Humans and other animals can quickly respond to unexpected terrains during walking, but little is known about the cortical dynamics in this process. To study the impact of unexpected terrains on brain activity, we allowed rats with blocked vision to walk on a treadmill in a bipedal posture and then walk on an uneven area at a random position on the treadmill belt. Whole brain EEG signals and hind limb kinematics of bipedal-walking rats were recorded. After encountering unexpected terrain, the θ band power of the bilateral M1, the γ band power of the left S1, and the θ to γ band power of the RSP significantly decreased compared with normal walking. Furthermore, when the rats left uneven terrain, the β band power of the bilateral M1 and the α band power of the right M1 decreased, while the γ band power of the left M1 significantly increased compared with normal walking. Compared with the flat terrain, the θ to low β (3–20 Hz) band power of the bilateral S1 increased after the rats contacted the uneven terrain and then decreased in the single- or double- support phase. These results support the hypothesis that unexpected terrains induced changes in cortical activity.


2021 ◽  
Vol 12 ◽  
Author(s):  
Faustyna Manikowska ◽  
Sabina Brazevic ◽  
Anna Krzyżańska ◽  
Marek Jóźwiak

Background: Gait dysfunction is a crucial factor that restricts independence and quality of life in children with cerebral palsy (CP). Gait training based on robotic-assisted therapy (RAT) is widely used, but information about effectiveness and ideal patient profile is not sufficient. Aim of this study was to assess the effect of RAT on gait parameters in spastic children with CP, and to determine whether changes in gait parameters are different among patients on different ambulatory levels.Method: A total of 26 children with bilateral spastic CP were divided into two groups based on their functional ability: non-assisted ambulator (NAS) or assisted ambulator (AS); and underwent a RAT program (30 training sessions of RAT during 10 weeks). Gait analysis was performed: before the therapy (t1), right after (t2), and 6 weeks later (t3).Results: No significant changes in spatiotemporal parameters or gait deviation index at t2 or t3. Double support symmetry significantly improved (t1 vs. t3, p = 0.03) for the whole group (NAS + AS). Walking speed symmetry significantly improved (t2 vs. t3, p = 0.02) for group AS.Conclusion: RAT based on our protocol did not change spatiotemporal parameters and kinematics of walking except limited improvement in some aspects of gait symmetry. We did not find differences in changes in selected objective gait parameters among children with CP in different ambulatory levels.


2021 ◽  
Vol 11 (12) ◽  
pp. 1648
Author(s):  
John W. Chow ◽  
Dobrivoje S. Stokic

Given the paucity of longitudinal data in gait recovery after stroke, we compared temporospatial gait characteristics of stroke patients during subacute (<2 months post-onset, T0) and at approximately 6 and 12 months post-onset (T1 and T2, respectively) and explored the relationship between gait characteristics at T0 and the changes in gait speed from T0 to T1. Forty-six participants were assessed at T0 and a subsample of 24 participants at T2. Outcome measures included Fugl-Meyer lower-extremity motor score, 14 temporospatial gait parameters and symmetry indices of 5 step parameters. Except for step width, all temporospatial parameters improved from T0 to T1 (p ≤ 0.0001). Additionally, significant improvements in symmetry were found for the initial double-support time and single-support time (p ≤ 0.0001). Although group results at T2 were not different from those at T1, the individual analysis revealed that 42% (10/24) of the subsample showed a significant increase in gait speed. The increase in gait speed from T0 to T1 was negatively correlated with gait speed and stride length, and positively correlated with the symmetry indices of stance and single-support times at T0 (p ≤ 0.002). Temporospatial gait parameters and stance time symmetry improve over the first 6 months after stroke with an apparent plateau thereafter. Approximately 40% of the subsample continue to increase gait speed from 6 to 12 months post-stroke. A greater increase in gait speed during the first 6 months post-stroke is associated with initially slower walking, shorter stride length, and more pronounced asymmetry in stance and single-support times. The improvement in lower-extremity motor function and bilateral improvements in step parameters collectively suggest that gait changes over the first 12 months after stroke are likely due to neurological recovery, although some compensation by the non-paretic side cannot be excluded.


Sensors ◽  
2021 ◽  
Vol 21 (24) ◽  
pp. 8286
Author(s):  
Luis R. Peraza ◽  
Kirsi M. Kinnunen ◽  
Roisin McNaney ◽  
Ian J. Craddock ◽  
Alan L. Whone ◽  
...  

The use of wearable sensors allows continuous recordings of physical activity from participants in free-living or at-home clinical studies. The large amount of data collected demands automatic analysis pipelines to extract gait parameters that can be used as clinical endpoints. We introduce a deep learning-based automatic pipeline for wearables that processes tri-axial accelerometry data and extracts gait events—bout segmentation, initial contact (IC), and final contact (FC)—from a single sensor located at either the lower back (near L5), shin or wrist. The gait events detected are posteriorly used for gait parameter estimation, such as step time, length, and symmetry. We report results from a leave-one-subject-out (LOSO) validation on a pilot study dataset of five participants clinically diagnosed with Parkinson’s disease (PD) and six healthy controls (HC). Participants wore sensors at three body locations and walked on a pressure-sensing walkway to obtain reference gait data. Mean absolute errors (MAE) for the IC events ranged from 22.82 to 33.09 milliseconds (msecs) for the lower back sensor while for the shin and wrist sensors, MAE ranges were 28.56–64.66 and 40.19–72.50 msecs, respectively. For the FC-event detection, MAE ranges were 29.06–48.42, 40.19–72.70 and 36.06–60.18 msecs for the lumbar, wrist and shin sensors, respectively. Intraclass correlation coefficients, ICC(2,k), between the estimated parameters and the reference data resulted in good-to-excellent agreement (ICC ≥ 0.84) for the lumbar and shin sensors, excluding the double support time (ICC = 0.37 lumbar and 0.38 shin) and swing time (ICC = 0.55 lumbar and 0.59 shin). The wrist sensor also showed good agreements, but the ICCs were lower overall than for the other two sensors. Our proposed analysis pipeline has the potential to extract up to 100 gait-related parameters, and we expect our contribution will further support developments in the fields of wearable sensors, digital health, and remote monitoring in clinical trials.


Author(s):  
I. N. Vankina ◽  
D. A. Fetisov

Modeling the anthropomorphic robot movement is of great interest to researchers all over the world. At the same time, the movement control of a walking mechanism is always a high dimension challenge. The difficulty with the anthropomorphic robot control is also caused by the fact that such a mechanism has always a hybrid dynamics and represents a sequential change of two phases – the single support phase and the double support phase (phase of changing robot’s leg). At the single support phase and at another phase the behavior of the biped robot is described by a system of ordinary differential equations and by a system of linear algebraic equations, respectively.The task of biped robot movement control has been studied in detail for the case when the robot moves over the horizontal surface. Obstacles make the task significantly complicated. The paper considers the movement control of the biped robot over the surface that is a periodic alternation of horizontal sections and obstacles. The obstacles represent steps of the same height known. It is assumed that the lengths of horizontal sections and steps are known as well. The objective is to create a control that provides robot’s periodic movement over the specified surface according to inherent characteristics of a walking human.For the single support phase, the outputs are proposed, the equality of which to zero corresponds to the robot’s movement with a given set of characteristics. The paper presents the feedback controls that stabilize the proposed outputs for a finite amount of time. By choosing the feedback parameters, it is possible to adjust the stabilization time so that the outputs become equal to zero when reached the end of each step.It is shown that for the chosen control law, the problem of constructing the control of robot’s periodic movement is reduced to the solution of a nonlinear equation. In the paper, we discuss the approaches to solving this equation and present the results of numerical simulation.The results obtained can be used to solve the problem of providing control of the biped robot movement over the surfaces with obstacles of a more complicated shape.Modeling the anthropomorphic robot movement is of great interest to researchers all over the world. At the same time, the movement control of a walking mechanism is always a high dimension challenge. The difficulty with the anthropomorphic robot control is also caused by the fact that such a mechanism has always a hybrid dynamics and represents a sequential change of two phases – the single support phase and the double support phase (phase of changing robot’s leg). At the single support phase and at another phase the behavior of the biped robot is described by a system of ordinary differential equations and by a system of linear algebraic equations, respectively.The task of biped robot movement control has been studied in detail for the case when the robot moves over the horizontal surface. Obstacles make the task significantly complicated. The paper considers the movement control of the biped robot over the surface that is a periodic alternation of horizontal sections and obstacles. The obstacles represent steps of the same height known. It is assumed that the lengths of horizontal sections and steps are known as well. The objective is to create a control that provides robot’s periodic movement over the specified surface according to inherent characteristics of a walking human.For the single support phase, the outputs are proposed, the equality of which to zero corresponds to the robot’s movement with a given set of characteristics. The paper presents the feedback controls that stabilize the proposed outputs for a finite amount of time. By choosing the feedback parameters, it is possible to adjust the stabilization time so that the outputs become equal to zero when reached the end of each step.It is shown that for the chosen control law, the problem of constructing the control of robot’s periodic movement is reduced to the solution of a nonlinear equation. In the paper, we discuss the approaches to solving this equation and present the results of numerical simulation.The results obtained can be used to solve the problem of providing control of the biped robot movement over the surfaces with obstacles of a more complicated shape.


2021 ◽  
Vol 11 (12) ◽  
pp. 1605
Author(s):  
Tauana Callais Franco do Nascimento ◽  
Flavia Martins Gervásio ◽  
Antonia Pignolo ◽  
Guilherme Augusto Santos Bueno ◽  
Aline Araújo do Carmo ◽  
...  

Introduction: Postural abnormalities are common in patients with Parkinson’s disease (PD) and lead to gait abnormalities. Relationships between changes in the trunk posture of PD patients and gait profile score (GPS) and gait spatiotemporal parameters are poorly investigated. The aim of the current study was to investigate the relationships between trunk posture, GPS, and gait spatiotemporal parameters, in patients with PD. Materials and Methods: Twenty-three people with PD and nineteen age-matched healthy people participated in this study. A 3D gait kinematical analysis was applied to all participants using the Plug-In Gait Full BodyTM tool. Trunk and limb kinematics patterns and gait spatio-temporal parameters of patients with PD and the control group were compared. Additionally, correlations between trunk kinematics patterns, gait spatio-temporal parameters, and GPS of the PD group were tested. Results: Cadence, opposite foot off, step time, single support, double support, foot off, gait speed, trunk kinematics, and GPS showed significant differences between the two groups (p ≤ 0.05). Posture of the trunk during gait was not related to the spatio-temporal parameters and gait profile score in the PD group. The trunk flexor pattern influenced GPS domains, mainly of the ankle and the knee. Discussion and Conclusions: Flexed posture of the trunk in patients with PD seems to influence both ankle and knee movement patterns during the gait. The GPS analysis provided direct and simplified kinematic information for the PD group. These results may have implications for understanding the importance of considering the positioning of the trunk during gait.


2021 ◽  
Vol 27 (6) ◽  
pp. 592-596
Author(s):  
Hyun-Seung Rhyu ◽  
Soung-Yob Rhi

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.


Author(s):  
Artur Stolarczyk ◽  
Magda Stolarczyk ◽  
Łukasz Oleksy ◽  
Grzegorz J. Maciąg ◽  
Piotr Stępiński ◽  
...  

Abstract Introduction Total hip replacement (THR) is considered one of the most effective medical procedures in treatment of osteoarthritis. Since its introduction, there has been a worldwide debate over proper implant selection in terms of size, bearing type and shape. Following study was designed to assess the importance of femoral head size in long-term follow-up. Materials and methods A cohort of 30 patients with primary end stage osteoarthritis who underwent total hip replacement was analysed retrospectively. A homogenous group was chosen with no major differences in BMI. Patients’ gait parameters were measured in a biomechanics laboratory using the 3D BTS Smart system. WOMAC and VAS questionnaires were used to assess patient reported outcome. Results The subgroup with larger implant head size had several outcomes significantly superior to the subgroup with standard head size and non-inferior to healthy hips. Following variables were measured during this study: time of support phase, time of swing phase, double support time, walking hip extension angle. Conclusions Use of larger sized femoral heads during THR gives better results in terms of gait pattern. Since restoring the gait pattern is one of the aspects of rehabilitation and returning to daily activities it seems to be an important observation.


Author(s):  
Mohamed A. Abdel Ghafar ◽  
Osama R Abdelraouf ◽  
Amr A. Abdel-aziem ◽  
Gihan Samir Mousa ◽  
Ali O. Selim ◽  
...  

Background: One of the important goals in the treatment of spastic cerebral palsy is to maintain efficient and effective walking in order to be independent in activities and participate in society. Objective: To compare the efficacy of foot combination taping of kinesio tape and athletic tape vs ankle foot orthosis in correcting spatiotemporal gait parameters in children with spastic diplegia. Methods: Thirty-six children with spastic diplegia were randomly assigned into 3 groups; control, combination taping, and ankle foot orthosis groups. Children in the control group, in addition to those in both experimental groups, continued with conventional physical therapy, 1 h, 3 times per week for 4 weeks. Spatiotemporal gait parameters were assessed with the GAITRite system before and after the application of interventions. Results: Significant increases in walking velocity, step length, stride length, right single support duration, and left single support duration of the ankle foot orthosis and combination taping groups than pre-intervention values. [AQ9] Moreover, the post--intervention values of the double support duration of the ankle foot orthosis and combination taping groups were significantly lower than pre-intervention values. There were no significant differences between the post-intervention values of the ankle foot orthosis and combination taping groups for all parameters. Conclusion: The results demonstrated that combination taping is an effective alternative technique to ankle foot orthosis to improve spatiotemporal parameters in children with spastic diplegic in combination with conventional physiotherapy.


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