Evaluation of gait transitional phases using neuromechanical outputs and somatosensory inputs in an overground walk

Gait dynamic stability evaluation in patients undergoing hip joint fractures - tools to measure rehabilitation effectiveness

A hip joint fracture includes a break in the thigh (femur) or coxa bone near the pelvis. During fracture healing, stability and weight bearing by the affected limb are key indicators to measure patients' improvement. Conventionally, the rehabilitation effectiveness is monitored through clinical examinations, patients' feedback, and few studies also reported instrumented gait evaluations. A gap remains there to numerically quantify the recovery in patients' stability and weight bearing in response to rehabilitation therapies. This study introduces Nyquist and Bode (N&B) methods to analyse the instrumented gait signals further and evaluate gait stability in hip fracture patients during weight loading and unloading transitions. The centre of pressure (CoP) data was recorded using force plates for conditions: coxa hip fracture (HC), femur hip fracture (HF), and normal hip joint (NH). The time rate of CoP signals illustrated two major impulses during the loading and unloading phases which were modelled in time and frequency domains. The frequency models were further analysed by applying N&B methods and stability margins were computed for both impaired and healthy conditions. Results illustrated a significant decrease (Kruskal-Wallis's test, p < 0.001) in the intralimb walking stability of both fracture conditions. Further, Spearman's correlation between CoP velocities of fractured and intact limbs illustrated significant interlimb dependencies to maintain walking stability (p < 0.001) during weight loading and unloading transitions. Overall, the HF impairment illustrated the least intralimb walking stability and relatively greater interlimb dependencies. Clinically, these methods and findings are important to measure the recovery in patients undergoing rehabilitation after a hip joint or other lower limb impairments.

Cross-Domain Self-Supervised Complete Geometric Representation Learning for Real-Scanned Point Cloud Based Pathological Gait Analysis

Accurate lower-limb pose estimation is a prerequisite of skeleton based pathological gait analysis. To achieve this goal in free-living environments for long-term monitoring, single depth sensor has been proposed in research. However, the depth map acquired from a single viewpoint encodes only partial geometric information of the lower limbs and exhibits large variations across different viewpoints. Existing off-the-shelf three-dimensional (3D) pose tracking algorithms and public datasets for depth based human pose estimation are mainly targeted at activity recognition applications. They are relatively insensitive to skeleton estimation accuracy, especially at the foot segments. Furthermore, acquiring ground truth skeleton data for detailed biomechanics analysis also requires considerable effort. To address these issues, we propose a novel cross-domain self-supervised complete geometric representation learning framework, with knowledge transfer from the unlabelled synthetic point clouds of full lower-limb surfaces. The proposed method can significantly reduce the number of ground truth skeletons (with only 1\%) in the training phase, meanwhile ensuring accurate and precise pose estimation and capturing discriminative features across different pathological gait patterns compared to other methods.

Cross-Subject and Cross-Modal Transfer for Generalized Abnormal Gait Pattern Recognition

For abnormal gait recognition, pattern-specific features indicating abnormalities are interleaved with the subject-specific differences representing biometric traits. Deep representations are, therefore, prone to overfitting, and the models derived cannot generalize well to new subjects. Furthermore, there is limited availability of abnormal gait data obtained from precise Motion Capture (Mocap) systems because of regulatory issues and slow adaptation of new technologies in health care. On the other hand, data captured from markerless vision sensors or wearable sensors can be obtained in home environments, but noises from such devices may prevent the effective extraction of relevant features. To address these challenges, we propose a cascade of deep architectures that can encode cross-modal and cross-subject transfer for abnormal gait recognition. Cross-modal transfer maps noisy data obtained from RGBD and wearable sensors to accurate 4-D representations of the lower limb and joints obtained from the Mocap system. Subsequently, cross-subject transfer allows disentangling subject-specific from abnormal pattern-specific gait features based on a multiencoder autoencoder architecture. To validate the proposed methodology, we obtained multimodal gait data based on a multicamera motion capture system along with synchronized recordings of electromyography (EMG) data and 4-D skeleton data extracted from a single RGBD camera. Classification accuracy was improved significantly in both Mocap and noisy modalities.

A model identification approach to quantify impact of whole-body vertical vibrations on limb compliant dynamics and walking stability

Extensive research is ongoing in the field of orthoses/exoskeleton design for efficient lower limbs assistance. However, despite wearable devices reported to improve lower limb mobility, their structural impacts on whole-body vertical dynamics have not been investigated. This study introduced a model identification approach and frequency domain analysis to quantify the impacts of orthosis-generated vibrations on limb stability and contractile dynamics. Experiments were recorded in the motion capture lab using 11 unimpaired subjects by wearing an adjustable ankle-foot orthosis (AFO). The lower limb musculoskeletal structure was identified as spring-mass (SM) and spring-mass-damper (SMD) based compliant models using the whole-body centre-of-mass acceleration data. Furthermore, Nyquist and Bode methods were implemented to quantify stabilities resulting from vertical impacts. Our results illustrated a significant decrease (p < 0.05) in lower limb contractile properties by wearing AFO compared with a normal walk. Also, stability margins quantified by wearing AFO illustrated a significant variance in terms of gain-margins (p < 0.05) for both loading and unloading phases whereas phase-margins decreased (p < 0.05) only for the respective unloading phases. The methods introduced here provide evidence that wearable orthoses significantly affect lower limb vertical dynamics and should be considered when evaluating orthosis/prosthesis/exoskeleton effectiveness.