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Katmah R, Shehhi AA, Jelinek HF, Hulleck AA, Khalaf K. A Systematic Review of Gait Analysis in the Context of Multimodal Sensing Fusion and AI. IEEE Trans Neural Syst Rehabil Eng 2023; 31:4189-4202. [PMID: 37847624 DOI: 10.1109/tnsre.2023.3325215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
BACKGROUND Neurological diseases are a leading cause of disability and mortality. Gait, or human walking, is a significant predictor of quality of life, morbidity, and mortality. Gait patterns and other kinematic, kinetic, and balance gait features are accurate and powerful diagnostic and prognostic tools. OBJECTIVE This review article focuses on the applicability of gait analysis using fusion techniques and artificial intelligence (AI) models. The aim is to examine the significance of mixing several types of wearable and non-wearable sensor data and the impact of this combination on the performance of AI models. METHOD In this systematic review, 66 studies using more than two modalities to record and analyze gait were identified. 40 studies incorporated multiple gait analysis modalities without the use of artificial intelligence to extract gait features such as kinematic, kinetic, margin of stability, temporal, and spatial gait parameters, as well as cerebral activity. Similarly, 26 studies analyzed gait data using multimodal fusion sensors and AI algorithms. RESULTS The research summarized here demonstrates that the quality of gait analysis and the effectiveness of AI models can both benefit from the integration of data from many sensors. Meanwhile, the utilization of EMG signals in fusion data is especially advantageous. CONCLUSION The findings of this review suggest that a smart, portable, wearable-based gait and balance assessment system can be developed using multimodal sensing of the most cutting-edge, clinically relevant tools and technology available. The information presented in this article may serve as a vital springboard for such development.
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Pacini Panebianco G, Bisi MC, Stagni R, Fantozzi S. Timing estimation for gait in water from inertial sensor measurements: Analysis of the performance of 17 algorithms. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 197:105703. [PMID: 32818913 DOI: 10.1016/j.cmpb.2020.105703] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND AND OBJECTIVES Walking in water is used for rehabilitation in different pathological conditions. For the characterization of gait alterations related to pathology, gait timing assessment is of primary importance. With the widespread use of inertial sensors, several algorithms have been proposed for gait timing estimation (i.e. gait events and temporal parameters) out of the water, while an assessment of their performance for walking in water is still missing. The purpose of the present study was to assess the performance in the temporal segmentation for gait in water of 17 algorithms proposed in the literature. METHODS Ten healthy volunteers mounting 5 tri-axial inertial sensors (trunk, shanks and feet) walked on dry land and in water. Seventeen different algorithms were implemented and classified based on: 1) sensor position, 2) target variable, and 3) computational approach. Gait events identified from synchronized video recordings were assumed as reference. Temporal parameters were calculated from gait events. Algorithm performance was analysed in terms of sensitivity, positive predictive value, accuracy, and repeatability. RESULTS For walking in water, all Trunk-based algorithms provided a sensitivity lower than 81% and a positive predictive value lower than 94%, as well as acceleration-based algorithms, independently from sensor location, with the exception of two Shank-based ones. Drop in algorithm sensitivity and positive predictive value was associated to significant differences in the stride pattern of the specific analysed variables during walking in water as compared to walking on dry land, as shown by the intraclass correlation coefficient. When using Shank- or Foot-based algorithms, gait events resulted delayed, but the delay was compensated in the estimate of Stride and Step time; a general underestimation of Stance- and overestimation of Swing-time was observed, with minor exceptions. CONCLUSION Sensor position, target variable and computational approach determined different error distributions for different gait events and temporal parameters for walking in water. This work supports an evidence-based selection of the most appropriate algorithm for gait timing estimation for walking in water as related to the specific application, and provides relevant information for the design of new algorithms for the specific motor task.
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Affiliation(s)
- Giulia Pacini Panebianco
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", Viale del Risorgimento, 2, University of Bologna, Bologna 40136, Italy; Health Sciences and Technologies - Interdepartmental Center for Industrial Research, Via Tolara di Sopra, 50, 40064 Ozzano dell'Emilia, Italy.
| | - Maria Cristina Bisi
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", Viale del Risorgimento, 2, University of Bologna, Bologna 40136, Italy.
| | - Rita Stagni
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", Viale del Risorgimento, 2, University of Bologna, Bologna 40136, Italy; Health Sciences and Technologies - Interdepartmental Center for Industrial Research, Via Tolara di Sopra, 50, 40064 Ozzano dell'Emilia, Italy.
| | - Silvia Fantozzi
- Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", Viale del Risorgimento, 2, University of Bologna, Bologna 40136, Italy; Health Sciences and Technologies - Interdepartmental Center for Industrial Research, Via Tolara di Sopra, 50, 40064 Ozzano dell'Emilia, Italy.
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A review on muscle activation behaviour during gait in shallow water and deep-water running and surface electromyography procedures. J Bodyw Mov Ther 2020; 24:432-441. [PMID: 33218545 DOI: 10.1016/j.jbmt.2020.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 05/27/2020] [Accepted: 06/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Surface electromyography (sEMG) can provide information on muscle activation patterns during gait. OBJECTIVES To characterize electromyographic activity during gait in shallow water and during deep-water running compare to on land and to review and analyse underwater surface-electromyographic (sEMG) procedures. SEARCH METHODS Eight databases (MEDLINE, EMBASE, WEB OF SCIENCE, SPORT Discus, CINAHL, SCOPUS, SCIELO, and LILACS) were searched from their inception to the December of 2019. SELECTION CRITERIA The selected studies had to be related to electromyographic analysis of gait in an aquatic environment. DATA COLLECTION AND ANALYSIS The studies that met the inclusion criteria were reviewed by two independent reviewers and divided into four groups. RESULTS Ten studies met the inclusion criteria. Lower muscle activation was found with treadmill water walking compared to treadmill land walking. With deep-water running, the leg muscles (tibialis anterior and gastrocnemius lateralis) have lower muscle activation when compared to on land running, but the trunk and thigh muscles have higher activation. CONCLUSION If gait is performed on an aquatic treadmill, the muscles assessed had lower muscle activation when compared to land. During deep-water running activities, lower activation of the distal leg muscles and a higher activation thigh muscles were found when compared to on land. Studies did not follow standard processes in sEMG procedures.
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Saleh MSM, Rehab NI, Aly SMA. Effect of aquatic versus land motor dual task training on balance and gait of patients with chronic stroke: A randomized controlled trial. NeuroRehabilitation 2019; 44:485-492. [DOI: 10.3233/nre-182636] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Nagwa Ibrahim Rehab
- Department of Physical Therapy for Neuromuscular Disorders and its Surgery, Faculty of Physical Therapy, Cairo University, Egypt
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Posada-Quintero H, Noh Y, Eaton-Robb C, Florian JP, Chon KH. Feasibility Testing of Hydrophobic Carbon Electrodes for Acquisition of Underwater Surface Electromyography Data. Ann Biomed Eng 2018; 46:1397-1405. [PMID: 29736693 DOI: 10.1007/s10439-018-2042-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 05/03/2018] [Indexed: 11/25/2022]
Abstract
Underwater surface electromyography (sEMG) signals are especially of interest for rehabilitation and sports medicine applications. Silver/silver chloride (Ag/AgCl) hydrogel electrodes, although the gold standard for sEMG data collection, require waterproofing for underwater applications. Having to apply waterproof tape over electrodes impedes the deployment of sEMG in immersed conditions. As a better alternative for underwater applications, we have developed carbon black/polydimethylsiloxane (CB/PDMS) electrodes for collecting sEMG signals under water. We recruited twenty subjects to collect simultaneous recordings of sEMG signals using Ag/AgCl and CB/PDMS electrodes on biceps brachii, triceps brachii, and tibial anterior muscles. The Ag/AgCL electrodes were covered in waterproof tape, and the CB/PDMS electrodes were not. We found no differences in sEMG signal amplitudes between both sensors, for the three muscles. Moderate mean correlation between Ag/AgCl and CB/PDMS electrodes was found on the linear envelopes (≥ 0.7); correlation was higher for power spectral densities (≥ 0.84). Ag/AgCl electrodes performed better in response to noise, whilst the CB/PDMS electrodes were more sensitive to myoelectric activity in triceps and tibialis, and exhibited better response to motion artifacts in the measurements on the triceps and tibialis. Results suggest that sEMG signal collection is possible under water using CB/PDMS electrodes without requiring any waterproof or adhesive tape.
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Affiliation(s)
- Hugo Posada-Quintero
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA.
| | - Yeonsik Noh
- College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA.,Department of Electrical and Computer Engineering, University of Massachusetts Amherst, Amherst, MA, USA
| | - Caitlin Eaton-Robb
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
| | | | - Ki H Chon
- Department of Biomedical Engineering, University of Connecticut, Storrs, CT, USA
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Abdul Jabbar K, Kudo S, Goh KW, Goh MR. Comparison in three dimensional gait kinematics between young and older adults on land and in shallow water. Gait Posture 2017; 57:102-108. [PMID: 28599157 DOI: 10.1016/j.gaitpost.2017.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 05/16/2017] [Accepted: 05/19/2017] [Indexed: 02/02/2023]
Abstract
This study investigated in three-dimensional space, firstly whether the aquatic medium and secondly ageing, had any effect on the lower limb's joint angles during aquatic-based gait. Three-dimensional joint kinematics of the lower limb of 51 healthy male participants [25 young group (24.6±4.9 years, 172.1±5.5cm, 69.8±10.3kg) and 26 older group (58.5±5.1 years, 167.9±5.1cm, 70.8±12.1kg)] were quantified during land and shallow water walking. Participants walked at their self-selected comfortable speed in both mediums. The results suggested that the properties of water - hydrodynamic drag, and buoyancy - affected the gait kinematics for both groups. Both age groups used more of their hip flexion in the aquatic environment to help them propel forward instead of using the ankle plantarflexion. The effect of age during the aquatic-based gait was identified in ankle adduction angle and knee abduction/adduction angle at initial contact. Only the older group elicited a significantly smaller ankle adduction angle during the aquatic-based gait when compared to the land-based gait. Only the young group elicited a significantly larger knee abduction/adduction angle at initial contact during the aquatic-based gait when compared to the land-based gait. These findings can facilitate professionals in the area of aquatic rehabilitation to better customise aquatic-based walking exercise programmes to suit their client's specific needs.
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Affiliation(s)
| | - Shigetada Kudo
- School of Sports, Health and Leisure, Republic Polytechnic, Singapore.
| | - Kee Wee Goh
- School of Sports, Health and Leisure, Republic Polytechnic, Singapore
| | - Ming Rong Goh
- Rehabilitative Services, Changi General Hospital, Singapore
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Kim MC, Han SK, Kim SK. Changes in the Range of Motion of the Hip Joint and the Muscle Activity of the Rectus Femoris and Biceps Femoris of Stroke Patients during Obstacles Crossing on the Ground and Underwater. J Phys Ther Sci 2014; 26:1143-6. [PMID: 25202169 PMCID: PMC4155208 DOI: 10.1589/jpts.26.1143] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Accepted: 02/16/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to examine range of motion (ROM) and the muscle
activity of stroke patients during obstacle task on the ground and underwater. [Subjects]
The subjects of this study were seven stroke patients in a hospital located in Daejeon,
South Korea. [Methods] The measurements in this study were conducted in an exercise
therapy room and a pool dedicated to underwater exercise (water temperature 33.5 °C, air
temperature 27 °C) in the hospital building. The pool’s water depth was determined by
considering the levels of the xiphoid process of the study subjects. Ten-centimeter-high
obstacles were used. An electrogoniometer was used to examine the ROM of flexion and
extension of the hip joints on the affected side. An MP150 system a BioNomadix 2-channel
wireless EMG transmitter was used to examine the muscle activity of the rectus femoris and
biceps femoris of the affected side. [Conclusion] The results suggest that the unaffected
side was supported, that the affected side moved, and that the hip joint was bent more
underwater than on the ground. The rectus femoris and bicpes femoris were activated
significantly less underwater than on the ground in all sections.
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Affiliation(s)
- Myung-Chul Kim
- Department of Physical Therapy, Faculty of Health Science, Eulji University, Republic of Korea
| | - Seul-Ki Han
- Department of Health Science, Graduate School, Eulji University, Republic of Korea
| | - Seung-Kyun Kim
- Department of Health Science, Graduate School, Eulji University, Republic of Korea
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Park SW, Lee KJ, Shin DC, Shin SH, Lee MM, Song CH. The effect of underwater gait training on balance ability of stroke patients. J Phys Ther Sci 2014; 26:899-903. [PMID: 25013292 PMCID: PMC4085217 DOI: 10.1589/jpts.26.899] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 01/07/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to investigate the effects of underwater
treadmill gait training on the balance ability of stroke patients. [Subjects] Twenty-two
patients with stroke were randomly assigned to an underwater treadmill group (n =11) or a
control group (n =11). [Methods] Both groups received general rehabilitation for 30 min
per session, 5 times per week, over a 4-week period. The underwater treadmill group
received additional underwater gait training for 30 min per session, 5 times per week,
over the same 4-week period. Static and dynamic balances were evaluated before and after
the intervention. [Results] The means of static and dynamic balance ability increased
significantly in both groups, but there was no significant difference between the two
groups. [Conclusion] Compared to the general rehabilitation program, underwater treadmill
gait training was not more effective at improving the balance ability of stroke patients
than land-based training.
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Affiliation(s)
- Seok Woo Park
- Department of Physical Therapy, College of Health Science, Sahmyook University, Republic of Korea
| | - Kyoung Jin Lee
- Department of Physical Therapy, College of Health Science, Sahmyook University, Republic of Korea
| | - Doo Chul Shin
- Department of Physical Therapy, College of Health Science, Sahmyook University, Republic of Korea
| | - Seung Ho Shin
- Department of Physical Therapy, College of Health Science, Sahmyook University, Republic of Korea
| | - Myung Mo Lee
- Department of Physical Therapy, College of Health Science, Sahmyook University, Republic of Korea
| | - Chang Ho Song
- Department of Physical Therapy, College of Health Science, Sahmyook University, Republic of Korea
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The Effects of a Water-Based Exercise Program on Strength and Functionality of Older Adults. J Aging Phys Act 2012; 20:469-83. [DOI: 10.1123/japa.20.4.469] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective:To analyze the effects of a water-based exercise program on peak torque (PT) and rate of torque development (RTD) during maximal voluntary ballistic isometric contractions of the lower limb muscles and the performance of a number of functional tests in the elderly.Method:Thirty-seven elderly were randomly assigned to water-based training (3 d/wk for 12 wk) or a control group. Extensor and flexor PT and RTD of the ankle, knee, and hip joints and functional tests were evaluated before and after training.Results:PT increased after training for the hip flexors (18%) and extensors (40%) and the plantar-flexor (42%) muscles in the water-based group. RTD increased after training for the hip-extensor (10%), knee-extensor (11%), and ankle plantar-flexor (27%) muscles in the water-based group. Functional tests also improved after training in the water-based group (p< .05).Conclusion:The water-based program improved PT and RTD and functional performance in the elderly.
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Comparison and reproducibility of sEMG during manual muscle testing on land and in water. J Electromyogr Kinesiol 2011; 21:95-101. [DOI: 10.1016/j.jelekin.2010.05.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2009] [Revised: 05/11/2010] [Accepted: 05/11/2010] [Indexed: 11/30/2022] Open
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Analysis of various conditions in order to measure electromyography of isometric contractions in water and on air. J Electromyogr Kinesiol 2010; 20:988-93. [DOI: 10.1016/j.jelekin.2009.12.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 12/08/2009] [Accepted: 12/08/2009] [Indexed: 11/20/2022] Open
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Electromyographic signal and force comparisons during maximal voluntary isometric contraction in water and on dry land. Eur J Appl Physiol 2010; 110:1075-82. [DOI: 10.1007/s00421-010-1598-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2010] [Indexed: 10/19/2022]
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Sims EL, Carland JM, Keefe FJ, Kraus VB, Guilak F, Schmitt D. Sex differences in biomechanics associated with knee osteoarthritis. J Women Aging 2010; 21:159-70. [PMID: 20183142 DOI: 10.1080/08952840903054856] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Osteoarthritis of the knee is seen more frequently in females than males. However, few studies have examined the interplay of gender, gait mechanics, pain, and disability in persons with osteoarthritis. This study examines the influence of anthropometrics, radiographic disease severity, pain, and disability on gender differences in gait mechanics in patients with knee osteoarthritis. Gait mechanics for 26 men and 30 women were collected using 3-D kinematics and kinetics. Women had a significantly lower knee adduction moment than men and a significantly higher stride frequency. Within female subjects, variations in gait mechanics were primarily explained by weight, BMI, pain, and disability. In males, variations in gait mechanics were primarily explained by age and disability.
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Affiliation(s)
- Ershela L Sims
- Department of Biological Anthropology & Anatomy, Duke University Medical Center, 202 Biological Sciences Building, Box 90383, Durham, NC 27708, USA.
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Jung T, Lee D, Charalambous C, Vrongistinos K. The Influence of Applying Additional Weight to the Affected Leg on Gait Patterns During Aquatic Treadmill Walking in People Poststroke. Arch Phys Med Rehabil 2010; 91:129-36. [DOI: 10.1016/j.apmr.2009.09.012] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Revised: 08/02/2009] [Accepted: 09/14/2009] [Indexed: 11/24/2022]
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Kotani K, Hirato Y, Ishigaki T, Shimada H, Toda K, Horii K. Biomechanical analysis of walking through a hallway under flooded conditions. J Physiol Anthropol 2009; 28:23-8. [PMID: 19212091 DOI: 10.2114/jpa2.28.23] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
The objective of this study is to measure muscle activity during walking in order to estimate the distance that must be traveled for safe evacuation when the effect of the flow velocity changes. In the present study, electromyogram data were measured for six muscles on the right lower extremity, namely, the rectus femoris, vastus lateralis, long head of the biceps femoris, medial gastrocnemius, tibialis anterior, and gluteus medius. The experimental conditions included walking through a flooded hallway with 0.5-m-high water flowing at four different flow velocities (0, 0.47, 0.76, and 1.12 m/s in the direction opposite to the walking direction) and walking on dry ground. From the results, the tibialis anterior exhibited the highest muscle activity of up to 85% MVC with the toe off the ground when the flow velocity was the highest, suggesting that the subject tended to avoid stumbling against water flow during ankle dorsiflexion. The activity of the gluteus medius increased with the flow velocity, suggesting that the subject tried to stabilize the pelvic area to avoid falling. Empirical data for muscle activity during walking under flooded conditions in association with water height and flow velocity will contribute to better understanding safe evacuation from flooded urban underground areas.
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Affiliation(s)
- Kentaro Kotani
- Faculty of Engineering Science, Kansai University, Suita, Osaka 564-8680, Japan.
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