1
|
Bonato P, Feipel V, Corniani G, Arin-Bal G, Leardini A. Position paper on how technology for human motion analysis and relevant clinical applications have evolved over the past decades: Striking a balance between accuracy and convenience. Gait Posture 2024; 113:191-203. [PMID: 38917666 DOI: 10.1016/j.gaitpost.2024.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/30/2024] [Accepted: 06/10/2024] [Indexed: 06/27/2024]
Abstract
BACKGROUND Over the past decades, tremendous technological advances have emerged in human motion analysis (HMA). RESEARCH QUESTION How has technology for analysing human motion evolved over the past decades, and what clinical applications has it enabled? METHODS The literature on HMA has been extensively reviewed, focusing on three main approaches: Fully-Instrumented Gait Analysis (FGA), Wearable Sensor Analysis (WSA), and Deep-Learning Video Analysis (DVA), considering both technical and clinical aspects. RESULTS FGA techniques relying on data collected using stereophotogrammetric systems, force plates, and electromyographic sensors have been dramatically improved providing highly accurate estimates of the biomechanics of motion. WSA techniques have been developed with the advances in data collection at home and in community settings. DVA techniques have emerged through artificial intelligence, which has marked the last decade. Some authors have considered WSA and DVA techniques as alternatives to "traditional" HMA techniques. They have suggested that WSA and DVA techniques are destined to replace FGA. SIGNIFICANCE We argue that FGA, WSA, and DVA complement each other and hence should be accounted as "synergistic" in the context of modern HMA and its clinical applications. We point out that DVA techniques are especially attractive as screening techniques, WSA methods enable data collection in the home and community for extensive periods of time, and FGA does maintain superior accuracy and should be the preferred technique when a complete and highly accurate biomechanical data is required. Accordingly, we envision that future clinical applications of HMA would favour screening patients using DVA in the outpatient setting. If deemed clinically appropriate, then WSA would be used to collect data in the home and community to derive relevant information. If accurate kinetic data is needed, then patients should be referred to specialized centres where an FGA system is available, together with medical imaging and thorough clinical assessments.
Collapse
Affiliation(s)
- Paolo Bonato
- Dept of PM&R, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, USA
| | - Véronique Feipel
- Laboratory of Functional Anatomy, Faculty of Motor Sciences, Laboratory of Anatomy, Biomechanics and Organogenesis, Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Giulia Corniani
- Dept of PM&R, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, USA
| | - Gamze Arin-Bal
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey; Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Alberto Leardini
- Movement Analysis Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| |
Collapse
|
2
|
Prado M, Oyama S, Giambini H. Marker-Based Versus IMU-Based Kinematics for Estimates of Lumbar Spine Loads Using a Full-Body Musculoskeletal Model. J Appl Biomech 2024; 40:306-315. [PMID: 38881179 DOI: 10.1123/jab.2023-0202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 04/10/2024] [Accepted: 04/17/2024] [Indexed: 06/18/2024]
Abstract
Musculoskeletal modeling, typically implemented using marker-based systems in laboratory environments, is commonly used for noninvasive estimations of loads. Inertial measurement units (IMUs) have become an alternative for the evaluation of kinematics. However, estimates of spine joint contact forces using IMUs have yet to be thoroughly evaluated. Dynamics tasks and static postures from activities of daily living were captured on 11 healthy subjects using both systems simultaneously. Spine kinematics obtained from IMU- and marker-based systems and L4-L5 joint contact forces were compared. Lateral bending resulted in a weak agreement with significant differences between the 2 systems (P = .02, average root mean-squared error = 4.81), whereas flexion-extension and axial rotation exhibited the highest agreement with no significant differences (P < .05, average root mean-squared error = 5.51 and P < .31, average root mean-squared error = 5.08, respectively). All tasks showed excellent correlations (R2 = .76-.99) in estimated loads between systems. Differences in predicted loads at the L4-L5 were only observed during flexion-extension (1041 N vs 947 N, P = .0004) and walking with weights (814 N vs 727 N, P = .004). Different joint reaction force outcomes were obtained in 2 of the 8 tasks between systems, suggesting that IMUs can be robust tools allowing for convenient and less expensive evaluations and for longitudinal assessments inside and outside the laboratory setting.
Collapse
Affiliation(s)
- Maria Prado
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| | - Sakiko Oyama
- Department of Kinesiology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Hugo Giambini
- Department of Biomedical Engineering and Chemical Engineering, University of Texas at San Antonio, San Antonio, TX, USA
| |
Collapse
|
3
|
Halabi R, Gonzalez-Torres C, MacLean S, Husain MI, Pratap A, Alda M, Mulsant BH, Ortiz A. A Novel Unsupervised Machine Learning Approach to Assess Postural Dynamics in Euthymic Bipolar Disorder. IEEE J Biomed Health Inform 2024; 28:4903-4911. [PMID: 38691437 PMCID: PMC11303098 DOI: 10.1109/jbhi.2024.3394754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
Bipolar disorder (BD) is a mood disorder with different phases alternating between euthymia, manic or hypomanic episodes, and depressive episodes. While motor abnormalities are commonly seen during depressive or manic episodes, not much attention has been paid to postural abnormalities during periods of euthymia and their association with illness burden. We collected 24-hour posture data in 32 euthymic participants diagnosed with BD using a shirt-based wearable. We extracted a set of nine time-domain features, and performed unsupervised participant clustering. We investigated the association between posture variables and 12 clinical characteristics of illness burden. Based on their postural dynamics during the daytime, evening, or nighttime, participants clustered in three clusters. Higher illness burden was associated with lower postural variability, in particular during daytime. Participants who exhibited a mostly upright sitting/standing posture during the night with frequent nighttime postural transitions had the highest number of lifetime depressive episodes. Euthymic participants with BD exhibit postural abnormalities that are associated with illness burden, especially with the number of depressive episodes. Our results contribute to understanding the role of illness burden on posture changes and sleep consolidation in periods of euthymia.
Collapse
|
4
|
Cheng KC, Chiu YL, Tsai CL, Hsu YL, Tsai YJ. Fatigue Affects Body Acceleration During Vertical Jumping and Agility Tasks in Elite Young Badminton Players. Sports Health 2024:19417381241245908. [PMID: 38634629 DOI: 10.1177/19417381241245908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Badminton is a sport demanding both high aerobic and anaerobic fitness levels, and fatigue can significantly impact game performance. However, relevant studies are limited, and none have employed a wearable inertial measurement unit (IMU) to investigate the effects of fatigue on athletic performance in the field. HYPOTHESIS Overall performance and body acceleration in both time and frequency domains during the fundamental badminton skills of vertical jumping and changes of direction will be affected by fatigue. STUDY DESIGN Cross-sectional study. LEVEL OF EVIDENCE Level 3. METHODS A total of 38 young badminton players competing at the Division I level participated. Body accelerations while performing vertical jump and agility-T tests before and immediately after undergoing a fatigue protocol were measured by an IMU, positioned at the L4 to L5 level. RESULTS Jumping height decreased significantly by 4 cm (P < 0.01) after fatigue with greater downward acceleration (1.03 m/s2, P < 0.05) during the squatting subphase. Finishing time increased significantly by 50 ms only during the 10-m side-shuffling of the agility-T test (P = 0.02) after fatigue with greater peak and mean accelerations (3.83 m/s2, P = 0.04; 0.43 m/s2, P < 0.01), and higher median and mean frequency (0.38 Hz, P = 0.04, 0.11 Hz, P = 0.01). CONCLUSION This study using a wearable IMU demonstrates the effects of fatigue on body acceleration in badminton players. The frequency-domain analysis further indicated that fatigue might lead to loss of voluntary control of active muscles and increased impacts on the passive elastic elements. CLINICAL RELEVANCE The findings imply that fatigue can lead to diminished athletic performance and highlight the potential for an increased risk of sports injuries. Consequently, maintaining precision in monitoring fatigue is crucial for elite young badminton players.
Collapse
Affiliation(s)
- Kai-Chia Cheng
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
| | - Ya-Lan Chiu
- Department of Physical Therapy, National Chung Kung University, Tainan, Taiwan
| | - Chia-Liang Tsai
- Institute of Physical Education, Health and Leisure Studies, National Chung Kung University, Tainan, Taiwan
| | - Yu-Liang Hsu
- Department of Mechanical and Electro-Mechanical Engineering, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Yi-Ju Tsai
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
- Department of Physical Therapy, National Chung Kung University, Tainan, Taiwan
- Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
| |
Collapse
|
5
|
Huang S, Dai H, Yu X, Wu X, Wang K, Hu J, Yao H, Huang R, Niu W. A contactless monitoring system for accurately predicting energy expenditure during treadmill walking based on an ensemble neural network. iScience 2024; 27:109093. [PMID: 38375238 PMCID: PMC10875158 DOI: 10.1016/j.isci.2024.109093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 12/09/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024] Open
Abstract
The monitoring of treadmill walking energy expenditure (EE) plays an important role in health evaluations and management, particularly in older individuals and those with chronic diseases. However, universal and highly accurate prediction methods for walking EE are still lacking. In this paper, we propose an ensemble neural network (ENN) model that predicts the treadmill walking EE of younger and older adults and stroke survivors with high precision based on easy-to-obtain features. Compared with previous studies, the proposed model reduced the estimation error by 13.95% and 66.20% for stroke survivors and younger adults, respectively. Furthermore, a contactless monitoring system was developed based on Kinect, mm-wave radar, and ENN algorithms, and the treadmill walking EE was monitored in real time. This ENN model and monitoring system can be combined with smart devices and treadmill, making them suitable for evaluating, monitoring, and tracking changes in health during exercise and in rehabilitation environments.
Collapse
Affiliation(s)
- Shangjun Huang
- Translational Research Center, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201619, China
| | - Houde Dai
- Quanzhou Institute of Equipment Manufacturing, Haixi Institutes, Chinese Academy of Sciences, Jinjiang 362201, China
| | - Xiaoming Yu
- Rehabilitation Medical Center, Shanghai Seventh’s Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200137, China
| | - Xie Wu
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Kuan Wang
- Translational Research Center, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201619, China
| | - Jiaxin Hu
- Quanzhou Institute of Equipment Manufacturing, Haixi Institutes, Chinese Academy of Sciences, Jinjiang 362201, China
| | - Hanchen Yao
- Quanzhou Institute of Equipment Manufacturing, Haixi Institutes, Chinese Academy of Sciences, Jinjiang 362201, China
| | - Rui Huang
- Key Laboratory of Exercise and Health Sciences, Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Wenxin Niu
- Translational Research Center, Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai 201619, China
| |
Collapse
|
6
|
Iseki C, Hayasaka T, Yanagawa H, Komoriya Y, Kondo T, Hoshi M, Fukami T, Kobayashi Y, Ueda S, Kawamae K, Ishikawa M, Yamada S, Aoyagi Y, Ohta Y. Artificial Intelligence Distinguishes Pathological Gait: The Analysis of Markerless Motion Capture Gait Data Acquired by an iOS Application (TDPT-GT). SENSORS (BASEL, SWITZERLAND) 2023; 23:6217. [PMID: 37448065 DOI: 10.3390/s23136217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 06/22/2023] [Accepted: 07/04/2023] [Indexed: 07/15/2023]
Abstract
Distinguishing pathological gait is challenging in neurology because of the difficulty of capturing total body movement and its analysis. We aimed to obtain a convenient recording with an iPhone and establish an algorithm based on deep learning. From May 2021 to November 2022 at Yamagata University Hospital, Shiga University, and Takahata Town, patients with idiopathic normal pressure hydrocephalus (n = 48), Parkinson's disease (n = 21), and other neuromuscular diseases (n = 45) comprised the pathological gait group (n = 114), and the control group consisted of 160 healthy volunteers. iPhone application TDPT-GT captured the subjects walking in a circular path of about 1 meter in diameter, a markerless motion capture system, with an iPhone camera, which generated the three-axis 30 frames per second (fps) relative coordinates of 27 body points. A light gradient boosting machine (Light GBM) with stratified k-fold cross-validation (k = 5) was applied for gait collection for about 1 min per person. The median ability model tested 200 frames of each person's data for its distinction capability, which resulted in the area under a curve of 0.719. The pathological gait captured by the iPhone could be distinguished by artificial intelligence.
Collapse
Affiliation(s)
- Chifumi Iseki
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, Yamagata 990-2331, Japan
- Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Tatsuya Hayasaka
- Department of Anesthesiology, Yamagata University School of Medicine, Yamagata 990-2331, Japan
| | - Hyota Yanagawa
- Department of Medicine, Yamagata University School of Medicine, Yamagata 990-2331, Japan
| | - Yuta Komoriya
- Department of Anesthesiology, Yamagata University School of Medicine, Yamagata 990-2331, Japan
| | - Toshiyuki Kondo
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, Yamagata 990-2331, Japan
| | - Masayuki Hoshi
- Department of Physical Therapy, Fukushima Medical University School of Health Sciences, 10-6 Sakaemachi, Fukushima 960-8516, Japan
| | - Tadanori Fukami
- Department of Informatics, Faculty of Engineering, Yamagata University, Yonezawa 992-8510, Japan
| | - Yoshiyuki Kobayashi
- Human Augmentation Research Center, National Institute of Advanced Industrial Science and Technology (AIST), Kashiwa II Campus, University of Tokyo, Kashiwa 277-0882, Japan
| | - Shigeo Ueda
- Shin-Aikai Spine Center, Katano Hospital, Katano 576-0043, Japan
| | - Kaneyuki Kawamae
- Department of Anesthesia and Critical Care Medicine, Ohta-Nishinouti Hospital, Koriyama 963-8558, Japan
| | - Masatsune Ishikawa
- Rakuwa Villa Ilios, Rakuwakai Healthcare System, Kyoto 607-8062, Japan
- Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan
| | - Shigeki Yamada
- Normal Pressure Hydrocephalus Center, Rakuwakai Otowa Hospital, Kyoto 607-8062, Japan
- Department of Neurosurgery, Nagoya City University Graduate School of Medical Science, Nagoya 467-8601, Japan
- Interfaculty Initiative in Information Studies, Institute of Industrial Science, The University of Tokyo, Tokyo 113-8654, Japan
| | | | - Yasuyuki Ohta
- Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, Yamagata 990-2331, Japan
| |
Collapse
|