A Simple Low-Cost Wearable Sensor for Long-Term Ambulatory Monitoring of Knee Joint Kinematics

Bending Angle Sensor Based on Double-Layer Capacitance Suitable for Human Joint

Goal: To develop bending angle sensors based on double-layer capacitance for monitoring joint angles during cycling exercises. Methods: We develop a bending angle sensor based on double-layer capacitive and conducted three stretching, bending, and cycling tests to evaluate its validity. Results: We demonstrate that the bending angle sensor based on double-layer capacitance minimizes the change in the capacitance difference in the stretching test. The hysteresis and root mean square error (RMSE) compared with the optical motion capture show hysteresis: 8.0% RMSE and 3.1° in the bending test. Moreover, a cycling experiment for human joint angle measurements confirm the changes in accuracy. The RMSEs ranged from 4.7° to 7.0°, even when a human wears leggings fixed with the developed bending-angle sensor in the cycling test. Conclusion: The developed bending angle sensor provides a practical application of the quantitative and observational evaluation tool for knee joint angles.

Healthcare Monitoring Using Low-Cost Sensors to Supplement and Replace Human Sensation: Does It Have Potential to Increase Independent Living and Prevent Disease?

Continuous monitoring of health status has the potential to enhance the quality of life and life expectancy of people suffering from chronic illness and of the elderly. However, such systems can only come into widespread use if the cost of manufacturing is low. Advancements in material science and engineering technology have led to a significant decrease in the expense of developing healthcare monitoring devices. This review aims to investigate the progress of the use of low-cost sensors in healthcare monitoring and discusses the challenges faced when accomplishing continuous and real-time monitoring tasks. The major findings include (1) only a small number of publications (N = 50) have addressed the issue of healthcare monitoring applications using low-cost sensors over the past two decades; (2) the top three algorithms used to process sensor data include SA (Statistical Analysis, 30%), SVM (Support Vector Machine, 18%), and KNN (K-Nearest Neighbour, 12%); and (3) wireless communication techniques (Zigbee, Bluetooth, Wi-Fi, and RF) serve as the major data transmission tools (77%) followed by cable connection (13%) and SD card data storage (10%). Due to the small fraction (N = 50) of low-cost sensor-based studies among thousands of published articles about healthcare monitoring, this review not only summarises the progress of related research but calls for researchers to devote more effort to the consideration of cost reduction as well as the size of these components.

Biomechanics beyond the lab: Remote technology for osteoarthritis patient data-A scoping review

The objective of this project is to produce a review of available and validated technologies suitable for gathering biomechanical and functional research data in patients with osteoarthritis (OA), outside of a traditionally fixed laboratory setting. A scoping review was conducted using defined search terms across three databases (Scopus, Ovid MEDLINE, and PEDro), and additional sources of information from grey literature were added. One author carried out an initial title and abstract review, and two authors independently completed full-text screenings. Out of the total 5,164 articles screened, 75 were included based on inclusion criteria covering a range of technologies in articles published from 2015. These were subsequently categorised by technology type, parameters measured, level of remoteness, and a separate table of commercially available systems. The results concluded that from the growing number of available and emerging technologies, there is a well-established range in use and further in development. Of particular note are the wide-ranging available inertial measurement unit systems and the breadth of technology available to record basic gait spatiotemporal measures with highly beneficial and informative functional outputs. With the majority of technologies categorised as suitable for part-remote use, the number of technologies that are usable and fully remote is rare and they usually employ smartphone software to enable this. With many systems being developed for camera-based technology, such technology is likely to increase in usability and availability as computational models are being developed with increased sensitivities to recognise patterns of movement, enabling data collection in the wider environment and reducing costs and creating a better understanding of OA patient biomechanical and functional movement data.

Wearable Mid-Activity Measurement of Lower Limb Electrical Bioimpedance Estimates Vertical Ground Reaction Force Features

In recent years, wearable mid-activity electrical bioimpedance (EBI) sensing has been used to non-invasively track changes in edema and swelling levels within human joints. While the physiological origin of the changes in mid-activity EBI measurements have been demonstrated, EBI waveform patterns during activity have not been explored. In this work, we present a novel approach to extract waveform features from EBI measurements during gait to estimate the changes in vertical ground reaction forces (vGRF) corresponding to fatigue. Wearable EBI and vGRF data were measured from six healthy subjects during an asymmetric fatiguing protocol. For the exercised leg, the first peak of vGRF corresponding to the initial phase of simple support, decreased significantly and the loading rate increased significantly between the beginning and the end of the protocol. No significant change in these parameters were observed for the control leg. The first peak of vGRF and loading rate during the protocol (15 walking sessions) were correlated to the multi-frequency EBI features with mean Pearson's r=0.81 and r=0.777, respectively. The results of this proof-of-concept study demonstrate the feasibility of estimating biomechanical parameters during activity with wearable EBI. Clinical Relevance - The proposed wearable system and associated signal processing could enable convenient tracking of changes in vGRFs during daily living activities, allowing physiotherapists and doctors to remotely monitor the progress and adherence of their patients and thereby reducing the number of clinical visits.

Estimating Ground Reaction Force and Center of Pressure using Low-Cost Wearable Devices

OBJECTIVE

Ambulatory monitoring of ground reaction force (GRF) and center of pressure (CoP) could improve management of health conditions that impair mobility. Insoles instrumented with force-sensitive resistors (FSRs) are an unobtrusive, low-cost, and low-power technology for sampling GRF and CoP in real-world environments. However, FSRs have variable response characteristics that complicate estimation of GRF and CoP. This study introduces a unique data analytic pipeline that enables accurate estimation of GRF and CoP despite relatively inaccurate FSR responses. This paper also investigates whether inclusion of a complementary knee angle sensor improves estimation accuracy.

METHODS

Seventeen healthy subjects were equipped with an insole instrumented with six FSRs and a string-based knee angle sensor. Subjects walked in a straight line at self-selected slow, preferred, and fast speeds over an in-ground force platform. Twenty repetitions were performed for each speed. Supervised machine learning models estimated weight-normalized GRF and shoe size-normalized CoP, which were re-scaled to obtain GRF and CoP.

RESULTS

Anteroposterior GRF, Vertical GRF, and Anteroposterior CoP were estimated with a normalized root mean square error (NRMSE) of less than 5%. Mediolateral GRF and CoP were estimated with an NRMSE of 8.1% and 6.4%$ respectively. Knee angle-related features slightly improved GRF estimates.

CONCLUSION

Normalized models accurately estimated GRF and CoP despite deficiencies in FSR data.

SIGNIFICANCE

Ambulatory use of the proposed system could enable objective, longitudinal monitoring of severity and progression for a variety of health conditions.

Estimation of knee and ankle angles during walking using thigh and shank angles

Estimation of joints' trajectories is commonly used in human gait analysis, and in the development of motion planners and high-level controllers for prosthetics, orthotics, exoskeletons and humanoids. Human locomotion is the result of the cooperation between leg joints and limbs. This suggests the existence of underlying relationships between them which lead to a harmonic gait. In this study we aimed to estimate knee and ankle trajectories using thigh and shank angles. To do so, an estimation approach was developed that continuously mapped the inputs to the outputs, which did not require switching rules, speed estimation, gait percent identification or look-up tables. The estimation algorithm was based on a nonlinear auto-regressive model with exogenous inputs. The method was then combined with wavelets theory, and then the two were used in a neural network. To evaluate the estimation performance, three scenarios were developed which used only one source of inputs (i.e., only shank angles or only thigh angles). First, knee anglesθ_k(outputs) were estimated using thigh anglesθ_th(inputs). Second, ankle anglesθ_a(outputs) were estimated using thigh anglesθ_sh(inputs), and third, the ankle angles were estimated using shank angles (inputs). The proposed approach was investigated for 22 subjects at different walking speeds and the leave-one-subject-out procedure was used for training and testing the estimation algorithm. Average root mean square errors were 3.9°-5.3° and 2.1°-2.3° for knee and ankle angles, respectively. Average mean absolute errors (MAEs) MAEs were 3.2°-4° and 1.7°-1.8°, and average correlation coefficientsρ_ccwere 0.95-0.98 and 0.94-0.96 for knee and ankle angles, respectively. The limitations and strengths of the proposed approach are discussed in detail and the results are compared with several studies.