1
|
Filippou V, Backhouse MR, Redmond AC, Wong DC. Person-Specific Template Matching Using a Dynamic Time Warping Step-Count Algorithm for Multiple Walking Activities. SENSORS (BASEL, SWITZERLAND) 2023; 23:9061. [PMID: 38005449 PMCID: PMC10675039 DOI: 10.3390/s23229061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/22/2023] [Accepted: 11/07/2023] [Indexed: 11/26/2023]
Abstract
This study aimed to develop and evaluate a new step-count algorithm, StepMatchDTWBA, for the accurate measurement of physical activity using wearable devices in both healthy and pathological populations. We conducted a study with 30 healthy volunteers wearing a wrist-worn MOX accelerometer (Maastricht Instruments, NL). The StepMatchDTWBA algorithm used dynamic time warping (DTW) barycentre averaging to create personalised templates for representative steps, accounting for individual walking variations. DTW was then used to measure the similarity between the template and accelerometer epoch. The StepMatchDTWBA algorithm had an average root-mean-square error of 2 steps for healthy gaits and 12 steps for simulated pathological gaits over a distance of about 10 m (GAITRite walkway) and one flight of stairs. It outperformed benchmark algorithms for the simulated pathological population, showcasing the potential for improved accuracy in personalised step counting for pathological populations. The StepMatchDTWBA algorithm represents a significant advancement in accurate step counting for both healthy and pathological populations. This development holds promise for creating more precise and personalised activity monitoring systems, benefiting various health and wellness applications.
Collapse
Affiliation(s)
- Valeria Filippou
- Institute of Medical and Biological Engineering, University of Leeds, Leeds LS2 9JT, UK
| | | | - Anthony C. Redmond
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds LS2 9JT, UK;
| | - David C. Wong
- Leeds Institute of Health Informatics, University of Leeds, Leeds LS2 9JT, UK;
| |
Collapse
|
2
|
Mohan DM, Khandoker AH, Wasti SA, Ismail Ibrahim Ismail Alali S, Jelinek HF, Khalaf K. Assessment Methods of Post-stroke Gait: A Scoping Review of Technology-Driven Approaches to Gait Characterization and Analysis. Front Neurol 2021; 12:650024. [PMID: 34168608 PMCID: PMC8217618 DOI: 10.3389/fneur.2021.650024] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 05/07/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Gait dysfunction or impairment is considered one of the most common and devastating physiological consequences of stroke, and achieving optimal gait is a key goal for stroke victims with gait disability along with their clinical teams. Many researchers have explored post stroke gait, including assessment tools and techniques, key gait parameters and significance on functional recovery, as well as data mining, modeling and analyses methods. Research Question: This study aimed to review and summarize research efforts applicable to quantification and analyses of post-stroke gait with focus on recent technology-driven gait characterization and analysis approaches, including the integration of smart low cost wearables and Artificial Intelligence (AI), as well as feasibility and potential value in clinical settings. Methods: A comprehensive literature search was conducted within Google Scholar, PubMed, and ScienceDirect using a set of keywords, including lower extremity, walking, post-stroke, and kinematics. Original articles that met the selection criteria were included. Results and Significance: This scoping review aimed to shed light on tools and technologies employed in post stroke gait assessment toward bridging the existing gap between the research and clinical communities. Conventional qualitative gait analysis, typically used in clinics is mainly based on observational gait and is hence subjective and largely impacted by the observer's experience. Quantitative gait analysis, however, provides measured parameters, with good accuracy and repeatability for the diagnosis and comparative assessment throughout rehabilitation. Rapidly emerging smart wearable technology and AI, including Machine Learning, Support Vector Machine, and Neural Network approaches, are increasingly commanding greater attention in gait research. Although their use in clinical settings are not yet well leveraged, these tools promise a paradigm shift in stroke gait quantification, as they provide means for acquiring, storing and analyzing multifactorial complex gait data, while capturing its non-linear dynamic variability and offering the invaluable benefits of predictive analytics.
Collapse
Affiliation(s)
- Dhanya Menoth Mohan
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Ahsan Habib Khandoker
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Sabahat Asim Wasti
- Neurological Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Sarah Ismail Ibrahim Ismail Alali
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Herbert F Jelinek
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| | - Kinda Khalaf
- Department of Biomedical Engineering, Health Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, United Arab Emirates
| |
Collapse
|
3
|
Ahmadi S, Siragy T, Nantel J. Regularity of kinematic data between single and dual-task treadmill walking in people with Parkinson's disease. J Neuroeng Rehabil 2021; 18:20. [PMID: 33526049 PMCID: PMC7852223 DOI: 10.1186/s12984-021-00807-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Accepted: 01/11/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Regularity, quantified by sample entropy (SampEn), has been extensively used as a gait stability measure. Yet, there is no consensus on the calculation process and variant approaches, e.g. single-scale SampEn with and without incorporating a time delay greater than one, multiscale SampEn, and complexity index, have been used to calculate the regularity of kinematic or kinetic signals. The aim of the present study was to test the discriminatory performance of the abovementioned approaches during single and dual-task walking in people with Parkinson's disease (PD). METHODS Seventeen individuals with PD were included in this study. Participants completed two walking trials that included single and dual-task conditions. The secondary task was word searching with twelve words randomly appearing in the participants' visual field. Trunk linear acceleration at sternum level, linear acceleration of the center of gravity, and angular velocity of feet, shanks, and thighs, each in three planes of motion were collected. The regularity of signals was computed using approaches mentioned above for single and dual-task conditions. RESULTS Incorporating a time delay greater than one and considering multiple scales helped better distinguish between single and dual-task walking. For all signals, the complexity index, defined as the summary of multiscale SampEn analysis, was the most efficient discriminatory index between single-task walking and dual-tasking in people with Parkinson's disease. Specifically, the complexity index of the trunk linear acceleration of the center of gravity distinguished between the two walking conditions in all three planes of motion. CONCLUSIONS The significant results observed across the 24 signals studied in this study are illustrative examples of the complexity index's potential as a gait feature for classifying different walking conditions.
Collapse
Affiliation(s)
- Samira Ahmadi
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Tarique Siragy
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada.
| |
Collapse
|
4
|
Bach MM, Daffertshofer A, Dominici N. The development of mature gait patterns in children during walking and running. Eur J Appl Physiol 2021; 121:1073-1085. [PMID: 33439307 PMCID: PMC7966230 DOI: 10.1007/s00421-020-04592-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 12/17/2020] [Indexed: 12/11/2022]
Abstract
PURPOSE We sought to identify the developing maturity of walking and running in young children. We assessed gait patterns for the presence of flight and double support phases complemented by mechanical energetics. The corresponding classification outcomes were contrasted via a shotgun approach involving several potentially informative gait characteristics. A subsequent clustering turned out very effective to classify the degree of gait maturity. METHODS Participants (22 typically developing children aged 2-9 years and 7 young, healthy adults) walked/ran on a treadmill at comfortable speeds. We determined double support and flight phases and the relationship between potential and kinetic energy oscillations of the center-of-mass. Based on the literature, we further incorporated a total of 93 gait characteristics (including the above-mentioned ones) and employed multivariate statistics comprising principal component analysis for data compression and hierarchical clustering for classification. RESULTS While the ability to run including a flight phase increased with age, the flight phase did not reach 20% of the gait cycle. It seems that children use a walk-run-strategy when learning to run. Yet, the correlation strength between potential and kinetic energies saturated and so did the amount of recovered mechanical energy. Clustering the set of gait characteristics allowed for classifying gait in more detail. This defines a metric for maturity in terms of deviations from adult gait, which disagrees with chronological age. CONCLUSIONS The degree of gait maturity estimated statistically using various gait characteristics does not always relate directly to the chronological age of the child.
Collapse
Affiliation(s)
- Margit M Bach
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute of Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Andreas Daffertshofer
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute of Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Nadia Dominici
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences & Institute of Brain and Behavior Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| |
Collapse
|
5
|
Ahmadi S, Sepehri N, Wu C, Szturm T. Sample Entropy of Human Gait Center of Pressure Displacement: A Systematic Methodological Analysis. ENTROPY 2018; 20:e20080579. [PMID: 33265668 PMCID: PMC7513106 DOI: 10.3390/e20080579] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 07/27/2018] [Accepted: 08/02/2018] [Indexed: 11/20/2022]
Abstract
Sample entropy (SampEn) has been used to quantify the regularity or predictability of human gait signals. There are studies on the appropriate use of this measure for inter-stride spatio-temporal gait variables. However, the sensitivity of this measure to preprocessing of the signal and to variant values of template size (m), tolerance size (r), and sampling rate has not been studied when applied to “whole” gait signals. Whole gait signals are the entire time series data obtained from force or inertial sensors. This study systematically investigates the sensitivity of SampEn of the center of pressure displacement in the mediolateral direction (ML COP-D) to variant parameter values and two pre-processing methods. These two methods are filtering the high-frequency components and resampling the signals to have the same average number of data points per stride. The discriminatory ability of SampEn is studied by comparing treadmill walk only (WO) to dual-task (DT) condition. The results suggest that SampEn maintains the directional difference between two walking conditions across variant parameter values, showing a significant increase from WO to DT condition, especially when signals are low-pass filtered. Moreover, when gait speed is different between test conditions, signals should be low-pass filtered and resampled to have the same average number of data points per stride.
Collapse
Affiliation(s)
- Samira Ahmadi
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada
| | - Nariman Sepehri
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada
- Correspondence: ; Tel.: +1-204-474-6834
| | - Christine Wu
- Department of Mechanical Engineering, University of Manitoba, Winnipeg, MB R3T 5V6, Canada
| | - Tony Szturm
- Department of Physical Therapy, College of Rehabilitation Sciences, University of Manitoba, Winnipeg, MB R3E 0T6, Canada
| |
Collapse
|
6
|
Kikkert LHJ, de Groot MH, van Campen JP, Beijnen JH, Hortobágyi T, Vuillerme N, Lamoth CCJ. Gait dynamics to optimize fall risk assessment in geriatric patients admitted to an outpatient diagnostic clinic. PLoS One 2017; 12:e0178615. [PMID: 28575126 PMCID: PMC5456316 DOI: 10.1371/journal.pone.0178615] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 05/16/2017] [Indexed: 01/20/2023] Open
Abstract
Fall prediction in geriatric patients remains challenging because the increased fall risk involves multiple, interrelated factors caused by natural aging and/or pathology. Therefore, we used a multi-factorial statistical approach to model categories of modifiable fall risk factors among geriatric patients to identify fallers with highest sensitivity and specificity with a focus on gait performance. Patients (n = 61, age = 79; 41% fallers) underwent extensive screening in three categories: (1) patient characteristics (e.g., handgrip strength, medication use, osteoporosis-related factors) (2) cognitive function (global cognition, memory, executive function), and (3) gait performance (speed-related and dynamic outcomes assessed by tri-axial trunk accelerometry). Falls were registered prospectively (mean follow-up 8.6 months) and one year retrospectively. Principal Component Analysis (PCA) on 11 gait variables was performed to determine underlying gait properties. Three fall-classification models were then built using Partial Least Squares-Discriminant Analysis (PLS-DA), with separate and combined analyses of the fall risk factors. PCA identified 'pace', 'variability', and 'coordination' as key properties of gait. The best PLS-DA model produced a fall classification accuracy of AUC = 0.93. The specificity of the model using patient characteristics was 60% but reached 80% when cognitive and gait outcomes were added. The inclusion of cognition and gait dynamics in fall classification models reduced misclassification. We therefore recommend assessing geriatric patients' fall risk using a multi-factorial approach that incorporates patient characteristics, cognition, and gait dynamics.
Collapse
Affiliation(s)
- Lisette H. J. Kikkert
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
- Univ. Grenoble Alpes, EA AGEIS, Grenoble, France
- MC Slotervaart Hospital, Department of Geriatric Medicine, Amsterdam, The Netherlands
| | - Maartje H. de Groot
- MC Slotervaart Hospital, Department of Geriatric Medicine, Amsterdam, The Netherlands
- The Hague University of Applied Sciences, Faculty of Health, Nutrition & Sport, The Hague, The Netherlands
| | - Jos P. van Campen
- MC Slotervaart Hospital, Department of Geriatric Medicine, Amsterdam, The Netherlands
| | - Jos H. Beijnen
- MC Slotervaart Hospital, Department of Pharmacy and Pharmacology, Amsterdam, The Netherlands
- Utrecht University, Science Faculty, Department of Pharmaceutical Sciences, Utrecht, The Netherlands
| | - Tibor Hortobágyi
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| | - Nicolas Vuillerme
- Univ. Grenoble Alpes, EA AGEIS, Grenoble, France
- Institut Universitaire de France, Paris, France
| | - Claudine C. J. Lamoth
- University of Groningen, University Medical Center Groningen, Center for Human Movement Sciences, Groningen, The Netherlands
| |
Collapse
|