1
|
Ripic Z, Nienhuis M, Signorile JF, Best TM, Jacobs KA, Eltoukhy M. A comparison of three-dimensional kinematics between markerless and marker-based motion capture in overground gait. J Biomech 2023; 159:111793. [PMID: 37725886 DOI: 10.1016/j.jbiomech.2023.111793] [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: 03/26/2023] [Revised: 07/20/2023] [Accepted: 09/04/2023] [Indexed: 09/21/2023]
Abstract
Vision-based methods using RGB inputs for human pose estimation have grown in recent years but have undergone limited testing in clinical and biomechanics research areas like gait analysis. The purpose of the present study was to compare lower extremity kinematics during overground gait between a traditional marker-based approach and a commercial multi-view markerless system in a sample of subjects including young adults, older adults, and adults diagnosed with Parkinson's disease. A convenience sample of 35 adults between the age of 18-85 years were included in this study, yielding a total of 114 trials and 228 gait cycles that were compared between systems. A total of 30 time normalized waveforms, including three-dimensional joint centers, segment angles, and joint angles were compared between systems using root mean-squared error (RMSE), range of motion difference (ΔROM), Pearson correlation coefficients (r), and interclass correlation coefficients (ICC). RMSEs for joint center positions were less than 28 mm in all joints with correlations indicating good to excellent agreement. RMSEs for segment and joint angles were in range of previous results, with highest agreement between systems in the sagittal plane. ΔROM differences were within reference values that characterize clinical groups like Parkinson's disease, stroke, or knee osteoarthritis. Further improvements in pelvis tracking, markerless keypoint model definitions, and standardization of comparison study protocols are needed. Nevertheless, markerless solutions seem promising toward unrestricted motion analysis in biomechanics research and clinical settings.
Collapse
Affiliation(s)
- Zachary Ripic
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, United States; Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Mitch Nienhuis
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, United States
| | - Joseph F Signorile
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, United States; Center on Aging, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Thomas M Best
- Sports Medicine Institute, University of Miami Miller School of Medicine, Miami, FL, United States; Department of Orthopaedics, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Kevin A Jacobs
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, United States
| | - Moataz Eltoukhy
- Department of Kinesiology and Sport Sciences, University of Miami, Miami, FL, United States; Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States; Department of Industrial and Systems Engineering, University of Miami, Miami, FL, United States.
| |
Collapse
|
2
|
De Keersmaecker E, Van Bladel A, Zaccardi S, Lefeber N, Rodriguez-Guerrero C, Kerckhofs E, Jansen B, Swinnen E. Virtual reality-enhanced walking in people post-stroke: effect of optic flow speed and level of immersion on the gait biomechanics. J Neuroeng Rehabil 2023; 20:124. [PMID: 37749566 PMCID: PMC10518929 DOI: 10.1186/s12984-023-01254-0] [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] [Received: 10/25/2022] [Accepted: 09/18/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Optic flow-the apparent visual motion experienced while moving-is absent during treadmill walking. With virtual reality (VR), optic flow can be controlled to mediate alterations in human walking. The aim of this study was to investigate (1) the effects of fully immersive VR and optic flow speed manipulation on gait biomechanics, simulator sickness, and enjoyment in people post-stroke and healthy people, and (2) the effects of the level of immersion on optic flow speed and sense of presence. METHODS Sixteen people post-stroke and 16 healthy controls performed two VR-enhanced treadmill walking sessions: the semi-immersive GRAIL session and fully immersive head-mounted display (HMD) session. Both consisted of five walking trials. After two habituation trials (without and with VR), participants walked three more trials under the following conditions: matched, slow, and fast optic flow. Primary outcome measures were spatiotemporal parameters and lower limb kinematics. Secondary outcomes (simulator sickness, enjoyment, and sense of presence) were assessed with the Simulator Sickness Questionnaire, Visual Analogue Scales, and Igroup Presence Questionnaire. RESULTS When walking with the immersive HMD, the stroke group walked with a significantly slower cadence (-3.69strides/min, p = 0.006), longer stride time (+ 0.10 s, p = 0.017) and stance time for the unaffected leg (+ 1.47%, p = 0.001) and reduced swing time for the unaffected leg (- 1.47%, p = 0.001). Both groups responded to the optic flow speed manipulation such that people accelerated with a slow optic flow and decelerated with a fast optic flow. Compared to the semi-immersive GRAIL session, manipulating the optic flow speed with the fully immersive HMD had a greater effect on gait biomechanics whilst also eliciting a higher sense of presence. CONCLUSION Adding fully immersive VR while walking on a self-paced treadmill led to a more cautious gait pattern in people post-stroke. However, walking with the HMD was well tolerated and enjoyable. People post-stroke altered their gait parameters when optic flow speed was manipulated and showed greater alterations with the fully-immersive HMD. Further work is needed to determine the most effective type of optic flow speed manipulation as well as which other principles need to be implemented to positively influence the gait pattern of people post-stroke. TRIAL REGISTRATION NUMBER The study was pre-registered at ClinicalTrials.gov (NCT04521829).
Collapse
Affiliation(s)
- Emma De Keersmaecker
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium.
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium.
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium.
- Alliance research group REBI (Rehabilitation technology for people with a brain injury), Vrije Universiteit Brussel & Ghent University, Brussels, Belgium.
| | - Anke Van Bladel
- Alliance research group REBI (Rehabilitation technology for people with a brain injury), Vrije Universiteit Brussel & Ghent University, Brussels, Belgium
- Faculty of Medicine and Health Sciences, Department Rehabilitation Sciences, Campus UZ Gent, Ghent, Belgium
| | - Silvia Zaccardi
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Electronics and Informatics, Engineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nina Lefeber
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
- Movement and Nutrition for Health and Performance, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Eric Kerckhofs
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bart Jansen
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Department of Electronics and Informatics, Engineering Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Imec, Leuven, Belgium
| | - Eva Swinnen
- Rehabilitation Research, Department of Physiotherapy, Human Physiology and Anatomy, Vrije Universiteit Brussel, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Brussels, Belgium
- Brussels Human Robotic Research Center (BruBotics), Vrije Universiteit Brussel, Brussels, Belgium
- Alliance research group REBI (Rehabilitation technology for people with a brain injury), Vrije Universiteit Brussel & Ghent University, Brussels, Belgium
| |
Collapse
|
3
|
Chen J, Romero R, Thompson LA. Motion Analysis of Balance Pre and Post Sensorimotor Exercises to Enhance Elderly Mobility: A Case Study. APPLIED SCIENCES (BASEL, SWITZERLAND) 2023; 13:889. [PMID: 38501123 PMCID: PMC10947499 DOI: 10.3390/app13020889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Quantitative assessment of movement using motion capture provides insights on mobility which are not evident from clinical evaluation. Here, in older individuals that were healthy or had suffered a stroke, we aimed to investigate their balance in terms of changes in body kinematics and muscle activity. Our research question involved determining the effects on post- compared to pre-sensorimotor training exercises on maintaining or improving balance. Our research hypothesis was that training would improve the gait and balance by increasing joint angles and extensor muscle activities in lower extremities and spatiotemporal measures of stroke and elderly people. This manuscript describes a motion capture-based evaluation protocol to assess joint angles and spatiotemporal parameters (cadence, step length and walking speed), as well as major extensor and flexor muscle activities. We also conducted a case study on a healthy older participant (male, age, 65) and an older participant with chronic stroke (female, age, 55). Both participants performed a walking task along a path with a rectangular shape which included tandem walking forward, right side stepping, tandem walking backward, left side stepping to the starting location. For the stroke participant, the training improved the task completion time by 19 s. Her impaired left leg had improved step length (by 0.197 m) and cadence (by 10 steps/min) when walking forward, and cadence (by 12 steps/min) when walking backward. The non-impaired right leg improved cadence when walking forward (by 15 steps/min) and backward (by 27 steps/min). The joint range of motion (ROM) did not change in most cases. However, the ROM of the hip joint increased significantly by 5.8 degrees (p = 0.019) on the left leg side whereas the ROMs of hip joint and knee joint increased significantly by 4.1 degrees (p = 0.046) and 8.1 degrees (p = 0.007) on the right leg side during backward walking. For the healthy participant, the significant changes were only found in his right knee joint ROM having increased by 4.2 degrees (p = 0.031) and in his left ankle joint ROM having increased by 5.5 degrees (p = 0.006) during the left side stepping.
Collapse
Affiliation(s)
- Ji Chen
- Biomedical Engineering Program, Department of Mechanical Engineering, University of the District of Columbia, Washington, DC 20008, USA
| | - Roni Romero
- Biomedical Engineering Program, Department of Mechanical Engineering, University of the District of Columbia, Washington, DC 20008, USA
| | - Lara A. Thompson
- Biomedical Engineering Program, Department of Mechanical Engineering, University of the District of Columbia, Washington, DC 20008, USA
| |
Collapse
|
4
|
Ryabov SA, Boyko AN. [Knee range of motion as a marker of the effectiveness of medical intervention in multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:84-87. [PMID: 37560839 DOI: 10.17116/jnevro202312307284] [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] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To measure the knee range of motion (ROM) in the sagittal plane by video analysis in patients with multiple sclerosis (MS) after a course of medical rehabilitation and determine the minimal clinically important differences (MCID). MATERIAL AND METHODS We examined 45 patients (37 women, 8 men) with relapsing-remitting (n=38) and secondary-progressive MS before and after a course of medical rehabilitation. Gait parameters were recorded on video analysis system Physiomed Smart («Physiomed», Germany, the Davis protocol). RESULTS The course of complex medical rehabilitation contributes to an increase knee ROM in MS patients in a wide range of disability (EDSS <6.5 points). MCID is estimated as 7.14° in mild (EDSS ≤4.0) and as 7.67° in moderate (EDSS=4.5-5.5) gait impairment. CONCLUSION The results will assist clinicians and researchers in interpreting the significance of observed kinematic changes in the knee joint in MS patients after medical intervention.
Collapse
Affiliation(s)
- S A Ryabov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A N Boyko
- Pirogov Russian National Research Medical University, Moscow, Russia
- Federal Center of Brain Research and Neurotechnologies» of the Federal Medical Biological Agency, Moscow, Russia
| |
Collapse
|
5
|
Gil-Castillo J, Barria P, Aguilar Cárdenas R, Baleta Abarza K, Andrade Gallardo A, Biskupovic Mancilla A, Azorín JM, Moreno JC. A Robot-Assisted Therapy to Increase Muscle Strength in Hemiplegic Gait Rehabilitation. Front Neurorobot 2022; 16:837494. [PMID: 35574230 PMCID: PMC9100587 DOI: 10.3389/fnbot.2022.837494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/30/2022] [Indexed: 11/24/2022] Open
Abstract
This study examines the feasibility of using a robot-assisted therapy methodology based on the Bobath concept to perform exercises applied in conventional therapy for gait rehabilitation in stroke patients. The aim of the therapy is to improve postural control and movement through exercises based on repetitive active-assisted joint mobilization, which is expected to produce strength changes in the lower limbs. As therapy progresses, robotic assistance is gradually reduced and the patient's burden increases with the goal of achieving a certain degree of independence. The relationship between force and range of motion led to the analysis of both parameters of interest. The study included 23 volunteers who performed 24 sessions, 2 sessions per week for 12 weeks, each lasting about 1 h. The results showed a significant increase in hip abduction and knee flexion strength on both sides, although there was a general trend of increased strength in all joints. However, the range of motion at the hip and ankle joints was reduced. The usefulness of this platform for transferring exercises from conventional to robot-assisted therapies was demonstrated, as well as the benefits that can be obtained in muscle strength training. However, it is suggested to complement the applied therapy with exercises for the maintenance and improvement of the range of motion.
Collapse
Affiliation(s)
- Javier Gil-Castillo
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - Patricio Barria
- Research and Development Unit, Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas, Chile
- Electrical Engineering Department, Universidad de Magallanes, Punta Arenas, Chile
- Systems Engineering and Automation Department, Universidad Miguel Hernández de Elche, Elche, Spain
| | | | - Karim Baleta Abarza
- Research and Development Unit, Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas, Chile
| | - Asterio Andrade Gallardo
- Research and Development Unit, Rehabilitation Center Club de Leones Cruz del Sur, Punta Arenas, Chile
| | | | - José M. Azorín
- Systems Engineering and Automation Department, Universidad Miguel Hernández de Elche, Elche, Spain
| | - Juan C. Moreno
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
- *Correspondence: Juan C. Moreno
| |
Collapse
|
6
|
Nilsson S, Ertzgaard P, Lundgren M, Grip H. Test-Retest Reliability of Kinematic and Temporal Outcome Measures for Clinical Gait and Stair Walking Tests, Based on Wearable Inertial Sensors. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22031171. [PMID: 35161916 PMCID: PMC8838027 DOI: 10.3390/s22031171] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/17/2022] [Accepted: 01/30/2022] [Indexed: 05/16/2023]
Abstract
It is important to assess gait function in neurological disorders. A common outcome measure from clinical walking tests is average speed, which is reliable but does not capture important kinematical and temporal aspects of gait function. An extended gait analysis must be time efficient and reliable to be included in the clinical routine. The aim of this study was to add an inertial sensor system to a gait test battery and analyze the test-retest reliability of kinematic and temporal outcome measures. Measurements and analyses were performed in the hospital environment by physiotherapists using customized software. In total, 22 healthy persons performed comfortable gait, fast gait, and stair walking, with 12 inertial sensors attached to the feet, shank, thigh, pelvis, thorax, and arms. Each person participated in 2 test sessions, with about 3-6 days between the sessions. Kinematics were calculated based on a sensor fusion algorithm. Sagittal peak angles, sagittal range of motion, and stride frequency were derived. Intraclass-correlation coefficients were determined to analyze the test-retest reliability, which was good to excellent for comfortable and fast gait, with exceptions for hip, knee, and ankle peak angles during fast gait, which showed moderate reliability, and fast gait stride frequency, which showed poor reliability. In stair walking, all outcome measures except shoulder extension showed good to excellent reliability. Inertial sensors have the potential to improve the clinical evaluation of gait function in neurological patients, but this must be verified in patient groups.
Collapse
Affiliation(s)
- Sofie Nilsson
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linkoping University, 581 83 Linköping, Sweden; (S.N.); (P.E.)
| | - Per Ertzgaard
- Department of Rehabilitation Medicine and Department of Health, Medicine and Caring Sciences, Linkoping University, 581 83 Linköping, Sweden; (S.N.); (P.E.)
| | - Mikael Lundgren
- Department of Rehabilitation, Västervik Hospital, 593 33 Västervik, Sweden;
| | - Helena Grip
- Department of Radiation Sciences, Biomedical Engineering, Umeå University, 901 87 Umeå, Sweden
- Correspondence: ; Tel.: +46-907854029
| |
Collapse
|