Closing the Wearable Gap: Mobile Systems for Kinematic Signal Monitoring of the Foot and Ankle

RF. Comparison of the Capacitance of a Cyclically Fatigued Stretch Sensor to a Non-Fatigued Stretch Sensor When Performing Static and Dynamic Foot-Ankle Motions

Motion capture is the current gold standard for assessing movement of the human body, but laboratory settings do not always mimic the natural terrains and movements encountered by humans. To overcome such limitations, a smart sock that is equipped with stretch sensors is being developed to record movement data outside of the laboratory. For the smart sock stretch sensors to provide valuable feedback, the sensors should have durability of both materials and signal. To test the durability of the stretch sensors, the sensors were exposed to high-cycle fatigue testing with simultaneous capture of the capacitance. Following randomization, either the fatigued sensor or an unfatigued sensor was placed in the plantarflexion position on the smart sock, and participants were asked to complete the following static movements: dorsiflexion, inversion, eversion, and plantarflexion. Participants were then asked to complete gait trials. The sensor was then exchanged for either an unfatigued or fatigued plantarflexion sensor, depending upon which sensor the trials began with, and each trial was repeated by the participant using the opposite sensor. Results of the tests show that for both the static and dynamic movements, the capacitive output of the fatigued sensor was consistently higher than that of the unfatigued sensor suggesting that an upwards drift of the capacitance was occurring in the fatigued sensors. More research is needed to determine whether stretch sensors should be pre-stretched prior to data collection, and to also determine whether the drift stabilizes once the cyclic softening of the materials comprising the sensor has stabilized.

Wearables for Biomechanical Performance Optimization and Risk Assessment in Industrial and Sports Applications

Wearable technologies are emerging as a useful tool with many different applications. While these devices are worn on the human body and can capture numerous data types, this literature review focuses specifically on wearable use for performance enhancement and risk assessment in industrial- and sports-related biomechanical applications. Wearable devices such as exoskeletons, inertial measurement units (IMUs), force sensors, and surface electromyography (EMG) were identified as key technologies that can be used to aid health and safety professionals, ergonomists, and human factors practitioners improve user performance and monitor risk. IMU-based solutions were the most used wearable types in both sectors. Industry largely used biomechanical wearables to assess tasks and risks wholistically, which sports often considered the individual components of movement and performance. Availability, cost, and adoption remain common limitation issues across both sports and industrial applications.

Diagnosing gait disorders based on angular variations of knee and ankle joints utilizing a developed wearable motion sensor

Here, a sensory motion system is developed to diagnose gait disorders using the estimation of angular variations in the knee and ankle joints. The sensory system includes two transmitter sensors and a central node, where each transmitter comprises three sensors of accelerometer, gyroscopes, and magnetometer to estimate the angular movements in the ankle and knee joints. By using a proposed filter, the angular variation is estimated in a personal computer employing the raw data of the motion sensors that are sent by the central node. The obtained results of the presented filter in comparison to an actual reference illustrate that the root mean square error is less than 1.01, 1.34, and 1.61 degrees, respectively, for the angles of ϕ and θ and ψ that illustrate an improvement of 40% than the previous work. Moreover, a quantity value is defined based on the correlation between knee and ankle angles that show the amount of correctness in gating. Thus, the proposed system can be utilized for people who suffer problems in gait and help them to improve their movements.

RF. Fatigue Testing of Wearable Sensing Technologies: Issues and Opportunities

Standards for the fatigue testing of wearable sensing technologies are lacking. The majority of published fatigue tests for wearable sensors are performed on proof-of-concept stretch sensors fabricated from a variety of materials. Due to their flexibility and stretchability, polymers are often used in the fabrication of wearable sensors. Other materials, including textiles, carbon nanotubes, graphene, and conductive metals or inks, may be used in conjunction with polymers to fabricate wearable sensors. Depending on the combination of the materials used, the fatigue behaviors of wearable sensors can vary. Additionally, fatigue testing methodologies for the sensors also vary, with most tests focusing only on the low-cycle fatigue (LCF) regime, and few sensors are cycled until failure or runout are achieved. Fatigue life predictions of wearable sensors are also lacking. These issues make direct comparisons of wearable sensors difficult. To facilitate direct comparisons of wearable sensors and to move proof-of-concept sensors from "bench to bedside", fatigue testing standards should be established. Further, both high-cycle fatigue (HCF) and failure data are needed to determine the appropriateness in the use, modification, development, and validation of fatigue life prediction models and to further the understanding of how cracks initiate and propagate in wearable sensing technologies.

Closing the Wearable Gap-Part VII: A Retrospective of Stretch Sensor Tool Kit Development for Benchmark Testing

This paper presents a retrospective of the benchmark testing methodologies developed and accumulated into the stretch sensor tool kit (SSTK) by the research team during the Closing the Wearable Gap series of studies. The techniques developed to validate stretchable soft robotic sensors (SRS) as a means for collecting human kinetic and kinematic data at the foot-ankle complex and at the wrist are reviewed. Lessons learned from past experiments are addressed, as well as what comprises the current SSTK based on what the researchers learned over the course of multiple studies. Three core components of the SSTK are featured: (a) material testing tools, (b) data analysis software, and (c) data collection devices. Results collected indicate that the stretch sensors are a viable means for predicting kinematic data based on the most recent gait analysis study conducted by the researchers (average root mean squared error or RMSE = 3.63°). With the aid of SSTK defined in this study summary and shared with the academic community on GitHub, researchers will be able to undergo more rigorous validation methodologies of SRS validation. A summary of the current state of the SSTK is detailed and includes insight into upcoming experiments that will utilize more sophisticated techniques for fatigue testing and gait analysis, utilizing SRS as the data collection solution.

Wearable Stretch Sensors for Human Movement Monitoring and Fall Detection in Ergonomics

Wearable sensors are beneficial for continuous health monitoring, movement analysis, rehabilitation, evaluation of human performance, and for fall detection. Wearable stretch sensors are increasingly being used for human movement monitoring. Additionally, falls are one of the leading causes of both fatal and nonfatal injuries in the workplace. The use of wearable technology in the workplace could be a successful solution for human movement monitoring and fall detection, especially for high fall-risk occupations. This paper provides an in-depth review of different wearable stretch sensors and summarizes the need for wearable technology in the field of ergonomics and the current wearable devices used for fall detection. Additionally, the paper proposes the use of soft-robotic-stretch (SRS) sensors for human movement monitoring and fall detection. This paper also recapitulates the findings of a series of five published manuscripts from ongoing research that are published as Parts I to V of “Closing the Wearable Gap” journal articles that discuss the design and development of a foot and ankle wearable device using SRS sensors that can be used for fall detection. The use of SRS sensors in fall detection, its current limitations, and challenges for adoption in human factors and ergonomics are also discussed.

Closing the Wearable Gap—Part VI: Human Gait Recognition Using Deep Learning Methodologies

A novel wearable solution using soft robotic sensors (SRS) has been investigated to model foot-ankle kinematics during gait cycles. The capacitance of SRS related to foot-ankle basic movements was quantified during the gait movements of 20 participants on a flat surface as well as a cross-sloped surface. In order to evaluate the power of SRS in modeling foot-ankle kinematics, three-dimensional (3D) motion capture data was also collected for analyzing gait movement. Three different approaches were employed to quantify the relationship between the SRS and the 3D motion capture system, including multivariable linear regression, an artificial neural network (ANN), and a time-series long short-term memory (LSTM) network. Models were compared based on the root mean squared error (RMSE) of the prediction of the joint angle of the foot in the sagittal and frontal plane, collected from the motion capture system. There was not a significant difference between the error rates of the three different models. The ANN resulted in an average RMSE of 3.63, being slightly more successful in comparison to the average RMSE values of 3.94 and 3.98 resulting from multivariable linear regression and LSTM, respectively. The low error rate of the models revealed the high performance of SRS in capturing foot-ankle kinematics during the human gait cycle.

Validity and Reliability of an Inertial Device for Measuring Dynamic Weight-Bearing Ankle Dorsiflexion

A decrease in ankle dorsiflexion causes changes in biomechanics, and different instruments have been used for ankle dorsiflexion testing under static conditions. Consequently, the industry of inertial sensors has developed easy-to-use devices, which measure dynamic ankle dorsiflexion and provide additional parameters such as velocity, acceleration, or movement deviation. Therefore, the aims of this study were to analyze the concurrent validity and test-retest reliability of an inertial device for measuring dynamic weight-bearing ankle dorsiflexion. Sixteen participants were tested using an inertial device (WIMU) and a digital inclinometer. Ankle dorsiflexion from left and right ankle repetitions was used for validity analysis, whereas test-retest reliability was analyzed by comparing measurements from the first and second days. The standard error of the measurement (SEM) between the instruments was very low for both ankle measurements (SEM < 0.6°). No significant differences between instruments were found for the left ankle measurement (p > 0.05) even though a significant systematic bias (~1.77°) was found for the right ankle (d = 0.79). R² was very close to 1 in the left and right ankles (R² = 0.85–0.89) as well as the intraclass correlation coefficient (ICC > 0.95). Test-retest reliability analysis showed that systematic bias was below 1° for both instruments, even though a systematic bias (~1.50°) with small effect size was found in the right ankle (d = 0.49) with WIMU. The ICC was very close to 1 and the coefficient of variation (CV) was lower than 4% in both instruments. Thus, WIMU is a valid and reliable inertial device for measuring dynamic weight-bearing ankle dorsiflexion.

Closing the Wearable Gap-Part V: Development of a Pressure-Sensitive Sock Utilizing Soft Sensors

The purpose of this study was to evaluate the use of compressible soft robotic sensors (C-SRS) in determining plantar pressure to infer vertical and shear forces in wearable technology: A ground reaction pressure sock (GRPS). To assess pressure relationships between C-SRS, pressure cells on a BodiTrakTM Vector Plate, and KistlerTM Force Plates, thirteen volunteers performed three repetitions of three different movements: squats, shifting center-of-pressure right to left foot, and shifting toes to heels with C-SRS in both anterior-posterior (A/P) and medial-lateral (M/L) sensor orientations. Pearson correlation coefficient of C-SRS to BodiTrakTM Vector Plate resulted in an average R-value greater than 0.70 in 618/780 (79%) of sensor to cell comparisons. An average R-value greater than 0.90 was seen in C-SRS comparison to KistlerTM Force Plates during shifting right to left. An autoregressive integrated moving average (ARIMA) was conducted to identify and estimate future C-SRS data. No significant differences were seen in sensor orientation. Sensors in the A/P orientation reported a mean R2 value of 0.952 and 0.945 in the M/L sensor orientation, reducing the effectiveness to infer shear forces. Given the high R values, the use of C-SRSs to infer normal pressures appears to make the development of the GRPS feasible.

Closing the Wearable Gap—Part IV: 3D Motion Capture Cameras Versus Soft Robotic Sensors Comparison of Gait Movement Assessment

The purpose of this study was to use 3D motion capture and stretchable soft robotic sensors (SRS) to collect foot-ankle movement on participants performing walking gait cycles on flat and sloped surfaces. The primary aim was to assess differences between 3D motion capture and a new SRS-based wearable solution. Given the complex nature of using a linear solution to accurately quantify the movement of triaxial joints during a dynamic gait movement, 20 participants performing multiple walking trials were measured. The participant gait data was then upscaled (for the SRS), time-aligned (based on right heel strikes), and smoothed using filtering methods. A multivariate linear model was developed to assess goodness-of-fit based on mean absolute error (MAE; 1.54), root mean square error (RMSE; 1.96), and absolute R2 (R2; 0.854). Two and three SRS combinations were evaluated to determine if similar fit scores could be achieved using fewer sensors. Inversion (based on MAE and RMSE) and plantar flexion (based on R2) sensor removal provided second-best fit scores. Given that the scores indicate a high level of fit, with further development, an SRS-based wearable solution has the potential to measure motion during gait- based tasks with the accuracy of a 3D motion capture system.

Closing the Wearable Gap—Part III: Use of Stretch Sensors in Detecting Ankle Joint Kinematics During Unexpected and Expected Slip and Trip Perturbations

Background: An induced loss of balance resulting from a postural perturbation has been reported as the primary source for postural instability leading to falls. Hence; early detection of postural instability with novel wearable sensor-based measures may aid in reducing falls and fall-related injuries. The purpose of the study was to validate the use of a stretchable soft robotic sensor (SRS) to detect ankle joint kinematics during both unexpected and expected slip and trip perturbations. Methods: Ten participants (age: 23.7 ± 3.13 years; height: 170.47 ± 8.21 cm; mass: 82.86 ± 23.4 kg) experienced a counterbalanced exposure of an unexpected slip, an unexpected trip, an expected slip, and an expected trip using treadmill perturbations. Ankle joint kinematics for dorsiflexion and plantarflexion were quantified using three-dimensional (3D) motion capture through changes in ankle joint range of motion and using the SRS through changes in capacitance when stretched due to ankle movements during the perturbations. Results: A greater R-squared and lower root mean square error in the linear regression model was observed in comparing ankle joint kinematics data from motion capture with stretch sensors. Conclusions: Results from the study demonstrated that 71.25% of the trials exhibited a minimal error of less than 4.0 degrees difference from the motion capture system and a greater than 0.60 R-squared value in the linear model; suggesting a moderate to high accuracy and minimal errors in comparing SRS to a motion capture system. Findings indicate that the stretch sensors could be a feasible option in detecting ankle joint kinematics during slips and trips.

Data Processing and Wearable Systems for Effective Human Monitoring

The last few decades have seen an unrestrained diffusion of smart-integrated technologies that are extremely pervasive and customized based on humans’ environments and habits [...]

Closing the Wearable Gap-Part II: Sensor Orientation and Placement for Foot and Ankle Joint Kinematic Measurements

The linearity of soft robotic sensors (SRS) was recently validated for movement angle assessment using a rigid body structure that accurately depicted critical movements of the foot–ankle complex. The purpose of this study was to continue the validation of SRS for joint angle movement capture on 10 participants (five male and five female) performing ankle movements in a non-weight bearing, high-seated, sitting position. The four basic ankle movements—plantar flexion (PF), dorsiflexion (DF), inversion (INV), and eversion (EVR)—were assessed individually in order to select good placement and orientation configurations (POCs) for four SRS positioned to capture each movement type. PF, INV, and EVR each had three POCs identified based on bony landmarks of the foot and ankle while the DF location was only tested for one POC. Each participant wore a specialized compression sock where the SRS could be consistently tested from all POCs for each participant. The movement data collected from each sensor was then compared against 3D motion capture data. R-squared and root-mean-squared error averages were used to assess relative and absolute measures of fit to motion capture output. Participant robustness, opposing movements, and gender were also used to identify good SRS POC placement for foot–ankle movement capture.