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Küderle A, Ullrich M, Roth N, Ollenschläger M, Ibrahim AA, Moradi H, Richer R, Seifer AK, Zürl M, Sîmpetru RC, Herzer L, Prossel D, Kluge F, Eskofier BM. Gaitmap-An Open Ecosystem for IMU-Based Human Gait Analysis and Algorithm Benchmarking. IEEE OPEN JOURNAL OF ENGINEERING IN MEDICINE AND BIOLOGY 2024; 5:163-172. [PMID: 38487091 PMCID: PMC10939318 DOI: 10.1109/ojemb.2024.3356791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/15/2023] [Accepted: 01/17/2024] [Indexed: 03/17/2024] Open
Abstract
Goal: Gait analysis using inertial measurement units (IMUs) has emerged as a promising method for monitoring movement disorders. However, the lack of public data and easy-to-use open-source algorithms hinders method comparison and clinical application development. To address these challenges, this publication introduces the gaitmap ecosystem, a comprehensive set of open source Python packages for gait analysis using foot-worn IMUs. Methods: This initial release includes over 20 state-of-the-art algorithms, enables easy access to seven datasets, and provides eight benchmark challenges with reference implementations. Together with its extensive documentation and tooling, it enables rapid development and validation of new algorithm and provides a foundation for novel clinical applications. Conclusion: The published software projects represent a pioneering effort to establish an open-source ecosystem for IMU-based gait analysis. We believe that this work can democratize the access to high-quality algorithm and serve as a driver for open and reproducible research in the field of human gait analysis and beyond.
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Affiliation(s)
- Arne Küderle
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Martin Ullrich
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Nils Roth
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Malte Ollenschläger
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Alzhraa A. Ibrahim
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
- Department of Molecular NeurologyFAU Erlangen91054ErlangenGermany
- Computer Science Department, Faculty of Computers and InformationAssiut UniversityAssiut Governorate71515Egypt
| | - Hamid Moradi
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Robert Richer
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Ann-Kristin Seifer
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Matthias Zürl
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Raul C. Sîmpetru
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Liv Herzer
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Dominik Prossel
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Felix Kluge
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
| | - Bjoern M. Eskofier
- Machine Learning and Data Analytics LabFriedrich-Alexander Universität Erlangen-Nürnberg (FAU)91054ErlangenGermany
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Kim T, Yu X, Xiong S. A multifactorial fall risk assessment system for older people utilizing a low-cost, markerless Microsoft Kinect. ERGONOMICS 2024; 67:50-68. [PMID: 37079340 DOI: 10.1080/00140139.2023.2202845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/29/2023] [Indexed: 05/03/2023]
Abstract
Falls among older people are a major health concern. This study aims to develop a multifactorial fall risk assessment system for older people using a low-cost, markerless Microsoft Kinect. A Kinect-based test battery was designed to comprehensively assess major fall risk factors. A follow-up experiment was conducted with 102 older participants to assess their fall risks. Participants were divided into high and low fall risk groups based on their prospective falls over a 6-month period. Results showed that the high fall risk group performed significantly worse on the Kinect-based test battery. The developed random forest classification model achieved an average classification accuracy of 84.7%. In addition, the individual's performance was computed as the percentile value of a normative database to visualise deficiencies and targets for intervention. These findings indicate that the developed system can not only screen out 'at risk' older individuals with good accuracy, but also identify potential fall risk factors for effective fall intervention.Practitioner summary: Falls are the leading cause of injuries in older people. We newly developed a multifactorial fall risk assessment system for older people utilising a low-cost, markerless Kinect. Results showed that the developed system can screen out 'at risk' individuals and identify potential risk factors for effective fall intervention.
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Affiliation(s)
- Taekyoung Kim
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
- KT R&D Center, Seoul, Republic of Korea
| | - Xiaoqun Yu
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
| | - Shuping Xiong
- Human Factors and Ergonomics Laboratory, Department of Industrial and Systems Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejoen, Republic of Korea
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Ferley DD, Osborn R, Vukovich M. Retrograde Training: Effects on Lower Body Strength and Power. Int J Sports Med 2023; 44:215-223. [PMID: 36455596 DOI: 10.1055/a-1796-7808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Backward walking and running on positive grades (retrograde training) represents a closed kinetic chain exercise used by rehabilitation specialists for patellofemoral-related injuries. To date, no longitudinal studies exist to support it use. This investigation examined the effects of retrograde training on lower body strength and power in recreational athletes aged 18-50 years over 6 weeks. Thirty-seven subjects were divided into two groups. Group 1 performed retrograde training 3 days∙wk-1 using treadmill speeds, grades and bout durations ranging from 1.6-4.9 m∙sec-1, 2.5-27.5% and 10-30 seconds, respectively (RG, n=19). Group 2 was a control group who continued their normal training (CON, n=18). Pre- and posttests assessed a variety of unilateral and bilateral measures including vertical and linear jumps, one repetition maximum leg press strength, and positive and negative power during weighted squat jumping on a horizontal leg press with a force plate. RG improved significantly in all tests (P<0.05). Mean effect size (ES) of the relative improvement in a majority of tests revealed a moderate to very large ES of RG training (ES range: 0.77-2.71). We conclude retrograde training effective for improving lower body strength and power in recreational athletes.
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Affiliation(s)
- Derek D Ferley
- Avera Sports, Avera McKennan Hospital and University Health Center, Sioux Falls, United States
| | - Roy Osborn
- School of Health Sciences, University of South Dakota, Vermillion, United States
| | - Matt Vukovich
- Health & Nutritional Sciences, South Dakota State University, Brookings, United States
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Kim YK, Visscher RMS, Viehweger E, Singh NB, Taylor WR, Vogl F. A deep-learning approach for automatically detecting gait-events based on foot-marker kinematics in children with cerebral palsy-Which markers work best for which gait patterns? PLoS One 2022; 17:e0275878. [PMID: 36227847 PMCID: PMC9562216 DOI: 10.1371/journal.pone.0275878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/25/2022] [Indexed: 11/06/2022] Open
Abstract
Neuromotor pathologies often cause motor deficits and deviations from typical locomotion, reducing the quality of life. Clinical gait analysis is used to effectively classify these motor deficits to gain deeper insights into resulting walking behaviours. To allow the ensemble averaging of spatio-temporal metrics across individuals during walking, gait events, such as initial contact (IC) or toe-off (TO), are extracted through either manual annotation based on video data, or through force thresholds using force plates. This study developed a deep-learning long short-term memory (LSTM) approach to detect IC and TO automatically based on foot-marker kinematics of 363 cerebral palsy subjects (age: 11.8 ± 3.2). These foot-marker kinematics, including 3D positions and velocities of the markers located on the hallux (HLX), calcaneus (HEE), distal second metatarsal (TOE), and proximal fifth metatarsal (PMT5), were extracted retrospectively from standard barefoot gait analysis sessions. Different input combinations of these four foot-markers were evaluated across three gait subgroups (IC with the heel, midfoot, or forefoot). For the overall group, our approach detected 89.7% of ICs within 16ms of the true event with a 18.5% false alarm rate. For TOs, only 71.6% of events were detected with a 33.8% false alarm rate. While the TOE|HEE marker combination performed well across all subgroups for IC detection, optimal performance for TO detection required different input markers per subgroup with performance differences of 5-10%. Thus, deep-learning LSTM based detection of IC events using the TOE|HEE markers offers an automated alternative to avoid operator-dependent and laborious manual annotation, as well as the limited step coverage and inability to measure assisted walking for force plate-based detection of IC events.
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Affiliation(s)
- Yong Kuk Kim
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
- * E-mail:
| | - Rosa M. S. Visscher
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Elke Viehweger
- Laboratory for Movement Analysis, Department of Orthopedics, University Children’s Hospital Basel, Basel, Switzerland
| | - Navrag B. Singh
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
| | - William R. Taylor
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
| | - Florian Vogl
- Laboratory for Movement Biomechanics, Institute for Biomechanics, ETH Zürich, Zürich, Switzerland
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Shapiro M, Shaki S, Gottlieb U, Springer S. Random walk: Random number generation during backward and forward walking- the role of aging. Front Aging Neurosci 2022; 14:888979. [PMID: 36247999 PMCID: PMC9554272 DOI: 10.3389/fnagi.2022.888979] [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: 03/03/2022] [Accepted: 09/05/2022] [Indexed: 11/28/2022] Open
Abstract
Deficits in executive function, visuospatial abilities, and cognitive embodiment may impair gait performance. This study aimed to investigate the effect of age on random number generation (RNG) performance during forward and backward locomotion to assess cognitive flexibility and cognitive embodiment during walking. Another aim was to examine the effect of age on the associations of RNG performance during walking with stride time variability (STV), the percentage of double support (DS%), and visuospatial abilities as measured by a spatial orientation test (SOT). Twenty old (age 68.8 ± 5.3, 65% female) and 20 young (age 25.2 ± 2.2, 45% female) adults generated random numbers during backward walking (BW) and forward walking (FW) over-ground and over a treadmill with an internal focus of attention and visual-attentive distraction; six walking conditions in total. To assess cognitive flexibility, sample entropy was calculated for each RNG sequence. The average of the first 5 numbers in each RNG task was calculated to assess the relationship between small/large numbers and movement direction. STV and DS% were recorded using inertial measurement units, and spatial orientation was measured using a computerized test. The older subjects had less flexibility in generating random numbers in three of the six walking conditions. A negative correlation between RNG flexibility and STV was found in older adults during treadmill BW with visual-attentive distraction and forward over-ground walking, whereas no correlations were demonstrated in the young group. The spatial orientation score (a higher value means a worse outcome) correlated positively with RNG flexibility in the older group under all walking conditions, suggesting that older adults with better visuospatial orientation have lower cognitive flexibility, and vice versa. There was no correlation between small/large numbers and direction of motion in either group. The correlation between RNG flexibility and STV may indicate similar executive control of verbal and gait rhythmicity in old adults. Conversely, our results suggest that cognitive flexibility and visuospatial ability may decline differently.
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Affiliation(s)
- Maxim Shapiro
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Samuel Shaki
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Uri Gottlieb
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Shmuel Springer
- The Neuromuscular and Human Performance Laboratory, Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
- *Correspondence: Shmuel Springer,
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Gottlieb U, Hoffman JR, Springer S. The Immediate Carryover Effects of Peroneal Functional Electrical Stimulation Differ between People with and without Chronic Ankle Instability. SENSORS (BASEL, SWITZERLAND) 2022; 22:1622. [PMID: 35214526 PMCID: PMC8874504 DOI: 10.3390/s22041622] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 02/10/2022] [Accepted: 02/17/2022] [Indexed: 11/16/2022]
Abstract
Chronic ankle instability (CAI) is a common condition that may develop after an ankle sprain. Compared with healthy individuals, those with CAI demonstrate excessive ankle inversion and increased peroneal electromyography (EMG) activity throughout the stance phase of gait, which may put them at greater risk for re-injury. Functional electrical stimulation (FES) of targeted muscles may provide benefits as a treatment modality to stimulate immediate adaptation of the neuromuscular system. The present study investigated the effect of a single, 10 min peroneal FES session on ankle kinematics and peroneal EMG activity in individuals with (n = 24) or without (n = 24) CAI. There were no significant differences in ankle kinematics between the groups before the intervention. However, after the intervention, healthy controls demonstrated significantly less ankle inversion between 0-9% (p = 0.009) and 82-87% (p = 0.011) of the stance phase. Furthermore, a significant within-group difference was observed only in the control group, demonstrating increased ankle eversion between 0-7% (p = 0.011) and 67-81% (p = 0.006) of the stance phase after the intervention. Peroneal EMG activity did not differ between groups or measurements. These findings, which demonstrate that peroneal FES can induce ankle kinematics adaptations during gait, can help to develop future interventions for people with CAI.
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Affiliation(s)
| | | | - Shmuel Springer
- Neuromuscular and Human Performance Laboratory, Department of Physiotherapy, Faculty of Health Sciences, Ariel University, Ariel 40700, Israel; (U.G.); (J.R.H.)
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Warmerdam E, Romijnders R, Geritz J, Elshehabi M, Maetzler C, Otto JC, Reimer M, Stuerner K, Baron R, Paschen S, Beyer T, Dopcke D, Eiken T, Ortmann H, Peters F, von der Recke F, Riesen M, Rohwedder G, Schaade A, Schumacher M, Sondermann A, Maetzler W, Hansen C. Proposed Mobility Assessments with Simultaneous Full-Body Inertial Measurement Units and Optical Motion Capture in Healthy Adults and Neurological Patients for Future Validation Studies: Study Protocol. SENSORS 2021; 21:s21175833. [PMID: 34502726 PMCID: PMC8434336 DOI: 10.3390/s21175833] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/24/2021] [Accepted: 08/27/2021] [Indexed: 01/06/2023]
Abstract
Healthy adults and neurological patients show unique mobility patterns over the course of their lifespan and disease. Quantifying these mobility patterns could support diagnosing, tracking disease progression and measuring response to treatment. This quantification can be done with wearable technology, such as inertial measurement units (IMUs). Before IMUs can be used to quantify mobility, algorithms need to be developed and validated with age and disease-specific datasets. This study proposes a protocol for a dataset that can be used to develop and validate IMU-based mobility algorithms for healthy adults (18–60 years), healthy older adults (>60 years), and patients with Parkinson’s disease, multiple sclerosis, a symptomatic stroke and chronic low back pain. All participants will be measured simultaneously with IMUs and a 3D optical motion capture system while performing standardized mobility tasks and non-standardized activities of daily living. Specific clinical scales and questionnaires will be collected. This study aims at building the largest dataset for the development and validation of IMU-based mobility algorithms for healthy adults and neurological patients. It is anticipated to provide this dataset for further research use and collaboration, with the ultimate goal to bring IMU-based mobility algorithms as quickly as possible into clinical trials and clinical routine.
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A Novel Framework for Quantifying Accuracy and Precision of Event Detection Algorithms in FES-Cycling. SENSORS 2021; 21:s21134571. [PMID: 34283104 PMCID: PMC8272114 DOI: 10.3390/s21134571] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 02/06/2023]
Abstract
Functional electrical stimulation (FES) is a technique used in rehabilitation, allowing the recreation or facilitation of a movement or function, by electrically inducing the activation of targeted muscles. FES during cycling often uses activation patterns which are based on the crank angle of the pedals. Dynamic changes in their underlying predefined geometrical models (e.g., change in seating position) can lead to desynchronised contractions. Adaptive algorithms with a real-time interpretation of anatomical segments can avoid this and open new possibilities for the automatic design of stimulation patterns. However, their ability to accurately and precisely detect stimulation triggering events has to be evaluated in order to ensure their adaptability to real-case applications in various conditions. In this study, three algorithms (Hilbert, BSgonio, and Gait Cycle Index (GCI) Observer) were evaluated on passive cycling inertial data of six participants with spinal cord injury (SCI). For standardised comparison, a linear phase reference baseline was used to define target events (i.e., 10%, 40%, 60%, and 90% of the cycle’s progress). Limits of agreement (LoA) of ±10% of the cycle’s duration and Lin’s concordance correlation coefficient (CCC) were used to evaluate the accuracy and precision of the algorithm’s event detections. The delays in the detection were determined for each algorithm over 780 events. Analysis showed that the Hilbert and BSgonio algorithms validated the selected criteria (LoA: +5.17/−6.34% and +2.25/−2.51%, respectively), while the GCI Observer did not (LoA: +8.59/−27.89%). When evaluating control algorithms, it is paramount to define appropriate criteria in the context of the targeted practical application. To this end, normalising delays in event detection to the cycle’s duration enables the use of a criterion that stays invariable to changes in cadence. Lin’s CCC, comparing both linear correlation and strength of agreement between methods, also provides a reliable way of confirming comparisons between new control methods and an existing reference.
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