Ambulatory Human Gait Phase Detection Using Wearable Inertial Sensors and Hidden Markov Model

Hidden Markov Model for Parkinson's Disease Patients Using Balance Control Data

Understanding the behavior of the human postural system has become a very attractive topic for many researchers. This system plays a crucial role in maintaining balance during both stationary and moving states. Parkinson's disease (PD) is a prevalent degenerative movement disorder that significantly impacts human stability, leading to falls and injuries. This research introduces an innovative approach that utilizes a hidden Markov model (HMM) to distinguish healthy individuals and those with PD. Interestingly, this methodology employs raw data obtained from stabilometric signals without any preprocessing. The dataset used for this study comprises 60 subjects divided into healthy and PD patients. Impressively, the proposed method achieves an accuracy rate of up to 98% in effectively differentiating healthy subjects from those with PD.

A Fusion-Assisted Multi-Stream Deep Learning and ESO-Controlled Newton-Raphson-Based Feature Selection Approach for Human Gait Recognition

The performance of human gait recognition (HGR) is affected by the partial obstruction of the human body caused by the limited field of view in video surveillance. The traditional method required the bounding box to recognize human gait in the video sequences accurately; however, it is a challenging and time-consuming approach. Due to important applications, such as biometrics and video surveillance, HGR has improved performance over the last half-decade. Based on the literature, the challenging covariant factors that degrade gait recognition performance include walking while wearing a coat or carrying a bag. This paper proposed a new two-stream deep learning framework for human gait recognition. The first step proposed a contrast enhancement technique based on the local and global filters information fusion. The high-boost operation is finally applied to highlight the human region in a video frame. Data augmentation is performed in the second step to increase the dimension of the preprocessed dataset (CASIA-B). In the third step, two pre-trained deep learning models-MobilenetV2 and ShuffleNet-are fine-tuned and trained on the augmented dataset using deep transfer learning. Features are extracted from the global average pooling layer instead of the fully connected layer. In the fourth step, extracted features of both streams are fused using a serial-based approach and further refined in the fifth step by using an improved equilibrium state optimization-controlled Newton-Raphson (ESOcNR) selection method. The selected features are finally classified using machine learning algorithms for the final classification accuracy. The experimental process was conducted on 8 angles of the CASIA-B dataset and obtained an accuracy of 97.3, 98.6, 97.7, 96.5, 92.9, 93.7, 94.7, and 91.2%, respectively. Comparisons were conducted with state-of-the-art (SOTA) techniques, and showed improved accuracy and reduced computational time.

Human gait-labeling uncertainty and a hybrid model for gait segmentation

Motion capture systems are widely accepted as ground-truth for gait analysis and are used for the validation of other gait analysis systems. To date, their reliability and limitations in manual labeling of gait events have not been studied.

Objectives

Evaluate manual labeling uncertainty and introduce a hybrid stride detection and gait-event estimation model for autonomous, long-term, and remote monitoring.

Methods

Estimate inter-labeler inconsistencies by computing the limits-of-agreement. Develop a hybrid model based on dynamic time warping and convolutional neural network to identify valid strides and eliminate non-stride data in inertial (walking) data collected by a wearable device. Finally, detect gait events within a valid stride region.

Results

The limits of inter-labeler agreement for key gait events heel off, toe off, heel strike, and flat foot are 72, 16, 24, and 80 ms, respectively; The hybrid model's classification accuracy for stride and non-stride are 95.16 and 84.48%, respectively; The mean absolute error for detected heel off, toe off, heel strike, and flat foot are 24, 5, 9, and 13 ms, respectively, when compared to the average human labels.

Conclusions

The results show the inherent labeling uncertainty and the limits of human gait labeling of motion capture data; The proposed hybrid-model's performance is comparable to that of human labelers, and it is a valid model to reliably detect strides and estimate the gait events in human gait data.

Significance

This work establishes the foundation for fully automated human gait analysis systems with performances comparable to human-labelers.

A Systematic Review of Time Series Classification Techniques Used in Biomedical Applications

Background: Digital clinical measures collected via various digital sensing technologies such as smartphones, smartwatches, wearables, and ingestible and implantable sensors are increasingly used by individuals and clinicians to capture the health outcomes or behavioral and physiological characteristics of individuals. Time series classification (TSC) is very commonly used for modeling digital clinical measures. While deep learning models for TSC are very common and powerful, there exist some fundamental challenges. This review presents the non-deep learning models that are commonly used for time series classification in biomedical applications that can achieve high performance. Objective: We performed a systematic review to characterize the techniques that are used in time series classification of digital clinical measures throughout all the stages of data processing and model building. Methods: We conducted a literature search on PubMed, as well as the Institute of Electrical and Electronics Engineers (IEEE), Web of Science, and SCOPUS databases using a range of search terms to retrieve peer-reviewed articles that report on the academic research about digital clinical measures from a five-year period between June 2016 and June 2021. We identified and categorized the research studies based on the types of classification algorithms and sensor input types. Results: We found 452 papers in total from four different databases: PubMed, IEEE, Web of Science Database, and SCOPUS. After removing duplicates and irrelevant papers, 135 articles remained for detailed review and data extraction. Among these, engineered features using time series methods that were subsequently fed into widely used machine learning classifiers were the most commonly used technique, and also most frequently achieved the best performance metrics (77 out of 135 articles). Statistical modeling (24 out of 135 articles) algorithms were the second most common and also the second-best classification technique. Conclusions: In this review paper, summaries of the time series classification models and interpretation methods for biomedical applications are summarized and categorized. While high time series classification performance has been achieved in digital clinical, physiological, or biomedical measures, no standard benchmark datasets, modeling methods, or reporting methodology exist. There is no single widely used method for time series model development or feature interpretation, however many different methods have proven successful.

Identification of gait patterns in walking with crutches through the selection of significant spatio-temporal parameters

Forearm crutches are one of the most accepted aids in rehabilitation for walking. The improper use of crutches may prolong the rehabilitation period and cause further limb damage or pain. However, it is possible to tackle this issue by using instrumented crutches that provide a quantitative gait analysis of the users. In addition, the study of different aspects of crutch walking could assist clinicians in choosing the optimum crutch gait pattern for individuals and instruct them to use the aids correctly. Measurements from the crutches are influenced by the performed gait pattern, determined by the legs and arms' sequence of movement. Since different parameters can describe gait, this paper aims to identify four gait patterns in walking with crutches through a reliable selection of gait parameters. In this study, we collected data from twenty healthy volunteers performing four gait patterns to reach this goal. First, we segmented the gait sequence in periodic cycles to detect two main phases, swing and stance. Then, we calculated different parameters for each gait walking pattern. Subsequently, we found a reduced set of parameters through some feature selection techniques. Selected parameters were validated employing three classification models. After evaluating the models' metrics, our findings indicated that the set of selected parameters could identify a crutch walking pattern.

Gait Recognition for Lower Limb Exoskeletons Based on Interactive Information Fusion

In recent decades, although the research on gait recognition of lower limb exoskeleton robot has been widely developed, there are still limitations in rehabilitation training and clinical practice. The emergence of interactive information fusion technology provides a new research idea for the solution of this problem, and it is also the development trend in the future. In order to better explore the issue, this paper summarizes gait recognition based on interactive information fusion of lower limb exoskeleton robots. This review introduces the current research status, methods, and directions for information acquisition, interaction, fusion, and gait recognition of exoskeleton robots. The content involves the research progress of information acquisition methods, sensor placements, target groups, lower limb sports biomechanics, interactive information fusion, and gait recognition model. Finally, the current challenges, possible solutions, and promising prospects are analysed and discussed, which provides a useful reference resource for the study of interactive information fusion and gait recognition of rehabilitation exoskeleton robots.

Comparison of Shod and Unshod Gait in Patients With Parkinson's Disease With Subthalamic and Nigral Stimulation

Background: The Parkinsonian [i.e., Parkinson's disease (PD)] gait disorder represents a therapeutical challenge with residual symptoms despite the use of deep brain stimulation of the subthalamic nucleus (STN DBS) and medical and rehabilitative strategies. The aim of this study was to assess the effect of different DBS modes as combined stimulation of the STN and substantia nigra (STN+SN DBS) and environmental rehabilitative factors as footwear on gait kinematics.

Methods: This single-center, randomized, double-blind, crossover clinical trial assessed shod and unshod gait in patients with PD with medication in different DBS conditions (i.e., STIM OFF, STN DBS, and STN+SN DBS) during different gait tasks (i.e., normal gait, fast gait, and gait during dual task) and compared gait characteristics to healthy controls. Notably, 15 patients participated in the study, and 11 patients were analyzed after a dropout of four patients due to DBS-induced side effects.

Results: Gait was modulated by both factors, namely, footwear and DBS mode, in patients with PD. Footwear impacted gait characteristics in patients with PD similarly to controls with longer step length, lower cadence, and shorter single-support time. Interestingly, DBS exerted specific effects depending on gait tasks with increased cognitive load. STN+SN DBS was the most efficient DBS mode compared to STIM OFF and STN DBS with intense effects as step length increment during dual task.

Conclusion: The PD gait disorder is a multifactorial symptom, impacted by environmental factors as footwear and modulated by DBS. DBS effects on gait were specific depending on the gait task, with the most obvious effects with STN+SN DBS during gait with increased cognitive load.

Stride segmentation of inertial sensor data using statistical methods for different walking activities

Human gait data can be collected using inertial measurement units (IMUs). An IMU is an electronic device that uses an accelerometer and gyroscope to capture three-axial linear acceleration and three-axial angular velocity. The data so collected are time series in nature. The major challenge associated with these data is the segmentation of signal samples into stride-specific information, that is, individual gait cycles. One empirical approach for stride segmentation is based on timestamps. However, timestamping is a manual technique, and it requires a timing device and a fixed laboratory set-up which usually restricts its applicability outside of the laboratory. In this study, we have proposed an automatic technique for stride segmentation of accelerometry data for three different walking activities. The autocorrelation function (ACF) is utilized for the identification of stride boundaries. Identification and extraction of stride-specific data are done by devising a concept of tuning parameter ( $t_{p}$ ) which is based on minimum standard deviation ( $\sigma$ ). Rigorous experimentation is done on human activities and postural transition and Osaka University – Institute of Scientific and Industrial Research gait inertial sensor datasets. Obtained mean stride duration for level walking, walking upstairs, and walking downstairs is 1.1, 1.19, and 1.02 s with 95% confidence interval [1.08, 1.12], [1.15, 1.22], and [0.97, 1.07], respectively, which is on par with standard findings reported in the literature. Limitations of accelerometry and ACF are also discussed. stride segmentation; human activity recognition; accelerometry; gait parameter estimation; gait cycle; inertial measurement unit; autocorrelation function; wearable sensors; IoT; edge computing; tinyML.