Kinect V2-Based Gait Analysis for Children with Cerebral Palsy: Validity and Reliability of Spatial Margin of Stability and Spatiotemporal Variables

Children with cerebral palsy (CP) have high risks of falling. It is necessary to evaluate gait stability for children with CP. In comparison to traditional motion capture techniques, the Kinect has the potential to be utilised as a cost-effective gait stability assessment tool, ensuring frequent and uninterrupted gait monitoring. To evaluate the validity and reliability of this measurement, in this study, ten children with CP performed two testing sessions, of which gait data were recorded by a Kinect V2 sensor and a referential Motion Analysis system. The margin of stability (MOS) and gait spatiotemporal metrics were examined. For the spatiotemporal parameters, intraclass correlation coefficient (ICC2,k) values were from 0.83 to 0.99 between two devices and from 0.78 to 0.88 between two testing sessions. For the MOS outcomes, ICC2,k values ranged from 0.42 to 0.99 between two devices and 0.28 to 0.69 between two test sessions. The Kinect V2 was able to provide valid and reliable spatiotemporal gait parameters, and it could also offer accurate outcome measures for the minimum MOS. The reliability of the Kinect V2 when assessing time-specific MOS variables was limited. The Kinect V2 shows the potential to be used as a cost-effective tool for CP gait stability assessment.

[1]  Alexander T. Peebles,et al.  Dynamic margin of stability during gait is altered in persons with multiple sclerosis. , 2016, Journal of biomechanics.

[2]  Niall Murray,et al.  Human gait assessment using a 3D marker-less multimodal motion capture system , 2019, Multimedia Tools and Applications.

[3]  Anika Steinert,et al.  Using New Camera-Based Technologies for Gait Analysis in Older Adults in Comparison to the Established GAITRite System , 2019, Sensors.

[4]  Bert Arnrich,et al.  Evaluation of the Pose Tracking Performance of the Azure Kinect and Kinect v2 for Gait Analysis in Comparison with a Gold Standard: A Pilot Study , 2020, Sensors.

[5]  Friedemann Paul,et al.  Maximum walking speed in multiple sclerosis assessed with visual perceptive computing , 2017, PloS one.

[6]  T. Wren,et al.  Prevalence of Specific Gait Abnormalities in Children With Cerebral Palsy: Influence of Cerebral Palsy Subtype, Age, and Previous Surgery , 2005, Journal of pediatric orthopedics.

[7]  Alex Mihailidis,et al.  Concurrent validity of the Microsoft Kinect for Windows v2 for measuring spatiotemporal gait parameters. , 2016, Medical engineering & physics.

[8]  Curtis L. Johnson,et al.  Dynamic stability during walking in children with and without cerebral palsy. , 2019, Gait & posture.

[9]  D. Altman,et al.  STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT , 1986, The Lancet.

[10]  J. McGinley,et al.  Perceived Cause, Environmental Factors, and Consequences of Falls in Adults with Cerebral Palsy: A Preliminary Mixed Methods Study , 2015, Rehabilitation research and practice.

[11]  M. Woollacott,et al.  Assessment of postural control in children with cerebral palsy: a review. , 2013, Research in developmental disabilities.

[12]  Vincent Bonnet,et al.  Whole Body Center of Mass Estimation with Portable Sensors: Using the Statically Equivalent Serial Chain and a Kinect , 2014, Sensors.

[13]  J. Fleiss The design and analysis of clinical experiments , 1987 .

[14]  Sicco A Bus,et al.  Concurrent validity and reliability of a low-cost gait analysis system for assessment of spatiotemporal gait parameters. , 2019, Journal of rehabilitation medicine.

[15]  H. Ucan,et al.  Predictive Factors for Inpatient Falls among Children with Cerebral Palsy☆, ☆☆ , 2017, Journal of pediatric nursing.

[16]  Kelly J. Bower,et al.  Dynamic balance and instrumented gait variables are independent predictors of falls following stroke , 2019, Journal of NeuroEngineering and Rehabilitation.

[17]  L. Chèze,et al.  Adjustments to McConville et al. and Young et al. body segment inertial parameters. , 2007, Journal of Biomechanics.

[18]  A. Trabacca,et al.  Falls in Hospitalized Children With Neurodevelopmental Conditions: A Cross-sectional, Correlational Study , 2017, Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses.

[19]  Jonathan B Dingwell,et al.  Dynamic margins of stability during human walking in destabilizing environments. , 2012, Journal of biomechanics.

[20]  Yves J. Gschwind,et al.  A Kinect and Inertial Sensor-Based System for the Self-Assessment of Fall Risk: A Home-Based Study in Older People , 2016, Hum. Comput. Interact..

[21]  Craig R. Denegar,et al.  Assessing Reliability and Precision of Measurement: An Introduction to Intraclass Correlation and Standard Error of Measurement , 1993 .

[22]  P. Beek,et al.  Children with cerebral palsy exhibit greater and more regular postural sway than typically developing children , 2007, Experimental Brain Research.

[23]  Moataz Eltoukhy,et al.  Validity of the Microsoft Kinect™ in assessing spatiotemporal and lower extremity kinematics during stair ascent and descent in healthy young individuals. , 2018, Medical engineering & physics.

[24]  J S Higginson,et al.  Two simple methods for determining gait events during treadmill and overground walking using kinematic data. , 2008, Gait & posture.

[25]  T. Lu,et al.  BALANCE CONTROL DURING LEVEL WALKING IN CHILDREN WITH SPASTIC DIPLEGIC CEREBRAL PALSY , 2011 .

[26]  Max J. Kurz,et al.  Differences in the dynamic gait stability of children with cerebral palsy and typically developing children. , 2012, Gait & posture.

[27]  Shorouk Elshennawy,et al.  Effects of backward gait training on balance, gross motor function, and gait in children with cerebral palsy: a systematic review , 2018, Clinical rehabilitation.

[28]  D. Sutherland The evolution of clinical gait analysis. Part II kinematics. , 2002, Gait & posture.

[29]  Babak Taati,et al.  Vision-based assessment of gait features associated with falls in people with dementia. , 2020, The journals of gerontology. Series A, Biological sciences and medical sciences.

[30]  André Luiz Felix Rodacki,et al.  Center of mass in analysis of dynamic stability during gait following stroke: A systematic review. , 2019, Gait & posture.

[31]  G Pioggia,et al.  Validation of low-cost system for gait assessment in children with ataxia , 2020, Comput. Methods Programs Biomed..

[32]  K. Bjornson,et al.  Effectiveness of Rehabilitation Interventions to Improve Gait Speed in Children With Cerebral Palsy: Systematic Review and Meta-analysis , 2016, Physical Therapy.

[33]  Peter J Beek,et al.  Stepping strategies used by post-stroke individuals to maintain margins of stability during walking. , 2013, Clinical biomechanics.

[34]  P. Meyns,et al.  The efficacy of functional gait training in children and young adults with cerebral palsy: a systematic review and meta‐analysis , 2018, Developmental medicine and child neurology.

[35]  Ross A Clark,et al.  Gait assessment using the Microsoft Xbox One Kinect: Concurrent validity and inter-day reliability of spatiotemporal and kinematic variables. , 2015, Journal of biomechanics.

[36]  D. Winter,et al.  Stiffness control of balance in quiet standing. , 1998, Journal of neurophysiology.

[37]  E. Bertini,et al.  Spatio-temporal parameters of ataxia gait dataset obtained with the Kinect , 2020, Data in brief.

[38]  E. Boyer,et al.  Gait pathology subtypes are not associated with self-reported fall frequency in children with cerebral palsy. , 2018, Gait & posture.

[39]  R. Palisano,et al.  Development and reliability of a system to classify gross motor function in children with cerebral palsy , 1997, Developmental medicine and child neurology.

[40]  Mariano Alcañiz,et al.  Reliability and comparison of Kinect-based methods for estimating spatiotemporal gait parameters of healthy and post-stroke individuals. , 2018, Journal of biomechanics.

[41]  Sunil K. Agrawal,et al.  Adaptation of Stability during Perturbed Walking in Parkinson’s Disease , 2017, Scientific Reports.

[42]  Babak Taati,et al.  Measuring Gait Variables Using Computer Vision to Assess Mobility and Fall Risk in Older Adults With Dementia , 2020, IEEE Journal of Translational Engineering in Health and Medicine.

[43]  Saeid Motiian,et al.  Automated extraction and validation of children’s gait parameters with the Kinect , 2015, BioMedical Engineering OnLine.

[44]  Daniel A Bloch,et al.  Postural balance in children with cerebral palsy. , 2002, Developmental medicine and child neurology.

[45]  Dustin A. Bruening,et al.  Automated event detection algorithms in pathological gait. , 2014, Gait & posture.

[46]  S. Walt,et al.  Reliability of upper and lower limb three-dimensional kinematics in children with hemiplegia. , 2005, Gait & posture.

[47]  A L Hof,et al.  The condition for dynamic stability. , 2005, Journal of biomechanics.

[48]  R. T. Moura,et al.  Kinect v2 based system for gait assessment of children with cerebral palsy in rehabilitation settings , 2020, Journal of medical engineering & technology.

[49]  Shmuel Springer,et al.  Validity of the Kinect for Gait Assessment: A Focused Review , 2016, Sensors.

[50]  L. Noreau,et al.  Association between characteristics of locomotion and accomplishment of life habits in children with cerebral palsy. , 1998, Physical therapy.

[51]  S. Paolucci,et al.  Stability and harmony of gait in children with cerebral palsy. , 2011, Research in developmental disabilities.

[52]  S. Ghai,et al.  Virtual Reality Enhances Gait in Cerebral Palsy: A Training Dose-Response Meta-Analysis , 2019, Front. Neurol..

[53]  Jian Yang,et al.  A musculoskeletal model driven by dual Microsoft Kinect Sensor data , 2017, Multibody System Dynamics.

[54]  M. Whittle Three-dimensional motion of the center of gravity of the body during walking , 1997 .

[55]  E. A. Abd El-Kafy,et al.  Effect of Postural Balance Training on Gait Parameters in Children with Cerebral Palsy , 2014, American journal of physical medicine & rehabilitation.

[56]  J. Weir Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. , 2005, Journal of strength and conditioning research.

[57]  Yanxin Zhang,et al.  Postural stability during gait for adults with hereditary spastic paraparesis. , 2019, Journal of biomechanics.

[58]  Julius Verrel,et al.  Accuracy and Reliability of the Kinect Version 2 for Clinical Measurement of Motor Function , 2016, PloS one.

[59]  A M O Bakheit,et al.  Comparison of three definitions of the mid-stance and mid-swing events of the gait cycle in children , 2006, Disability and rehabilitation.

[60]  Restricted Arm Swing Affects Gait Stability and Increased Walking Speed Alters Trunk Movements in Children with Cerebral Palsy , 2016, Front. Hum. Neurosci..

[61]  Kade Paterson,et al.  Instrumenting gait assessment using the Kinect in people living with stroke: reliability and association with balance tests , 2015, Journal of NeuroEngineering and Rehabilitation.

[62]  J. Andrysek,et al.  Single-session reliability of discrete gait parameters in ambulatory children with cerebral palsy based on GMFCS level. , 2008, Gait & posture.

[63]  J P Cobb,et al.  Validity and sensitivity of the longitudinal asymmetry index to detect gait asymmetry using Microsoft Kinect data. , 2017, Gait & posture.

[64]  Ross A Clark,et al.  Three-dimensional cameras and skeleton pose tracking for physical function assessment: A review of uses, validity, current developments and Kinect alternatives. , 2019, Gait & posture.

[65]  Rolf Moe-Nilssen,et al.  Test-retest reliability of spatial and temporal gait parameters in children with cerebral palsy as measured by an electronic walkway. , 2008, Gait & posture.

[66]  Moataz Eltoukhy,et al.  Improved kinect-based spatiotemporal and kinematic treadmill gait assessment. , 2017, Gait & posture.

[67]  Xu Xu,et al.  Accuracy of the Microsoft Kinect for measuring gait parameters during treadmill walking. , 2015, Gait & posture.

[68]  Mariano Alcañiz,et al.  Gait analysis with the Kinect v2: normative study with healthy individuals and comprehensive study of its sensitivity, validity, and reliability in individuals with stroke , 2019, Journal of NeuroEngineering and Rehabilitation.

[69]  N. Keijsers,et al.  Test-retest reliability of stability outcome measures during treadmill walking in patients with balance problems and healthy controls. , 2019, Gait & posture.

[70]  Pei-Luen Patrick Rau,et al.  Are cost-effective technologies feasible to measure gait in older adults? A systematic review of evidence-based literature. , 2019, Archives of gerontology and geriatrics.

[71]  R. Amutha,et al.  Detection of fall for the elderly in an indoor environment using a tri-axial accelerometer and Kinect depth data , 2020, Multidimens. Syst. Signal Process..

[72]  Franck Multon,et al.  Detection of gait cycles in treadmill walking using a Kinect. , 2015, Gait & posture.

[73]  Anup Nandy,et al.  Gait deficits and dynamic stability in children and adolescents with cerebral palsy: A systematic review and meta-analysis. , 2019, Clinical biomechanics.