Shotgun approaches to gait analysis: insights & limitations

BackgroundIdentifying features for gait classification is a formidable problem. The number of candidate measures is legion. This calls for proper, objective criteria when ranking their relevance.MethodsFollowing a shotgun approach we determined a plenitude of kinematic and physiological gait measures and ranked their relevance using conventional analysis of variance (ANOVA) supplemented by logistic and partial least squares (PLS) regressions. We illustrated this approach using data from two studies involving stroke patients, amputees, and healthy controls.ResultsOnly a handful of measures turned out significant in the ANOVAs. The logistic regressions, by contrast, revealed various measures that clearly discriminated between experimental groups and conditions. The PLS regression also identified several discriminating measures, but they did not always agree with those of the logistic regression.Discussion & conclusionExtracting a measure’s classification capacity cannot solely rely on its statistical validity but typically requires proper post-hoc analysis. However, choosing the latter inevitably introduces some arbitrariness, which may affect outcome in general. We hence advocate the use of generic expert systems, possibly based on machine-learning.

[1]  Peter J Beek,et al.  Online gait event detection using a large force platform embedded in a treadmill. , 2008, Journal of biomechanics.

[2]  V. von Tscharner,et al.  Subspace Identification and Classification of Healthy Human Gait , 2013, PloS one.

[3]  W. Warren,et al.  The dynamics of gait transitions: effects of grade and load. , 1998, Journal of motor behavior.

[4]  Kenneth Meijer,et al.  Activity identification using body-mounted sensors—a review of classification techniques , 2009, Physiological measurement.

[5]  R Begg,et al.  A machine learning approach for automated recognition of movement patterns using basic, kinetic and kinematic gait data. , 2005, Journal of biomechanics.

[6]  S H Holzreiter,et al.  Assessment of gait patterns using neural networks. , 1993, Journal of biomechanics.

[7]  T Chau,et al.  A review of analytical techniques for gait data. Part 2: neural network and wavelet methods. , 2001, Gait & posture.

[8]  R Lafuente,et al.  Design and test of neural networks and statistical classifiers in computer-aided movement analysis: a case study on gait analysis. , 1998, Clinical biomechanics.

[9]  R. Waters,et al.  Energy cost of walking of amputees: the influence of level of amputation. , 1976, The Journal of bone and joint surgery. American volume.

[10]  Peter Federolf,et al.  A holistic approach to study the temporal variability in gait. , 2012, Journal of biomechanics.

[11]  Jeffrey M. Hausdorff,et al.  Altered fractal dynamics of gait: reduced stride-interval correlations with aging and Huntington's disease. , 1997, Journal of applied physiology.

[12]  K. Newell,et al.  Walking speed influences on gait cycle variability. , 2007, Gait & posture.

[13]  Hervé Abdi,et al.  Partial least squares methods: partial least squares correlation and partial least square regression. , 2013, Methods in molecular biology.

[14]  D. Sternad,et al.  Slower speeds in patients with diabetic neuropathy lead to improved local dynamic stability of continuous overground walking. , 2000, Journal of biomechanics.

[15]  C. Vaughan,et al.  Rectification and non-linear pre-processing of EMG signals for cortico-muscular analysis , 2003, Journal of Neuroscience Methods.

[16]  Daphne Wezenberg,et al.  Relation between aerobic capacity and walking ability in older adults with a lower-limb amputation. , 2013, Archives of physical medicine and rehabilitation.

[17]  Andreas Daffertshofer,et al.  PCA in studying coordination and variability: a tutorial. , 2004, Clinical biomechanics.

[18]  P J Beek,et al.  Steady and transient coordination structures of walking and running. , 2009, Human movement science.

[19]  P. Beek,et al.  Gait in patients with pregnancy-related pain in the pelvis: an emphasis on the coordination of transverse pelvic and thoracic rotations. , 2002, Clinical biomechanics.

[20]  N. Troje Decomposing biological motion: a framework for analysis and synthesis of human gait patterns. , 2002, Journal of vision.

[21]  Jeffrey M. Hausdorff Gait dynamics in Parkinson's disease: common and distinct behavior among stride length, gait variability, and fractal-like scaling. , 2009, Chaos.

[22]  L. V. D. van der Woude,et al.  Effect of balance support on the energy cost of walking after stroke. , 2013, Archives of physical medicine and rehabilitation.

[23]  R. van Emmerik,et al.  Age-related changes in upper body adaptation to walking speed in human locomotion. , 2005, Gait & posture.

[24]  Jeffrey M. Hausdorff,et al.  A new measure for quantifying the bilateral coordination of human gait: effects of aging and Parkinson’s disease , 2007, Experimental Brain Research.

[25]  P. Beek,et al.  Pelvis-thorax coordination in the transverse plane during gait. , 2002, Gait & posture.

[26]  Jeffrey M. Hausdorff Gait variability: methods, modeling and meaning , 2005, Journal of NeuroEngineering and Rehabilitation.

[27]  Sheldon R Simon,et al.  Quantification of human motion: gait analysis-benefits and limitations to its application to clinical problems. , 2004, Journal of biomechanics.

[28]  M. P. Griffin,et al.  Sample entropy analysis of neonatal heart rate variability. , 2002, American journal of physiology. Regulatory, integrative and comparative physiology.

[29]  C. Lamoth,et al.  Gait stability and variability measures show effects of impaired cognition and dual tasking in frail people , 2011, Journal of NeuroEngineering and Rehabilitation.

[30]  C. J. Huberty,et al.  Multivariate analysis versus multiple univariate analyses. , 1989 .

[31]  Taiga Yamasaki,et al.  Phase reset and dynamic stability during human gait. , 2003, Bio Systems.

[32]  J. Dingwell,et al.  Effects of walking speed, strength and range of motion on gait stability in healthy older adults. , 2008, Journal of biomechanics.

[33]  P. Allard,et al.  Muscle Power Compensatory Mechanisms in Below-Knee Amputee Gait , 2001, American journal of physical medicine & rehabilitation.

[34]  Rachid Aissaoui,et al.  Automatic Classification of Asymptomatic and Osteoarthritis Knee Gait Patterns Using Kinematic Data Features and the Nearest Neighbor Classifier , 2008, IEEE Transactions on Biomedical Engineering.

[35]  Perry,et al.  Knee kinetics in trans-tibial amputee gait. , 1998, Gait & posture.

[36]  J. G. Barton,et al.  An application of neural networks for distinguishing gait patterns on the basis of hip-knee joint angle diagrams , 1997 .

[37]  Marco Schieppati,et al.  Tuning of a basic coordination pattern constructs straight-ahead and curved walking in humans. , 2004, Journal of neurophysiology.

[38]  H Houdijk,et al.  Mind your step: metabolic energy cost while walking an enforced gait pattern. , 2011, Gait & posture.

[39]  K. Newell,et al.  Long range correlations in the stride interval of running. , 2006, Gait & posture.

[40]  Stephen H. M. Brown,et al.  Less is more: high pass filtering, to remove up to 99% of the surface EMG signal power, improves EMG-based biceps brachii muscle force estimates. , 2004, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[41]  A. Daffertshofer,et al.  Effects of chronic low back pain on trunk coordination and back muscle activity during walking: changes in motor control , 2006, European Spine Journal.

[42]  H. Houdijk,et al.  Variability and stability analysis of walking of transfemoral amputees. , 2010, Medical engineering & physics.

[43]  Abhijit S. Pandya,et al.  Dynamic pattern recognition of coordinated biological motion , 1990, Neural Networks.

[44]  Gert S. Faber,et al.  Estimating Dynamic Gait Stability Using Data from Non-aligned Inertial Sensors , 2010, Annals of Biomedical Engineering.

[45]  A. Geurts,et al.  Dual-task assessment of reorganization of postural control in persons with lower limb amputation. , 1991, Archives of physical medicine and rehabilitation.

[46]  Roman Rosipal,et al.  Overview and Recent Advances in Partial Least Squares , 2005, SLSFS.

[47]  Dieter Merkl,et al.  Clinical gait analysis by neural networks: issues and experiences , 1997, Proceedings of Computer Based Medical Systems.

[48]  A. Goldberger,et al.  Loss of 'complexity' and aging. Potential applications of fractals and chaos theory to senescence. , 1992, JAMA.

[49]  P. Beek,et al.  Interlimb coordination in prosthetic walking: effects of asymmetry and walking velocity. , 2002, Acta psychologica.

[50]  Joarder Kamruzzaman,et al.  Support Vector Machines and Other Pattern Recognition Approaches to the Diagnosis of Cerebral Palsy Gait , 2006, IEEE Transactions on Biomedical Engineering.

[51]  Jonathan B Dingwell,et al.  Differences between local and orbital dynamic stability during human walking. , 2007, Journal of biomechanical engineering.

[52]  J. Richman,et al.  Physiological time-series analysis using approximate entropy and sample entropy. , 2000, American journal of physiology. Heart and circulatory physiology.

[53]  Y. Benjamini,et al.  Controlling the false discovery rate: a practical and powerful approach to multiple testing , 1995 .

[54]  M. Rosenstein,et al.  A practical method for calculating largest Lyapunov exponents from small data sets , 1993 .

[55]  P. Beek,et al.  Maximum Lyapunov exponents as predictors of global gait stability: a modelling approach. , 2012, Medical engineering & physics.

[56]  J. Dingwell,et al.  Kinematic variability and local dynamic stability of upper body motions when walking at different speeds. , 2006, Journal of biomechanics.

[57]  K. Desloovere,et al.  Motor function following multilevel botulinum toxin type A treatment in children with cerebral palsy , 2006, Developmental medicine and child neurology.

[58]  Thompson Sarkodie-Gyan,et al.  Automatic classification of pathological gait patterns using ground reaction forces and machine learning algorithms , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[59]  Marimuthu Palaniswami,et al.  Support vector machines for automated gait classification , 2005, IEEE Transactions on Biomedical Engineering.

[60]  Angelo M. Sabatini,et al.  Machine Learning Methods for Classifying Human Physical Activity from On-Body Accelerometers , 2010, Sensors.

[61]  Matjaz Gams,et al.  Automatic recognition of gait-related health problems in the elderly using machine learning , 2012, Multimedia Tools and Applications.

[62]  Jeffrey M. Hausdorff,et al.  Long-range anticorrelations and non-Gaussian behavior of the heartbeat. , 1993, Physical review letters.