The development and concurrent validity of a real-time algorithm for temporal gait analysis using inertial measurement units.

The use of inertial measurement units (IMUs) for gait analysis has emerged as a tool for clinical applications. Shank gyroscope signals have been utilized to identify heel-strike and toe-off, which serve as the foundation for calculating temporal parameters of gait such as single and double limb support time. Recent publications have shown that toe-off occurs later than predicted by the dual minima method (DMM), which has been adopted as an IMU-based gait event detection algorithm.In this study, a real-time algorithm, Noise-Zero Crossing (NZC), was developed to accurately compute temporal gait parameters. Our objective was to determine the concurrent validity of temporal gait parameters derived from the NZC algorithm against parameters measured by an instrumented walkway. The accuracy and precision of temporal gait parameters derived using NZC were compared to those derived using the DMM. The results from Bland-Altman Analysis showed that the NZC algorithm had excellent agreement with the instrumented walkway for identifying the temporal gait parameters of Gait Cycle Time (GCT), Single Limb Support (SLS) time, and Double Limb Support (DLS) time. By utilizing the moment of zero shank angular velocity to identify toe-off, the NZC algorithm performed better than the DMM algorithm in measuring SLS and DLS times. Utilizing the NZC algorithm's gait event detection preserves DLS time, which has significant clinical implications for pathologic gait assessment.

[1]  Edwin van Asseldonk,et al.  Use of Inertial Sensors for Ambulatory Assessment of Center-of-Mass Displacements During Walking , 2012, IEEE Transactions on Biomedical Engineering.

[2]  J. M. Donelan,et al.  Walking speed and slope estimation using shank-mounted inertial measurement units , 2009, 2009 IEEE International Conference on Rehabilitation Robotics.

[3]  Jung-Keun Lee,et al.  Quasi real-time gait event detection using shank-attached gyroscopes , 2011, Medical & Biological Engineering & Computing.

[4]  Catherine Dehollain,et al.  Gait assessment in Parkinson's disease: toward an ambulatory system for long-term monitoring , 2004, IEEE Transactions on Biomedical Engineering.

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

[6]  Annet J. Dallmeijer,et al.  The importance of addressing heteroscedasticity in the reliability analysis of ratio‐scaled variables: an example based on walking energy‐cost measurements , 2012, Developmental Medicine & Child Neurology.

[7]  Thomas Seel,et al.  IMU-Based Joint Angle Measurement for Gait Analysis , 2014, Sensors.

[8]  Qingguo Li,et al.  A concurrent comparison of inertia sensor-based walking speed estimation methods , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[9]  Thomas Seel,et al.  Joint axis and position estimation from inertial measurement data by exploiting kinematic constraints , 2012, 2012 IEEE International Conference on Control Applications.

[10]  M. Hanlon,et al.  Real-time gait event detection using wearable sensors. , 2006, Gait & posture.

[11]  Benjamin L Patritti,et al.  Assessing gait variability in transtibial amputee fallers based on spatial-temporal gait parameters normalized for walking speed. , 2015, Archives of physical medicine and rehabilitation.

[12]  Adrian Burns,et al.  An adaptive gyroscope-based algorithm for temporal gait analysis , 2010, Medical & Biological Engineering & Computing.

[13]  S. Fritz,et al.  White paper: "walking speed: the sixth vital sign". , 2009, Journal of geriatric physical therapy.

[14]  Jan Kool,et al.  A simple procedure to synchronize concurrent measurements of gait and brain electrical activity and preliminary results from a pilot measurement involving motor-cognitive dual-tasking in healthy older and young volunteers , 2014, Journal of Neuroscience Methods.

[15]  Richard W. Bohannon Comfortable and maximum walking speed of adults aged 20-79 years: reference values and determinants. , 1997, Age and ageing.

[16]  Annika Plate,et al.  Gait recording with inertial sensors--How to determine initial and terminal contact. , 2016, Journal of biomechanics.

[17]  R Lee Kirby,et al.  Effect of a shock-absorbing pylon on transmission of heel strike forces during the gait of people with unilateral trans-tibial amputations: A pilot study , 2007, Prosthetics and orthotics international.

[18]  K. Aminian,et al.  Evaluation of an ambulatory system for gait analysis in hip osteoarthritis and after total hip replacement. , 2004, Gait & posture.

[19]  J. Allum,et al.  Gait event detection using linear accelerometers or angular velocity transducers in able-bodied and spinal-cord injured individuals. , 2006, Gait & posture.

[20]  Maria Cristina Bisi,et al.  Gait variability and stability measures: Minimum number of strides and within-session reliability , 2014, Comput. Biol. Medicine.

[21]  Graham K. Kerr,et al.  Concurrent Validity of Accelerations Measured Using a Tri-Axial Inertial Measurement Unit while Walking on Firm, Compliant and Uneven Surfaces , 2014, PloS one.

[22]  Christine Azevedo Coste,et al.  Implementation and Validation of a Stride Length Estimation Algorithm, Using a Single Basic Inertial Sensor on Healthy Subjects and Patients Suffering from Parkinson’s Disease , 2015 .

[23]  B. E. Maki,et al.  Gait Changes in Older Adults: Predictors of Falls or Indicators of Fear? , 1997, Journal of the American Geriatrics Society.

[24]  Claudia Giacomozzi,et al.  Appropriateness of plantar pressure measurement devices: a comparative technical assessment. , 2010, Gait & posture.

[25]  Kamiar Aminian,et al.  Spatio-temporal parameters of gait measured by an ambulatory system using miniature gyroscopes. , 2002, Journal of biomechanics.

[26]  Jeffrey M. Hausdorff,et al.  Gait variability and basal ganglia disorders: Stride‐to‐stride variations of gait cycle timing in parkinson's disease and Huntington's disease , 1998, Movement disorders : official journal of the Movement Disorder Society.

[27]  John H Hollman,et al.  Number of strides required for reliable measurements of pace, rhythm and variability parameters of gait during normal and dual task walking in older individuals. , 2010, Gait & posture.

[28]  Dympna O'Sullivan,et al.  Real-world Gyroscope-based Gait Event Detection and Gait Feature Extraction , 2014, eTELEMED 2014.

[29]  Nira Herrmann,et al.  Accuracy, reliability, and validity of a spatiotemporal gait analysis system. , 2006, Medical engineering & physics.

[30]  Xavier Crevoisier,et al.  Quantitative estimation of foot-flat and stance phase of gait using foot-worn inertial sensors. , 2013, Gait & posture.

[31]  B. Galna,et al.  Quantification of soft tissue artifact in lower limb human motion analysis: a systematic review. , 2010, Gait & posture.

[32]  Bijan Najafi,et al.  Laboratory in a box: Wearable sensors and its advantages for gait analysis , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[33]  Vibhor Agrawal,et al.  Missing Sample Recovery for Wireless Inertial Sensor-Based Human Movement Acquisition , 2016, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[34]  Morris Vanegas,et al.  Characterization of inertial measurement unit placement on the human body upon repeated donnings , 2015, 2015 IEEE 12th International Conference on Wearable and Implantable Body Sensor Networks (BSN).

[35]  Rae Baxter,et al.  Acknowledgments.-The authors would like to , 1982 .

[36]  M H Granat,et al.  A practical gait analysis system using gyroscopes. , 1999, Medical engineering & physics.

[37]  Joseph Mizrahi,et al.  Modeling the Foot-Strike Event in Running Fatigue via Mechanical Impedances , 2012 .

[38]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[39]  T P Andriacchi,et al.  Walking speed as a basis for normal and abnormal gait measurements. , 1977, Journal of biomechanics.

[40]  Jinsup Song,et al.  Reliability of plantar pressure platforms. , 2013, Gait & posture.

[41]  Hylton B Menz,et al.  Reliability of the TekScan MatScan® system for the measurement of plantar forces and pressures during barefoot level walking in healthy adults , 2010, Journal of Foot and Ankle Research.

[42]  Noor Azina Ismail,et al.  Statistical Methods Used to Test for Agreement of Medical Instruments Measuring Continuous Variables in Method Comparison Studies: A Systematic Review , 2012, PloS one.