A Novel Method to Estimate the Full Knee Joint Kinematics Using Low Cost IMU Sensors for Easy to Implement Low Cost Diagnostics

Effects of static exercises on hip muscle fatigue and knee wobble assessed by surface electromyography and inertial measurement unit data

Hip muscle weakness can be a precursor to or a result of lower limb injuries. Assessment of hip muscle strength and muscle motor fatigue in the clinic is important for diagnosing and treating hip-related impairments. Muscle motor fatigue can be assessed with surface electromyography (sEMG), however sEMG requires specialized equipment and training. Inertial measurement units (IMUs) are wearable devices used to measure human motion, yet it remains unclear if they can be used as a low-cost alternative method to measure hip muscle fatigue. The goals of this work were to (1) identify which of five pre-selected exercises most consistently and effectively elicited muscle fatigue in the gluteus maximus, gluteus medius, and rectus femoris muscles and (2) determine the relationship between muscle fatigue using sEMG sensors and knee wobble using an IMU device. This work suggests that a wall sit and single leg knee raise activity fatigue the gluteus medius, gluteus maximus, and rectus femoris muscles most reliably (p < 0.05) and that the gluteus medius and gluteus maximus muscles were fatigued to a greater extent than the rectus femoris (p = 0.031 and p = 0.0023, respectively). Additionally, while acceleration data from a single IMU placed on the knee suggested that more knee wobble may be an indicator of muscle fatigue, this single IMU is not capable of reliably assessing fatigue level. These results suggest the wall sit activity could be used as simple, static exercise to elicit hip muscle fatigue in the clinic, and that assessment of knee wobble in addition to other IMU measures could potentially be used to infer muscle fatigue under controlled conditions. Future work examining the relationship between IMU data, muscle fatigue, and multi-limb dynamics should be explored to develop an accessible, low-cost, fast and standardized method to measure fatiguability of the hip muscles in the clinic.

Knee Angle Estimation with Dynamic Calibration Using Inertial Measurement Units for Running

The knee flexion angle is an important measurement for studies of the human gait. Running is a common activity with a high risk of knee injury. Studying the running gait in realistic situations is challenging because accurate joint angle measurements typically come from optical motion-capture systems constrained to laboratory settings. This study considers the use of shank and thigh inertial sensors within three different filtering algorithms to estimate the knee flexion angle for running without requiring sensor-to-segment mounting assumptions, body measurements, specific calibration poses, or magnetometers. The objective of this study is to determine the knee flexion angle within running applications using accelerometer and gyroscope information only. Data were collected for a single test participant (21-year-old female) at four different treadmill speeds and used to validate the estimation results for three filter variations with respect to a Vicon optical motion-capture system. The knee flexion angle filtering algorithms resulted in root-mean-square errors of approximately three degrees. The results of this study indicate estimation results that are within acceptable limits of five degrees for clinical gait analysis. Specifically, a complementary filter approach is effective for knee flexion angle estimation in running applications.

Integration of force and IMU sensors for developing low-cost portable gait measurement system in lower extremities

Gait analysis is the method to accumulate walking data. It is useful in diagnosing diseases, follow-up of symptoms, and rehabilitation post-treatment. Several techniques have been developed to assess human gait. In the laboratory, gait parameters are analyzed by using a camera capture and a force plate. However, there are several limitations, such as high operating costs, the need for a laboratory and a specialist to operate the system, and long preparation time. This paper presents the development of a low-cost portable gait measurement system by using the integration of flexible force sensors and IMU sensors in outdoor applications for early detection of abnormal gait in daily living. The developed device is designed to measure ground reaction force, acceleration, angular velocity, and joint angles of the lower extremities. The commercialized device, including the motion capture system (Motive-OptiTrack) and force platform (MatScan), is used as the reference system to validate the performance of the developed system. The results of the system show that it has high accuracy in measuring gait parameters such as ground reaction force and joint angles in lower limbs. The developed device has a strong correlation coefficient compared with the commercialized system. The percent error of the motion sensor is below 8%, and the force sensor is lower than 3%. The low-cost portable device with a user interface was successfully developed to measure gait parameters for non-laboratory applications to support healthcare applications.

A frame orientation optimisation method for consistent interpretation of kinematic signals

In clinical movement biomechanics, kinematic data are often depicted as waveforms (i.e. signals), characterising the motion of articulating joints. Clinically meaningful interpretations of the underlying joint kinematics, however, require an objective understanding of whether two different kinematic signals actually represent two different underlying physical movement patterns of the joint or not. Previously, the accuracy of IMU-based knee joint angles was assessed using a six-degrees-of-freedom joint simulator guided by fluoroscopy-based signals. Despite implementation of sensor-to-segment corrections, observed errors were clearly indicative of cross-talk, and thus inconsistent reference frame orientations. Here, we address these limitations by exploring how minimisation of dedicated cost functions can harmonise differences in frame orientations, ultimately facilitating consistent interpretation of articulating joint kinematic signals. In this study, we present and investigate a frame orientation optimisation method (FOOM) that aligns reference frames and corrects for cross-talk errors, hence yielding a consistent interpretation of the underlying movement patterns. By executing optimised rotational sequences, thus producing angular corrections around each axis, we enable a reproducible frame definition and hence an approach for reliable comparison of kinematic data. Using this approach, root-mean-square errors between the previously collected (1) IMU-based data using functional joint axes, and (2) simulated fluoroscopy-based data relying on geometrical axes were almost entirely eliminated from an initial range of 0.7°-5.1° to a mere 0.1°-0.8°. Our results confirm that different local segment frames can yield different kinematic patterns, despite following the same rotation convention, and that appropriate alignment of reference frame orientation can successfully enable consistent kinematic interpretation.

A Framework for Analytical Validation of Inertial-Sensor-Based Knee Kinematics Using a Six-Degrees-of-Freedom Joint Simulator

The success of kinematic analysis that relies on inertial measurement units (IMUs) heavily depends on the performance of the underlying algorithms. Quantifying the level of uncertainty associated with the models and approximations implemented within these algorithms, without the complication of soft-tissue artefact, is therefore critical. To this end, this study aimed to assess the rotational errors associated with controlled movements. Here, data of six total knee arthroplasty patients from a previously published fluoroscopy study were used to simulate realistic kinematics of daily activities using IMUs mounted to a six-degrees-of-freedom joint simulator. A model-based method involving extended Kalman filtering to derive rotational kinematics from inertial measurements was tested and compared against the ground truth simulator values. The algorithm demonstrated excellent accuracy (root-mean-square error ≤0.9°, maximum absolute error ≤3.2°) in estimating three-dimensional rotational knee kinematics during level walking. Although maximum absolute errors linked to stair descent and sit-to-stand-to-sit rose to 5.2° and 10.8°, respectively, root-mean-square errors peaked at 1.9° and 7.5°. This study hereby describes an accurate framework for evaluating the suitability of the underlying kinematic models and assumptions of an IMU-based motion analysis system, facilitating the future validation of analogous tools.

Acquisition of Lower-Limb Motion Characteristics with a Single Inertial Measurement Unit—Validation for Use in Physiotherapy

In physiotherapy, there is still a lack of practical measurement options to track the progress of therapy or rehabilitation following injuries to the lower limbs objectively and reproducibly yet simply and with minimal effort and time. We aim at filling this gap with the design of an IMU (inertial measurement unit) system with only one sensor placed on the tibia edge. In our study, the IMU system evaluated a set of 10 motion tests by a score value for each test and stored them in a database for a more reliable longitudinal assessment of the progress. The sensor analyzed the different motion patterns and obtained characteristic physiological parameters, such as angle ranges, and spatial and angular displacements, such as knee valgus under load. The scores represent the patient’s coordination, stability, strength and speed. To validate the IMU system, these scores were compared to corresponding values from a simultaneously recorded marker-based 3D video motion analysis of the measurements from five healthy volunteers. Score differences between the two systems were almost always within 1–3 degrees for angle measurements. Timing-related measurements were nearly completely identical. The tests on the valgus stability of the knee showed equally small deviations but should nevertheless be repeated with patients, because the healthy subjects showed no signs of instability.

Inertial Sensor-to-Segment Calibration for Accurate 3D Joint Angle Calculation for Use in OpenSim

Inertial capture (InCap) systems combined with musculoskeletal (MSK) models are an attractive option for monitoring 3D joint kinematics in an ecological context. However, the primary limiting factor is the sensor-to-segment calibration, which is crucial to estimate the body segment orientations. Walking, running, and stair ascent and descent trials were measured in eleven healthy subjects with the Xsens InCap system and the Vicon 3D motion capture (MoCap) system at a self-selected speed. A novel integrated method that combines previous sensor-to-segment calibration approaches was developed for use in a MSK model with three degree of freedom (DOF) hip and knee joints. The following were compared: RMSE, range of motion (ROM), peaks, and R² between InCap kinematics estimated with different calibration methods and gold standard MoCap kinematics. The integrated method reduced the RSME for both the hip and the knee joints below 5°, and no statistically significant differences were found between MoCap and InCap kinematics. This was consistent across all the different analyzed movements. The developed method was integrated on an MSK model workflow, and it increased the sensor-to-segment calibration accuracy for an accurate estimate of 3D joint kinematics compared to MoCap, guaranteeing a clinical easy-to-use approach.

Algorithm for the Comparison of Human Periodic Movements Using Wearable Devices

In the context of teaching-learning of motor skills in a virtual environment, videos are generally used. The person who wants to learn a certain movement watches a video and tries to perform the activity. In this sense, feedback is rarely thought of. This article proposes an algorithm in which two periodic movements are compared, the one carried out by an expert and the one carried out by the person who is learning, in order to determine how closely these two movements are performed and to provide feedback from them. The algorithm starts from the capture of data through a wearable device that yields data from an accelerometer; in this case, the data of the expert and the data of the person who is learning are captured in a dataset of salsa dance steps. Adjustments are made to the data in terms of Pearson iterations, synchronization, filtering, and normalization, and DTW, linear regression, and error analysis are used to make the corresponding comparison of the two datasets. With the above, it is possible to determine if the cycles of the two signals coincide and how closely the learner's movements resemble those of the expert.

Vision-based human joint angular velocity estimation during squat and walking on a treadmill actions

Elderly health monitoring, rehabilitation training, and sport supervision could benefit from continuous assessment of joint angle, and angular velocity to identify the joint movement patterns. However, most of the measurement systems are designed based on special kinematic sensors to estimate angular velocities. The study aims to measure the lower limb joint angular velocity based on a 2D vision camera system during squat and walking on treadmill action using deep convolution neural network (CNN) architecture. Experiments were conducted on 12 healthy adults, and six digital cameras were used to capture the videos of the participant actions in lateral and frontal view. The normalized cross-correlation (Cc_norm) analysis was performed to obtain a degree of symmetry of the ground truth and estimated angular velocity waveform patterns. Mean Cc_norm for angular velocity estimation by deep CNN model has higher than 0.90 in walking on the treadmill and 0.89 in squat action. Furthermore, joint-wise angular velocities at the hip, knee, and ankle joints were observed and compared. The proposed system gets higher estimation performance under the lateral view and the frontal view of the camera. This study potentially eliminates the requirement of wearable sensors and proves the applicability of using video-based system to measure joint angular velocities during squat and walking on a treadmill actions.

Development of a Low-Cost Open-Source Measurement System for Joint Angle Estimation

The use of inertial measurement units (IMUs) is a low-cost alternative for measuring joint angles. This study aims to present a low-cost open-source measurement system for joint angle estimation. The system is modular and has hardware and software. The hardware was developed using a low-cost IMU and microcontroller. The IMU data analysis software was developed in Python and has three fusion filters: Complementary Filter, Kalman Filter, and Madgwick Filter. Three experiments were performed for the proof of concept of the system. First, we evaluated the knee joint of Lokomat, with a predefined average range of motion (ROM) of 60∘. In the second, we evaluated our system in a real scenario, evaluating the knee of a healthy adult individual during gait. In the third experiment, we evaluated the software using data from gold standard devices, comparing the results of our software with Ground Truth. In the evaluation of the Lokomat, our system achieved an average ROM of 58.28∘, and during evaluation in a real scenario it achieved an average ROM of 44.62∘. In comparing our software with Ground Truth, we achieved a root-mean-square error of 0.04 and a mean average percentage error of 2.95%. These results encourage the use of this system in other scenarios.

Accuracy of Measuring Knee Flexion after TKA through Wearable IMU Sensors

Wearable sensors have the potential to facilitate remote monitoring for patients recovering from knee replacement surgery. Using IMU sensors attached to the patients' leg, knee flexion can be monitored while the patients are recovering in their home environment. Ideally, these flexion angle measurements will have an accuracy and repeatability at least on par with current clinical standards. To validate the clinical accuracy of a two-sensor IMU system, knee flexion angles were measured in eight subjects post-TKA and compared with other in-clinic angle measurement techniques. These sensors are aligned to the patients' anatomy by taking a pose resting their operated leg on a box; an initial goniometer measurement defines the patients' knee flexion while taking that pose. The repeatability and accuracy of the system was subsequently evaluated by comparing knee flexion angles against goniometer readings and markerless optical motion capture data. The alignment pose was repeatable with a mean absolute error of 1.6 degrees. The sensor accuracy through the range of motion had a mean absolute error of 2.6 degrees. In conclusion, the presented sensor system facilitates a repeatable and accurate measurement of the knee flexion, holding the potential for effective remote monitoring of patients recovering from knee replacement surgery.

Improving Human Activity Recognition Performance by Data Fusion and Feature Engineering

Human activity recognition (HAR) is essential in many health-related fields. A variety of technologies based on different sensors have been developed for HAR. Among them, fusion from heterogeneous wearable sensors has been developed as it is portable, non-interventional and accurate for HAR. To be applied in real-time use with limited resources, the activity recognition system must be compact and reliable. This requirement can be achieved by feature selection (FS). By eliminating irrelevant and redundant features, the system burden is reduced with good classification performance (CP). This manuscript proposes a two-stage genetic algorithm-based feature selection algorithm with a fixed activation number (GFSFAN), which is implemented on the datasets with a variety of time, frequency and time-frequency domain features extracted from the collected raw time series of nine activities of daily living (ADL). Six classifiers are used to evaluate the effects of selected feature subsets from different FS algorithms on HAR performance. The results indicate that GFSFAN can achieve good CP with a small size. A sensor-to-segment coordinate calibration algorithm and lower-limb joint angle estimation algorithm are introduced. Experiments on the effect of the calibration and the introduction of joint angle on HAR shows that both of them can improve the CP.