Quantitative and Qualitative Running Gait Analysis through an Innovative Video-Based Approach

The running gait analysis technology: A comprehensive systematic literature review

Background

Running is practiced worldwide, but more than 50 % of runners suffer some form of musculoskeletal injury each year. Biomechanics of running is an important aspect of sports medicine and gait analysis is central in the study of running mechanics for prevention of injuries and enhancing performance.

Objectives

The purpose of this systematic literature review is to Saragiotto et al. (2014 Apr 4) 1 assess the methods employed in conducting gait analysis studies from 2020 to 2024, 2 discuss spatiotemporal characteristics, bilateral asymmetry, and RRI, (Lenhart et al., 2014 Mar) 3 present wearable technology, and (Willson et al., 2014) 4 provide recommendations for future research and application based on the findings.

Methods

The study was conducted following the PRISMA guidelines and was registered in the PROSPERO database under the number CRD42024572642. The systematic search of articles was performed in the Scopus database, considering the articles written in English and published in journals between 2004 and 2024, which are focused on the analysis of running gait. Data were collected, pre-processed, and processed according to certain inclusion and exclusion criteria.

Results

Of 2175 articles, only 43 studies were included. The studies were mainly concerned with spatiotemporal features (Patino and Ferreira, 2018) ,16 gait asymmetry and injuries (Crowther et al., 2007 Jun 1) ,9 biomechanics (Mason et al., 2023 Sep 1) ,8 and gait measurement tools (Schubert et al., 2014 May 1) .10 IMUs, accelerometers, and pressure sensors were established as wearable technologies that can be used to monitor gait in the sports setting.

Conclusion

In this review, we discuss the latest developments in wearable technology for gait analysis, which can be considered a viable alternative to laboratory-based methods. However, the need to use standard methods and validation procedures has not lost its importance as it is crucial for the practical application of these technologies.

Protocol

Registration number CRD42024572642.

Clinical Effect Analysis of Wearable Sensor Technology-Based Gait Function Analysis in Post-Transcranial Magnetic Stimulation Stroke Patients

(1) Background: This study evaluates the effectiveness of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) in improving gait in post-stroke hemiplegic patients, using wearable sensor technology for objective gait analysis. (2) Methods: A total of 72 stroke patients were randomized into control, sham stimulation, and LF-rTMS groups, with all receiving standard medical treatment. The LF-rTMS group underwent stimulation on the unaffected hemisphere for 6 weeks. Key metrics including the Fugl-Meyer Assessment Lower Extremity (FMA-LE), Berg Balance Scale (BBS), Modified Barthel Index (MBI), and gait parameters were measured before and after treatment. (3) Results: The LF-rTMS group showed significant improvements in the FMA-LE, BBS, MBI, and various gait parameters compared to the control and sham groups (p < 0.05). Specifically, the FMA-LE scores improved by an average of 5 points (from 15 ± 3 to 20 ± 2), the BBS scores increased by 8 points (from 35 ± 5 to 43 ± 4), the MBI scores rose by 10 points (from 50 ± 8 to 60 ± 7), and notable enhancements in gait parameters were observed: the gait cycle time was reduced from 2.05 ± 0.51 s to 1.02 ± 0.11 s, the stride length increased from 0.56 ± 0.04 m to 0.97 ± 0.08 m, and the walking speed improved from 35.95 ± 7.14 cm/s to 75.03 ± 11.36 cm/s (all p < 0.001). No adverse events were reported. The control and sham groups exhibited improvements but were not as significant. (4) Conclusions: LF-rTMS on the unaffected hemisphere significantly enhances lower-limb function, balance, and daily living activities in subacute stroke patients, with the gait parameters showing a notable improvement. Wearable sensor technology proves effective in providing detailed, objective gait analysis, offering valuable insights for clinical applications in stroke rehabilitation.

Automated recognition of asymmetric gait and fatigue gait using ground reaction force data

Introduction: The purpose of this study was to evaluate the effect of running-induced fatigue on the characteristic asymmetry of running gait and to identify non-linear differences in bilateral lower limbs and fatigued gait by building a machine learning model. Methods: Data on bilateral lower limb three-dimensional ground reaction forces were collected from 14 male amateur runners before and after a running-induced fatigue experiment. The symmetry function (SF) was used to assess the degree of symmetry of running gait. Statistical parameter mapping (Paired sample T-test) algorithm was used to examine bilateral lower limb differences and asymmetry changes pre- and post-fatigue of time series data. The support vector ma-chine (SVM) algorithm was used to recognize the gait characteristics of both lower limbs before and after fatigue and to build the optimal algorithm model by setting different kernel functions. Results: The results showed that the ground reaction forces were asymmetrical (SF > 0.5) both pre-and post-fatigue and mainly concentrated in the medial-lateral direction. The asymmetry of the medial-lateral direction increased significantly after fatigue (p < 0.05). In addition, we concluded that the polynomial kernel function could make the SVM model the most accurate in classifying left and right gait features (accuracy of 85.3%, 82.4%, and 82.4% in medial-lateral, anterior-posterior and vertical directions, respectively). Gaussian radial basis kernel function was the optimal kernel function of the SVM algorithm model for fatigue gait recognition in the medial-lateral and vertical directions (accuracy of 54.2% and 62.5%, respectively). Moreover, polynomial was the optimal kernel function of the anterior-posterior di-rection (accuracy = 54.2%). Discussion: We proved in this study that the SVM algorithm model depicted good performance in identifying asymmetric and fatigue gaits. These findings can provide implications for running injury prevention, movement monitoring, and gait assessment.

An Alternative Athlete Monitoring System Using Cost-Effective Inertial Sensing Instrumentation

An examination of the human gait is feasible using inertial sensing. The embedded accelerometer and gyroscope in an inertial measurement unit can evaluate physical activity-based sports and this unit is relatively affordable compared to global positioning systems or video recording quantification. This study developed a cost-effective sports monitoring investigation method with an inertial sensor attached to the right leg of the athletes. In total, four parameters were simultaneously tracked to assess the entire sensor performance in real-time. The accelerometer measured the typical leg angle when walking and running, whereas the gyroscope processed the raw data to obtain the stride frequency from the time-domain data. Moreover, a comparison between the accelerometer and gyroscope was presented while simultaneously attaining the signal to convert the time-domain data to frequency results. Also, the number of strides and linear velocity was expressed as results in this study. To confirm the results, a statistical hypothesis test was implemented for all obtained results. The results indicated that the inertial sensing instrumentation used in this study is promising and could be an affordable alternative option for a sports monitoring system.

Human Movement Quality Assessment Using Sensor Technologies in Recreational and Professional Sports: A Scoping Review

The use of sensor technology in sports facilitates the data-driven evaluation of human movement not only in terms of quantity but also in terms of quality. This scoping review presents an overview of sensor technologies and human movement quality assessments in ecologically-similar environments. We searched four online databases to identify 16 eligible articles with either recreational and/or professional athletes. A total of 50% of the studies used inertial sensor technology, 31% vision-based sensor technology. Most of the studies (69%) assessed human movement quality using either the comparison to an expert's performance, to an exercise definition or to the athletes' individual baseline performance. A total of 31% of the studies used expert-based labeling of the movements to label data. None of the included studies used a control group-based study design to investigate impact on training progress, injury prevention or behavior change. Although studies have used sensor technology for movement quality assessment, the transfer from the lab to the field in recreational and professional sports is still emerging. Hence, research would benefit from impact studies of technology-assisted training interventions including control groups as well as investigating features of human movement quality in addition to kinematic parameters.

Knee Joint Menisci Are Shock Absorbers: A Biomechanical In-Vitro Study on Porcine Stifle Joints

The aim of this biomechanical in vitro study was to answer the question whether the meniscus acts as a shock absorber in the knee joint or not. The soft tissue of fourteen porcine knee joints was removed, leaving the capsuloligamentous structures intact. The joints were mounted in 45° neutral knee flexion in a previously validated droptower setup. Six joints were exposed to an impact load of 3.54 J, and the resultant loss factor (η) was calculated. Then, the setup was modified to allow sinusoidal loading under dynamic mechanical analysis (DMA) conditions. The remaining eight knee joints were exposed to 10 frequencies ranging from 0.1 to 5 Hz at a static load of 1210 N and a superimposed sinusoidal load of 910 N (2.12 times body weight). Forces (F) and deformation (l) were continuously recorded, and the loss factor (tan δ) was calculated. For both experiments, four meniscus states (intact, medial posterior root avulsion, medial meniscectomy, and total lateral and medial meniscectomy) were investigated. During the droptower experiments, the intact state indicated a loss factor of η = 0.1. Except for the root avulsion state (−15%, p = 0.12), the loss factor decreased (p &lt; 0.046) up to 68% for the total meniscectomy state (p = 0.028) when compared to the intact state. Sinusoidal DMA testing revealed that knees with an intact meniscus had the highest loss factors, ranging from 0.10 to 0.15. Any surgical manipulation lowered the damping ability: Medial meniscectomy resulted in a reduction of 24%, while the resection of both menisci lowered tan δ by 18% compared to the intact state. This biomechanical in vitro study indicates that the shock-absorbing ability of a knee joint is lower when meniscal tissue is resected. In other words, the meniscus contributes to the shock absorption of the knee joint not only during impact loads, but also during sinusoidal loads. The findings may have an impact on the rehabilitation of young, meniscectomized patients who want to return to sports. Consequently, such patients are exposed to critical loads on the articular cartilage, especially when performing sports with recurring impact loads transmitted through the knee joint surfaces.

Assessing a Sensory-Motor-Cognition Triad in Amnestic Mild Cognitive Impairment With Dichotic Listening While Walking: A Dual-Task Paradigm

A contemporary topic in aging research relates to the significance of cognitive changes proper to mild cognitive impairment (MCI) to higher risk of falls and gait deteriorations. The present study addresses this question in the amnestic type of MCI (aMCI) by examining a triad of interrelated comorbidities occurring in the MCI condition: attentional impairments, hearing loss and gait disturbances. To this end, we applied a dichotic listening (DL) test during over-ground walking. DL assesses spontaneous and lateralized auditory attention in three conditions (i.e., free report or Non-forced (NF), Forced-Right (FR) ear and Forced-Left (FL) ear). Earlier reports suggest that this dual-task paradigm evoke asymmetric gait effects on healthy controls, which are moderated by degree of hearing loss. Therefore, the aim of the present study was to evaluate the effects of DL on bilateral (data from both limbs) and lateralized (each limb separately) gait outcomes in a group of forty-three aMCI participants (mean = 71.19) and fifty-two healthy older controls (mean = 70.90) by using hearing loss as a covariate in all analyses. Results showed the aMCI group presented overall compromised gait parameters, especially higher gait variability in all DL conditions during lateralized attentional control. These findings were observed bilaterally, and no lateralized effects on gait were observed. Only after controlling for hearing acuity, gait asymmetries on step length variability emerged almost exclusively in healthy controls. It was concluded that hearing loss in the aMCI group together with higher attentional impairments preclude aMCI individuals to properly execute DL and therefore, they do not display gait asymmetries. The present data demonstrate that varied demands on attentional control dependent on hearing acuity affects gait negatively in healthy older adults and aMCI individuals in very different ways. The appearance of asymmetric effects seems to be a perturbation related to normal aging, while the lack of asymmetries but exaggerated gait variability characterizes aMCI. The present findings show the intricate interplay of sensory, cognitive, and motor deteriorations in different group of older adults, which stresses the need of addressing co-occurring comorbidities behind gait perturbations in individuals prone to develop a dementia state.

A Case-Control Study of the Effects of Chronic Low Back Pain in Spatiotemporal Gait Parameters

Chronic low back pain and biomechanical walking imbalances are closely related. It is relevant to identify if there are alterations in spatiotemporal gait patterns in subjects with CLBP (cases) versus healthy subjects (controls) to plan training interventions of motor control gait patterns, and thus allowing normal physical activity of the individual. This study is intended to identify if spatiotemporal alterations occur in the gait cycle in CLBP subjects (cases) compared with a control group (healthy patients) analyzed with an OptoGait LED sensors gait program. Method: A total of n = 147 participants: n = 75 cases (CLBP) and n = 72 healthy controls subjects were studied with OptoGait gait program. Results: Significant differences were found between the two groups and both feet in foot stride, for the differences of the total stride and contact, for gait cadence and total stride length of the gait cycle (p < 0.05). Conclusions: CLBP may alter some normal gait patterns measured by OptoGait; this finding presents imbalances in gait cycle as an underlying factor. The gait is part of daily life of any individual and it is an important physical activity in relation to the maintenance of an optimal state of health. In addition, future studies are deemed necessary.