Measuring Spatiotemporal Parameters on Treadmill Walking Using Wearable Inertial System

The test-retest reliability of an IMU-based motion capture system for total body angular momentum range, medial-lateral margin of stability, and step width: Effects of walkway length and number of consecutive strides

Establishing the test-retest reliability of a motion capture system is important to support repeated walking balance assessments and to discern the relevance of significant changes to measured outcomes. Reliability of walking outcomes could also be impacted by the number of consecutive strides analysed. The primary objective of this study was to evaluate the test-retest reliability of the XSens Awinda inertial sensor-based system for total body angular momentum range, margin of stability, and step width. Twenty-eight young adults (24 ± 4 years) completed two data collections > 48 hours apart, consisting of 10 walking trials in a laboratory (8 meters) and a hallway (20 meters). Total body kinematic data from 17 sensors were used to calculate ranges of total body angular momentum (H), medial-lateral margin of stability (MOSML), and step width (SW). Intra-class correlations (ICC ± 95% confidence intervals) and minimum detectable change values at a 95% confidence level (MDC95) were calculated using different stride counts. ICCs indicated moderate to excellent reliability for ranges of H, MOSML, and SW. MDC95 levels were small for ranges of H and large for MOSML and SW. ICCs were greater in the laboratory for MOSML and similar between the laboratory and hallway for ranges of H and SW. MDC95 indicated better reliability for the hallway suggesting that settings with a longer walkway may be ideal for reliable outcomes. The greatest improvements to reliability occurred within the first 10 consecutive strides, indicating at least 10 consecutive strides across multiple trials are recommended for improved reliability.

The effect of transcranial direct current stimulation combined with task-specific training on spatio-temporal gait parameters and functional mobility in individuals with stroke: a systematic review and meta-analysis

INTRODUCTION

Transcranial direct current stimulation (tDCS) has a priming effect on post- stroke motor rehabilitation.

OBJECTIVE

We verified whether tDCS combined with task-specific training was superior to nonintervention, task-specific training, or simulated intervention in improving spatio-temporal gait parameters and functional mobility in stroke patients.

METHODS

We searched MEDLINE, EMBASE, CINAHL, Scopus, Cochrane Central, Web of Science, and LILACS for articles published until May 2024, using terms related to stroke, tDCS, and task-specific training. The risk of bias was assessed using the PEDro scale. The Grading of Recommendations, Assessment, Development, and Evaluation methodology was used to classify the certainty of the evidence for each outcome. Meta-analysis was performed using a random-effects model.

RESULTS

A total of 1,685 studies were identified, of which 18 were included in the qualitative analysis. Seven studies were included in the meta-analysis; all outcomes were classified as "very low quality." Improvements in walking speed only were associated with tDCS combined with task-specific training (mean difference [MD], 0.06; 95% confidence interval [CI]: 0.04, 0.07; p < 0.001; I  = 0%). There were no differences in other spatio-temporal gait parameters or functional mobility.

CONCLUSION

This systematic review provides low-quality evidence that tDCS, in combination with task-specific training, increases speed in individuals after stroke. Both interventions, tDCS and task-specific training, are inexpensive and easy to implement; therefore, the mean estimate may be considered clinically worthwhile, although the CIs spans both clinically trivial and worthwhile effects.

REGISTRATION

International Prospective Register of Systematic Reviews (PROSPERO; number CRD42023396021).

The difference in gait pattern between adults with obesity and adults with a normal weight, assessed with 3D-4D gait analysis devices: a systematic review and meta-analysis

OBJECTIVE

A systematic review and meta-analysis were performed following PRISMA 2020 guidelines to identify the difference in gait pattern between adults with obesity and adults with a normal bodyweight assessed with 3D-4D gait analysis (3D-4DGA) devices.

METHODS

Articles about the spatiotemporal parameters of adults with obesity compared with adults with a normal bodyweight using a 3DGA were sought on the 4th of October 2023 in three different databases (PubMed, Web of Science and IEEE). A total of 3371 articles were found: 2065 with PubMed, 1185 with Web of Science, and 121 with IEEE. The data was screened double-blind. Fourteen case control studies were included in the systematic review and meta-analysis, and for all of them, the risk of bias was determined. Obesity was defined using the BMI, with a range of 30 kg/m² until 54.06 kg/m². Participants from both sexes (35% men and 65% women) were included, and they had an age range of 18-65 years.

RESULTS AND DISCUSSION

The risk of bias was assessed with the Newcastle Ottowa Scale (NOS), and the certainty of evidence was assessed with the Evidence-Based Richtlijn Ontwikkeling (EBRO). The meta-analysis showed a decrease in gait speed and cadence and an increase in stance phase, double stance, and step width. No significant difference was found regarding stride length. In the systematic review, step length, step rate, and swing phase were found to have decreased. Regarding the single stance, step time, CoM, and CoP, no conclusions could be drawn.

CONCLUSION

There is a difference in gait parameters between adults with obesity and adults with a normal bodyweight. Namely, the gait speed, step rate, step length, swing phase is decreased in adults with obesity. However, there is an increase in step width, stance phase, and double stance phase.

Comparative analysis of the effects of gender on lower extremity kinematics following a 5 km running time trial in collegiate recreational runners

To explore whether collegiate recreational runners of different genders exhibit different lower extremity kinematics following a 5 km running time trial. Thirty collegiate recreational runners (15 males, 15 females) participated. The participants performed kinematic tests using IMUs before and after the 5 km running time trial. Spatiotemporal parameters were recorded via the Garmin HRM-RUN during the 5 km running time trial. The peak hip, knee and ankle joint angles and angular velocity were compared within and between groups using two-way analysis of variance. Spatiotemporal parameters were compared between groups using independent t tests. In terms of kinematic parameters, gender and time have a significant interaction effect on the peak knee internal rotation angle (P = 0.036) after 5 km running time trial. The peak ankle eversion angular velocity after running was significantly greater than that before running in male runners (P = 0.015). In terms of spatiotemporal parameters, the average cadence of females was significantly greater than that of males during running (P = 0.003). The Collegiate recreational runners presented gender-specific lower extremity kinematic characteristics following a 5 km running time trial. The peak knee internal rotation angle significantly increased after the 5 km running time trial in female runners. It should be paid more attention to the association between gender-specific lower extremity kinematic characteristics and running-related injuries in the future.

Effect of Kinematic Analysis on the Gait of School-Going Children With Different Types of Foot Arches: An Observational Study Using Xsens 3D Motion Technology

Background Gait mechanics can be influenced by foot structure, particularly in children with different types of arches, such as normal arches, flat feet, and high arches. Understanding how foot structure affects gait is essential for developing targeted interventions to improve walking efficiency and reduce injury risk. This observational study uses Xsens 3D motion technology (Xsens Technologies B.V., Netherlands) to analyze the impact of different foot arches on gait in school-going children. Objective The aim of the study is to investigate the effect of foot arch types on gait variables, such as speed, step length, cadence, and gait phases, in school-going children, using advanced kinematic analysis. Methods A total of 558 children were classified into three groups based on their foot arch type: normal arch, flat foot, and high arch. Kinematic data was collected using Xsens 3D motion technology to analyze gait variables. One-way ANOVA was used to compare continuous variables (age, height, weight, body mass index (BMI)) between the groups, while the chi-square test was used for categorical variables (gender). Gait variables were analyzed using one-way ANOVA and Tukey's post-hoc test. Results No significant differences were observed between the groups in terms of age, height, weight, BMI, or gender (p > 0.05). However, significant differences were found in all gait variables (p < 0.0001). Flat-footed individuals exhibited the highest walking speed (1.03 m/s), step count (34.01 steps/min), and step length (7.50 m), while high-arch participants demonstrated slower speeds (0.96 m/s) and wider step width (-0.16 m). High-arch individuals also spent more time in the double and single support phases, indicating a need for increased balance during gait. Conclusion Foot arch type significantly affects gait mechanics in school-going children. Children with flat feet exhibit faster gait speeds and longer step lengths, while those with high arches demonstrate slower, more cautious walking patterns. These results highlight the importance of individualized interventions, such as orthotics or gait training, to optimize walking efficiency and reduce the risk of gait-related issues in children with abnormal foot arches.

Design of a multi-sensor walking boot to quantify the forefoot rocker motion as a function of walking speed

In this study, we designed a wearable multi-sensor walking boot to measure foot angular momentum and introduced a novel method to quantify forefoot rocker motion as a function of walking speed. A treadmill walking experiment was conducted with eight healthy subjects wearing the multi-sensor walking boot. Using the collected data, we calculated foot angular momentum and the average rate of change in angular momentum during the double support phase. In addition, we used linear regression analysis to quantify foot rotation patterns across increasing walking speeds, assessing the potential of this method as a walking indicator. The results demonstrated that the foot rotation pattern in the healthy group was characterized by a gradual scaling of angular momentum and its average rate of change, with strong correlations to walking speed. Based on these findings, we conclude that the proposed method for quantifying forefoot rocker motion relative to walking speed can serve as an effective indicator of normal walking.

Higher Levels of Serum Leptin Are Linked with a Reduction in Gait Stability: A Sex-Based Association

Gait stability prevents falls and injuries during physical activities. Muscle strength, aging, and co-existing chronic diseases are factors that affect gait stability. Leptin is an adipokine with pro-inflammatory properties. Several reports demonstrated an association between serum leptin and a reduction in muscle strength. Given the above relationships, we hypothesized that serum leptin could be associated with gait stability. To test this, 146 apparently healthy university students were recruited. Data collection involved anthropometric measurements, physical activity (PA) data, gait parameters, and serum leptin levels. A gait instability index was derived from the percentages of double support time and walking asymmetry (WA) collected from smartphones. Females demonstrated higher leptin levels and WA despite a lower body mass index (BMI). Lower PA levels were also observed among females. Leptin levels were negatively correlated with WA, step count, and vigorous PA (p < 0.05). These correlations remained significant following correction for leptin by BMI. Using logistic regression, a higher leptin-to-BMI ratio was associated with high gait instability (OR = 9.97, 95%CI: 4.17-23.84, p < 0.001). After stratification by sex, this association was only evident among females (OR = 6.09, 95%CI: 1.04-35.56, p = 0.045). These findings suggest a sex-based association between serum leptin and gait stability among apparently healthy students.

Perceiving inter-leg speed differences while walking on a split-belt treadmill

Walking is one of the most common forms of self-motion in humans. Most humans can walk effortlessly over flat uniform terrain, but also a variety of more challenging surfaces, as they adjust their gait to the demands of the terrain. In this, they rely in part on the perception of their own gait and of when it needs to be adjusted. Here, we investigated how well N = 48 participants detected speed differences between two belts of a split-belt treadmill. As participants walked at a constant speed, we either accelerated or decelerated one of the belts at quasi-random intervals and asked participants to judge their relative speeds in a two-alternative forced-choice task. Using an adaptive psychophysical procedure, we obtained precise perception-threshold estimates for inter-leg speed differences after accelerating or decelerating one belt. We found that most participants could detect even very small speed differences, with mean threshold estimates of just over 7% for both perturbation types. These were relatively stable within, but highly variable across participants. Increased-speed and decreased-speed thresholds were highly correlated, indicating that despite different biomechanics, the detection mechanisms might be similar. This sheds light on how perceiving their own motion helps humans manage interlimb coordination in perturbed walking.

Experimental Comparison between 4D Stereophotogrammetry and Inertial Measurement Unit Systems for Gait Spatiotemporal Parameters and Joint Kinematics

(1) Background: Traditional gait assessment methods have limitations like time-consuming procedures, the requirement of skilled personnel, soft tissue artifacts, and high costs. Various 3D time scanning techniques are emerging to overcome these issues. This study compares a 3D temporal scanning system (Move4D) with an inertial motion capture system (Xsens) to evaluate their reliability and accuracy in assessing gait spatiotemporal parameters and joint kinematics. (2) Methods: This study included 13 healthy people and one hemiplegic patient, and it examined stance time, swing time, cycle time, and stride length. Statistical analysis included paired samples t-test, Bland-Altman plot, and the intraclass correlation coefficient (ICC). (3) Results: A high degree of agreement and no significant difference (p > 0.05) between the two measurement systems have been found for stance time, swing time, and cycle time. Evaluation of stride length shows a significant difference (p < 0.05) between Xsens and Move4D. The highest root-mean-square error (RMSE) was found in hip flexion/extension (RMSE = 10.99°); (4) Conclusions: The present work demonstrated that the system Move4D can estimate gait spatiotemporal parameters (gait phases duration and cycle time) and joint angles with reliability and accuracy comparable to Xsens. This study allows further innovative research using 4D (3D over time) scanning for quantitative gait assessment in clinical practice.

Accuracy, Validity, and Reliability of Markerless Camera-Based 3D Motion Capture Systems versus Marker-Based 3D Motion Capture Systems in Gait Analysis: A Systematic Review and Meta-Analysis

(1) Background: Marker-based 3D motion capture systems (MBS) are considered the gold standard in gait analysis. However, they have limitations for which markerless camera-based 3D motion capture systems (MCBS) could provide a solution. The aim of this systematic review and meta-analysis is to compare the accuracy, validity, and reliability of MCBS and MBS. (2) Methods: A total of 2047 papers were systematically searched according to PRISMA guidelines on 7 February 2024, in two different databases: Pubmed (1339) and WoS (708). The COSMIN-tool and EBRO guidelines were used to assess risk of bias and level of evidence. (3) Results: After full text screening, 22 papers were included. Spatiotemporal parameters showed overall good to excellent accuracy, validity, and reliability. For kinematic variables, hip and knee showed moderate to excellent agreement between the systems, while for the ankle joint, poor concurrent validity and reliability were measured. The accuracy and concurrent validity of walking speed were considered excellent in all cases, with only a small bias. The meta-analysis of the inter-rater reliability and concurrent validity of walking speed, step time, and step length resulted in a good-to-excellent intraclass correlation coefficient (ICC) (0.81; 0.98). (4) Discussion and conclusions: MCBS are comparable in terms of accuracy, concurrent validity, and reliability to MBS in spatiotemporal parameters. Additionally, kinematic parameters for hip and knee in the sagittal plane are considered most valid and reliable but lack valid and accurate measurement outcomes in transverse and frontal planes. Customization and standardization of methodological procedures are necessary for future research to adequately compare protocols in clinical settings, with more attention to patient populations.

Curved non-motorized treadmills do not biomechanically replicate overground running better than motorized treadmills

The purpose of this study was to determine if curved non-motorized treadmills can reproduce overground running better than motorized treadmills by analysing the differences in joint kinematics (hip, knee, and ankle) using SPM. Nineteen recreational runners completed three randomized running tests on these surfaces. Kinematic data from the hip, knee, and ankle joints were collected. Two-tailed SPM t-tests were performed to analyse time-continuous gait cycles in three anatomical planes of each joint. Higher within-subject variability was observed in the frontal and transverse planes during curved non-motorized treadmill running. SPM analysis showed more significant differences (p < 0.05) between curved non-motorized treadmill and overground than between motorized treadmill and overground, mainly in knee (from 12% to 30% and 93% to 99% of the gait cycle) and ankle (from 19% to 23% of the gait cycle) in the sagittal plane. Therefore, running on curved non-motorized treadmills is more biomechanically different compared to overground than motorized treadmills, and might not be the best strategy to replicate overground running in terms of joint kinematics during highly controlled research studies. However, they could be an interesting tool in rehabilitation or training environments since the changes observed in joint kinematics were likely not functionally relevant.

Overground walking with a constraint force on the nonparetic leg during swing improves weight shift toward the paretic side in people after stroke

Targeting enhancing the use of the paretic leg during locomotor practice might improve motor function of the paretic leg. The purpose of this study was to determine whether application of constraint force to the nonparetic leg in the posterior direction during overground walking would enhance the use of the paretic leg in people with chronic stroke. Fifteen individuals after stroke participated in two experimental conditions, i.e., overground walking with a constraint force applied to the nonparetic leg and overground walking only. Each participant was tested in the following procedures that consisted of overground walking with either constraint force or no constraint force, instrumented split-belt treadmill walking, and pressure-sensitive gait mat walking before and after the overground walking. Overground walking practice with constraint force resulted in greater enhancement in lateral weight shift toward the paretic side (P < 0.01), muscle activity of the paretic hip abductors (P = 0.04), and propulsion force of the paretic leg (P = 0.05) compared with the results of the no-constraint condition. Overground walking practice with constraint force tended to induce greater increase in self-selected overground walking speed (P = 0.06) compared with the effect of the no-constraint condition. The increase in propulsion force from the paretic leg was positively correlated with the increase in self-selected walking speed (r = 0.6, P = 0.03). Overground walking with constraint force applied to the nonparetic leg during swing phase of gait may enhance use of the paretic leg, improve weight shifting toward the paretic side and propulsion of the paretic leg, and consequently increase walking speed.NEW & NOTEWORTHY Application of constraint force to the nonparetic leg during overground walking induced improved lateral weight shifts toward the paretic leg and enhanced muscle activity of the paretic leg during walking. In addition, one session of overground walking with constraint force might induce an increase in propulsive force of the paretic leg and an increase in self-selected overground walking speed, which might be partially due to the improvement in motor control of the paretic leg.

Running Footwear and Impact Peak Differences in Recreational Runners

Running is a physical activity and the investigation of its biomechanical aspects is crucial both to avoid injuries and enhance performance. Recreational runners may be liable to increased stress over the body, particularly to lower limb joints. This study investigates the different running patterns of recreational runners by analyzing characteristics of the footwear impact peak, spatiotemporal, and kinematic parameters among those that present with a peak impact and those that do not, with a 3D markerless system. Thirty recreational runners were divided into two groups: impact peak group (IP) (n = 16) and no impact peak group (n = 14) (n-IP). Kinematic and spatiotemporal parameters showed a large Cohen's d effect size between the groups. The mean hip flexion was IP 40.40° versus n-IP 32.30° (d = -0.82). Hip extension was IP 30.20° versus n-IP 27.70° (d = -0.58), and ankle dorsiflexion was IP 20.80°, versus n-IP 13.37° (d = -1.17). Stride length was IP 117.90 cm versus n-IP 105.50 cm (d = -0.84). Steps per minute was IP group 170 spm, versus n-IP 163 spm (d = -0.51). The heel-to-toe drop was mainly 10-12 mm for the IP group and 4-6 mm for the n-IP group. Recreational runners whose hip extension is around 40°, ankle dorsiflexion around 20°, and initial foot contact around 14°, may be predisposed to the presence of an impact peak.

Detection of Human Gait Phases Using Textile Pressure Sensors: A Low Cost and Pervasive Approach

Human gait analysis is a standard method used for detecting and diagnosing diseases associated with gait disorders. Wearable technologies, due to their low costs and high portability, are increasingly being used in gait and other medical analyses. This paper evaluates the use of low-cost homemade textile pressure sensors to recognize gait phases. Ten sensors were integrated into stretch pants, achieving an inexpensive and pervasive solution. Nevertheless, such a simple fabrication process leads to significant sensitivity variability among sensors, hindering their adoption in precision-demanding medical applications. To tackle this issue, we evaluated the textile sensors for the classification of gait phases over three machine learning algorithms for time-series signals, namely, random forest (RF), time series forest (TSF), and multi-representation sequence learner (Mr-SEQL). Training and testing signals were generated from participants wearing the sensing pants in a test run under laboratory conditions and from an inertial sensor attached to the same pants for comparison purposes. Moreover, a new annotation method to facilitate the creation of such datasets using an ordinary webcam and a pose detection model is presented, which uses predefined rules for label generation. The results show that textile sensors successfully detect the gait phases with an average precision of 91.2% and 90.5% for RF and TSF, respectively, only 0.8% and 2.3% lower than the same values obtained from the IMU. This situation changes for Mr-SEQL, which achieved a precision of 79% for the textile sensors and 36.8% for the IMU. The overall results show the feasibility of using textile pressure sensors for human gait recognition.

Gait Recognition for Lower Limb Exoskeletons Based on Interactive Information Fusion

In recent decades, although the research on gait recognition of lower limb exoskeleton robot has been widely developed, there are still limitations in rehabilitation training and clinical practice. The emergence of interactive information fusion technology provides a new research idea for the solution of this problem, and it is also the development trend in the future. In order to better explore the issue, this paper summarizes gait recognition based on interactive information fusion of lower limb exoskeleton robots. This review introduces the current research status, methods, and directions for information acquisition, interaction, fusion, and gait recognition of exoskeleton robots. The content involves the research progress of information acquisition methods, sensor placements, target groups, lower limb sports biomechanics, interactive information fusion, and gait recognition model. Finally, the current challenges, possible solutions, and promising prospects are analysed and discussed, which provides a useful reference resource for the study of interactive information fusion and gait recognition of rehabilitation exoskeleton robots.