IMU-based ambulatory walking speed estimation in constrained treadmill and overground walking

This study evaluated the performance of a walking speed estimation system based on using an inertial measurement unit (IMU), a combination of accelerometers and gyroscopes. The walking speed estimation algorithm segments the walking sequence into individual stride cycles (two steps) based on the inverted pendulum-like behaviour of the stance leg during walking and it integrates the angular velocity and linear accelerations of the shank to determine the displacement of each stride. The evaluation was performed in both treadmill and overground walking experiments with various constraints on walking speed, step length and step frequency to provide a relatively comprehensive assessment of the system. Promising results were obtained in providing accurate and consistent walking speed/step length estimation in different walking conditions. An overall percentage root mean squared error (%RMSE) of 4.2 and 4.0% was achieved in treadmill and overground walking experiments, respectively. With an increasing interest in understanding human walking biomechanics, the IMU-based ambulatory system could provide a useful walking speed/step length measurement/control tool for constrained walking studies.     

IMU-based ambulatory walking speed estimation in constrained treadmill and overground walking

This study evaluated the performance of a walking speed estimation system based on using an inertial measurement unit (IMU), a combination of accelerometers and gyroscopes. The walking speed estimation algorithm segments the walking sequence into individual stride cycles (two steps) based on the inverted pendulum-like behaviour of the stance leg during walking and it integrates the angular velocity and linear accelerations of the shank to determine the displacement of each stride. The evaluation was performed in both treadmill and overground walking experiments with various constraints on walking speed, step length and step frequency to provide a relatively comprehensive assessment of the system. Promising results were obtained in providing accurate and consistent walking speed/step length estimation in different walking conditions. An overall percentage root mean squared error (%RMSE) of 4.2 and 4.0% was achieved in treadmill and overground walking experiments, respectively. With an increasing interest in understanding human walking biomechanics, the IMU-based ambulatory system could provide a useful walking speed/step length measurement/control tool for constrained walking studies.     

Can treadmill walking be used to assess propulsion generation?

Instrumented treadmills offer significant advantages for analysis of human locomotion, including recording consecutive steady-state gait cycles, precisely controlling walking speed, and avoiding force plate targeting. However, some studies of hemiparetic walking on a treadmill have suggested that the moving treadmill belt may fundamentally alter propulsion mechanics. Any differences in propulsion mechanics during treadmill walking would be problematic since recent studies assessing propulsion have provided fundamental insight into hemiparetic walking. The purpose of this study was to test the hypothesis that there would be no difference in the generation of anterior/posterior (A/P) propulsion by performing a carefully controlled comparison of the A/P ground reaction forces (GRFs) and impulses in healthy adults during treadmill and overground walking. Gait data were collected from eight subjects walking overground and on a treadmill with speed and cadence controlled. Peak negative and positive horizontal GRFs in early and late stance, respectively, were reduced by less than 5% of body weight (p<0.05) during treadmill walking compared to overground walking. The magnitude of the braking impulse was similarly lower (p<0.05) during treadmill walking, but no significant difference was found between propulsion impulses. While there were some subtle differences in A/P GRFs between overground and treadmill walking, these results suggest there is no fundamental difference in propulsion mechanics. We conclude that treadmill walking can be used to investigate propulsion generation in healthy and by implication clinical populations.     

Walking speed changes in response to novel user-driven treadmill control

Implementing user-driven treadmill control in gait training programs for rehabilitation may be an effective means of enhancing motor learning and improving functional performance. This study aimed to determine the effect of a user-driven treadmill control scheme on walking speeds, anterior ground reaction forces (AGRF), and trailing limb angles (TLA) of healthy adults. Twenty-three participants completed a 10-m overground walking task to measure their overground self-selected (SS) walking speeds. Then, they walked at their SS and fastest comfortable walking speeds on an instrumented split-belt treadmill in its fixed speed and user-driven control modes. The user-driven treadmill controller combined inertial-force, gait parameter, and position based control to adjust the treadmill belt speed in real time. Walking speeds, peak AGRF, and TLA were compared among test conditions using paired t-tests (α = 0.05). Participants chose significantly faster SS and fast walking speeds in the user-driven mode than the fixed speed mode (p > 0.05). There was no significant difference between the overground SS walking speed and the SS speed from the user-driven trials (p < 0.05). Changes in AGRF and TLA were caused primarily by changes in walking speed, not the treadmill controller. Our findings show the user-driven treadmill controller allowed participants to select walking speeds faster than their chosen speeds on the fixed speed treadmill and similar to their overground speeds. Since user-driven treadmill walking increases cognitive activity and natural mobility, these results suggest user-driven treadmill control would be a beneficial addition to current gait training programs for rehabilitation.     

Speed training with body weight unloading improves walking energy cost and maximal speed in 75- to 85-year-old healthy women.

This randomized controlled study was designed to prove the hypothesis that a novel approach to high-speed interval training, based on walking on a treadmill with the use of body weight unloading (BWU), would have improved energy cost and speed of overground walking in healthy older women. Participants were randomly assigned to either the exercise group (n = 11, 79.6 +/- 3.7 yr, mean +/- SD) or the nonintervention control group (n = 11, 77.6 +/- 2.3 yr). During the first 6 wk, the exercise group performed walking interval training on the treadmill with 40% BWU at the maximal walking speed corresponding to an intensity close to heart rate at ventilatory threshold (T(vent) walking speed). Each session consisted of four sets of 5 min of walking (three 1-min periods at T(vent) walking speed, with two 1-min intervals at comfortable walking speed in between each period at T(vent) walking speed) with 1-min interval between each set. Speed was increased session by session until the end of week 6. BWU was then progressively reduced to 10% during the last 6 wk of intervention. After 12 wk, the walking energy cost per unit of distance at all self-selected overground walking speeds (slow, comfortable, and fast) was significantly reduced in the range from 18 to 21%. The exercise group showed a 13% increase in maximal walking speed and a 67% increase in mechanical power output at T(vent) after the training program. The novel "overspeed" training approach has been demonstrated to be effective in improving energy cost and speed of overground walking in healthy older women.     

Energy exchange between subject and belt during treadmill walking

Treadmill walking aims to simulate overground walking, but intra-stride belt speed variations of treadmills result in some interaction between treadmill and subject, possibly obstructing this aim. Especially in self-paced treadmill walking, in which the belt speed constantly adjusts to the subject, these interactions might affect the gait pattern significantly. The aim of this study was to quantify the energy exchange between subject and treadmill, during the fixed speed (FS) and self-paced (SP) modes of treadmill walking. Eighteen subjects walked on a dual-belt instrumented treadmill at both modes. The energy exchange was calculated as the integration of the product of the belt speed deviation and the fore-aft ground reaction force over the stride cycle. The total positive energy exchange was 0.44 J/stride and the negative exchange was 0.11 J/stride, which was both less than 1.6% of the performed work on the center of mass. Energy was mainly exchanged from subject to treadmill during both the braking and propulsive phase of gait. The two treadmill modes showed a similar pattern of energy exchange, with a slightly increased energy exchange during the braking phase of SP walking. It is concluded that treadmill walking is only mildly disturbed by subject-belt interactions when using instrumented treadmills with adequate belt control.     

Biomechanics of overground vs. treadmill walking in healthy individuals.

The goal of this study was to compare treadmill walking with overground walking in healthy subjects with no known gait disorders. Nineteen subjects were tested, where each subject walked on a split-belt instrumented treadmill as well as over a smooth, flat surface. Comparisons between walking conditions were made for temporal gait parameters such as step length and cadence, leg kinematics, joint moments and powers, and muscle activity. Overall, very few differences were found in temporal gait parameters or leg kinematics between treadmill and overground walking. Conversely, sagittal plane joint moments were found to be quite different, where during treadmill walking trials, subjects demonstrated less dorsiflexor moments, less knee extensor moments, and greater hip extensor moments. Joint powers in the sagittal plane were found to be similar at the ankle but quite different at the knee and hip joints. Differences in muscle activity were observed between the two walking modalities, particularly in the tibialis anterior throughout stance, and in the hamstrings, vastus medialis and adductor longus during swing. While differences were observed in muscle activation patterns, joint moments and joint powers between the two walking modalities, the overall patterns in these behaviors were quite similar. From a therapeutic perspective, this suggests that training individuals with neurological injuries on a treadmill appears to be justified.     

Dynamic gait stability of treadmill versus overground walking in young adults

Treadmill has been broadly used in laboratory and rehabilitation settings for the purpose of facilitating human locomotion analysis and gait training. The objective of this study was to determine whether dynamic gait stability differs or resembles between the two walking conditions (overground vs. treadmill) among young adults. Fifty-four healthy young adults (age: 23.9 ± 4.7 years) participated in this study. Each participant completed five trials of overground walking followed by five trials of treadmill walking at a self-selected speed while their full body kinematics were gathered by a motion capture system. The spatiotemporal gait parameters and dynamic gait stability were compared between the two walking conditions. The results revealed that participants adopted a “cautious gait” on the treadmill compared with over ground in response to the possible inherent challenges to balance imposed by treadmill walking. The cautious gait, which was achieved by walking slower with a shorter step length, less backward leaning trunk, shortened single stance phase, prolonged double stance phase, and more flatfoot landing, ensures the comparable dynamic stability between the two walking conditions. This study could provide insightful information about dynamic gait stability control during treadmill ambulation in young adults.     

The consistency of maximum running speed measurements in humans using a feedback-controlled treadmill,and a comparison with maximum attainable speed during overground locomotion

Consistent measurement of maximum running speed overground is problematic due to the difficulty in precise, continual measurement of speed, and the substantial workload in accelerating the body promoting the onset of fatigue. Treadmills remove the requirement for acceleration which enables more repeats. They also allow experiments to be carried out in controlled environments and where space is limited, but they usually depend on manual and subjective speed control. Here we used a draw-wire position sensor and a proportional–derivative (PD) controller to automatically adjust treadmill belt speed of a large equine treadmill. The feedback loop took the real-time position and velocity of the runner relative to the front of the treadmill as input. This control system allowed runners to accelerate from walking speed to a peak running speed within a few strides and then decelerate as quickly as they wished. We used the system to evaluate the variation in maximum speed determination that results from one trial to 10 trials, in eleven individuals. Three trials gave a maximum speed 97.8% of that achieved after ten. The approach used is appropriate for any treadmill where the running zone length is greater than three metres and the speed controller can be externally controlled. Subjects ran 11.5% faster on the treadmill than overground, part of which can be explained by the removal of aerodynamic drag and the fatigue of overground running. Additional factors may, however, contribute to athletes running faster on a treadmill, for instance some aspect of stability or control.     

Improving community ambulation after stroke: the AMBULATE trial

Background  

It has been reported that following rehabilitation, only 7% of stroke survivors are able to walk at a level commensurate with community participation. Previous research indicates that treadmill and overground walking training can improve walking capacity in people living in the community after stroke. The main objectives of the AMBULATE trial are to determine (i) whether a 4-month treadmill walking program is more effective than a 2-month program, compared to control, in improving walking capacity, health and community participation and (ii) the "threshold" walking speed that results in sufficient walking capacity that makes walking self-sustaining.     

A probabilistic method to estimate gait kinetics in the absence of ground reaction force measurements

Human joint torques during gait are usually computed using inverse dynamics. This method requires a skeletal model, kinematics and measured ground reaction forces and moments (GRFM). Measuring GRFM is however only possible in a controlled environment. This paper introduces a probabilistic method based on probabilistic principal component analysis to estimate the joint torques for healthy gait without measured GRFM. A gait dataset of 23 subjects was obtained containing kinematics, measured GRFM and joint torques from inverse dynamics in order to obtain a probabilistic model. This model was then used to estimate the joint torques of other subjects without measured GRFM. Only kinematics, a skeletal model and timing of gait events are needed. Estimation only takes 0.28 ms per time instant. Using cross-validation, the resulting root mean square estimation errors for the lower-limb joint torques are found to be approximately 0.1 Nm/kg, which is 6–18% of the range of the ground truth joint torques. Estimated joint torque and GRFM errors are up to two times smaller than model-based state-of-the-art methods. Model-free artificial neural networks can achieve lower errors than our method, but are less repeatable, do not contain uncertainty information on the estimates and are difficult to use in situations which are not in the learning set. In contrast, our method performs well in a new situation where the walking speed is higher than in the learning dataset. The method can for example be used to estimate the kinetics during overground walking without force plates, during treadmill walking without (separate) force plates and during ambulatory measurements.     

Comparison of EMG signal of the flexor hallucis longus recorded using surface and intramuscular electrodes during walking

The purpose of this study was to compare the use of intramuscular (iEMG) and surface (sEMG) electromyography electrodes to record flexor hallucis longus (FHL) muscle activity during walking, and describe the role of the FHL. Muscle activity was recorded in 12 participants using sEMG and iEMG during treadmill and overground walking. Inter-tester reliability for visual detection of onset and offset of muscle activity was high (ICC = 1.00). During the loading period, the number of bursts of muscle activity was statistically significantly greater using iEMG compared to sEMG when treadmill walking (p = 0.016), and the duration of muscle activity was significantly greater for iEMG (p = 0.01) on both walking surfaces. There were no differences for peak and mean root mean squared (p ≥ 0.07). The FHL activity observed during the loading period (heel strike to forefoot strike) supports the function of the FHL to act as a dynamic ankle stabiliser of the rearfoot, as well as contributing to propulsion during the latter part of stance. The choice of electrodes to detect FHL activity should be dependent on whether the loading and propulsive periods are of interest, and whether treadmill or overground walking will be examined.     

Changes in knee function associated with treadmill ambulation

A comparison of level walking, on a walkway and on a treadmill, was performed using ten normal subjects. Motion about the knee was measured using a triaxial electrogoniometer, and foot-floor contact patterns were recorded by means of four foot switches attached to the sole of each shoe. On the walkway, the data were collected with the subject moving at a comfortable walking speed. The treadmill was then set at the average velocity obtained on the walkway. Knee joint rotation in the coronal and transverse planes did not change significantly between the walkway and the treadmill. In the sagittal plane, significant differences were found for total motion (p less than 0.01), swing phase motion (p less than 0.01), knee position at heel strike (p less than 0.05), and maximum swing phase extension (p less than 0.01). A comparison of the foot-floor contact patterns between walkway and treadmill ambulation revealed reduced heel contact time, with an increase in toe contact while on the treadmill. It was concluded that sagittal plane knee kinematics during level treadmill walking differ significantly from level overground walking.     

Determination of toe-off event time during treadmill locomotion using kinematic data

Researchers collecting gait kinematic data during treadmill locomotion are often interested in determining the times of toe off and heel strike for each stride. In the absence of additional hardware, only position data collected with motion-capture equipment may be available. Others have published methods for using kinematic data for detecting overground gait events. However, during treadmill locomotion, especially running, overground methods may not possess sufficient accuracy. The purpose of this paper is to describe a method for using kinematic data to determine the time of toe off during treadmill locomotion. Ten subjects walked and ran on a treadmill while a motion-capture system collected positional data from heel and toe markers. The treadmill was equipped with force platforms that allowed an accurate determination of foot-ground contact. The time of toe off was determined using the vertical component of the toe marker, and this method was found to have greater accuracy for event detection than other published methods. Researchers can use the described method to determine times of heel strike and toe off during treadmill locomotion using only kinematic data.     

Ground reaction force estimation using an insole-type pressure mat and joint kinematics during walking

Kinetic analysis of walking requires joint kinematics and ground reaction force (GRF) measurement, which are typically obtained from a force plate. GRF is difficult to measure in certain cases such as slope walking, stair climbing, and track running. Nevertheless, estimating GRF continues to be of great interest for simulating human walking. The purpose of the study was to develop reaction force models placed on the sole of the foot to estimate full GRF when only joint kinematics are provided (Type-I), and to estimate ground contact shear forces when both joint kinematics and foot pressure are provided (Type-II and Type-II-val). The GRF estimation models were attached to a commercial full body skeletal model using the AnyBody Modeling System, which has an inverse dynamics-based optimization solver. The anterior–posterior shear force and medial–lateral shear force could be estimated with approximate accuracies of 6% BW and 2% BW in all three methods, respectively. Vertical force could be estimated in the Type-I model with an accuracy of 13.75% BW. The accuracy of the force estimation was the highest during the mid-single-stance period with an average RMS for errors of 3.10% BW, 1.48% BW, and 7.48% BW for anterior–posterior force, medial–lateral force, and vertical force, respectively. The proposed GRF estimation models could predict full and partial GRF with high accuracy. The design of the contact elements of the proposed model should make it applicable to various activities where installation of a force measurement system is difficult, including track running and treadmill walking.     

Accuracy of mobile biplane X-ray imaging in measuring 6-degree-of-freedom patellofemoral kinematics during overground gait

The aim of this study was to evaluate the accuracy with which mobile biplane X-ray imaging can be used to measure patellofemoral kinematics of the intact knee during overground gait. A unique mobile X-ray imaging system tracked and recorded biplane fluoroscopic images of two human cadaver knees during simulated overground walking at a speed of 0.7 m/s. Six-degree-of-freedom patellofemoral kinematics were calculated using a bone volumetric model-based method and the results then compared against those derived from a gold-standard bead-based method. RMS errors for patellar anterior translation, superior translation and lateral shift were 0.19 mm, 0.34 mm and 0.37 mm, respectively. RMS errors for patellar flexion, lateral tilt and lateral rotation were 1.08°, 1.15° and 1.46°, respectively. The maximum RMS error for patellofemoral translations was approximately one-half that reported previously for tibiofemoral translations using the same mobile X-ray imaging system while the maximum RMS error for patellofemoral rotations was nearly two times larger than corresponding errors reported for tibiofemoral rotations. The lower accuracy in measuring patellofemoral rotational motion is likely explained by the symmetric nature of the patellar geometry and the smaller size of the patella compared to the tibia.     

The physiological cost of carrying light and heavy loads

Nine subjects walked on a treadmill with load weights equal to 10% and 40% of body weight carried on the back. Although the speed of the treadmill was selected so that the measured oxygen consumption (VO2) was the same for both load conditions, the heavier load placed an extra strain on the cardiopulmonary system and was perceived by all subjects as harder work than the lighter load. When the subjects worked at their own pace, walking on a level road or climbing stairs with load weights equal to 10% and 40% of body weight, they compensated for the heavier load by decreasing walking speed or climbing rate. Although the energy costs calculated from walking speed, body and load weight for self-paced walking and the external work of stair climbing were the same for both load conditions, the heavier load was again perceived as harder work. These findings are discussed as they relate to the definition of acceptable load weights.     

Torsion and Antero-Posterior Bending in the In Vivo Human Tibia Loading Regimes during Walking and Running

Bending, in addition to compression, is recognized to be a common loading pattern in long bones in animals. However, due to the technical difficulty of measuring bone deformation in humans, our current understanding of bone loading patterns in humans is very limited. In the present study, we hypothesized that bending and torsion are important loading regimes in the human tibia. In vivo tibia segment deformation in humans was assessed during walking and running utilizing a novel optical approach. Results suggest that the proximal tibia primarily bends to the posterior (bending angle: 0.15°–1.30°) and medial aspect (bending angle: 0.38°–0.90°) and that it twists externally (torsion angle: 0.67°–1.66°) in relation to the distal tibia during the stance phase of overground walking at a speed between 2.5 and 6.1 km/h. Peak posterior bending and peak torsion occurred during the first and second half of stance phase, respectively. The peak-to-peak antero-posterior (AP) bending angles increased linearly with vertical ground reaction force and speed. Similarly, peak-to-peak torsion angles increased with the vertical free moment in four of the five test subjects and with the speed in three of the test subjects. There was no correlation between peak-to-peak medio-lateral (ML) bending angles and ground reaction force or speed. On the treadmill, peak-to-peak AP bending angles increased with walking and running speed, but peak-to-peak torsion angles and peak-to-peak ML bending angles remained constant during walking. Peak-to-peak AP bending angle during treadmill running was speed-dependent and larger than that observed during walking. In contrast, peak-to-peak tibia torsion angle was smaller during treadmill running than during walking. To conclude, bending and torsion of substantial magnitude were observed in the human tibia during walking and running. A systematic distribution of peak amplitude was found during the first and second parts of the stance phase.     

Fractal fluctuations in spatiotemporal variables when walking on a self-paced treadmill

This study investigated the fractal dynamic properties of stride time (ST), stride length (SL) and stride speed (SS) during walking on a self-paced treadmill (STM) in which the belt speed is automatically controlled by the walking speed. Twelve healthy young subjects participated in the study. The subjects walked at their preferred walking speed under four conditions: STM, STM with a metronome (STM+met), fixed-speed (conventional) treadmill (FTM), and FTM with a metronome (FTM+met). To compare the fractal dynamics between conditions, the mean, variability, and fractal dynamics of ST, SL, and SS were compared. Moreover, the relationship among the variables was examined under each walking condition using three types of surrogates. The mean values of all variables did not differ between the two treadmills, and the variability of all variables was generally larger for STM than for FTM. The use of a metronome resulted in a decrease in variability in ST and SS for all conditions. The fractal dynamic characteristics of SS were maintained with STM, in contrast to FTM, and only the fractal dynamic characteristics of ST disappeared when using a metronome. In addition, the fractal dynamic patterns of the cross-correlated surrogate results were identical to those of all variables for the two treadmills. In terms of the fractal dynamic properties, STM walking was generally closer to overground walking than FTM walking. Although further research is needed, the present results will be useful in research on gait fractal dynamics and rehabilitation.     

Effect of surgery to implant motion and force sensors on vertical ground reaction forces in the ovine model

Activities of daily living (ADLs) generate complex, multidirectional forces in the anterior cruciate ligament (ACL). While calibration problems preclude direct measurement in patients, ACL forces can conceivably be measured in animals after technical challenges are overcome. For example, motion and force sensors can be implanted in the animal but investigators must determine the extent to which these sensors and surgery affect normal gait. Our objectives in this study were to determine (1) if surgically implanting knee motion sensors and an ACL force sensor significantly alter normal ovine gait and (2) how increasing gait speed and grade on a treadmill affect ovine gait before and after surgery. Ten skeletally mature, female sheep were used to test four hypotheses: (1) surgical implantation of sensors would significantly decrease average and peak vertical ground reaction forces (VGRFs) in the operated limb, (2) surgical implantation would significantly decrease single limb stance duration for the operated limb, (3) increasing treadmill speed would increase VGRFs pre- and post operatively, and (4) increasing treadmill grade would increase the hind limb VGRFs pre- and post operatively. An instrumented treadmill with two force plates was used to record fore and hind limb VGRFs during four combinations of two speeds (1.0 m/s and 1.3 m/s) and two grades (0 deg and 6 deg). Sensor implantation decreased average and peak VGRFs less than 10% and 20%, respectively, across all combinations of speed and grade. Sensor implantation significantly decreased the single limb stance duration in the operated hind limb during inclined walking at 1.3 m/s but had no effect on single limb stance duration in the operated limb during other activities. Increasing treadmill speed increased hind limb peak (but not average) VGRFs before surgery and peak VGRF only in the unoperated hind limb during level walking after surgery. Increasing treadmill grade (at 1 m/s) significantly increased hind limb average and peak VGRFs before surgery but increasing treadmill grade post op did not significantly affect any response measure. Since VGRF values exceeded 80% of presurgery levels, we conclude that animal gait post op is near normal. Thus, we can assume normal gait when conducting experiments following sensor implantation. Ultimately, we seek to measure ACL forces for ADLs to provide design criteria and evaluation benchmarks for traditional and tissue engineered ACL repairs and reconstructions.