Gait posture estimation using wearable acceleration and gyro sensors

A method for gait analysis using wearable acceleration sensors and gyro sensors is proposed in this work. The volunteers wore sensor units that included a tri-axis acceleration sensor and three single axis gyro sensors. The angular velocity data measured by the gyro sensors were used to estimate the translational acceleration in the gait analysis. The translational acceleration was then subtracted from the acceleration sensor measurements to obtain the gravitational acceleration, giving the orientation of the lower limb segments. Segment orientation along with body measurements were used to obtain the positions of hip, knee, and ankle joints to create stick figure models of the volunteers. This method can measure the three-dimensional positions of joint centers of the hip, knee, and ankle during movement. Experiments were carried out on the normal gait of three healthy volunteers. As a result, the flexion–extension (F–E) and the adduction–abduction (A–A) joint angles of the hips and the flexion–extension (F–E) joint angles of the knees were calculated and compared with a camera motion capture system. The correlation coefficients were above 0.88 for the hip F–E, higher than 0.72 for the hip A–A, better than 0.92 for the knee F–E. A moving stick figure model of each volunteer was created to visually confirm the walking posture. Further, the knee and ankle joint trajectories in the horizontal plane showed that the left and right legs were bilaterally symmetric.     

On the estimation of joint kinematics during gait.

In gait analysis, the concepts of Euler and helical (screw) angles are used to define the three-dimensional relative joint angular motion of lower extremities. Reliable estimation of joint angular motion depends on the accurate definition and construction of embedded axes within each body segment. In this paper, using sensitivity analysis, we quantify the effects of uncertainties in the definition and construction of embedded axes on the estimation of joint angular motion during gait. Using representative hip and knee motion data from normal subjects and cerebral palsy patients, the flexion-extension axis is analytically perturbed +/- 15 degrees in 5 degrees steps from a reference position, and the joint angles are recomputed for both Euler and helical angle definitions. For the Euler model, hip and knee flexion angles are relatively unaffected while the ab/adduction and rotation angles are significantly affected throughout the gait cycle. An error of 15 degrees in the definition of flexion-extension axis gives rise to maximum errors of 8 and 12 degrees for the ab/adduction angle, and 10-15 degrees for the rotation angles at the hip and knee, respectively. Furthermore, the magnitude of errors in ab/adduction and rotation angles are a function of the flexion angle. The errors for the ab/adduction angles increase with increasing flexion angle and for the rotation angle, decrease with increasing flexion angle. In cerebral palsy patients with flexed knee pattern of gait, this will result in distorted estimation of ab/adduction and rotation. For the helical model, similar results are obtained for the helical angle and associated direction cosines.(ABSTRACT TRUNCATED AT 250 WORDS)     

Walking with increased ankle pushoff decreases hip muscle moments

In a simple bipedal walking model, an impulsive push along the trailing limb (similar to ankle plantar flexion) or a torque at the hip can power level walking. This suggests a tradeoff between ankle and hip muscle requirements during human gait. People with anterior hip pain may benefit from walking with increased ankle pushoff if it reduces hip muscle forces. The purpose of our study was to determine if simple instructions to alter ankle pushoff can modify gait dynamics and if resulting changes in ankle pushoff have an effect on hip muscle requirements during gait. We hypothesized that changes in ankle kinetics would be inversely related to hip muscle kinetics. Ten healthy subjects walked on a custom split-belt force-measuring treadmill at 1.25m/s. We recorded ground reaction forces and lower extremity kinematic data to calculate joint angles and internal muscle moments, powers and angular impulses. Subjects walked under three conditions: natural pushoff, decreased pushoff and increased pushoff. For the decreased pushoff condition, subjects were instructed to push less with their feet as they walked. Conversely, for the increased pushoff condition, subjects were instructed to push more with their feet. As predicted, walking with increased ankle pushoff resulted in lower peak hip flexion moment, power and angular impulse as well as lower peak hip extension moment and angular impulse (p<0.05). Our results emphasize the interchange between hip and ankle kinetics in human walking and suggest that increased ankle pushoff during gait may help to compensate for hip muscle weakness or injury and reduce hip joint forces.     

Physical sensor difference-based method and virtual sensor difference-based method for visual and quantitative estimation of lower limb 3D gait posture using accelerometers and magnetometers

An approach using a physical sensor difference-based algorithm and a virtual sensor difference-based algorithm to visually and quantitatively confirm lower limb posture was proposed. Three accelerometers and two MAG(3)s (inertial sensor module) were used to measure the accelerations and magnetic field data for the calculation of flexion/extension (FE) and abduction/adduction (AA) angles of hip joint and FE, AA and internal/external rotation (IE) angles of knee joint; then, the trajectories of knee and ankle joints were obtained with the joint angles and segment lengths. There was no integration of acceleration or angular velocity for the joint rotations and positions, which is an improvement on the previous method in recent literature. Compared with the camera motion capture system, the correlation coefficients in five trials were above 0.91 and 0.92 for the hip FE and AA, respectively, and higher than 0.94, 0.93 and 0.93 for the knee joint FE, AA and IE, respectively.     

Physical sensor difference-based method and virtual sensor difference-based method for visual and quantitative estimation of lower limb 3D gait posture using accelerometers and magnetometers

An approach using a physical sensor difference-based algorithm and a virtual sensor difference-based algorithm to visually and quantitatively confirm lower limb posture was proposed. Three accelerometers and two MAG³s (inertial sensor module) were used to measure the accelerations and magnetic field data for the calculation of flexion/extension (FE) and abduction/adduction (AA) angles of hip joint and FE, AA and internal/external rotation (IE) angles of knee joint; then, the trajectories of knee and ankle joints were obtained with the joint angles and segment lengths. There was no integration of acceleration or angular velocity for the joint rotations and positions, which is an improvement on the previous method in recent literature. Compared with the camera motion capture system, the correlation coefficients in five trials were above 0.91 and 0.92 for the hip FE and AA, respectively, and higher than 0.94, 0.93 and 0.93 for the knee joint FE, AA and IE, respectively.     

Validity of time series kinematical data as measured by a markerless motion capture system on a flatland for gait assessment

As a cost-effective, clinician-friendly gait assessment tool, the Kinect v2 sensor may be effective for assessing lower extremity joint kinematics. This study aims to examine the validity of time series kinematical data as measured by the Kinect v2 on a flatland for gait assessment. In this study, 51 healthy subjects walked on a flatland while kinematic data were extracted concurrently using the Kinect and Vicon systems. The kinematic outcomes comprised the hip and knee joint angles. Parallel translation of Kinect data obtained throughout the gait cycle was performed to minimize the differences between the Kinect and Vicon data. The ensemble curves of the hip and knee joint angles were compared to investigate whether the Kinect sensor can consistently and accurately assess lower extremity joint motion throughout the gait cycle. Relative consistency was assessed using Pearson correlation coefficients. Joint angles measured by the Kinect v2 followed the trend of the trajectories made by the Vicon data in both the hip and knee joints in the sagittal plane. The trajectories of the hip and knee joint angles in the frontal plane differed between the Kinect and Vicon data. We observed moderate to high correlation coefficients of 20%–60% of the gait cycle, and the largest difference between Kinect and Vicon data was 4.2°. Kinect v2 time series kinematical data obtained on the flatland are validated if the appropriate correction procedures are performed. Future studies are warranted to examine the reproducibility and systematic bias of the Kinect v2.     

All joint moments significantly contribute to trunk angular acceleration

Computationally advanced biomechanical analyses of gait demonstrate the often counter-intuitive roles of joint moments on various aspects of gait such as propulsion, swing initiation, and balance. Each joint moment can produce linear and angular acceleration of all body segments (including those on which the moment does not directly act) due to the dynamic coupling inherent in the interconnected musculoskeletal system. This study presents quantitative relationships between individual joint moments and trunk control with respect to balance during gait to show that the ankle, knee, and hip joint moments all affect the angular acceleration of the trunk. We show that trunk angular acceleration is affected by all joints in the leg with varying degrees of dependence during the gait cycle. Furthermore, it is shown that inter-planar coupling exists and a two-dimensional analysis of trunk balance neglects important out-of-plane joint moments that affect trunk angular acceleration.     

Crouched postures reduce the capacity of muscles to extend the hip and knee during the single-limb stance phase of gait

Many children with cerebral palsy walk in a crouch gait that progressively worsens over time, decreasing walking efficiency and leading to joint degeneration. This study examined the effect of crouched postures on the capacity of muscles to extend the hip and knee joints and the joint flexions induced by gravity during the single-limb stance phase of gait. We first characterized representative mild, moderate, and severe crouch gait kinematics based on a large group of subjects with cerebral palsy (N=316). We then used a three-dimensional model of the musculoskeletal system and its associated equations of motion to determine the effect of these crouched gait postures on (1) the capacity of individual muscles to extend the hip and knee joints, which we defined as the angular accelerations of the joints, towards extension, that resulted from applying a 1N muscle force to the model, and (2) the angular acceleration of the joints induced by gravity. Our analysis showed that the capacities of almost all the major hip and knee extensors were markedly reduced in a crouched gait posture, with the exception of the hamstrings muscle group, whose extension capacity was maintained in a crouched posture. Crouch gait also increased the flexion accelerations induced by gravity at the hip and knee throughout single-limb stance. These findings help explain the increased energy requirements and progressive nature of crouch gait in patients with cerebral palsy.     

Gait analysis using gravitational acceleration measured by wearable sensors

A novel method for measuring human gait posture using wearable sensor units is proposed. The sensor units consist of a tri-axial acceleration sensor and three gyro sensors aligned on three axes. The acceleration and angular velocity during walking were measured with seven sensor units worn on the abdomen and the lower limb segments (both thighs, shanks and feet). The three-dimensional positions of each joint are calculated from each segment length and joint angle. Joint angle can be estimated mechanically from the gravitational acceleration along the anterior axis of the segment. However, the acceleration data during walking includes three major components; translational acceleration, gravitational acceleration and external noise. Therefore, an optimization analysis was represented to separate only the gravitational acceleration from the acceleration data. Because the cyclic patterns of acceleration data can be found during constant walking, a FFT analysis was applied to obtain some characteristic frequencies in it. A pattern of gravitational acceleration was assumed using some parts of these characteristic frequencies. Every joint position was calculated from the pattern under the condition of physiological motion range of each joint. An optimized pattern of the gravitational acceleration was selected as a solution of an inverse problem. Gaits of three healthy volunteers were measured by walking for 20 s on a flat floor. As a result, the acceleration data of every segment was measured simultaneously. The characteristic three-dimensional walking could be shown by the expression using a stick figure model. In addition, the trajectories of the knee joint in the horizontal plane could be checked by visual imaging on a PC. Therefore, this method provides important quantitive information for gait diagnosis.     

Invariant hip moment pattern while walking with a robotic hip exoskeleton

Robotic lower limb exoskeletons hold significant potential for gait assistance and rehabilitation; however, we have a limited understanding of how people adapt to walking with robotic devices. The purpose of this study was to test the hypothesis that people reduce net muscle moments about their joints when robotic assistance is provided. This reduction in muscle moment results in a total joint moment (muscle plus exoskeleton) that is the same as the moment without the robotic assistance despite potential differences in joint angles. To test this hypothesis, eight healthy subjects trained with the robotic hip exoskeleton while walking on a force-measuring treadmill. The exoskeleton provided hip flexion assistance from approximately 33% to 53% of the gait cycle. We calculated the root mean squared difference (RMSD) between the average of data from the last 15 min of the powered condition and the unpowered condition. After completing three 30-min training sessions, the hip exoskeleton provided 27% of the total peak hip flexion moment during gait. Despite this substantial contribution from the exoskeleton, subjects walked with a total hip moment pattern (muscle plus exoskeleton) that was almost identical and more similar to the unpowered condition than the hip angle pattern (hip moment RMSD 0.027, angle RMSD 0.134, p<0.001). The angle and moment RMSD were not different for the knee and ankle joints. These findings support the concept that people adopt walking patterns with similar joint moment patterns despite differences in hip joint angles for a given walking speed.     

Quantitative evaluation of the major determinants of human gait

Accurate knowledge of the isolated contributions of joint movements to the three-dimensional displacement of the center of mass (COM) is fundamental for understanding the kinematics of normal walking and for improving the treatment of gait disabilities. Saunders et al. (1953) identified six kinematic mechanisms to explain the efficient progression of the whole-body COM in the sagittal, transverse, and coronal planes. These mechanisms, referred to as the major determinants of gait, were pelvic rotation, pelvic list, stance knee flexion, foot and knee mechanisms, and hip adduction. The aim of the present study was to quantitatively assess the contribution of each major gait determinant to the anteroposterior, vertical, and mediolateral displacements of the COM over one gait cycle. The contribution of each gait determinant was found by applying the concept of an ‘influence coefficient’, wherein the partial derivative of the COM displacement with respect to a prescribed determinant was calculated. The analysis was based on three-dimensional measurements of joint angular displacements obtained from 23 healthy young adults walking at slow, normal and fast speeds. We found that hip flexion, stance knee flexion, and ankle-foot interaction (comprised of ankle plantarflexion, toe flexion and the displacement of the center of pressure) are the major determinants of the displacements of the COM in the sagittal plane, while hip adduction and pelvic list contribute most significantly to the mediolateral displacement of the COM in the coronal plane. Pelvic rotation and pelvic list contribute little to the vertical displacement of the COM at all walking speeds. Pelvic tilt, hip rotation, subtalar inversion, and back extension, abduction and rotation make negligible contributions to the displacements of the COM in all three anatomical planes.     

Healthy older adults have insufficient hip range of motion and plantar flexor strength to walk like healthy young adults

Limited plantar flexor strength and hip extension range of motion (ROM) in older adults are believed to underlie common age-related differences in gait. However, no studies of age-related differences in gait have quantified the percentage of strength and ROM used during gait. We examined peak hip angles, hip torques and plantar flexor torques, and corresponding estimates of functional capacity utilized (FCU), which we define as the percentage of available strength or joint ROM used, in 10 young and 10 older healthy adults walking under self-selected and controlled (slow and fast) conditions. Older adults walked with about 30% smaller hip extension angle, 28% larger hip flexion angle, 34% more hip extensor torque in the slow condition, and 12% less plantar flexor torque in the fast condition than young adults. Older adults had higher FCU than young adults for hip flexion angle (47% vs. 34%) and hip extensor torque (48% vs. 27%). FCUs for plantar flexor torque (both age groups) and hip extension angle (older adults in all conditions; young adults in self-selected gait) were not significantly <100%, and were higher than for other measures examined. Older adults lacked sufficient hip extension ROM to walk with a hip extension angle as large as that of young adults. Similarly, in the fast gait condition older adults lacked the strength to match the plantar flexor torque produced by young adults. This supports the hypothesis that hip extension ROM and plantar flexor strength are limiting factors in gait and contribute to age-related differences in gait.     

Neuromuscular Activation of the Vastus Intermedius Muscle during Isometric Hip Flexion

Although activity of the rectus femoris (RF) differs from that of the other synergists in quadriceps femoris muscle group during physical activities in humans, it has been suggested that the activation pattern of the vastus intermedius (VI) is similar to that of the RF. The purpose of present study was to examine activation of the VI during isometric hip flexion. Ten healthy men performed isometric hip flexion contractions at 25%, 50%, 75%, and 100% of maximal voluntary contraction at hip joint angles of 90°, 110° and 130°. Surface electromyography (EMG) was used to record activity of the four quadriceps femoris muscles and EMG signals were root mean square processed and normalized to EMG amplitude during an isometric knee extension with maximal voluntary contraction. The normalized EMG was significantly higher for the VI than for the vastus medialis during hip flexion at 100% of maximal voluntary contraction at hip joint angles of 110° and 130° (P < 0.05). The onset of VI activation was 230–240 ms later than the onset of RF activation during hip flexion at each hip joint angle, which was significantly later than during knee extension at 100% of maximal voluntary contraction (P < 0.05). These results suggest that the VI is activated later than the RF during hip flexion. Activity of the VI during hip flexion might contribute to stabilize the knee joint as an antagonist and might help to smooth knee joint motion, such as in the transition from hip flexion to knee extension during walking, running and pedaling.     

Coupled oscillators utilised as gait rhythm generators of a two-legged walking machine

The gait of current two-legged walking machines differs from that of humans, although the kinematic structures of these machines' legs frequently imitate human limbs. This paper presents a method of generating the trajectories of hip and knee joint angles resulting in a gait pattern similar to that of a human. For this purpose the solutions of coupled van der Pol oscillator equations are utilised. There is much evidence that these equations can be treated as a good model of the central pattern generator generating functional (also locomotional) rhythms in living creatures. The oscillator equations are solved by numerical integration. The method of changing the type of gait by changing appropriate parameter values in the oscillator equations is presented (change of velocity and trajectory of leg-ends). The results obtained enable enhanced control of twolegged walking systems by including gait pattern generators which will assume a similar role to that of biological generators.     

Interpolation of segment Euler angles can provide a robust estimation of segment angular trajectories during asymmetric lifting tasks

Video-based field methods that estimate L5/S1 net joint moments from kinematics based on interpolation in the sagittal plane of joint angles alone can introduce a significant error on the interpolated joint angular trajectory when applied to asymmetric dynamic lifts. Our goal was to evaluate interpolation of segment Euler angles for a wide range of dynamic asymmetric lifting tasks using cubic spline methods by comparing the interpolated values with the continuous measured ones. For most body segments, the estimated trajectories of segment Euler angles have less than 5° RMSE (in each dimension) with 5-point cubic spline interpolation when there is no measurement error of interpolation points. Sensitivity analysis indicates that when the measurement error exists, the root mean square error (RMSE) of estimated trajectories increases. Comparison among different lifting conditions showed that lifting a load from a high initial position yielded a smaller RMSE than lifting from a low initial position. In conclusion, interpolation of segment Euler angles can provide a robust estimation of segment angular trajectories during asymmetric lifting when measurement error of interpolation points can be controlled at a low level.     

Footprints,Trackways, and Hip Heights of Bipedal Dinosaurs—Testing Hip Height Predictions with Computer Models

Three-dimensional, dynamic, computer models of the pelvis and hind limbs of theropods and ornithopods are used to produce synthetic trackways using a range of gait angles and degrees of limb joint flexion. The hip heights of the modeled stances are compared with the predictions of hip heights computed with various formulae that incorporate parameters measured from footprints and trackways. The tested formulae include: 4*footprint-length and other morphometric methods where the coefficients vary according to the size and taxonomic group of the inferred trackmaker, allometric methods with size and taxon specific coefficients and exponents, and pace-length divided by 0.6. The best fit (least difference) between model and predicted hip heights is achieved with the simple 4*footprint-length formula. The pace-length formula also works well, but only for a very narrow gait range. With one exception, a small theropod, the variable morphometric and allometric formulae consistently overestimate the hip heights in all case. For large theropods and ornithopods the overestimates can be up to 84% in extreme cases. There was also a trend for the magnitudes of overestimation to increase with increasing size of the trackmaker. The overestimates of hip height using these methods results in underestimation of the computed velocities attributed to the dinosaurs that made the trackways.     

Estimation of Quasi-Stiffness of the Human Hip in the Stance Phase of Walking

This work presents a framework for selection of subject-specific quasi-stiffness of hip orthoses and exoskeletons, and other devices that are intended to emulate the biological performance of this joint during walking. The hip joint exhibits linear moment-angular excursion behavior in both the extension and flexion stages of the resilient loading-unloading phase that consists of terminal stance and initial swing phases. Here, we establish statistical models that can closely estimate the slope of linear fits to the moment-angle graph of the hip in this phase, termed as the quasi-stiffness of the hip. Employing an inverse dynamics analysis, we identify a series of parameters that can capture the nearly linear hip quasi-stiffnesses in the resilient loading phase. We then employ regression analysis on experimental moment-angle data of 216 gait trials across 26 human adults walking over a wide range of gait speeds (0.75–2.63 m/s) to obtain a set of general-form statistical models that estimate the hip quasi-stiffnesses using body weight and height, gait speed, and hip excursion. We show that the general-form models can closely estimate the hip quasi-stiffness in the extension (R² = 92%) and flexion portions (R² = 89%) of the resilient loading phase of the gait. We further simplify the general-form models and present a set of stature-based models that can estimate the hip quasi-stiffness for the preferred gait speed using only body weight and height with an average error of 27% for the extension stage and 37% for the flexion stage.     

A practical solution to reduce soft tissue artifact error at the knee using adaptive kinematic constraints

Musculoskeletal modeling and simulations have vast potential in clinical and research fields, but face various challenges in representing the complexities of the human body. Soft tissue artifact from skin-mounted markers may lead to non-physiological representation of joint motions being used as inputs to models in simulations. To address this, we have developed adaptive joint constraints on five of the six degree of freedom of the knee joint based on in vivo tibiofemoral joint motions recorded during walking, hopping and cutting motions from subjects instrumented with intra-cortical pins inserted into their tibia and femur. The constraint boundaries vary as a function of knee flexion angle and were tested on four whole-body models including four to six knee degrees of freedom. A musculoskeletal model developed in OpenSim simulation software was constrained to these in vivo boundaries during level gait and inverse kinematics and dynamics were then resolved. Statistical parametric mapping indicated significant differences (p < 0.05) in kinematics between bone pin constrained and unconstrained model conditions, notably in knee translations, while hip and ankle flexion/extension angles were also affected, indicating the error at the knee propagates to surrounding joints. These changes to hip, knee, and ankle kinematics led to measurable changes in hip and knee transverse plane moments, and knee frontal plane moments and forces. Since knee flexion angle can be validly represented using skin mounted markers, our tool uses this reliable measure to guide the five other degrees of freedom at the knee and provide a more valid representation of the kinematics for these degrees of freedom.     

Higher medially-directed joint reaction forces are a characteristic of dysplastic hips: A comparative study using subject-specific musculoskeletal models

Acetabular dysplasia is a known cause of hip osteoarthritis. In addition to abnormal anatomy, changes in kinematics, joint reaction forces (JRFs), and muscle forces could cause tissue damage to the cartilage and labrum, and may contribute to pain and fatigue. The objective of this study was to compare lower extremity joint angles, moments, hip JRFs and muscle forces during gait between patients with symptomatic acetabular dysplasia and healthy controls. Marker trajectories and ground reaction forces were measured in 10 dysplasia patients and 10 typically developing control subjects. A musculoskeletal model was scaled in OpenSim to each subject and subject-specific hip joint centers were determined using reconstructions from CT images. Joint kinematics and moments were calculated using inverse kinematics and inverse dynamics, respectively. Muscle forces and hip JRFs were estimated with static optimization. Inter-group differences were tested for statistical significance (p ≤ 0.05) and large effect sizes (d ≥ 0.8). Results demonstrated that dysplasia patients had higher medially directed JRFs. Joint angles and moments were mostly similar between the groups, but large inter-group effect sizes suggested some restriction in range of motion by patients at the hip and ankle. Higher medially-directed JRFs and inter-group differences in hip muscle forces likely stem from lateralization of the hip joint center in dysplastic patients. Joint force differences, combined with reductions in range of motion at the hip and ankle may also indicate compensatory strategies by patients with dysplasia to maintain joint stability.     

Improving limb flexion in FES gait using the flexion withdrawal response for the spinal cord injured person

In the restoration of gait for paraplegics using functional electrical stimulation, the method most commonly used to produce hip flexion for the swing phase of gait has been the elicitation of the flexion withdrawal response. Several problems have been noted with the response: there is a decrease in the magnitude of the hip flexion to repeated stimuli (habituation); long latency; and inhibition of the response when stimulated bilaterally. These have been characterized and methods for overcoming the problems tested. Results show that increasing stimulation frequency reduces latency. Habituation can be reduced in some subjects by multiplexing two sites of stimulation. Habituation can further be reduced by applying single high-intensity pulses and this has been used in a one-step-ahead controller for regulating hip flexion angle. Inhibition due to bilateral stimulation had been significantly reduced by altering the timing of the stimulation to the two legs.