Assessing pedometer accuracy while walking, skipping, galloping, sliding, and hopping

The purpose of this study was to determine the accuracy of the pedometer when walking, skipping, galloping, sliding, and hopping. One hundred-two college students were fitted with a pedometer (Walk4Life LS-7010) at mid-thigh on the right and left of the hip. Participants then performed the randomly assigned movements for the length (26 m) of a hardwood court playing surface, during which time the investigator tallied the steps with a hand counter. Each step with the lead foot elicited a tally on the counter. Participants were instructed to perform the movement at a brisk pace, to jump-stop at the end of the court, and to remain still until after the pedometer reading was recorded. Repeated measure ANOVAs using the Bonferroni technique were used to compare differences between pedometer counts and hand counts. Significant differences were evident between the hand tally counts and readings from the right and left pedometers during all five locomotor movements (P < .01). Mean error was lowest between the hand tally and the average of the right and left pedometers while walking (-1.35 +/- 1.60) and hopping (-2.94 +/- 2.33), and increased while sliding (-6.42 +/- 4.78), galloping (-8.22 +/- 4.63), and skipping (-8.30 +/- 4.45). Results indicate the pedometer may not consistently register the vertical force produced by the trail foot contact, the lead foot contact, or a combination of the two while skipping, galloping, and sliding. Though the pedometer is a valid instrument when estimating physical activity levels, caution is urged when interpreting movements other than walking.     

Measuring core body temperature with a non-invasive sensor

In various occupations, workers may be exposed to extreme environmental conditions and physical activities. Under these conditions the ability to follow the workers' body temperature may protect them from overheating that may lead to heat related injuries. The "Dräger" Double Sensor (DS) is a novel device for assessing body-core temperature (T_c). The purpose of this study was to evaluate the accuracy of the DS in measuring T_c under heat stress. Seventeen male participants performed a three stage protocol: 30 min rest in a thermal comfort environment (20–22 °C, 50% relative humidity), followed by an exposure to a hot environment of 40 °C, 40% relative humidity −30 min at rest and 60 min of exercise (walking on a treadmill at 5 km/h and 2% elevation). Simultaneously temperatures measured by the DS (T_DS) and by rectal temperature (T_re) (YSI-401 thermistor) were recorded and then compared. During the three stages of the study the average temperature obtained by the DS was within±0.3 °C of rectal measurement. The correlation between T_DS and T_re was significantly better during the heat exposures phases than during resting under comfort conditions. These preliminary results are promising for potential use of the DS by workers under field conditions and especially under environmental heat stress or when dressed in protective garments. For this goal, further investigations are required to validate the accuracy of the DS under various levels of heat stress, clothing and working levels.     

Concurrent validity of the Microsoft Kinect for assessment of spatiotemporal gait variables

Spatiotemporal characteristics of gait such as step time and length are often associated with overall physical function in clinical populations, but can be difficult, time consuming and obtrusive to measure. This study assessed the concurrent validity of overground walking spatiotemporal data recorded using a criterion reference – a marker-based three-dimensional motion analysis (3DMA) system – and a low-cost, markerless alternative, the automated skeleton tracking output from the Microsoft Kinect™ (Kinect). Twenty-one healthy adults performed normal walking trials while being monitored using both systems. The outcome measures of gait speed, step length and time, stride length and time and peak foot swing velocity were derived using supervised automated analysis. To assess the agreement between the Kinect and 3DMA devices, Bland–Altman 95% bias and limits of agreement, percentage error, relative agreement (Pearson's correlation coefficients: r) overall agreement (concordance correlation coefficients: r_c) and landmark location linearity as a function of distance from the sensor were determined. Gait speed, step length and stride length from the two devices possessed excellent agreement (r and r_c values >0.90). Foot swing velocity possessed excellent relative (r=0.93) but only modest overall (r_c=0.54) agreement. Step time (r=0.82 and r_c=0.23) and stride time (r=0.69 and r_c=0.14) possessed excellent and modest relative agreement respectively but poor overall agreement. Landmark location linearity was excellent (R²=0.991). This widely available, low-cost and portable system could provide clinicians with significant advantages for assessing some spatiotemporal gait parameters. However, caution must be taken when choosing outcome variables as some commonly reported variables cannot be accurately measured.     

beta blockade and intermittent claudication: placebo controlled trial of atenolol and nifedipine and their combination.

OBJECTIVE--To determine the effects of the beta 1 selective adrenoceptor blocker atenolol, the dihydropyridine calcium antagonist nifedipine, and the combination of atenolol plus nifedipine on objective and subjective measures of walking performance and foot temperature in patients with intermittent claudication. DESIGN--Randomised controlled double blind four way crossover trial. SETTING--Royal Hallamshire Hospital, Sheffield. SUBJECTS--49 patients (40 men) aged 39-70 with chronic stable intermittent claudication. INTERVENTIONS--Atenolol 50 mg twice daily; slow release nifedipine 20 mg twice daily; atenolol 50 mg plus slow release nifedipine 20 mg twice daily; placebo. Each treatment was given for four weeks with no washout interval between treatments. MAIN OUTCOME MEASURES--Claudication and walking distances on treadmill; skin temperature of feet as measured by thermistor and probe; blood pressure before and after exercise; subjective assessments of walking difficulty and foot coldness with visual analogue scales. RESULTS--Atenolol did not significantly alter claudication distance (mean change -6%; 95% confidence interval 1% to -13%), walking distance (-2%; 4% to -8%), or foot temperature. Nifedipine did not alter claudication distance (-4%; 3% to -11%), walking distance (-4%; 3% to -10%), or foot temperature. Atenolol plus nifedipine did not alter claudication distance but significantly reduced walking distance (-9%; -3% to -15% (p less than 0.003)) and skin temperature of the more affected foot (-1.1 degrees C; 0 to -2.2 degrees C (p = 0.05)). These effects on walking distance and foot temperature seemed unrelated to blood pressure changes. CONCLUSIONS--There was no evidence of adverse or beneficial effects of atenolol or nifedipine, when given singly, on peripheral vascular disease. The combined treatment, however, affected walking ability and foot temperature adversely. This may have been due to beta blockade plus reduced vascular resistance, which might also explain the reported adverse effects of pindolol and labetalol on claudication.     

Shoe Sole Tread Designs and Outcomes of Slipping and Falling on Slippery Floor Surfaces

A gait experiment was conducted under two shoe sole and three floor conditions. The shoe soles and floors were characterized by the tread and groove designs on the surface. The coefficients of friction (COF) on the floor in the target area were measured. The subjects were required to walk on a walkway and stepping on a target area covered with glycerol. The motions of the feet of the subjects were captured. Gait parameters were calculated based on the motion data. Among the 240 trials, there were 37 no-slips, 81 microslips, 45 slides, and 77 slips. It was found that the condition with shoe sole and floor had both tread grooves perpendicular to the walking direction had the highest COF, the shortest slip distance, and the lowest percentages of slide and slip. The condition with shoe sole and floor had both tread grooves parallel to the walking direction had the lowest COF and the longest slip distance among all experimental conditions. The Pearson’s correlation coefficients between slip distance and slip velocity, time to foot flat, foot angle, and compensatory step length were 0.82 (p<0.0001), 0.33 (p<0.0001), −0.54 (p<0.0001), and −0.51 (p<0.0001), respectively.     

Stepping in the direction of the fall: the next foot placement can be predicted from current upper body state in steady-state walking

During human walking, perturbations to the upper body can be partly corrected by placing the foot appropriately on the next step. Here, we infer aspects of such foot placement dynamics using step-to-step variability over hundreds of steps of steady-state walking data. In particular, we infer dependence of the ‘next’ foot position on upper body state at different phases during the ‘current’ step. We show that a linear function of the hip position and velocity state (approximating the body center of mass state) during mid-stance explains over 80% of the next lateral foot position variance, consistent with (but not proving) lateral stabilization using foot placement. This linear function implies that a rightward pelvic deviation during a left stance results in a larger step width and smaller step length than average on the next foot placement. The absolute position on the treadmill does not add significant information about the next foot relative to current stance foot over that already available in the pelvis position and velocity. Such walking dynamics inference with steady-state data may allow diagnostics of stability and inform biomimetic exoskeleton or robot design.     

Intra-limb coordination while walking is affected by cognitive load and walking speed

Knowledge about intra-limb coordination (ILC) during challenging walking conditions provides insight into the adaptability of central nervous system (CNS) for controlling human gait. We assessed the effects of cognitive load and speed on the pattern and variability of the ILC in young people during walking. Thirty healthy young people (19 female and 11 male) participated in this study. They were asked to perform 9 walking trials on a treadmill, including walking at three paces (preferred, slower and faster) either without a cognitive task (single-task walking) or while subtracting 1?s or 3?s from a random three-digit number (simple and complex dual-task walking, respectively). Deviation phase (DP) and mean absolute relative phase (MARP) values—indicators of variability and phase dynamic of ILC, respectively—were calculated using the data collected by a motion capture system. We used a two-way repeated measure analysis of variance for statistical analysis. The results showed that cognitive load had a significant main effect on DP of right shank–foot and thigh–shank, left shank–foot and pelvis–thigh (p<0.05), and MARP of both thigh–shank segments (p<0.01). In addition, the main effect of walking speed was significant on DP of all segments in each side and MARP of both thigh–shank and pelvis–thigh segments (p<0.001). The interaction of cognitive load and walking speed was only significant for MARP values of left shank–foot and right pelvis–thigh (p<0.05 and p<0.001, respectively). We suggest that cognitive load and speed could significantly affect the ILC and variability and phase dynamic during walking.     

Optimum walking techniques for idealized animals

The vertical component of the force exerted by a foot on the ground, in the course of a step, may rise to a single maximum and decline again (as in human running) or may show two distinct maxima (as in human walking). A foot may remain on the ground for a large or small fraction of the duration of a stride. Mathematical models are used to investigate the effects of these differences of technique on the energy cost of locomotion. The optimum technique for a biped at a given speed is different from the optimum for a hypothetical many-legged animal. The optima for quadrupedal walking are likely to lie between these extremes.
The walking techniques adopted by men at different speeds are close to the optima indicated by the bipedal model. The two maxima of the force exerted by a foot are higher, and have a lower minimum between them, at higher speeds of walking. The techniques adopted by a sheep are close to the optima indicated by the many-legged model but dogs use techniques rather closer to the optima for bipeds.
The limitations of the models are discussed.     

Stable bipedal walking with a swing-leg protraction strategy

In bipedal locomotion, swing-leg protraction and retraction refer to the forward and backward motion, respectively, of the swing-leg before touchdown. Past studies have shown that swing-leg retraction strategy can lead to stable walking. We show that swing-leg protraction can also lead to stable walking. We use a simple 2D model of passive dynamic walking but with the addition of an actuator between the legs. We use the actuator to do full correction of the disturbance in a single step (a one-step dead-beat control). Specifically, for a given limit cycle we perturb the velocity at mid-stance. Then, we determine the foot placement strategy that allows the walker to return to the limit cycle in a single step. For a given limit cycle, we find that there is swing-leg protraction at shallow slopes and swing-leg retraction at steep slopes. As the limit cycle speed increases, the swing-leg protraction region increases. On close examination, we observe that the choice of swing-leg strategy is based on two opposing effects that determine the time from mid-stance to touchdown: the walker speed at mid-stance and the adjustment in the step length for one-step dead-beat control. When the walker speed dominates, the swing-leg retracts but when the step length dominates, the swing-leg protracts. This result suggests that swing-leg strategy for stable walking depends on the model parameters, the terrain, and the stability measure used for control. This novel finding has a clear implication in the development of controllers for robots, exoskeletons, and prosthetics and to understand stability in human gaits.     

Retention of improvement in gait stability over 14 weeks due to trip-perturbation training is dependent on perturbation dose

Perturbation training is an emerging approach to reduce fall risk in the elderly. This study examined potential differences in retention of improvements in reactive gait stability over 14 weeks resulting from unexpected trip-like gait perturbations. Twenty-four healthy middle-aged adults (41–62 years) were assigned randomly to either a single perturbation group (SINGLE, n = 9) or a group subjected to eight trip-like gait perturbations (MULTIPLE, n = 15). While participants walked on a treadmill a custom-built brake-and-release system was used to unexpectedly apply resistance during swing phase to the lower right limb via an ankle strap. The anteroposterior margin of stability (MoS) was calculated as the difference between the anterior boundary of the base of support and the extrapolated centre of mass at foot touchdown for the perturbed step and the first recovery step during the first and second (MULTIPLE group only) perturbation trials for the initial walking session and retention-test walking 14 weeks later. Group MULTIPLE retained the improvements in reactive gait stability to the perturbations (increased MoS at touchdown for perturbed and first recovery steps; p < 0.01). However, in group SINGLE no differences in MoS were detected after 14 weeks compared to the initial walking session. These findings provide evidence for the requirement of a threshold trip-perturbation dose if adaptive changes in the human neuromotor system over several months, aimed at the improvement in fall-resisting skills, are to occur.     

Two Independent Contributions to Step Variability during Over-Ground Human Walking

Human walking exhibits small variations in both step length and step width, some of which may be related to active balance control. Lateral balance is thought to require integrative sensorimotor control through adjustment of step width rather than length, contributing to greater variability in step width. Here we propose that step length variations are largely explained by the typical human preference for step length to increase with walking speed, which itself normally exhibits some slow and spontaneous fluctuation. In contrast, step width variations should have little relation to speed if they are produced more for lateral balance. As a test, we examined hundreds of overground walking steps by healthy young adults (N = 14, age < 40 yrs.). We found that slow fluctuations in self-selected walking speed (2.3% coefficient of variation) could explain most of the variance in step length (59%, P < 0.01). The residual variability not explained by speed was small (1.5% coefficient of variation), suggesting that step length is actually quite precise if not for the slow speed fluctuations. Step width varied over faster time scales and was independent of speed fluctuations, with variance 4.3 times greater than that for step length (P < 0.01) after accounting for the speed effect. That difference was further magnified by walking with eyes closed, which appears detrimental to control of lateral balance. Humans appear to modulate fore-aft foot placement in precise accordance with slow fluctuations in walking speed, whereas the variability of lateral foot placement appears more closely related to balance. Step variability is separable in both direction and time scale into balance- and speed-related components. The separation of factors not related to balance may reveal which aspects of walking are most critical for the nervous system to control.     

Comparison of in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and matched asymptomatic control subjects

The purpose of this study was to compare in vivo segmental foot motion during walking and step descent in patients with midfoot arthritis and asymptomatic control subjects. Segmental foot motion during walking and step descent was assessed using a multi-segment foot model in 30 patients with midfoot arthritis and 20 age, gender and BMI matched controls. Peak and total range of motion (ROM), referenced to subtalar neutral, were examined for each of the following dependent variables: 1st metatarso-phalangeal (MTP1) dorsiflexion, 1st metatarsal (MT1) plantarflexion, ankle dorsiflexion, calcaneal eversion and forefoot abduction. The results showed that, compared to level walking, step descent required greater MTP1 dorsiflexion (p<0.01), MPT1 plantarflexion (p<0.01), ankle dorsiflexion (p<0.01), calcaneus eversion (p=0.03) and forefoot abduction (p=0.01), in all subjects. In addition, step descent also necessitated greater MTP1 dorsiflexion (p<0.01), ankle dorsiflexion (p<0.01) and forefoot abduction (p=0.02) excursion compared to walking. Patients with midfoot arthritis responded differently to the step task compared to control subjects in terms of MT1 and calcaneus eversion excursion. During walking, patients with midfoot arthritis showed significantly less MT1 plantarflexion excursion compared to control subjects (p=0.03). However, during step descent, both groups showed similar MT1 plantarflexion excursion. During walking, patients with midfoot arthritis showed similar calcaneus eversion excursion compared to control subjects. However, during step descent, patients with midfoot arthritis showed significantly greater calcaneus eversion excursion compared to control subjects (p=0.03). Independently or in combination, these motions may contribute to articular stress and consequently to symptoms in patients with midfoot arthritis.     

Sideways walking: preferred is slow,slow is optimal,and optimal is expensive

When humans wish to move sideways, they almost never walk sideways, except for a step or two; they usually turn and walk facing forward. Here, we show that the experimental metabolic cost of walking sideways, per unit distance, is over three times that of forward walking. We explain this high metabolic cost with a simple mathematical model; sideways walking is expensive because it involves repeated starting and stopping. When walking sideways, our subjects preferred a low natural speed, averaging 0.575 m s⁻¹ (0.123 s.d.). Even with no prior practice, this preferred sideways walking speed is close to the metabolically optimal speed, averaging 0.610 m s⁻¹ (0.064 s.d.). Subjects were within 2.4% of their optimal metabolic cost per distance. Thus, we argue that sideways walking is avoided because it is expensive and slow, and it is slow because the optimal speed is low, not because humans cannot move sideways fast.     

Chemical alterations of hyaluronic acid and dermatan sulfate detected in aging human skin by infrared spectroscopy

Age-mediated deacetylation of hyaluronic acid and dermatan sulfate, and shift of sulfate ester configuration were indicated by infrared spectroscopy. Hyaluronic acid and the three dermatan sulfates (DS₁₈, DS₁₈ and DS₃₅), sequentially precipitated from adult skin with 18%, 28% and 35% ethanol, were analyzed at varying ages. At age 75 years, loss of infrared bands in the 1650-1600 cm⁻¹ region, at 1380 cm⁻¹ and 1320 cm⁻¹ and appearance of a band at 1560 cm⁻¹ were characteristic of hyaluronic acid and DS₃₅,·moreover, in DS₂₈ and DS₃₅ the intensities of the bands at 840 cm⁻¹ and 860 cm⁻ were, respectively, decreased and increased. A low intensity band in the 805-785 cm⁻¹ region was observed in the spectra of DS₁₈ (19–35 years), DS₂₈ (70–80 years) and DS₃₅ (all ages). It intensified in DS₂₈ of the 80-years-olds. In the 75±5-year-old group. ninhydrin-positive material of hyaluronic acid and DS₃₅ increased, while reducing GlcNAc of hyaluronic acid decreased. The data demonstrated hyaluronic acid and DS₃₅ deacetylation and suggested a decrease of equatorial sulfates with infrared band at 840 cm⁻¹ and an incrase of axial sulfates with band at 860 cm⁻¹ in DS₂₈ and DS₃₅ of the 75±5-yearl-old set. Equatorial sulfates with band in the 805±785 cm⁻¹ region apparently decreased in DS₁₈ after 35 years and increased in DS₂₈ of the oldest group.     

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.     

Mediator facilitated,laccase catalysed oxidation of granular potato starch and the physico-chemical characterisation of the oxidized products

The primary hydroxyl groups in potato starch were selectively oxidized to the corresponding aldehyde and carboxylic acid functionalities by mediators like TEMPO, using laccase from fungi as catalytic oxidant and oxygen as the primary oxidant. Oxidized starch products with degree of substitution (DS_CHO ranging from 0.16 to 16.4/100AGU and DS_COOH from 0.01 to 3.71 carboxyl groups/100AGU) were obtained with mediator facilitated enzymatic oxidation. Maximum conversion of the primary alcohol group was obtained at a pH of 5, with TEMPO as mediator, under oxygen bubbling and two step administration of Trametes versicolor laccase (200 + 200 nkat/g of starch). The oxidized products were characterised by IR spectroscopy, XRD and thermal studies. In the oxidized samples, the larger starch granules exhibited cracks and fractures in comparison to the smaller granules which were relatively unaffected, as observed from the microstructural studies.     

Step length determines minimum toe clearance in older adults and people with Parkinson’s disease

Reduced foot clearance when walking may increase the risk of trips and falls in people with Parkinson’s disease (PD). Changes in foot clearance in people with PD are likely to be associated with temporal-spatial characteristics of gait such as walking slowly which evokes alterations in the temporal-spatial control of stepping patterns. Enhancing our understanding of the temporal-spatial determinants of foot clearance may inform the design of falls prevention therapies.Thirty-six people with PD and 38 age-matched controls completed four intermittent walks under two conditions: self-selected and fast gait velocity. Temporal-spatial characteristics of gait and foot (heel and toe) clearance outcomes were obtained using an instrumented walkway and 3D motion capture, respectively. A general linear model was used to quantify the effect of PD and gait velocity on gait and foot clearance. Regression evaluated the temporal and spatial gait predictors of minimum toe clearance (MTC).PD walked slower regardless of condition (p = .016) and tended to increase their step length to achieve a faster gait velocity. Step length and the walk ratio consistently explained the greatest proportion of variance in MTC (>28% and >33%, respectively) regardless of group or walking condition (p < .001).Our results suggest step length is the primary determinant of MTC regardless of pathology. Interventions that focus on increasing step length may help to reduce the risk of trips and falls during gait, however, clinical trials are required for robust evaluation.     

Dynamic margins of stability during human walking in destabilizing environments

Understanding how humans maintain stability when walking, particularly when exposed to perturbations, is key to preventing falls. Here, we quantified how imposing continuous, pseudorandom anterior-posterior (AP) and mediolateral (ML) oscillations affected the control of dynamic walking stability. Twelve subjects completed five 3-minute walking trials in the Computer Assisted Rehabilitation ENvironment (CAREN) system under each of 5 conditions: no perturbation (NOP), AP platform (APP) or visual (APV) or ML platform (MLP) or visual (MLV) oscillations. We computed AP and ML margins of stability (MOS) for each trial. Mean MOS(ml) were consistently slightly larger during all perturbation conditions than during NOP (p≤0.038). Mean MOS(ap) for the APP, MLP and MLV oscillations were significantly smaller than during NOP (p<0.0005). Variability of both MOS(ap) and MOS(ml) was significantly greater during the MLP and MLV oscillations than during NOP (p<0.0005). We also directly quantified how the MOS on any given step affected the MOS on the following step using first-return plots. There were significant changes in step-to-step MOS(ml) dynamics between experimental conditions (p<0.0005). These changes suggested that subjects may have been trying to control foot placement, and consequently stability, during the perturbation conditions. Quantifying step-to-step changes in margins of dynamic stability may be more useful than mean MOS in assessing how individuals control walking stability.     

Obesity does not increase external mechanical work per kilogram body mass during walking

Walking is the most common type of physical activity prescribed for the treatment of obesity. The net metabolic rate during level walking (W/kg) is ~10% greater in obese vs. normal weight adults. External mechanical work (W_ext) is one of the primary determinants of the metabolic cost of walking, but the effects of obesity on W_ext have not been clearly established. The purpose of this study was to compare W_ext between obese and normal weight adults across a range of walking speeds. We hypothesized that W_ext (J/step) would be greater in obese adults but W_ext normalized to body mass would be similar in obese and normal weight adults. We collected right leg three-dimensional ground reaction forces (GRF) while twenty adults (10 obese, BMI=35.6 kg/m² and 10 normal weight, BMI=22.1 kg/m²) walked on a level, dual-belt force measuring treadmill at six speeds (0.50–1.75 m/s). We used the individual limb method (ILM) to calculate external work done on the center of mass. Absolute W_ext (J/step) was greater in obese vs. normal weight adults at each walking speed, but relative W_ext (J/step/kg) was similar between the groups. Step frequencies were not different. These results suggest that W_ext is not responsible for the greater metabolic cost of walking (W/kg) in moderately obese adults.     

Validity and reliability of a shoe-embedded sensor module for measuring foot progression angle during over-ground walking

Wearable systems are becoming increasingly popular for gait assessment outside of laboratory settings. A single shoe-embedded sensor module can measure the foot progression angle (FPA) during walking. The FPA has important clinical utility, particularly in populations with knee osteoarthritis, as it is a target for biomechanical treatments. However, the validity and the day-to-day reliability of FPA measurement using wearable systems during over-ground walking has yet to be established. Two gait analysis sessions on 20 healthy adults were conducted. During both sessions, participants performed natural over-ground walking in a motion capture laboratory and on a 100 m linear section of outdoor athletics track. FPA was measured in the laboratory via marker trajectory data, while the sensor module measured FPA during the outdoor track walking. Validity was examined by comparing the laboratory- and sensor-measured average FPA. Day-to-day reliability was examined by comparing the sensor-measured FPA between the first and second gait analysis sessions. Average absolute error between motion capture and sensor measured FPA were 1.7° and 2.1° at session 1 and 2, respectively. A Bland and Altman plot indicated no systematic bias, with 95% limit of agreement widths of 4.2° – 5.1°. Intraclass correlation coefficient (ICC_2k) analysis resulted in good to excellent validity (ICC = 0.89 – 0.91) and reliability (ICC = 0.95). Overall, the shoe-embedded sensor module is a valid and reliable method of measuring FPA during over-ground walking without the need for laboratory equipment.