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Overcoming the limitations of the Harmonic Ratio for the reliable assessment of gait symmetry
Affiliation:1. Department of Mechanical and Science Engineering, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;2. Department of Mechanical and Aerospace Engineering, Trine University, Angola, IN 46703, USA;3. Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA;1. Department of Sport Science, Otto von Guericke University Magdeburg, Zschokkestr. 32, 39104 Magdeburg, Germany;2. Institute for Biomechanics, ETH Zürich, Vladimir-Prelog-Weg 3-4, 8093 Zurich, Switzerland
Abstract:The Harmonic Ratio (HR) is an index based on the spectral analysis of lower trunk accelerations that is commonly used to assess the quality of gait. However, it presents several issues concerning reliability and interpretability. As a consequence, the literature provides very different values albeit corresponding to the same populations. In the present work, an improved harmonic ratio (iHR) was defined, relating the power of the intrinsic harmonics (i.e. associated with the symmetric component of gait) to the total power of the signal for each stride, leading to a normalised index ranging from 0 to 100%. The effect of the considered number of harmonics and strides on the estimate of both HR and iHR was assessed. The gait of three groups of volunteers was investigated: young healthy adults, elderly women and male trans-femoral amputees. Both HR and iHR were able to discriminate gait deviations from the gait of young healthy adults. Moreover, iHR proved to be more robust with respect to the number of considered harmonics and strides, and to exhibit a lower inter-stride variability. Additionally, using a normalised index as iHR led to a more straightforward interpretation and improved comparability. The importance of standardised conditions for the index evaluation was unveiled, and, in order to enhance the future comparability of the index, the following guidelines were presented: considering at least 20 harmonics and 20 strides; expressing the acceleration components in a repeatable, anatomical, local system of reference; and evaluating the iHR index, rather than the traditional HR.
Keywords:Locomotion  Gait quality indices  Reliability  Spectral analysis  Trunk acceleration  Inertial sensors
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