Plantar pressure distribution offers insights into foot function, gait mechanics, and foot-related issues. This systematic review presents an analysis of the use of artificial neural network techniques in the context of plantar pressure analysis. 60 studies were included in the review. Sample size, pathology, pressure sensor number, data collection device, utilization of other sensor devices, ground-truth methods, pre-processing dataset, neural network type, and evaluation metrics were evaluated. Utilization of customized wearable footwear devices for the acquisition of data was common amongst both healthy participants and patients. Inertial measurement units emerged as an effective compensatory measure to address the limitations associated with the distribution of plantar pressure. Ground truth methods predominantly relied on the usage of both annotations and reference devices. Multilayer perceptron, convolutional neural networks, and recurrent neural networks were identified as the most frequently employed artificial neural network algorithms across the reviewed studies. Finally, the evaluation of performance largely drew upon statistical descriptions and other machine learning methods. This review provides a comprehensive understanding of the use of artificial neural network techniques in plantar pressure analysis, highlighting opportunities for future research.
W wyniku analizy parametrów chodu jest możliwa ocena aktywności oraz stanu zdrowia osoby starszej. W referacie opisano uniwersalny system rejestracji parametrów ruchu oparty na czujnikach przyspieszenia, prędkości kątowej i ciśnienia atmosferycznego. Zarejestrowane wyniki są transmitowane do bramki zlokalizowanej w budynku, w którym przebywa osoba, a po przetworzeniu przesyłane do serwera platformy PERHEART. Artykuł zawiera opis zrealizowanego układu oraz wstępne wyniki badań systemu rejestracji.
EN
Analysis of gait parameters proved to be useful in assessment of the activity and health of an older adult. The paper describes a gait parameter recording system utilizing acceleration, angular velocity, and atmospheric pressure sensors. The recorded results are transmitted to the gateway located in the building where the person is staying and sent to the PERHEART platform server after processing. The article describes the implemented system and preliminary results of the system tests.
Chód jest jedną z najbardziej złożonych i najczęściej wykonywanych czynności przez człowieka. Cel pracy był dwojaki: analiza metody obliczania miar fraktalnych chodu, klasyfikacja z wykorzystaniem sztucznych sieci neuronowych (ANN) i ich przydatność w codziennej praktyce klinicznej oraz ustalenie minimalnego zestawu parametrów odzwierciedlających z wystarczającą dokładnością kliniczną zmiany u chorych po udarze mózgu. Badania przeprowadzono na podstawie danych archiwalnych 50 zdrowych osób chodzących i 50 chorych po udarze mózgu. Wykazano, że mniejsza liczba parametrów (wymiar fraktalny, indeks Hursta) pozwala na lepszy opis chodu. ANN są w stanie dokonać automatycznej oceny jakościowej, a nie tylko ilościowej chodu.
EN
Walking is one of the most complex and most frequently performedhuman activities. The aim of the study was twofold: analysis of the methodof calculating fractal gait measures, classification using artificial neural net-works (ANNs) and their usefulness in everyday clinical practice and establish-ing a minimum set of parameters reflecting with sufficient clinical accuracythe change in stroke patients. The study was based on the following datafrom archival records of 50 healthy walkers and 50 stroke patients. The studyshowed that fewer parameters (fractal dimension, Hurst index) allow for betterdescription of the walk. ANNs are able to make an automatic qualitative, notjust quantitative assessment of the walk.
Purpose: The aim of the study was to analyze the general kinematics of the cycle, leveling of the center of mass and inverted pendulum model in school-age children when they walk at three different auto-selected speeds. Methods: The kinematics of walking cycle, angular actions that contribute to reducing the vertical displacement of body center of mass (pelvis, hip, knee and ankle) and pendulumlike determining variables (mechanical work, pendulum-like recovery and congruity percentage), were analyzed in children for three different self-selected speeds. Differences for each variable with the speed were tested by ANOVA with Bonferroni post-hoc analysis. Omega squared (ω2) was calculated for the values of the effect sizes. Results: None of the angular variables associated with the leveling of the vertical trajectory of body center of mass changed. Likewise, recovery and congruity percentage presented values similar to those obtained in previous studies and did not show significant changes with the speeds. Conclusions: Nevertheless, changes in horizontal mechanical work and cycle phases, indicate that at some point during the cycle the mechanical energy transfer may have been affected for speed changes. Our results warn about the implication that small changes in the speed during functional evaluations of gait in children may have.
This paper summarizes the research on exoskeletons focusing on locomotion support and presenting their general features including the general control approaches. The major fields of exoskeleton applications are focused, namely the military and medical fields. The results of our research on muscles activation during human walking are shortly described. The current developmental trends are outlined in the conclusions part.
PL
W niniejszym artykule podsumowano wyniki badań przeprowadzonych nad egzoszkieletami przeznaczonymi do wspomagania czynności ruchowych. Przedstawiono ich główne cechy, a także główne podejścia ich sterowania. Podstawowymi obszarami użycia egzoszkieletów są zastosowania wojskowe i medyczne. Opisano zwięźle wyniki badań nad aktywacją mięśni podczas chodzenia przez człowieka. Obecne trendy rozwojowe przedstawiono w podsumowaniu.
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Objective gait analysis provide a large number of data, which are used for planning further treatment of the patient. Data from groups of patients are used for comparisons of different treatment methods, assessment of the severity of gait deviations, design of classification systems. The Gilette Gait Index (GGI) was designed to express the level of abnormality of the gait pattern of patients with cerebral palsy by one number: a measure of distance between the set of discrete gait parameters of a patient from a similar set of a healthy subject, based on 16 parameters. Gait pathology in other disorders is different, thus other variables may better describe their level of pathology. The aim was to see if modified GGI can be constructed based on other sets of gait variables. To decide which gait variables should be taken three different analytical methods were used: Hellwig Correlation Based Filter, random forest, and correlation methods. Gait data of 84 patients were retrospectively selected: 30 had spastic cerebral palsy, 24 scoliosis, 30 suffered the stroke. The results show, that in the final sets of the 16 parameters chosen by the analyses there are some parameters, which were not present in the original list of GGI. If the number of sixteen parameters is kept, there are more than one optimal set of parameters. In conclusion, the use of analytical methods enabled the choice of sets of 16 gait parameters which are specific for the medical problem, and the calculation of modified GGIs.
Purpose: It is not known how gait speed affects plantar pressure characteristics in flatfoot. The aim of this work was to investigate the effects of gait speed on plantar pressure variables in flatfoot by comparing it to normal foot posture. Methods: Thirty individuals with flatfoot and 30 individuals with normal foot posture were recruited. Plantar pressure variables were obtained by a pressure-sensitive mat at self-selected slow, normal, and fast speeds. All assessments were performed on the dominant foot, and three satisfactory steps were obtained for each gait speed condition. The order of gait speeds was randomized. Results: In the flatfoot group, the contact area was higher in the midfoot, third metatarsal, and hallux at all speeds, also in the second metatarsal at slow and normal speeds than the normal foot posture group ( p < 0.05). The maximum force was higher in the midfoot and hallux at all speeds in the flatfoot group ( p < 0.05). Also, the maximum force was lower in the first metatarsal at normal and fast speeds, and in the lateral heel at fast speed ( p < 0.05). In the flatfoot group, the peak pressure was found to be higher in the hallux at slow speed, but to be lower in the first metatarsal at fast speed ( p < 0.05). Further, plantar pressure distribution was affected by gait speed in both feet. Conclusions: Analysis of plantar pressure variables should be performed at different gait speeds.
The objective of the work was to define a new comprehensive method of evaluating gait pathology (Gait Kinematics Index, Global Symmetry Index and Gait Deviations Profile). Methods: The article presents in detail a mathematical algorithm of a new comprehensive method of evaluating gait pathology. Input data for the algorithm are the kinematic parameters of gait. The method is based on the determination of the following parameters: standardized angular variables (Wji), kinematic indicators of gait (KIj), gait cycle indicators (GCIi), Gait Kinematic Index (GKI), Gait Deviations Profile (GDP, GDPj), Global Symmetry Index (GSI) and Symmetry Indices (SIj) for kinematic gait values. The algorithm is based on the determination of the difference between results obtained in relation to the kinematics of movement of a given patient and the average value obtained in relation to the standard in each percentage of a gait cycle. The proposed method was tested using results obtained for 59 healthy persons and one patient with locomotor function disorder. Results: The GKI values for the reference group amounted to 0.89 ± 0.23. Information which can be obtained using the proposed gait assessment method was presented using an example of a patient with the disorder of locomotor functions. Areas of gait deviations, which were identified on the basis of the determined indicators, were presented in a graphic form using GDP. Conclusions: The new gait assessment method makes it possible to identify gait using a single numerical value, evaluate movements in individual joints and in subsequent moments as well as to assess the symmetry of gait.
Purpose: A novel portable system has been used to evaluate spatial knee movement, but its accuracy and repeatability is not known. The aim of this study was to investigate the accuracy and repeatability of the measurement. Methods: Ten healthy participants were included, and the knee motion trajectory during walking were assessed. Six evaluations were conducted (three days by two raters) for each participant. The motion parameters at the key points and the range of motion were statistically analyzed. Intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and the Bland–Altman method were used. Results: For intra-rater repeatability, 1) the ICC values range from 0.75 to 0.9 for rotations; and 0.64 to 0.96 for translations. Among the ICC values, 100% of rotations and 90% of translations were not less than 0.70; 2) among the SEM values, 100% of rotations were not more than 5°, while 73.3% of translations were less than 3 mm. For inter-rater repeatability, 1) the ICC values range from 0.68 to 0.99 for rotations; and 0.57 to 0.93 for translations. Among the ICC values, 95.6% of rotations and 82.2% of translations were not less than 0.70; 2) among the SEM values, 100% of rotations were not more than 5°, and 48.9% of translations were less than 3 mm. The Bland–Altman plots showed good agreement for intra- and inter-repeatability. Conclusions: The results indicated that the accuracy and repeatability of the measurement were acceptable, except for the inter-rater repeatability for translation. This may help researchers and physicians better interpret the measurement data.
Purpose: The purpose of the study was to describe changes in the kinematic parameters in the patients’ gait after total hip replacement. Methods: Research group of men in the end stage of osteoarthritis indicated to the THR (n = 10; age 54.1 ± 7.5 years; weight 92.2 ± 9.6 kg; height 179.7 ± 5.9 cm). All participants underwent a total of three measurements: before surgery, 3 and 6 months after the surgery. Using the 3D kinematic analysis system, the patients’ gait was recorded during each measurement session and kinematic analysis was carried out. The parameters that were monitored included the sagittal range of motion while walking in the ankle, the knee and the hip joints of the operated and the unoperated limb, and the range in the hip joint’s frontal plane, the rotation of pelvis in the frontal and transverse planes, as well as the speed of walking and the walking step length. Results: Significant increases were found in sagittal range of motion in the operated hip joint, sagittal range of motion in the ankle joint on the unoperated side and in the walking step length of the unoperated limb. Conclusions: During walking after a THR, the sagittal range of motion in the ankle of the unoperated limb increases. Also, the range of motion in the sagittal plane on the operated joint increases, which is related to the lengthening of the step of the unoperated lower limb.
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Chemotherapy-induced fatigue undermines the physical performance and alter gait behaviour of patients. In clinics, there is not a well-established method to objectively assess the effects of chemotherapy-induced fatigue on gait characteristics. Clinical trials commonly use 6 Minute Walking Tests (6MWT) to assess patients' gait. However, these studies only measure the distance that patients can walk. The distance does not provide comprehensive information about variations in ambulatory motion characteristics and body postural behaviour which can more appropriately describe the fatigue effects on general physical performance. Gait characteristics provide a manifestation of relationships between muscular and cardiovascular fitness status and physical motions. Hence, an assessment of gait characteristics provides more appropriate information about the effects of chemotherapy-induced fatigue on gait behaviour. A novel approach is proposed to objectively assess the impacts of chemotherapy-induced fatigue on cancer gait by analysing the gait characteristics during 6MWT. The joint angles of the lower body segments are measured by inertial sensors and modelled through a Hidden Markov Model (HMM) with Gaussian emissions. A Gaussian clustering method classifies the joint angles of first gait cycle to determine the six gait phases of a normal gait as initial training values. A comparison of gait characteristics before and after chemotherapy-induced fatigue determines the gait abnormalities. The method is applied to four cancer patients and outcomes are benchmarked against the gait of a healthy subject before and after running program-induced fatigue. The results indicate a more accurate quantitative-based tool to measure the effects of chemotherapy-induce fatigue on gait and physical performance.
Celem pracy jest określenie wpływu różnych ustawień ortezy typu Walker na zmianę kątów w stawach kończyn dolnych podczas chodu. W badaniach wzięło udział 10 zdrowych osób. Do badań czterech rodzajów chodu -jeden bez ortezy i trzy w różnych ustawieniach ortezy wykorzystano system Vicon. Udowodniono, że sposób ustawienia ortezy ma istotny wpływ na zmianę kątów w stawie kolanowym i biodrowym kończyny dolnej, na której jest noszona orteza. Bardzo korzystny jest brak wpływu ortezy na kinematykę kończyny wolnej od ortezy.
EN
The aim of the work is to determine the effect of various settings of Walker type orthosis on lower limb kinematics parameters during walking. 10 healthy people participated in the study. The Vicon system was used to test four types of the gait - one without an orthosis and three in different orthosis settings. It has been proven that the way the orthosis is positioned has a significant impact on changing the angles in the knee and hip joints of the lower limb, on which the orthosis is worn. The absence of the orthotic effect on the kinematics of the limb free from orthosis is very beneficial.
W pracy dokonano oceny biomechanicznej funkcji lokomocyjnych weterana wojennego. Uzyskane dla weterana wojennego wyniki ilościowej analizy chodu porównano z wartościami otrzymanymi dla grupy 56 zdrowych osób dorosłych, bez zaburzeń w obrębie narządu ruchu. Badania doświadczalne przeprowadzono z wykorzystaniem systemu optoelektronicznego BTS Smart. Analizie porównawczej poddano parametry czasowo-przestrzenne i kinematyczne chodu oraz zmiany energii całkowitej, potencjalnej, wypadkowej energii kinetycznej w czasie chodu. Uzyskane dla weterana wojennego wyniki znacznie odbiegały od wartości/zakresów normatywnych, wskazując na znaczne obrażenia aparatu ruch, które poniósł podczas wybuchu improwizowanego urządzenia wybuchowego.
EN
In the work the biomechanical evaluation of locomotion functions of a war veteran was made. The results of the quantitative gait analysis obtained for a war veteran were compared with the values obtained for a group of 56 healthy adults without locomotor disorders. Experimental studies were carried out using the BTS Smart optoelectronic system. The spatiotemporal and kinematic parameters of gait as well as changes in total energy, potential energy, kinetic energy and its components during gait were subjected to comparative analysis. The results obtained for a war veteran differed significantly from normative values / ranges, indicating significant injuries to the apparatus, which he suffered during the explosion of the improvised explosive device.
Portable, efficient, exact, detailed, early and cost-effective clinical gait analysis (CGA) has key influence for planning, development and assessment rehabilitation strategies and models, as far as for prosthetics assessment. Novel families of mobile CGA solutions may provide earlier detection, more exact diagnosis, and more effective therapy of the gait disorders. Remote integration of aforementioned solutions to hospital information system may provide better and more actual knowledge for clinical decision-making purposes. This study aims at review of the alternative wearable devices to measure selected gait parameters, depending on the desired accuracy level.
PL
Mobilna, efektywna, dokładna, szczególowa, wczesna i tania kliniczna analiza chodu ma kluczowy wpływ na planowanie, postęp i ocenę strategii i modeli rehabilitacji, jak również przedmiotów zaopatrzenia ortopedycznego. Nowe rodziny mobilnych rozwiązań do klinicznej analizy chodu mogą zapewnić wczesniejsze wykrywanie, dokładniejszą diagnostykęoraz efektywniejszą terapię deficytów chodu. Zdalna integracja ww. rozwiązań ze szpitalnym systemem informacyjnym może zapewnić lepszą i aktualniejszą wiedzę na potrzeby klinicznego podejmowania decyzji. Niniejszy artykuł stanowi przegląd urządzeń do pomiaru wybranych parametrów chodu, w zależności od poządanej dokładności.
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Background: In Parkinson's disease (PD), neuronal loss in the substantia nigra ultimate in dopaminergic denervation of the stiratum is followed by disarraying of the movements' preciseness, automatism, and agility. Hence, the seminal sign of PD is a change in motor performance of affected individuals. As PD is a neurodegenerative disease, progression of disability in mobility is an inevitable consequence. Indeed, the major cause of morbidity and mortality among patients with PD is the motor changes restricting their functional independence. Therefore, monitoring the manifestations of the disease is crucial to detect any worsening of symptoms timely, in order to maintain and improve the quality of life of these patients. Aim: The changes in motion of patients with PD can be ascertained by the help of wearable sensors attached to the limbs of subjects. Then analysing the recorded data for variation of signals would make it possible to figure an individualized profile of the disease. Advancement of such tools would improve understanding of the disease evolution in the long term and simplify the detection of precipitous changes in gait on a daily basis in the short term. In both cases the apperception of such events would contribute to improve the clinical decision making process with reliable data. To this end, we offer here a computational solution for effective monitoring of PD patients from gait analysis via multiple foot-worn sensors. Methods: We introduce a supervised model that is fed by ground reaction force (GRF) signals acquired from these gait sensors. We offer a hybrid model, called Locally Weighted Random Forest (LWRF), for regression analysis over the numerical features extracted from input signals to predict the severity of PD symptoms in terms of Universal Parkinson Disease Rating Scale (UPDRS) and Hoehn and Yahr (H&Y) scale. From GRF signals sixteen time-domain features and seven frequency-domain features were extracted and used. Results and conclusion: An experimental analysis conducted on a real data acquired from PD patients and healthy controls has shown that the predictions are highly correlated with the clinical annotations. Proposed approach for severity detection has the best correlation coefficient (CC), mean absolute error (MAE) and root mean squared error (RMSE) values with 0.895, 4.462 and 7.382 respectively in terms of UPDRS. The regression results for H&Y Scale discerns that proposed model outperforms other models with CC, MAE andRMSE with values 0.960, 0.168 and 0.306 respectively. In classification setup, proposed approach achieves higher accuracy in comparison with other studies with accuracy and specificity of 99.0% and 99.5% respectively. Main novelty of this approach is the fact that an exact value of the symptom level can be inferred rather than a categorical result that defines the severity of motor disorders.
W niniejszej pracy przedstawiono biomechaniczną analizę chodu pacjentów poruszających się w ortezach, u których zdiagnozowano mózgowe porażenie dziecięce lub pacjentów po operacji przepukliny oponowo-rdzeniowej. Badanie chodu przeprowadzono z wykorzystaniem systemu BTS Smart. Analizę przeprowadzono na podstawie zarejestrowanych w trakcie badania parametrów kinematycznych chodu oraz obliczonego wydatku energetycznego. Na podstawie uzyskanych wyników wykazano wpływ dobranych ortez na jakość chodu poszczególnych pacjentów.
EN
This article presents biomechanical analysis of gait patients with ankle-foot orthoses, who were diagnosed with cerebral palsy or patients after a surgery for myelomeningocele. The gait test was performed using the BTS Smart system. The analysis was based on the kinematic parameters of gait recorded during the study and the calculated energy expenditure. On the basis of the results obtained, the influence of selected orthoses on the quality of walking of individual patients was demonstrated.
The Gait Variability Index (GVI) summarizes overall gait quality, taking into account spatiotemporal parameters from a 3-dimensional gait analysis. However, there are no studies evaluating changes in gait patterns after stroke, based on the GVI. The study was designed to assess usefulness of the GVI for evaluation of gait pathology in subjects with stroke, compared to healthy individuals. Methods: Spatiotemporal gait parameters were examined in a group of 50 subjects at a chronic stage post-stroke and in 50 healthy controls. The GVI was calculated based on the 9 spatiotemporal data. Results: The findings show statistically significant differences between the values of the GVI for paretic and non-paretic limbs ( p < 0.001). Higher values of the index were identified in the case of non-paretic limb: 80.74 vs. 76.32. The GVI scores were decreased for both paretic and non-paretic limbs, compared to the controls – p < 0.001. Conclusions: The GDI score seems to be a viable tool for quantifying changes in gait pattern during evaluation of subjects with chronic post-stroke hemiparesis. Further studies should be conducted to validate the use of GVI in the post-stroke population.
Human gait motion analysis was one useful method for lower limb prosthesis study. The most often measured parameters were plantar pressure, kinetic and kinematic parameters. It was indispensable for prosthetic knee design and performance assessment. The aim of this study was to analysis the plantar pressure in traumatic above-knee amputee equipped with a developed microprocessor-controlled prosthetic knee. Methods: The maximum force of forefoot and rearfoot, the average vertical reaction force and pressure and the centre of pressure (COP) offset trajectories of ten above-knee amputees under different walking speeds were obtained. Results: Both forefoot and rearfoot force were bigger in intact leg than prosthetic leg. As the speed increased, the pressure increased in both sides. Forefoot bore more pressure than rearfoot in both legs. The average vertical pressure and force both increased along with the increase of speed. The force and pressure of intact side were always bigger than the prosthetic side. The trend of COP and gait line of the prosthetic and intact side had no significant difference. The length of the gait line of prosthetic side was greater than the intact side. Conclusions: The results of this study exhibited reduced plantar pressure in the prosthetic side. The typical butterfly diagrams were produced during different walking speeds. It indicated that the stability of the microprocessor-controlled prosthetic knee could be guaranteed.
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This paper proposes a novel gait rehabilitation analysis system, based on an innovative multimodal vision-based sensor setup, focused on detecting gait pattern changes over time. The proposed setup is based on inexpensive technologies, without compromising performance, and was designed to be deployed on walkers, which are a typical assistive aid used in gait rehabilitation. In the medical field the evaluation of a patient's rehabilitation progress is typically performed by a medical professional through subjective techniques based on the professional's visual perception and experience. In this context, we are proposing an automatic system to detect the progress of patients undergoing rehabilitation therapy. Our approach is able to perform novelty detection for gait pattern classification based on One- Class Support Vector Machines (OC-SVM). Using point-cloud and RGB-D data, we detect the lower limbs (waist, legs and feet) by using Weighted Kernel-Density Estimation and Weighted Least-Squares to segment the legs into several parts (thighs and shins), and by fitting 3D ellipsoids to model them. Feet are detected using k-means clustering and a Circular Hough Transform. A temporal analysis of the feet's depth is also performed to detect heel strike events. Spatiotemporal and kinematic features are extracted from the lower limbs' model and fed to a classifier based on the fusion of several OC-SVMs. Experiments with volunteers using the robotic walker platform ISR-AIWALKER, where the proposed system was deployed, revealed a lower limbs tracking accuracy of 38 and that our novelty detection approach successfully identified novel gait patterns, evidencing an overall 97.89% sensitivity.
Nowadays, fashion has caused that many young women are wearing high-heeled shoes. Therefore, the aim of this study was to examine the effects of long-term walking in high-heeled shoes on the foot mechanics during barefoot gait. Methods: Forty-three young women (22 ± 2.1 years) divided into two groups participated in this retrospective cohort study. The first group was composed of women who frequently wear high-heeled footwear. The second, infrequent wearers group, consisted of women who preferred flat-heeled shoes. Measurements of gait parameters were recorded for barefoot gait. A motion analysis system and two force plates were used in order to evaluate the lower-limb rocker mechanism, transverse foot arch height and parameters of ground reaction force. Results: Walking in high-heeled shoes modified barefoot foot mechanics, which manifested itself in a shorter duration (by ca. 4%) of the first and second rocker and a significantly longer duration (by 5%) of the third rocker phase as well as a substantial reduction in height of the transverse foot arch (by around 50%) in women habitually walking in high-heeled shoes. A significantly shorter relative duration of the third rocker (44.3% of cycle time) and greater value of the vertical component of ground reaction force (114.7% BW) in the third rocker phase were found in the group of women habitually walking in high-heeled shoes. Conclusions: The mechanism of foot rolling, with flattened foot arch, and significantly higher values of the vertical component of ground reaction force and shorter time might lead to overload in lowerlimb joints in young women.
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