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Field-based sprint performance assessments rely on metrics derived from a simple model of sprinting dynamics parameterized by 2 constants, v0 and τ, which indicate a sprinter's maximal theoretical velocity and the time it takes to approach v0, respectively. This study aims to automate sprint assessment by estimating v0 and τ using machine learning and accelerometer data. To this end, photocells recorded 10-m split times of 28 subjects for three 40-m sprints while wearing an accelerometer around the waist. Features extracted from the accelerometer data were used to train a classifier to identify the sprint start and regression models to estimate the sprint model parameters. Estimates of v0, τ, and 30-m sprint time (t30) were compared between the proposed method and a photocell method using root mean square error and Bland–Altman analysis. The root mean square error of the sprint start estimate was.22 seconds and ranged from.52 to.93 m/s for v0,.14 to.17 seconds for τ, and.23 to.34 seconds for t30. Model-derived sprint performance metrics from most regression models were significantly (P <.01) correlated with t30. Comparison of the proposed method and a physics-based method suggests pursuit of a combined approach because their strengths appear to complement each other. [ABSTRACT FROM AUTHOR]

Inertial measurement units (IMUs) offer an attractive way to study human lower-limb kinematics without traditional laboratory constraints. We present an error-state Kalman filter method to estimate 3D joint angles, joint angle ranges of motion, stride length, and step width using data from an array of seven body-worn IMUs. Importantly, this paper contributes a novel joint axis measurement correction that reduces joint angle drift errors without assumptions of strict hinge-like joint behaviors of the hip and knee. We evaluate the method compared to two optical motion capture methods on twenty human subjects performing six different types of walking gait consisting of forward walking (at three speeds), backward walking, and lateral walking (left and right). For all gaits, RMS differences in joint angle estimates generally remain below 5 degrees for all three ankle joint angles and for flexion/extension and abduction/adduction of the hips and knees when compared to estimates from reflective markers on the IMUs. Additionally, mean RMS differences in estimated stride length and step width remain below 0.13 m for all gait types, except stride length during slow walking. This study confirms the method's potential for non-laboratory based gait analysis, motivating further evaluation with IMU-only measurements and pathological gaits. [ABSTRACT FROM AUTHOR]

Wearable sensors facilitate the evaluation of gait and balance impairment in the free-living environment, often with observation periods spanning weeks, months, and even years. Data supporting the minimal duration of sensor wear, which is necessary to capture representative variability in impairment measures, are needed to balance patient burden, data quality, and study cost. Prior investigations have examined the duration required for resolving a variety of movement variables (e.g., gait speed, sit-to-stand tests), but these studies use differing methodologies and have only examined a small subset of potential measures of gait and balance impairment. Notably, postural sway measures have not yet been considered in these analyses. Here, we propose a three-level framework for examining this problem. Difference testing and intra-class correlations (ICC) are used to examine the agreement in features computed from potential wear durations (levels one and two). The association between features and established patient reported outcomes at each wear duration is also considered (level three) for determining the necessary wear duration. Utilizing wearable accelerometer data continuously collected from 22 persons with multiple sclerosis (PwMS) for 6 weeks, this framework suggests that 2 to 3 days of monitoring may be sufficient to capture most of the variability in gait and sway; however, longer periods (e.g., 3 to 6 days) may be needed to establish strong correlations to patient-reported clinical measures. Regression analysis indicates that the required wear duration depends on both the observation frequency and variability of the measure being considered. This approach provides a framework for evaluating wear duration as one aspect of the comprehensive assessment, which is necessary to ensure that wearable sensor-based methods for capturing gait and balance impairment in the free-living environment are fit for purpose. [ABSTRACT FROM AUTHOR]

Complex sensor arrays prohibit practical deployment of existing wearables-based algorithms for free-living analysis of muscle and joint mechanics. Machine learning techniques have been proposed as a potential solution, however, they are less interpretable and generalizable when compared to physics-based techniques. Herein, we propose a hybrid method utilizing inertial sensor- and electromyography (EMG)-driven simulation of muscle contraction to characterize knee joint and muscle mechanics during walking gait. Machine learning is used only to map a subset of measured muscle excitations to a full set thereby reducing the number of required sensors. We demonstrate the utility of the approach for estimating net knee flexion moment (KFM) as well as individual muscle moment and work during the stance phase of gait across nine unimpaired subjects. Across all subjects, KFM was estimated with 0.91%BW•H RMSE and strong correlations (r = 0.87) compared to ground truth inverse dynamics analysis. Estimates of individual muscle moments were strongly correlated (r = 0.81–0.99) with a reference EMG-driven technique using optical motion capture and a full set of electrodes as were estimates of muscle work (r = 0.88–0.99). Implementation of the proposed technique in the current work included instrumenting only three muscles with surface electrodes (lateral and medial gastrocnemius and vastus medialis) and both the thigh and shank segments with inertial sensors. These sensor locations permit instrumentation of a knee brace/sleeve facilitating a practically deployable mechanism for monitoring muscle and joint mechanics with performance comparable to the current state-of-the-art. [ABSTRACT FROM AUTHOR]

Falls are a significant problem for persons with multiple sclerosis (PwMS). Yet fall prevention interventions are not often prescribed until after a fall has been reported to a healthcare provider. While still nascent, objective fall risk assessments could help in prescribing preventative interventions. To this end, retrospective fall status classification commonly serves as an intermediate step in developing prospective fall risk assessments. Previous research has identified measures of gait biomechanics that differ between PwMS who have fallen and those who have not, but these biomechanical indices have not yet been leveraged to detect PwMS who have fallen. Moreover, they require the use of laboratory-based measurement technologies, which prevent clinical deployment. Here we demonstrate that a bidirectional long short-term (BiLSTM) memory deep neural network was able to identify PwMS who have recently fallen with good performance (AUC of 0.88) based on accelerometer data recorded from two wearable sensors during a one-minute walking task. These results provide substantial improvements over machine learning models trained on spatiotemporal gait parameters (21% improvement in AUC), statistical features from the wearable sensor data (16%), and patient-reported (19%) and neurologist-administered (24%) measures in this sample. The success and simplicity (two wearable sensors, only one-minute of walking) of this approach indicates the promise of inexpensive wearable sensors for capturing fall risk in PwMS. [ABSTRACT FROM AUTHOR]

Human lower-limb kinematic measurements are critical for many applications including gait analysis, enhancing athletic performance, reducing or monitoring injury risk, augmenting warfighter performance, and monitoring elderly fall risk, among others. We present a new method to estimate lower-limb kinematics using an error-state Kalman filter that utilizes an array of body-worn inertial measurement units (IMUs) and four kinematic constraints. We evaluate the method on a simplified 3-body model of the lower limbs (pelvis and two legs) during walking using data from simulation and experiment. Evaluation on this 3-body model permits direct evaluation of the ErKF method without several confounding error sources from human subjects (e.g., soft tissue artefacts and determination of anatomical frames). RMS differences for the three estimated hip joint angles all remain below 0.2 degrees compared to simulation and 1.4 degrees compared to experimental optical motion capture (MOCAP). RMS differences for stride length and step width remain within 1% and 4%, respectively compared to simulation and 7% and 5%, respectively compared to experiment (MOCAP). The results are particularly important because they foretell future success in advancing this approach to more complex models for human movement. In particular, our future work aims to extend this approach to a 7-body model of the human lower limbs composed of the pelvis, thighs, shanks, and feet. [ABSTRACT FROM AUTHOR]

Estimation of muscle excitations from a reduced sensor array could greatly improve current techniques in remote patient monitoring. Such an approach could allow continuous monitoring of clinically relevant biomechanical variables that are ideal for personalizing rehabilitation. In this paper, we introduce the notion of a muscle synergy function which describes the synergistic relationship between a subset of muscles. We develop from first principles an approximation to their behavior using Gaussian process regression and demonstrate the utility of the technique for estimating the excitation time-series of leg muscles during normal walking for nine healthy subjects. Specifically, excitations for six muscles were estimated using surface electromyography (sEMG) data during a finite time interval (called the input window) from four different muscles (called the input muscles) with mean absolute error (MAE) less than 5.0% of the maximum voluntary contraction (MVC) and that accounts for 82-88% of the variance (VAF) in the true excitations. Further, these estimated excitations informed muscle activations with less than 4.0% MAE and 89-93% VAF. We also present a detailed analysis of a number of different modeling choices, including every possible combination of four-, three- and two-muscle input sets, the size and structure of the input window, and the stationarity of the Gaussian process covariance functions. Further, application specific modifications for future use are discussed. The proposed technique lays a foundation to explore the use of reduced wearable sensor arrays and muscle synergy functions for monitoring clinically relevant biomechanics during daily life. [ABSTRACT FROM AUTHOR]

Childhood anxiety and depression often go undiagnosed. If left untreated these conditions, collectively known as internalizing disorders, are associated with long-term negative outcomes including substance abuse and increased risk for suicide. This paper presents a new approach for identifying young children with internalizing disorders using a 3-min speech task. We show that machine learning analysis of audio data from the task can be used to identify children with an internalizing disorder with 80% accuracy (54% sensitivity, 93% specificity). The speech features most discriminative of internalizing disorder are analyzed in detail, showing that affected children exhibit especially low-pitch voices, with repeatable speech inflections and content, and high-pitched response to surprising stimuli relative to controls. This new tool is shown to outperform clinical thresholds on parent-reported child symptoms, which identify children with an internalizing disorder with lower accuracy (67–77% versus 80%), and similar specificity (85–100% versus 93%), and sensitivity (0–58% versus 54%) in this sample. These results point toward the future use of this approach for screening children for internalizing disorders so that interventions can be deployed when they have the highest chance for long-term success. [ABSTRACT FROM AUTHOR]

Purpose of Review: Walking impairments are highly prevalent in persons with multiple sclerosis (PwMS) and are associated with reduced quality of life. Walking is traditionally quantified with various measures, including patient self-reports, clinical rating scales, performance measures, and advanced lab-based movement analysis techniques. Yet, the majority of these measures do not fully characterize walking (i.e., gait quality) nor adequately reflect walking in the real world (i.e., community ambulation) and have limited timescale (only measure walking at a single point in time). We discuss the potential of wearable sensors to provide sensitive, objective, and easy-to-use assessment of community ambulation in PwMS. Recent Findings: Wearable technology has the ability to measure all aspects of gait in PwMS yet is under-studied in comparison with other populations (e.g., older adults). Within the studies focusing on PwMS, half that measure pace collected free-living data, while only one study explored gait variability in free-living conditions. No studies explore gait asymmetry or complexity in free-living conditions. Summary: Wearable technology has the ability to provide objective, comprehensive, and sensitive measures of gait in PwMS. Future research should investigate this technology's ability to accurately assess free-living measures of gait quality, specifically gait asymmetry and complexity. [ABSTRACT FROM AUTHOR]

Background: Gait event detection is critical for remote gait analysis. Algorithms using a thigh-worn accelerometer for estimating spatiotemporal gait variables have demonstrated clinical utility in monitoring the gait of patients with gait and balance impairment. However, one may obtain accurate estimates of spatiotemporal variables, but with biased estimates of foot contact and foot off events. Some biomechanical analyses depend on accurate gait phase segmentation, but previous studies using a thigh-worn accelerometer have not quantified the error in estimating foot contact and foot off events.Methods: Gait events and spatiotemporal gait variables were estimated using a thigh-worn accelerometer from 32 healthy subjects across a range of walking speeds (0.56-1.78 m/s). Ground truth estimates were obtained using vertical ground reaction forces measured using a pressure treadmill. Estimation performance was quantified using absolute error, root mean square error, and correlation analysis.Results: Across all strides (N = 3,898), the absolute error in estimating foot contact, foot off, stride time, stance time, and swing time was similar to other accelerometer-based techniques (39 ± 28 ms, 28 ± 28 ms, 11 ± 14 ms, 46 ± 31 ms, and 45 ± 30 ms, respectively). The correlation between reference measurements and estimates of bout-average stride time, stance time, and swing time were 1.00, 0.92, and 0.80, respectively. The (5th, 95th) percentiles of the foot contact and foot off estimation errors were (-91 ms, 51 ms) and (-70 ms, 60 ms), the largest of which amounts to about three samples using the 31.25 Hz sampling frequency used in this study.Significance: Use of the proposed algorithm for estimating spatiotemporal gait variables is supported by the strong correlations with reference measurements. The gait event estimation error distributions provide bounds on the estimated gait events for enforcing gait phase-dependent task constraints for biomechanical analysis. [ABSTRACT FROM AUTHOR]

Dance involves a high volume of aesthetic, stretch-shortening cycle (SSC) actions, which may cause unique adaptations to performance. The strength dancers possess to withstand such frequency of SSCs remains elusive. The extensive training that dancers experience from a young age, however, yields anatomical and strength development that may contrast with that of untrained individuals. Therefore, the purpose of this study was to investigate differences in musculo-articular stiffness and maximal isometric plantar flexion and knee extension force between dancers and untrained individuals. A total of 16 females volunteered to participate in the study (N = 8 dancers; N = 8 untrained individuals). Dancers had a minimum of 10 years of dance experience and were currently training at the collegiate dance level three or more times per week. Untrained individuals had no dance background, nor were they currently involved in any form of regularized physical activity. All subjects completed a series of lower leg measurements and strength tests. This included a musculo-articular stiffness measurement using a free-oscillation technique, along with maximal isometric plantar flexion (MIP) and maximal isometric knee extension (MIKE) testing. The data indicate that dancers had a significantly greater rate of force development and peak force during MIP and rate of force development during MIKE in comparison to untrained individuals. Dancers also possessed significantly greater musculo-articular stiffness. Hence, the data provide some evidence that involvement in dance can result in greater muscle force generating capacity and musculo-articular stiffness due to the SSC mechanisms involved in dance movements. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to determine the feasibility of using a single inertial measurement unit (IMU) placed on the sacrum to estimate 3-dimensional ground reaction force ( F ) during linear acceleration and change of direction tasks. Force plate measurements of F and estimates from the proposed IMU method were collected while subjects ( n = 15) performed a standing sprint start (SS) and a 45° change of direction task (COD). Error in the IMU estimate of step-averaged component and resultant F was quantified by comparison to estimates from the force plate using Bland-Altman 95% limits of agreement (LOA), root mean square error (RMSE), Pearson’s product-moment correlation coefficient ( r ), and the effect size (ES) of the differences between the two systems. RMSE of the IMU estimate of step-average F ranged from 37.70 N to 77.05 N with ES between 0.04 and 0.47 for SS while for COD, RMSE was between 54.19 N to 182.92 N with ES between 0.08 and 1.69. Correlation coefficients between the IMU and force plate measurements were significant ( p ≤ 0.05) for all values ( r = 0.53 to 0.95) except the medio-lateral component of step-average F . The average angular error in the IMU estimate of the orientation of step-average F was ≤10° for all tasks. The results of this study suggest the proposed IMU method may be used to estimate sagittal plane components and magnitude of step-average F during a linear standing sprint start as well as the vertical component and magnitude of step-average F during a 45° change of direction task. [ABSTRACT FROM AUTHOR]

Wearable sensors have the potential to enable comprehensive patient characterization and optimized clinical intervention. Critical to realizing this vision is accurate estimation of biomechanical time-series in daily-life, including joint, segment, and muscle kinetics and kinematics, from wearable sensor data. The use of physical models for estimation of these quantities often requires many wearable devices making practical implementation more difficult. However, regression techniques may provide a viable alternative by allowing the use of a reduced number of sensors for estimating biomechanical time-series. Herein, we review 46 articles that used regression algorithms to estimate joint, segment, and muscle kinematics and kinetics. We present a high-level comparison of the many different techniques identified and discuss the implications of our findings concerning practical implementation and further improving estimation accuracy. In particular, we found that several studies report the incorporation of domain knowledge often yielded superior performance. Further, most models were trained on small datasets in which case nonparametric regression often performed best. No models were open-sourced, and most were subject-specific and not validated on impaired populations. Future research should focus on developing open-source algorithms using complementary physics-based and machine learning techniques that are validated in clinically impaired populations. This approach may further improve estimation performance and reduce barriers to clinical adoption. [ABSTRACT FROM AUTHOR]

Wearable sensor-based algorithms for estimating joint angles have seen great improvements in recent years. While the knee joint has garnered most of the attention in this area, algorithms for estimating hip joint angles are less available. Herein, we propose and validate a novel algorithm for this purpose with innovations in sensor-to-sensor orientation and sensor-to-segment alignment. The proposed approach is robust to sensor placement and does not require specific calibration motions. The accuracy of the proposed approach is established relative to optical motion capture and compared to existing methods for estimating relative orientation, hip joint angles, and range of motion (ROM) during a task designed to exercise the full hip range of motion (ROM) and fast walking using root mean square error (RMSE) and regression analysis. The RMSE of the proposed approach was less than that for existing methods when estimating sensor orientation ( 12.32 ° and 11.82 ° vs. 24.61 ° and 23.76 ° ) and flexion/extension joint angles ( 7.88 ° and 8.62 ° vs. 14.14 ° and 15.64 ° ). Also, ROM estimation error was less than 2.2 ° during the walking trial using the proposed method. These results suggest the proposed approach presents an improvement to existing methods and provides a promising technique for remote monitoring of hip joint angles. [ABSTRACT FROM AUTHOR]