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Background: Functional electrical stimulation (FES) can be used for compensation of foot-drop for post-stroke individuals by pre-programmed fixed stimulation; however, this stimulation seems no more effective than mechanical ankle foot orthoses., Objective: We evaluated the metrological quality of inertial sensors for movement reconstruction as compared with the gold-standard motion capturing system, to couple FES with inertial sensors to improve dorsiflexion on the paretic side, by using an adaptive stimulation taking into account individuals' performance post-stroke., Methods: Adults with ischemic or hemorrhagic stroke presenting foot-drop and able to walk 10m, were included from May 2016 to June 2017. Those with passive ankle dorsiflexion<0° with the knee stretched were excluded. Synchronous gait was analyzed with the VICON© system as the gold standard and inertial measurement units (IMUs) worn by participants. The main outcome was the dorsiflexion angle at the heel strike and mid-swing phase obtained from IMUs and the VICON system. Secondary outcomes were: stride length, walking speed, maximal ankle dorsiflexion velocity and fatigue detection., Results: We included 26 participants [18 males; mean age 58 (range 45-84) years]. During heel strike, the dorsiflexion angle measurements demonstrated a root mean square error (RMSE) of 5.5°; a mean average error (MAE) of 3.9°; Bland-Altman bias of -0.1° with limits of agreement -10.9° to+10.7° and good intra-class correlation coefficient (ICC) at 0.87 between the 2 techniques. During the mid-swing phase, the RMSE was 5.6; MAE 3.7°; Bland-Altman bias -0.9° with limits of agreement -11.7° to+9.8° and ICC 0.88. Good agreement was demonstrated for secondary outcomes and fatigue detection., Conclusions: IMU-based reconstruction algorithms were effective in measuring ankle dorsiflexion with small biases and good ICCs in adults with ischemic or hemorrhagic stroke presenting foot-drop. The precision obtained is sufficient to observe the fatigue influence on the dorsiflexion and therefore to use IMUs to adapt FES., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Pathological gait assessment and assistive control based on functional electrical stimulation (FES) in post-stroke individuals, brings out a common need to robustly quantify kinematics facing multiple constraints. This study proposes a novel approach using inertial sensors to compute dorsiflexion angles and spatio-temporal parameters, in order to be later used as inputs for online close-loop control of FES. 26 post-stroke subjects were asked to walk on a pressure mat equipped with inertial measurement units (IMU) and passive reflective markers. A total of 930 strides were individually analyzed and results between IMU-based algorithms and reference systems compared. Mean absolute (MA) errors of dorsiflexion angles were found to be less than 4°, while stride lengths were robustly segmented and estimated with a MA error less than 10 cm. These results open new doors to rehabilitation using adaptive FES closed-loop control strategies in "foot drop" syndrome correction.