Comprehensive measurement of stroke gait characteristics with a single accelerometer in the laboratory and community: a feasibility, validity and reliability study

Abstract

BackgroundApplication of objective measurement of stroke gait with accelerometer-based wearable technology and associated algorithms is increasing, despite reports questioning the accuracy of this technique in quantifying specific stroke-related gait impairments. The aim of this study is to determine the feasibility, validity and reliability of a low-cost open-source system incorporating algorithms and a single tri-axial accelerometer-based wearable to quantify gait characteristics in the laboratory and community post-stroke.MethodsTwenty-five participants with stroke wore the wearable (AX3, Axivity) on the lower back during a laboratory 2 minute continuous walk (preferred pace) on two occasions a week apart and continuously in the community for two consecutive 7 day periods. Video, instrumented walkway (GaitRite) and an OPAL accelerometer-based wearable were used as laboratory references.ResultsFeasibility of the proposed system was good. The system was valid for measuring step count (ICC 0.899). Inherent differences in gait quantification between algorithm and GaitRite resulted in difficulties comparing agreement between the different systems. Agreement was moderate-excellent (ICC 0.503–0.936) for mean and variability gait characteristics vs. OPAL. Agreement was moderate-poor between the system and OPAL for asymmetry characteristics. Moderate-excellent reliability (ICC 0.534–0.857) was demonstrated for 11/14 laboratory measured gait characteristics. Community test-retest reliability was good-excellent (ICC 0.867–0.983) for all except one (ICC 0.699) of the 19 gait characteristics.ConclusionThe proposed system is a low-cost, reliable tool for quantifying gait post-stroke with multiple potential applications. Further refinement to optimise gait quantification algorithms for certain gait characteristics including gait asymmetry is required.

Systematic review on the application of wearable inertial sensors to quantify everyday life motor activity in people with mobility impairments

“…All of them evaluated gait-related outcomes, but they differed considerably in the chosen setting. Two studies assessed the usability of a sensor system by reporting inconvenience [ 26 ] and adverse events [ 27 ], respectively, while eight studies reported the wearing time of the sensors in daily life [ 28 – 35 ].…”

“…This in turn enables the estimation of step frequency and cadence. Walking bouts were further analyzed in terms of temporo-spatial gait parameters [ 27 , 28 , 33 , 40 , 58 , 61 , 70 , 81 , 82 , 86 , 91 , 93 ], and joint kinematics (i.e. knee angle) [ 33 , 39 ].…”

Wearable hip-assist robot modulates cortical activation during gait in stroke patients: a functional near-infrared spectroscopy study

“…Hemiplegia is one of the most common impairments after stroke and significantly reduces walking ability. Poststroke hemiplegic gait is typically characterized by a reduced gait velocity and asymmetry of bilateral kinetic, kinematic and spatiotemporal parameters [ 1 – 3 ]. Gait function is an important factor in determining the ability to independently perform activities of daily living.…”

Wearable Hip-assist Robot Modulates Cortical Activation during Gait in Stroke Patients: A Functional Near-Infrared Spectroscopy Study

“…Hemiplegia is one of the most common impairments after stroke and signi cantly reduces walking ability. Poststroke hemiplegic gait is typically characterized by a reduced gait velocity and asymmetry of bilateral kinetic, kinematic and spatiotemporal parameters [1][2][3]. Gait function is an important factor in determining the ability to independently perform activities of daily living.…”