Using Sensor Technology to Measure Gait Capacity and Gait Performance in Rehabilitation Inpatients with Neurological Disorders

Abstract

The aim of this study was to objectively assess and compare gait capacity and gait performance in rehabilitation inpatients with stroke or incomplete spinal cord injury (iSCI) using inertial measurement units (IMUs). We investigated how gait capacity (what someone can do) is related to gait performance (what someone does). Twenty-two inpatients (11 strokes, 11 iSCI) wore ankle positioned IMUs during the daytime to assess gait. Participants completed two circuits to assess gait capacity. These were videotaped to certify the validity of the IMU algorithm. Regression analyses were used to investigate if gait capacity was associated with gait performance (i.e., walking activity and spontaneous gait characteristics beyond therapy time). The ankle positioned IMUs validly assessed the number of steps, walking time, gait speed, and stride length (r ≥ 0.81). The walking activity was strongly (r ≥ 0.76) related to capacity-based gait speed. Maximum spontaneous gait speed and stride length were similar to gait capacity. However, the average spontaneous gait speed was half the capacity-based gait speed. Gait capacity can validly be assessed using IMUs and is strongly related to gait performance in rehabilitation inpatients with neurological disorders. Measuring gait performance with IMUs provides valuable additional information about walking activity and spontaneous gait characteristics to inform about functional recovery.

Real-world gait and turning in individuals scheduled for total knee arthroplasty

“…Not only the value at the peak of the distribution (i.e. the most frequently observed gait speed per individual), was lower in individuals scheduled for TKA, but also the 95 th percentile of the distribution (resembling gait capacity (13, 37)) was lower. In combination with our finding that the IQR was not different between groups, these results indicate that in the group of individuals scheduled for TKA the whole distribution of individual gait speeds was shifted towards lower values.…”

Automatic Gait Events Detection with Inertial Measurement Units: Healthy Subjects and Moderate to Severe Impaired Patients

“…Gait analysis using IMU has gained widespread popularity, and several algorithms have been developed and demonstrated their efficacy in detecting gait events (GEs) of healthy individuals [13,24,44,4]. In clinical settings, measuring gait performance provides valuable additional information about walking activity and spontaneous gait characteristics, such as in the follow-up of neurological patients [18,5,45] or in preoperative examinations [46,47]. While some teams use only trunk wearable sensors that provide global features such as smoothness [48], a more precise analysis requires GE detection, which can be done with two separate IMUs on each lower limb [47].…”

Dynamic Stability, Symmetry, and Smoothness of Gait in People with Neurological Health Conditions

“…Based on previous studies [ 10 , 21 ], a formal sample size calculation accounting for a priori power analysis (α = 0.05; β = 0.8; ES = 0.6) was conducted using G*Power. According to this sample size estimation procedure, 20 participants with each neurological condition were enrolled.…”

“…These indices can characterize the gait performance of persons with neurological disorders [ 17 ] with a mild-to-severe disability and may represent a valid tool to lead the clinical decision-making process toward the personalization of rehabilitation training [ 18 ] and the evaluation of the effectiveness of neurorehabilitation treatments [ 17 , 19 , 20 ]. Several studies have reported the usefulness of IMU-based assessments in characterizing dynamic stability impairments in people with neurological disorders [ 6 , 7 , 9 , 21 ]. Recently, a study compared motor ability during gait in inpatients with stroke and incomplete spinal cord injury using IMUs [ 21 ], underscoring the valuable contribution that this approach provides to functional recovery.…”

“…Several studies have reported the usefulness of IMU-based assessments in characterizing dynamic stability impairments in people with neurological disorders [ 6 , 7 , 9 , 21 ]. Recently, a study compared motor ability during gait in inpatients with stroke and incomplete spinal cord injury using IMUs [ 21 ], underscoring the valuable contribution that this approach provides to functional recovery. Furthermore, shifting the paradigm from rehabilitation linked solely to the disease to one focused on the individual’s functionality could represent an advancement in the field of neurorehabilitation.…”