SIAMOC position paper on gait analysis in clinical practice: General requirements, methods and appropriateness. Results of an Italian consensus conference.

Gait analysis is recognized as a useful assessment tool in the field of human movement research. However, doubts remain on its real effectiveness as a clinical tool, i.e.

Comparative assessment of knee joint models used in multi-body kinematics optimisation for soft tissue artefact compensation.

Estimating joint kinematics from skin-marker trajectories recorded using stereophotogrammetry is complicated by soft tissue artefact (STA), an inexorable source of error. One solution is to use a bone pose estimator based on multi-body kinematics optimisation (MKO) embedding joint constraints to compensate for STA. However, there is some debate over the effectiveness of this method.

Overcoming the limitations of the Harmonic Ratio for the reliable assessment of gait symmetry.

The Harmonic Ratio (HR) is an index based on the spectral analysis of lower trunk accelerations that is commonly used to assess the quality of gait. However, it presents several issues concerning reliability and interpretability. As a consequence, the literature provides very different values albeit corresponding to the same populations.

To what extent is joint and muscle mechanics predicted by musculoskeletal models sensitive to soft tissue artefacts?

Musculoskeletal models are widely used to estimate joint kinematics, intersegmental loads, and muscle and joint contact forces during movement. These estimates can be heavily affected by the soft tissue artefact (STA) when input positional data are obtained using stereophotogrammetry, but this aspect has not yet been fully characterised for muscle and joint forces. This study aims to assess the sensitivity to the STA of three open-source musculoskeletal models, implemented in OpenSim.

Knee Kinematics Estimation Using Multi-Body Optimisation Embedding a Knee Joint Stiffness Matrix: A Feasibility Study.

The use of multi-body optimisation (MBO) to estimate joint kinematics from stereophotogrammetric data while compensating for soft tissue artefact is still open to debate. Presently used joint models embedded in MBO, such as mechanical linkages, constitute a considerable simplification of joint function, preventing a detailed understanding of it. The present study proposes a knee joint model where femur and tibia are represented as rigid bodies connected through an elastic element the behaviour of which is described by a single stiffness matrix.

Modeling the Human Tibiofemoral Joint Using Ex Vivo Determined Compliance Matrices.

Several approaches have been used to devise a model of the human tibiofemoral joint for embedment in lower limb musculoskeletal models. However, no study has considered the use of cadaveric 6 × 6 compliance (or stiffness) matrices to model the tibiofemoral joint under normal or pathological conditions. The aim of this paper is to present a method to determine the compliance matrix of an ex vivo tibiofemoral joint for any given equilibrium pose.

Multilevel Upper Body Movement Control during Gait in Children with Cerebral Palsy.

Upper body movements during walking provide information about balance control and gait stability. Typically developing (TD) children normally present a progressive decrease of accelerations from the pelvis to the head, whereas children with cerebral palsy (CP) exhibit a general increase of upper body accelerations. However, the literature describing how they are transmitted from the pelvis to the head is lacking.

Effects of walking on low-grade inflammation and their implications for Type 2 Diabetes.

Objective: Inflammatory cytokines released by hypertrophic adipocytes contribute to low-grade inflammation, a characteristic of Type 2 Diabetes. Skeletal muscle contraction during physical activity stimulates the secretion of anti-inflammatory cytokines able to counteract this inflammatory status. The aim of this study was to review the evidence of the effectiveness of walking as a physical activity intervention to reduce inflammation.

Assessing the Performance of Sensor Fusion Methods: Application to Magnetic-Inertial-Based Human Body Tracking.

Information from complementary and redundant sensors are often combined within sensor fusion algorithms to obtain a single accurate observation of the system at hand. However, measurements from each sensor are characterized by uncertainties. When multiple data are fused, it is often unclear how all these uncertainties interact and influence the overall performance of the sensor fusion algorithm.

Wheelchair Propulsion Biomechanics in Junior Basketball Players: A Method for the Evaluation of the Efficacy of a Specific Training Program.

As participation in wheelchair sports increases, the need of quantitative assessment of biomechanical performance indicators and of sports- and population-specific training protocols has become central. The present study focuses on junior wheelchair basketball and aims at (i) proposing a method to identify biomechanical performance indicators of wheelchair propulsion using an instrumented in-field test and (ii) developing a training program specific for the considered population and assessing its efficacy using the proposed method. Twelve athletes (10 M, 2 F, age = 17.

How Angular Velocity Features and Different Gyroscope Noise Types Interact and Determine Orientation Estimation Accuracy.

In human movement analysis, 3D body segment orientation can be obtained through the numerical integration of gyroscope signals. These signals, however, are affected by errors that, for the case of micro-electro-mechanical systems, are mainly due to: constant bias, scale factor, white noise, and bias instability. The aim of this study is to assess how the orientation estimation accuracy is affected by each of these disturbances, and whether it is influenced by the angular velocity magnitude and 3D distribution across the gyroscope axes.

What portion of the soft tissue artefact requires compensation when estimating joint kinematics?

When joint kinematics is analyzed using noninvasive stereophotogrammetry, movements of the skin markers relative to the underlying bone are regarded as artefacts (soft tissue artefact (STA)). Recent literature suggests that an appropriate estimation of joint kinematics may be obtained by compensating for only a portion of the STA, but no evidence for this case has been reported, and which portion of the STA should be selected remains an issue. The aim of this study was to fill this gap.

Hip joint centre position estimation using a dual unscented Kalman filter for computer-assisted orthopaedic surgery.

In computer-assisted knee surgery, the accuracy of the localization of the femur centre of rotation relative to the hip-bone (hip joint centre) is affected by the unavoidable and untracked pelvic movements because only the femoral pose is acquired during passive pivoting manoeuvres. We present a dual unscented Kalman filter algorithm that allows the estimation of the hip joint centre also using as input the position of a pelvic reference point that can be acquired with a skin marker placed on the hip, without increasing the invasiveness of the surgical procedure. A comparative assessment of the algorithm was carried out using data provided by in vitro experiments mimicking in vivo surgical conditions.

Estimating orientation using magnetic and inertial sensors and different sensor fusion approaches: accuracy assessment in manual and locomotion tasks.

Magnetic and inertial measurement units are an emerging technology to obtain 3D orientation of body segments in human movement analysis. In this respect, sensor fusion is used to limit the drift errors resulting from the gyroscope data integration by exploiting accelerometer and magnetic aiding sensors. The present study aims at investigating the effectiveness of sensor fusion methods under different experimental conditions.

A soft tissue artefact model driven by proximal and distal joint kinematics.

When analysing human movement through stereophotogrammetry, skin-markers are used. Their movement relative to the underlying bone is known as a soft tissue artefact (STA). A mathematical model to estimate subject- and marker-specific STAs generated during a given motor task, is required for both skeletal kinematic estimators and comparative assessment using simulation.

Integration of human walking gyroscopic data using empirical mode decomposition.

The present study was aimed at evaluating the Empirical Mode Decomposition (EMD) method to estimate the 3D orientation of the lower trunk during walking using the angular velocity signals generated by a wearable inertial measurement unit (IMU) and notably flawed by drift. The IMU was mounted on the lower trunk (L4-L5) with its active axes aligned with the relevant anatomical axes. The proposed method performs an offline analysis, but has the advantage of not requiring any parameter tuning.

The onset of type 2 diabetes: proposal for a multi-scale model.

Background: Type 2 diabetes mellitus (T2D) is a common age-related disease, and is a major health concern, particularly in developed countries where the population is aging, including Europe. The multi-scale immune system simulator for the onset of type 2 diabetes (MISSION-T2D) is a European Union-funded project that aims to develop and validate an integrated, multilevel, and patient-specific model, incorporating genetic, metabolic, and nutritional data for the simulation and prediction of metabolic and inflammatory processes in the onset and progression of T2D. The project will ultimately provide a tool for diagnosis and clinical decision making that can estimate the risk of developing T2D and predict its progression in response to possible therapies.

Use of weighted Fourier linear combiner filters to estimate lower trunk 3D orientation from gyroscope sensors data.

Background: The present study aimed at devising a data processing procedure that provides an optimal estimation of the 3-D instantaneous orientation of an inertial measurement unit (IMU). This result is usually obtained by fusing the data measured with accelerometers, gyroscopes, and magnetometers. Nevertheless, issues related to compensation of integration errors and high sensitivity of these devices to magnetic disturbances call for different solutions.

Real-time estimate of body kinematics during a planar squat task using a single inertial measurement unit.

This study aimed at the real-time estimation of the lower-limb joint and torso kinematics during a squat exercise, performed in the sagittal plane, using a single inertial measurement unit placed on the lower back. The human body was modeled with a 3-DOF planar chain. The planar IMU orientation and vertical displacement were estimated using one angular velocity and two acceleration components and a weighted Fourier linear combiner.

Trunk inclination estimate during the sprint start using an inertial measurement unit: a validation study.

The proper execution of the sprint start is crucial in determining the performance during a sprint race. In this respect, when moving from the crouch to the upright position, trunk kinematics is a key element. The purpose of this study was to validate the use of a trunk-mounted inertial measurement unit (IMU) in estimating the trunk inclination and angular velocity in the sagittal plane during the sprint start.

A hip joint kinematics driven model for the generation of realistic thigh soft tissue artefacts.

In human movement analysis, accuracy and robustness of the algorithms used to determine the location of centres of rotation from stereophotogrametric data depend mainly on their capacity to deal with the artefacts due to soft tissue deformation (STA). While evaluating these algorithms using a mathematical simulation approach, effectual realizations of STAs are needed. This study aimed at accomplishing this objective by modelling STAs, in twelve selected areas of the thigh, as a linear function of the hip angles, assuming no knee joint movement.

Assessing locomotor skills development in childhood using wearable inertial sensor devices: the running paradigm.

Objective quantitative evaluation of motor skill development is of increasing importance to carefully drive physical exercise programs in childhood. Running is a fundamental motor skill humans adopt to accomplish locomotion, which is linked to physical activity levels, although the assessment is traditionally carried out using qualitative evaluation tests. The present study aimed at investigating the feasibility of using inertial sensors to quantify developmental differences in the running pattern of young children.