Publications by authors named "Natalie Baddour"

The activities-specific balance confidence scale (ABC) assesses balance confidence during common activities. While low balance confidence can result in activity avoidance, excess confidence can increase fall risk. People with lower limb amputations can present with inconsistent gait, adversely affecting their balance confidence.

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Functional mobility tests, such as the L test of functional mobility, are recommended to provide clinicians with information regarding the mobility progress of lower-limb amputees. Smartphone inertial sensors have been used to perform subtask segmentation on functional mobility tests, providing further clinically useful measures such as fall risk. However, L test subtask segmentation rule-based algorithms developed for able-bodied individuals have not produced sufficiently acceptable results when tested with lower-limb amputee data.

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Prosthetic technology has advanced with the development of powered prostheses to enhance joint function and movement in the absence of native anatomy. However, there are no powered solutions available for hip-level amputees, and most existing hip prostheses are mounted to the front of the prosthetic socket, thereby limiting range of motion. This research introduces a novel laterally mounted powered hip joint (LMPHJ) that augments user movement.

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Background: Traumatic spinal cord injuries (TSCI) greatly affect the lives of patients and their families. Prognostication may improve treatment strategies, health care resource allocation, and counseling. Multivariable clinical prediction models (CPMs) for prognosis are tools that can estimate an absolute risk or probability that an outcome will occur.

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Background: Control system design for a microprocessor-controlled hip-knee-ankle-foot (HKAF) prosthesis is a challenge since hip disarticulation amputees lack the entire leg and, therefore, only have pelvis movement as user-guided input. This research proposes a method for determining hip joint angles from pelvis movement in a control system for the next generation of powered prostheses.

Method: Three-dimensional pelvic motion and stance time of 10 transfemoral (TF) prosthetic users were used to identify important features and to develop an algorithm to calculate hip angles from pelvis movement based on correlation and linear regression results.

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Background: Conducting clinical trials for traumatic spinal cord injury (tSCI) presents challenges due to patient heterogeneity. Identifying clinically similar subgroups using patient demographics and baseline injury characteristics could lead to better patient-centered care and integrated care delivery.

Purpose: We sought to (1) apply an unsupervised machine learning approach of cluster analysis to identify subgroups of tSCI patients using patient demographics and injury characteristics at baseline, (2) to find clinical similarity within subgroups using etiological variables and outcome variables, and (3) to create multi-dimensional labels for categorizing patients.

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Recent advancements in computing and artificial intelligence (AI) make it possible to quantitatively evaluate human movement using digital video, thereby opening the possibility of more accessible gait analysis. The Edinburgh Visual Gait Score (EVGS) is an effective tool for observational gait analysis, but human scoring of videos can take over 20 min and requires experienced observers. This research developed an algorithmic implementation of the EVGS from handheld smartphone video to enable automatic scoring.

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Hip-knee-ankle-foot prostheses (HKAF) are full lower-limb devices for people with hip amputations that enable individuals to regain their mobility and move freely within their chosen environment. HKAFs typically have high rejection rates among users, as well as gait asymmetry, increased trunk anterior-posterior lean, and increased pelvic tilt. A novel integrated hip-knee (IHK) unit was designed and evaluated to address the limitations of existing solutions.

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Predictive models for fall risk classification are valuable for early identification and intervention. However, lower limb amputees are often neglected in fall risk research despite having increased fall risk compared to age-matched able-bodied individuals. A random forest model was previously shown to be effective for fall risk classification of lower limb amputees, however manual labelling of foot strikes was required.

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People with a limb loss at the level of the hip or pelvis have the most difficulty returning to walking compared with those with a lower amputation. This is because their prosthesis must replace the hip, knee, and ankle joints. An adjustable hip-disarticulation/hemipelvectomy prosthesis simulator that allows able-bodied individuals to wear and assess a prosthesis can help researchers and manufacturers when designing new prosthetic components (ie, hip joints).

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Background: This research was conducted to better understand compensatory strategies during cross-slope walking for adults with and without a unilateral transtibial amputation.

Methods: Fourteen individuals with unilateral transtibial amputation and 14 individuals with no lower limb amputation participated in this study. Motion and force data were captured while participants walked on a treadmill in a virtual reality environment for level and ± 5° cross slopes.

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The 6-min walk test (6MWT) is commonly used to assess a person’s physical mobility and aerobic capacity. However, richer knowledge can be extracted from movement assessments using artificial intelligence (AI) models, such as fall risk status. The 2-min walk test (2MWT) is an alternate assessment for people with reduced mobility who cannot complete the full 6MWT, including some people with lower limb amputations; therefore, this research investigated automated foot strike (FS) detection and fall risk classification using data from a 2MWT.

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Article Synopsis
  • Foot strike detection is crucial for analyzing gait in individuals, and recent research focused on using smartphone sensors to automate this process, especially for lower limb amputees with unique gait patterns.
  • A new method was developed utilizing raw accelerometer and gyroscope signals from smartphones, training decision tree and LSTM models, yielding impressive accuracy metrics.
  • The LSTM model emerged as the most effective for automating foot strike identification in amputees, offering potential for clinical use and further applications like fall detection.
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Background: Although the global population of people with a hip disarticulation (HD) or hemipelvectomy (HP) amputation is small, the degree of disability is high, affecting function and independence. A comprehensive literature review is needed to examine the evidence for prostheses in these amputation levels.

Method: A scoping literature review was conducted to examine related research documents from 1950 to September 2020, found using Scopus, Web of Science, PubMed, and Google Scholar databases.

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Fall-risk classification is a challenging but necessary task to enable the recommendation of preventative programs for individuals identified at risk for falling. Existing research has primarily focused on older adults, with no predictive fall-risk models for lower limb amputees, despite their greater likelihood of fall-risk than older adults. In this study, 89 amputees with varying degrees of lower limb amputation were asked if they had fallen in the past 6 months.

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Objective: In this research, a marker-less 'smart hallway' is proposed where stride parameters are computed as a person walks through an institutional hallway. Stride analysis is a viable tool for identifying mobility changes, classifying abnormal gait, estimating fall risk, monitoring progression of rehabilitation programs, and indicating progression of nervous system related disorders.

Methods: Smart hallway was build using multiple Intel RealSense D415 depth cameras.

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The theory of the continuous two-dimensional (2D) Fourier Transform in polar coordinates has been recently developed but no discrete counterpart exists to date. In the first part of this two-paper series, we proposed and evaluated the theory of the 2D Discrete Fourier Transform (DFT) in polar coordinates. The theory of the actual manipulated quantities was shown, including the standard set of shift, modulation, multiplication, and convolution rules.

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Recognizing aggressive movements is a challenging task in human activity recognition. Wearable smartwatch technology with machine learning may be a viable approach for human aggressive behavior classification. This research identified a viable classification model and feature selector (CM-FS) combination for separating aggressive from non-aggressive movements using smartwatch data and determined if only one smartwatch is sufficient for this task.

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Ankle foot orthosis (AFO) stiffness affects ankle range of motion but can also provide energy storage and return to improve mobility. To perform multiple activities during the day, a person may want to change their AFO stiffness to meet their activity's demand. Carrying multiple AFOs and changing AFOs is inconvenient and could discourage users from engaging in multiple activities.

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Marker tracking for postural and range of motion (ROM) measurements transcends multiple disciplines (e.g., healthcare, ergonomics, engineering).

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Identifying people at risk of falling can prevent life altering injury. Existing research has demonstrated fall-risk classifier effectiveness in older adults from accelerometer-based data. The amputee population should similarly benefit from these classification techniques; however, validation is still required.

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Purpose: This research compares gait strategies to maintain stable gait over a variety of non-level walking conditions for individuals with a transtibial amputation and able-bodied individuals.

Methods: Twelve people with unilateral transtibial amputation and twelve able-bodied individuals walked on a self-paced treadmill in a park-like virtual environment with level and continuous perturbation conditions. Walking stability was quantified by margin-of-stability, step parameters (walking speed, temporal and spatial parameters, and foot clearance), and gait variability (standard deviations for margin-of-stability, step parameters, and root-mean-square of trunk acceleration).

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Vibration signal analysis is an important technique for bearing fault diagnosis. For bearings operating under constant rotational speed, faults can be diagnosed in the frequency domain since each type of fault has a specific Fault Characteristic Frequency (FCF), which is proportional to the shaft rotational speed. However, bearings often operate under time-varying speed conditions.

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Recent developments in photoacoustics have witnessed the implementation of a radar matched-filtering methodology into the continuous wave photoacoustic modality. The main merit of using matched filtering in continuous photoacoustics is the improvement in signal to noise ratio (SNR), but the correlation process may result in a loss of resolution. It is possible to enhance both SNR and resolution by matched-filtering and pulse compression with a frequency chirp.

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Background: Functionality and versatility of microprocessor-controlled stance-control knee-ankle-foot orthoses (M-SCKAFO) are dictated by their embedded control systems. Proper gait phase recognition (GPR) is required to enable these devices to provide sufficient knee-control at the appropriate time, thereby reducing the incidence of knee-collapse and fall events. Ideally, the M-SCKAFO sensor system would be local to the thigh and knee, to facilitate innovative orthosis designs that allow more flexibility for ankle joint selection and other orthosis components.

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