Inertial Sensor-Based Lower Limb Joint Kinematics: A Methodological Systematic Review.
ABSTRACT: The use of inertial measurement units (IMUs) has gained popularity for the estimation of lower limb kinematics. However, implementations in clinical practice are still lacking. The aim of this review is twofold-to evaluate the methodological requirements for IMU-based joint kinematic estimation to be applicable in a clinical setting, and to suggest future research directions. Studies within the PubMed, Web Of Science and EMBASE databases were screened for eligibility, based on the following inclusion criteria: (1) studies must include a methodological description of how kinematic variables were obtained for the lower limb, (2) kinematic data must have been acquired by means of IMUs, (3) studies must have validated the implemented method against a golden standard reference system. Information on study characteristics, signal processing characteristics and study results was assessed and discussed. This review shows that methods for lower limb joint kinematics are inherently application dependent. Sensor restrictions are generally compensated with biomechanically inspired assumptions and prior information. Awareness of the possible adaptations in the IMU-based kinematic estimates by incorporating such prior information and assumptions is necessary, before drawing clinical decisions. Future research should focus on alternative validation methods, subject-specific IMU-based biomechanical joint models and disturbed movement patterns in real-world settings.
Project description:Camera-based 3D motion analysis systems are considered to be the gold standard for movement analysis. However, using such equipment in a clinical setting is prohibitive due to the expense and time-consuming nature of data collection and analysis. Therefore, Inertial Measurement Units (IMUs) have been suggested as an alternative to measure movement in clinical settings. One area which is both important and challenging is the assessment of turning kinematics in individuals with movement disorders. This study aimed to validate the use of IMUs in the measurement of turning kinematics in healthy adults compared to a camera-based 3D motion analysis system. Data were collected from twelve participants using a Vicon motion analysis system which were compared with data from four IMUs placed on the forehead, middle thorax, and feet in order to determine accuracy and reliability. The results demonstrated that the IMU sensors produced reliable kinematic measures and showed excellent reliability (ICCs 0.80-0.98) and no significant differences were seen in paired t-tests in all parameters when comparing the two systems. This suggests that the IMU sensors provide a viable alternative to camera-based motion capture that could be used in isolation to gather data from individuals with movement disorders in clinical settings and real-life situations.
Project description:<h4>Background</h4>Inertial measurement unit (IMU)-based motion capture systems are gaining popularity for gait analysis outside laboratories. It is important to determine the performance of such systems in specific patient populations. We aimed to validate and determine within-day reliability of an IMU system for measuring lower limb gait kinematics and temporal-spatial parameters (TSP) in people with and without HIV.<h4>Methods</h4>Gait was recorded in eight adults with HIV (PLHIV) and eight HIV-seronegative participants (SNP), using IMUs and optical motion capture (OMC) simultaneously. Participants performed six gait trials. Fifteen TSP and 28 kinematic angles were extracted. Intraclass correlations (ICC), root-mean-square error (RMSE), mean absolute percentage error and Bland-Altman analyses were used to assess concurrent validity of the IMU system (relative to OMC) separately in PLHIV and SNP. IMU reliability was assessed during within-session retest of trials. ICCs were used to assess relative reliability. Standard error of measurement (SEM) and percentage SEM were used to assess absolute reliability.<h4>Results</h4>Between-system TSP differences demonstrated acceptable-to-excellent ICCs (0.71-0.99), except for double support time and temporophasic parameters (<?0.60). All TSP demonstrated good mean absolute percentage errors (?7.40%). For kinematics, ICCs were acceptable to excellent (0.75-1.00) for all but three range of motion (ROM) and four discrete angles. RMSE and bias were 0.0°-4.7° for all but two ROM and 10 discrete angles. In both groups, TSP reliability was acceptable to excellent for relative (ICC 0.75-0.99) (except for one temporal and two temporophasic parameters) and absolute (%SEM 1.58-15.23) values. Reliability trends of IMU-measured kinematics were similar between groups and demonstrated acceptable-to-excellent relative reliability (ICC 0.76-0.99) and clinically acceptable absolute reliability (SEM 0.7°-4.4°) for all but two and three discrete angles, respectively. Both systems demonstrated similar magnitude and directional trends for differences when comparing the gait of PLHIV with that of SNP.<h4>Conclusions</h4>IMU-based gait analysis is valid and reliable when applied in PLHIV; demonstrating a sufficiently low precision error to be used for clinical interpretation (<?5° for most kinematics; <?20% for TSP). IMU-based gait analysis is sensitive to subtle gait deviations that may occur in PLHIV.
Project description:Quantitative gait analysis can provide a description of joint kinematics and dynamics, and it is recognized as a clinically useful tool for functional assessment, diagnosis and intervention planning. Clinically interpretable parameters are estimated from quantitative measures (i.e. ground reaction forces, skin marker trajectories, etc.) through biomechanical modelling. In particular, the estimation of joint moments during motion is grounded on several modelling assumptions: (1) body segmental and joint kinematics is derived from the trajectories of markers and by modelling the human body as a kinematic chain; (2) joint resultant (net) loads are, usually, derived from force plate measurements through a model of segmental dynamics. Therefore, both measurement errors and modelling assumptions can affect the results, to an extent that also depends on the characteristics of the motor task analysed (i.e. gait speed). Errors affecting the trajectories of joint centres, the orientation of joint functional axes, the joint angular velocities, the accuracy of inertial parameters and force measurements (concurring to the definition of the dynamic model), can weigh differently in the estimation of clinically interpretable joint moments. Numerous studies addressed all these methodological aspects separately, but a critical analysis of how these aspects may affect the clinical interpretation of joint dynamics is still missing. This article aims at filling this gap through a systematic review of the literature, conducted on Web of Science, Scopus and PubMed. The final objective is hence to provide clear take-home messages to guide laboratories in the estimation of joint moments for the clinical practice.
Project description:Investigating the effects of load carriage on military soldiers using optical motion capture is challenging. However, inertial measurement units (IMUs) provide a promising alternative. Our purpose was to compare optical motion capture with an Xsens IMU system in terms of movement reconstruction using principal component analysis (PCA) using correlation coefficients and joint kinematics using root mean squared error (RMSE). Eighteen civilians performed military-type movements while their motion was recorded using both optical and IMU-based systems. Tasks included walking, running, and transitioning between running, kneeling, and prone positions. PCA was applied to both the optical and virtual IMU markers, and the correlations between the principal component (PC) scores were assessed. Full-body joint angles were calculated and compared using RMSE between optical markers, IMU data, and virtual markers generated from IMU data with and without coordinate system alignment. There was good agreement in movement reconstruction using PCA; the average correlation coefficient was 0.81 ± 0.14. RMSE values between the optical markers and IMU data for flexion-extension were less than 9°, and 15° for the lower and upper limbs, respectively, across all tasks. The underlying biomechanical model and associated coordinate systems appear to influence RMSE values the most. The IMU system appears appropriate for capturing and reconstructing full-body motion variability for military-based movements.
Project description:In inertial body tracking, the human body is commonly represented as a biomechanical model consisting of rigid segments with known lengths and connecting joints. The model state is then estimated via sensor fusion methods based on data from attached inertial measurement units (IMUs). This requires the relative poses of the IMUs w.r.t. the segments-the IMU-to-segment calibrations, subsequently called I2S calibrations-to be known. Since calibration methods based on static poses, movements and manual measurements are still the most widely used, potentially large human-induced calibration errors have to be expected. This work compares three newly developed/adapted extended Kalman filter (EKF) and optimization-based sensor fusion methods with an existing EKF-based method w.r.t. their segment orientation estimation accuracy in the presence of model calibration errors with and without using magnetometer information. While the existing EKF-based method uses a segment-centered kinematic chain biomechanical model and a constant angular acceleration motion model, the newly developed/adapted methods are all based on a free segments model, where each segment is represented with six degrees of freedom in the global frame. Moreover, these methods differ in the assumed motion model (constant angular acceleration, constant angular velocity, inertial data as control input), the state representation (segment-centered, IMU-centered) and the estimation method (EKF, sliding window optimization). In addition to the free segments representation, the optimization-based method also represents each IMU with six degrees of freedom in the global frame. In the evaluation on simulated and real data from a three segment model (an arm), the optimization-based method showed the smallest mean errors, standard deviations and maximum errors throughout all tests. It also showed the lowest dependency on magnetometer information and motion agility. Moreover, it was insensitive w.r.t. I2S position and segment length errors in the tested ranges. Errors in the I2S orientations were, however, linearly propagated into the estimated segment orientations. In the absence of magnetic disturbances, severe model calibration errors and fast motion changes, the newly developed IMU centered EKF-based method yielded comparable results with lower computational complexity.
Project description:Inertial measurement units (IMUs) are increasingly used to estimate movement quality and quantity to the infer the nature of motor behavior. The current literature contains several attempts to estimate movement smoothness using data from IMUs, many of which assume that the translational and rotational kinematics measured by IMUs can be directly used with the smoothness measures spectral arc length (SPARC) and log dimensionless jerk (LDLJ-V). However, there has been no investigation of the validity of these approaches. In this paper, we systematically evaluate the use of these measures on the kinematics measured by IMUs. We show that: (a) SPARC and LDLJ-V are valid measures of smoothness only when used with velocity; (b) SPARC and LDLJ-V applied on translational velocity reconstructed from IMU is highly error prone due to drift caused by integration of reconstruction errors; (c) SPARC can be applied directly on rotational velocities measured by a gyroscope, but LDLJ-V can be error prone. For discrete translational movements, we propose a modified version of the LDLJ-V measure, which can be applied to acceleration data (LDLJ-A). We evaluate the performance of these measures using simulated and experimental data. We demonstrate that the accuracy of LDLJ-A depends on the time profile of IMU orientation reconstruction error. Finally, we provide recommendations for how to appropriately apply these measures in practice under different scenarios, and highlight various factors to be aware of when performing smoothness analysis using IMU data.
Project description:The increased variations of temporal gait events when pathology is present are good candidate features for objective diagnostic tests. We hypothesised that the gait events hoof-on/off and stance can be detected accurately and precisely using features from trunk and distal limb-mounted Inertial Measurement Units (IMUs). Four IMUs were mounted on the distal limb and five IMUs were attached to the skin over the dorsal spinous processes at the withers, fourth lumbar vertebrae and sacrum as well as left and right tuber coxae. IMU data were synchronised to a force plate array and a motion capture system. Accuracy (bias) and precision (SD of bias) was calculated to compare force plate and IMU timings for gait events. Data were collected from seven horses. One hundred and twenty three (123) front limb steps were analysed; hoof-on was detected with a bias (SD) of -7 (23) ms, hoof-off with 0.7 (37) ms and front limb stance with -0.02 (37) ms. A total of 119 hind limb steps were analysed; hoof-on was found with a bias (SD) of -4 (25) ms, hoof-off with 6 (21) ms and hind limb stance with 0.2 (28) ms. IMUs mounted on the distal limbs and sacrum can detect gait events accurately and precisely.
Project description:Speed is an essential parameter in biomechanical analysis and general locomotion research. It is possible to estimate the speed using global positioning systems (GPS) or inertial measurement units (IMUs). However, GPS requires a consistent signal connection to satellites, and errors accumulate during IMU signals integration. In an attempt to overcome these issues, we have investigated the possibility of estimating the horse speed by developing machine learning (ML) models using the signals from seven body-mounted IMUs. Since motion patterns extracted from IMU signals are different between breeds and gaits, we trained the models based on data from 40 Icelandic and Franches-Montagnes horses during walk, trot, tölt, pace, and canter. In addition, we studied the estimation accuracy between IMU locations on the body (sacrum, withers, head, and limbs). The models were evaluated per gait and were compared between ML algorithms and IMU location. The model yielded the highest estimation accuracy of speed (RMSE = 0.25 m/s) within equine and most of human speed estimation literature. In conclusion, highly accurate horse speed estimation models, independent of IMU(s) location on-body and gait, were developed using ML.
Project description:3D joint kinematics can provide important information about the quality of movements. Optical motion capture systems (OMC) are considered the gold standard in motion analysis. However, in recent years, inertial measurement units (IMU) have become a promising alternative. The aim of this study was to validate IMU-based 3D joint kinematics of the lower extremities during different movements. Twenty-eight healthy subjects participated in this study. They performed bilateral squats (SQ), single-leg squats (SLS) and countermovement jumps (CMJ). The IMU kinematics was calculated using a recently-described sensor-fusion algorithm. A marker based OMC system served as a reference. Only the technical error based on algorithm performance was considered, incorporating OMC data for the calibration, initialization, and a biomechanical model. To evaluate the validity of IMU-based 3D joint kinematics, root mean squared error (RMSE), range of motion error (ROME), Bland-Altman (BA) analysis as well as the coefficient of multiple correlation (CMC) were calculated. The evaluation was twofold. First, the IMU data was compared to OMC data based on marker clusters; and, second based on skin markers attached to anatomical landmarks. The first evaluation revealed means for RMSE and ROME for all joints and tasks below 3°. The more dynamic task, CMJ, revealed error measures approximately 1° higher than the remaining tasks. Mean CMC values ranged from 0.77 to 1 over all joint angles and all tasks. The second evaluation showed an increase in the RMSE of 2.28°- 2.58° on average for all joints and tasks. Hip flexion revealed the highest average RMSE in all tasks (4.87°- 8.27°). The present study revealed a valid IMU-based approach for the measurement of 3D joint kinematics in functional movements of varying demands. The high validity of the results encourages further development and the extension of the present approach into clinical settings.
Project description:BACKGROUND:Inertial measurement units (IMUs) offer the ability to measure walking gait through a variety of biomechanical outcomes (e.g., spatiotemporal, kinematics, other). Although many studies have assessed their validity and reliability, there remains no quantitive summary of this vast body of literature. Therefore, we aimed to conduct a systematic review and meta-analysis to determine the i) concurrent validity and ii) test-retest reliability of IMUs for measuring biomechanical gait outcomes during level walking in healthy adults. METHODS:Five electronic databases were searched for journal articles assessing the validity or reliability of IMUs during healthy adult walking. Two reviewers screened titles, abstracts, and full texts for studies to be included, before two reviewers examined the methodological quality of all included studies. When sufficient data were present for a given biomechanical outcome, data were meta-analyzed on Pearson correlation coefficients (r) or intraclass correlation coefficients (ICC) for validity and reliability, respectively. Alternatively, qualitative summaries of outcomes were conducted on those that could not be meta-analyzed. RESULTS:A total of 82 articles, assessing the validity or reliability of over 100 outcomes, were included in this review. Seventeen biomechanical outcomes, primarily spatiotemporal parameters, were meta-analyzed. The validity and reliability of step and stride times were found to be excellent. Similarly, the validity and reliability of step and stride length, as well as swing and stance time, were found to be good to excellent. Alternatively, spatiotemporal parameter variability and symmetry displayed poor to moderate validity and reliability. IMUs were also found to display moderate reliability for the assessment of local dynamic stability during walking. The remaining biomechanical outcomes were qualitatively summarized to provide a variety of recommendations for future IMU research. CONCLUSIONS:The findings of this review demonstrate the excellent validity and reliability of IMUs for mean spatiotemporal parameters during walking, but caution the use of spatiotemporal variability and symmetry metrics without strict protocol. Further, this work tentatively supports the use of IMUs for joint angle measurement and other biomechanical outcomes such as stability, regularity, and segmental accelerations. Unfortunately, the strength of these recommendations are limited based on the lack of high-quality studies for each outcome, with underpowered and/or unjustified sample sizes (sample size median 12; range: 2-95) being the primary limitation.