Ecological validity of a deep learning algorithm to detect gait events from real-life walking bouts in mobility-limiting diseases
Frontiers in Neurology, vol. 14, pp. 1247532
Abstract
Introduction: The clinical assessment of mobility, and walking specifically, is still mainly based on functional tests that lack ecological validity. Thanks to inertial measurement units (IMUs), gait analysis is shifting to unsupervised monitoring in naturalistic and unconstrained settings. However, the extraction of clinically relevant gait parameters from IMU data often depends on heuristics-based algorithms that rely on empirically determined thresholds. These were mainly validated on small cohorts in supervised settings. Methods: Here, a deep learning (DL) algorithm was developed and validated for gait event detection in a heterogeneous population of different mobility-limiting disease cohorts and a cohort of healthy adults. Participants wore pressure insoles and IMUs on both feet for 2.5 h in their habitual environment. The raw accelerometer and gyroscope data from both feet were used as input to a deep convolutional neural network, while reference timings for gait events were based on the combined IMU and pressure insoles data. Results and discussion: The results showed a high-detection performance for initial contacts (ICs) (recall: 98%, precision: 96%) and final contacts (FCs) (recall: 99%, precision: 94%) and a maximum median time error of -0.02 s for ICs and 0.03 s for FCs. Subsequently derived temporal gait parameters were in good agreement with a pressure insoles-based reference with a maximum mean difference of 0.07, -0.07, and <0.01 s for stance, swing, and stride time, respectively. Thus, the DL algorithm is considered successful in detecting gait events in ecologically valid environments across different mobility-limiting diseases.
Authors 49
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Robbin Romijnders corresponding
Christian-Albrechts-Universität zu Kiel · University Hospital Schleswig-Holstein
Affiliation as printed
Arbeitsgruppe Neurogeriatrie, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
Digital Signal Processing and System Theory, Electrical and Information Engineering, Faculty of Engineering, Kiel University, Kiel, Germany
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Affiliation as printed
Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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University Hospital Schleswig-Holstein
Affiliation as printed
Arbeitsgruppe Neurogeriatrie, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
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Friedrich-Alexander-Universität Erlangen-Nürnberg
Affiliation as printed
Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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École Polytechnique Fédérale de Lausanne
Affiliation as printed
Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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Affiliation as printed
Department of Electronics and Telecommunications, Polytechnic of Turin, Turin, Italy
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Affiliation as printed
Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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École Polytechnique Fédérale de Lausanne
Affiliation as printed
Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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Affiliation as printed
Gesellschaft für Medizinische Forschung, Robert-Bosch Foundation GmbH, Stuttgart, Germany
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Affiliation as printed
Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom
INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, United Kingdom
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Newcastle upon Tyne Hospitals NHS Foundation Trust
Affiliation as printed
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom
INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, United Kingdom
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Affiliation as printed
School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
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Universitat Pompeu Fabra · Barcelona Institute for Global Health · Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Affiliation as printed
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
CIBER Epidemiología y Salud Pública, Madrid, Spain
Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Affiliation as printed
Department of Electronics and Telecommunications, Polytechnic of Turin, Turin, Italy
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University College Dublin · Insight SFI Research Centre for Data Analytics
Affiliation as printed
Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Affiliation as printed
Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRISDV), University of Bologna, Bologna, Italy
Health Sciences and Technologies—Interdepartmental Center for Industrial Research (CIRISDV), University of Bologna, Bologna, Italy
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Affiliation as printed
Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
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Affiliation as printed
Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, United Kingdom
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Friedrich-Alexander-Universität Erlangen-Nürnberg
Affiliation as printed
Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Affiliation as printed
School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
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Affiliation as printed
Grünenthal GmbH, Aachen, Germany
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Universitat Pompeu Fabra · Barcelona Institute for Global Health · Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Affiliation as printed
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
CIBER Epidemiología y Salud Pública, Madrid, Spain
Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Tel Aviv Sourasky Medical Center
Affiliation as printed
Center for the Study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Tel Aviv University · Tel Aviv Sourasky Medical Center
Affiliation as printed
Center for the Study of Movement, Cognition and Mobility, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Department of Physical Therapy, Sackler Faculty of Medicine & Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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Affiliation as printed
School of Computing, Newcastle University, Newcastle upon Tyne, United Kingdom
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Affiliation as printed
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
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University College Dublin · Insight SFI Research Centre for Data Analytics
Affiliation as printed
Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Affiliation as printed
Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Novartis (Switzerland) · Friedrich-Alexander-Universität Erlangen-Nürnberg · Novartis Institutes for BioMedical Research
Affiliation as printed
Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
Novartis Institute of Biomedical Research, Novartis Pharma AG, Basel, Switzerland
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Universitat Pompeu Fabra · Barcelona Institute for Global Health · Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Affiliation as printed
Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
CIBER Epidemiología y Salud Pública, Madrid, Spain
Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom
INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, United Kingdom
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Affiliation as printed
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
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Affiliation as printed
Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Novartis (Switzerland) · Novartis Institutes for BioMedical Research
Affiliation as printed
Novartis Institute of Biomedical Research, Novartis Pharma AG, Basel, Switzerland
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Affiliation as printed
Department of Electrical, Electronic and Information Engineering "Guglielmo Marconi", University of Bologna, Bologna, Italy
Health Sciences and Technologies-Interdepartmental Center for Industrial Research (CIRISDV), University of Bologna, Bologna, Italy
Health Sciences and Technologies—Interdepartmental Center for Industrial Research (CIRISDV), University of Bologna, Bologna, Italy
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Newcastle upon Tyne Hospitals NHS Foundation Trust · Newcastle University
Affiliation as printed
Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, United Kingdom
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Affiliation as printed
Gesellschaft für Medizinische Forschung, Robert-Bosch Foundation GmbH, Stuttgart, Germany
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom
INSIGNEO Institute for In Silico Medicine, The University of Sheffield, Sheffield, United Kingdom
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Sheffield Teaching Hospitals NHS Foundation Trust
Affiliation as printed
Department of Neuroscience and Sheffield NIHR Translational Neuroscience BRC, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
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University College Dublin · Insight SFI Research Centre for Data Analytics
Affiliation as printed
Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland
School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
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Swiss Center for Electronics and Microtechnology (Switzerland) · École Polytechnique Fédérale de Lausanne
Affiliation as printed
Digital Health Department, CSEM SA, Neuchâtel, Switzerland
Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
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Friedrich-Alexander-Universität Erlangen-Nürnberg
Affiliation as printed
Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Norwegian University of Science and Technology
Affiliation as printed
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
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Affiliation as printed
Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
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Newcastle University · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering, The University of Sheffield, Sheffield, United Kingdom
Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
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Christian-Albrechts-Universität zu Kiel
Affiliation as printed
Digital Signal Processing and System Theory, Electrical and Information Engineering, Faculty of Engineering, Kiel University, Kiel, Germany
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University Hospital Schleswig-Holstein
Affiliation as printed
Arbeitsgruppe Neurogeriatrie, Department of Neurology, Universitätsklinikum Schleswig-Holstein, Kiel, Germany
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