Correction: Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium
Journal of NeuroEngineering and Rehabilitation, vol. 21, pp. 71
Abstract
Background: Although digital mobility outcomes (DMOs) can be readily calculated from real-world data collected with wearable devices and ad-hoc algorithms, technical validation is still required. The aim of this paper is to comparatively assess and validate DMOs estimated using real-world gait data from six different cohorts, focusing on gait sequence detection, foot initial contact detection (ICD), cadence (CAD) and stride length (SL) estimates. Methods: Twenty healthy older adults, 20 people with Parkinson’s disease, 20 with multiple sclerosis, 19 with proximal femoral fracture, 17 with chronic obstructive pulmonary disease and 12 with congestive heart failure were monitored for 2.5 h in the real-world, using a single wearable device worn on the lower back. A reference system combining inertial modules with distance sensors and pressure insoles was used for comparison of DMOs from the single wearable device. We assessed and validated three algorithms for gait sequence detection, four for ICD, three for CAD and four for SL by concurrently comparing their performances (e.g., accuracy, specificity, sensitivity, absolute and relative errors). Additionally, the effects of walking bout (WB) speed and duration on algorithm performance were investigated. Results: We identified two cohort-specific top performing algorithms for gait sequence detection and CAD, and a single best for ICD and SL. Best gait sequence detection algorithms showed good performances (sensitivity > 0.73, positive predictive values > 0.75, specificity > 0.95, accuracy > 0.94). ICD and CAD algorithms presented excellent results, with sensitivity > 0.79, positive predictive values > 0.89 and relative errors < 11% for ICD and < 8.5% for CAD. The best identified SL algorithm showed lower performances than other DMOs (absolute error < 0.21 m). Lower performances across all DMOs were found for the cohort with most severe gait impairments (proximal femoral fracture). Algorithms’ performances were lower for short walking bouts; slower gait speeds (< 0.5 m/s) resulted in reduced performance of the CAD and SL algorithms. Conclusions: Overall, the identified algorithms enabled a robust estimation of key DMOs. Our findings showed that the choice of algorithm for estimation of gait sequence detection and CAD should be cohort-specific (e.g., slow walkers and with gait impairments). Short walking bout length and slow walking speed worsened algorithms’ performances. Trial registration ISRCTN – 12246987.
Authors 49
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Affiliation as printed
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
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École Polytechnique Fédérale de Lausanne
Affiliation as printed
Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
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Friedrich-Alexander-Universität Erlangen-Nürnberg
Affiliation as printed
Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
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Affiliation as printed
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
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École Polytechnique Fédérale de Lausanne
Affiliation as printed
Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
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Friedrich-Alexander-Universität Erlangen-Nürnberg
Affiliation as printed
Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
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Tel Aviv Sourasky Medical Center
Affiliation as printed
Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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University of Sassari · Politecnico di Torino
Affiliation as printed
Department of Biomedical Sciences, University of Sassari, Sassari, Italy
Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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Newcastle upon Tyne Hospitals NHS Foundation Trust · NIHR Newcastle Biomedical Research Centre · Newcastle University
Affiliation as printed
National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
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École Polytechnique Fédérale de Lausanne
Affiliation as printed
Laboratory of Movement Analysis and Measurement, Ecole Polytechnique Federale de Lausanne, Lausanne, Switzerland
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Affiliation as printed
Robert Bosch Gesellschaft für Medizinische Forschung, Stuttgart, Germany
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Affiliation as printed
Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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Newcastle upon Tyne Hospitals NHS Foundation Trust
Affiliation as printed
The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
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Affiliation as printed
School of Computing, Newcastle University, Newcastle Upon Tyne, UK
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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 (CIBERESP), Madrid, Spain
Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
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Affiliation as printed
Department of Electronics and Telecommunications, Politecnico di Torino, 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 Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
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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 (CIRI-SDV), 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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Friedrich-Alexander-Universität Erlangen-Nürnberg
Affiliation as printed
Machine Learning and Data Analytics Lab, 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, UK
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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 (CIBERESP), Madrid, Spain
Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
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University Hospital Schleswig-Holstein
Affiliation as printed
Department of Neurology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
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Rush University Medical Center · Tel Aviv University · Tel Aviv Sourasky Medical Center
Affiliation as printed
Center for the Study of Movement, Cognition and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Rush Alzheimer's Disease Center and Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA
Sagol School of Neuroscience and Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Affiliation as printed
School of Computing, Newcastle University, Newcastle Upon Tyne, UK
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Affiliation as printed
Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle Upon Tyne, UK
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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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Novartis (Switzerland) · Friedrich-Alexander-Universität Erlangen-Nürnberg · Novartis Institutes for BioMedical Research
Affiliation as printed
Machine Learning and Data Analytics Lab, Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-Universität Erlangen Nürnberg, Erlangen, Germany
Novartis Institutes 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 (CIBERESP), Madrid, Spain
Universitat Pompeu Fabra, Barcelona, Catalonia, Spain
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University Hospital Schleswig-Holstein
Affiliation as printed
Department of Neurology, University Medical Center Schleswig-Holstein Campus Kiel, Kiel, Germany
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Affiliation as printed
Department of Sport, Exercise and Rehabilitation, Northumbria University Newcastle, Newcastle Upon Tyne, UK
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Novartis (Switzerland) · Novartis Institutes for BioMedical Research
Affiliation as printed
Novartis Institutes of Biomedical Research, Novartis Pharma AG, Basel, Switzerland
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Affiliation as printed
McRoberts BV, The Hague, Netherlands
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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 (CIRI-SDV), University of Bologna, Bologna, Italy
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Affiliation as printed
Robert Bosch Gesellschaft für Medizinische Forschung, Stuttgart, Germany
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
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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, UK
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Affiliation as printed
Digital Health R&D, AstraZeneca, Stockholm, Sweden
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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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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, Newcastle Upon Tyne, UK
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Newcastle upon Tyne Hospitals NHS Foundation Trust · NIHR Newcastle Biomedical Research Centre · Newcastle University
Affiliation as printed
National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
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Newcastle upon Tyne Hospitals NHS Foundation Trust · NIHR Newcastle Biomedical Research Centre · Newcastle University
Affiliation as printed
National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
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Insigneo · University of Sheffield
Affiliation as printed
Department of Mechanical Engineering and Insigneo Institute for in Silico Medicine, The University of Sheffield, Sheffield, UK
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Silvia Del Din corresponding
Newcastle upon Tyne Hospitals NHS Foundation Trust · NIHR Newcastle Biomedical Research Centre · Newcastle University
Affiliation as printed
National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK. silvia.del-din@ncl.ac.uk
Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK. silvia.del-din@ncl.ac.uk
National Institute for Health and Care Research (NIHR) Newcastle Biomedical Research Centre (BRC), Newcastle University and The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
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