RESUMEN
Wearable sensing using inertial measurement units (IMUs) is enabling portable and customized gait retraining for knee osteoarthritis. However, the vibrotactile feedback that users receive directly depends on the accuracy of IMU-based kinematics. This study investigated how kinematic errors impact an individual's ability to learn a therapeutic gait using vibrotactile cues. Sensor accuracy was computed by comparing the IMU-based foot progression angle to marker-based motion capture, which was used as ground truth. Thirty subjects were randomized into three groups to learn a toe-in gait: one group received vibrotactile feedback during gait retraining in the laboratory, another received feedback outdoors, and the control group received only verbal instruction and proceeded directly to the evaluation condition. All subjects were evaluated on their ability to maintain the learned gait in a new outdoor environment. We found that subjects with high tracking errors exhibited more incorrect responses to vibrotactile cues and slower learning rates than subjects with low tracking errors. Subjects with low tracking errors outperformed the control group in the evaluation condition, whereas those with higher error did not. Errors were correlated with foot size and angle magnitude, which may indicate a non-random bias. The accuracy of IMU-based kinematics has a cascading effect on feedback; ignoring this effect could lead researchers or clinicians to erroneously classify a patient as a non-responder if they did not improve after retraining. To use patient and clinician time effectively, future implementation of portable gait retraining will require assessment across a diverse range of patients.
Asunto(s)
Señales (Psicología) , Osteoartritis de la Rodilla , Humanos , Fenómenos Biomecánicos , Marcha/fisiología , Pie , Caminata/fisiologíaRESUMEN
OBJECTIVE: Exercise monitoring with low-cost wearables could improve the efficacy of remote physical-therapy prescriptions by tracking compliance and informing the delivery of tailored feedback. While a multitude of commercial wearables can detect activities of daily life, such as walking and running, they cannot accurately detect physical-therapy exercises. The goal of this study was to build open-source classifiers for remote physical-therapy monitoring and provide insight on how data collection choices may impact classifier performance. METHODS: We trained and evaluated multi-class classifiers using data from 19 healthy adults who performed 37 exercises while wearing 10 inertial measurement units (IMUs) on the chest, pelvis, wrists, thighs, shanks, and feet. We investigated the effect of sensor density, location, type, sampling frequency, output granularity, feature engineering, and training-data size on exercise-classification performance. RESULTS: Exercise groups (n = 10) could be classified with 96% accuracy using a set of 10 IMUs and with 89% accuracy using a single pelvis-worn IMU. Multiple sensor modalities (i.e., accelerometers and gyroscopes), high sampling frequencies, and more data from the same population did not improve model performance, but in the future data from diverse populations and better feature engineering could. CONCLUSIONS: Given the growing demand for exercise monitoring systems, our sensitivity analyses, along with open-source tools and data, should reduce barriers for product developers, who are balancing accuracy with product formfactor, and increase transparency and trust in clinicians and patients.