Cédric Schwartz

Development and validation of an accelerometer-based method for quantifying gait events

An original signal processing algorithm is presented to automatically extract, on a stride-by-stride basis, four consecutive fundamental events of walking, heel strike (HS), toe strike (TS), heel-off (HO), and toe-off (TO), from wireless accelerometers applied to the right and left foot. First, the signals recorded from heel and toe three-axis accelerometers are segmented providing heel and toe flat phases. Then, the four gait events are defined from these flat phases. The accelerometer-based event identification was validated in seven healthy volunteers and a total of 247 trials against reference data provided by a force plate, a kinematic 3D analysis system, and video camera. HS, TS, HO, and TO were detected with a temporal accuracy ± precision of 1.3 ms ± 7.2 ms, -4.2 ms ± 10.9 ms, -3.7 ms ± 14.5 ms, and -1.8 ms ± 11.8 ms, respectively, with the associated 95% confidence intervals ranging from -6.3 ms to 2.2 ms. It is concluded that the developed accelerometer-based method can accurately and precisely detect HS, TS, HO, and TO, and could thus be used for the ambulatory monitoring of gait features computed from these events when measured concurrently in both feet.

Evaluation of a geometry-based knee joint compared to a planar knee joint

Today neuromuscular simulations are used in several fields, such as diagnostics and planing of surgery, to get a deeper understanding of the musculoskeletal system. During the last year, new models and datasets have been presented which can provide us with more in-depth simulations and results. The same kind of development has occurred in the field of studying the human knee joint using complex three dimensional finite element models and simulations. In the field of musculoskeletal simulations, no such knee joints can be used. Instead the most common knee joint description is an idealized knee joint with limited accuracy or a planar knee joint which only describes the knee motion in a plane. In this paper, a new knee joint based on both equations and geometry is introduced and compared to a common clinical planar knee joint. The two kinematical models are analyzed using a gait motion, and are evaluated using the muscle activation and joint reaction forces which are compared to in-vivo measured forces. We show that we are able to predict the lateral, anterior and longitudinal moments, and that we are able to predict better knee and hip joint reaction forces.

An Automated Statistical Shape Model Developmental Pipeline: Application to the Human Scapula and Humerus

This paper presents development of statistical shape models based on robust and rigid-groupwise registration followed by pointset nonrigid registration. The main advantages of the pipeline include automation in that the method does not rely on manual landmarks or a regionalization step; there is no bias in the choice of reference during the correspondence steps and the use of the probabilistic principal component analysis framework increases the domain of the shape variability. A comparison between the widely used expectation maximization-iterative closest point algorithm and a recently reported groupwise method on publicly available data (hippocampus) using the well-known criteria of generality, specificity, and compactness is also presented. The proposed method gives similar values but the curves of generality and specificity are superior to those of the other two methods. Finally, the method is applied to the human scapula, which is a known difficult structure, and the human humerus.

Building and Tracking Root Shapes

An algorithm aiming at robust and simultaneous registrations of a sequence of 3-D shapes was recently presented by Jacq et al. [IEEE Trans. Biomed. Eng., vol. 55, no. 5, 2008]. This algorithm has to carry out an implicit representation of their common root shape (RS). A particular emphasis was put on the median consensus shape, which is a specific type of RS. Unlike this previous study, mainly focusing on the algorithm foundations while dealing with very specific applications examples, this paper attempts to show the versatility of the RS concept through a set of three problems involving a wider scope of application. The first problem copes with the design of prosthetic cortical plates for the hip joint. It shows how an explicit reconstruction of the RS, coming with its consensus map, could bring out an intermediary anatomical support from which pragmatic choices could be made, thereby performing a tradeoff between morphological, surgical, and production considerations. The second problem addresses in vivo real-time shoulder biomechanics through a miniature 3-D video camera. This new protocol implicitly operates through RS tracking of the content of virtual spotlights. It is shown that the current medical-oriented protocol, while operating within expert offices through low-cost equipments, could challenge high-end professional equipments despite some limitations of the 3-D video cameras currently available. The last problem deals with respiratory motions. This is an auxiliary measurement required by some medical imaging systems that can be handled as a basic application case of the former new protocol.

Dominance effect on scapula 3-dimensional posture and kinematics in healthy male and female populations

BACKGROUND The contralateral shoulder is often used as a reference when evaluating a pathologic shoulder. However, the literature provides contradictory results regarding the symmetry of the scapular pattern in a healthy population. We assume that several factors including gender and type of motion may influence the bilateral symmetry of the scapulae. MATERIALS AND METHODS The dominant and nondominant shoulders of 2 populations of men and women comprising 11 subjects each were evaluated for 3 distinct motions: flexion in the sagittal plane, abduction in the frontal plane, and glenohumeral internal/external rotation with the arm abducted at 90°. Posture, kinematics, and range of motion were studied separately. RESULTS Asymmetries are observed for motions performed in the frontal and sagittal plane but not for internal/external rotation with the arm abducted at 90°. For both male and female populations, multiplanar asymmetries are observed and the dominant scapula has a larger upward rotation. The asymmetries mainly originate in the scapulas kinematics and not in its original posture. CONCLUSION Small but significant asymmetries exist between the dominant and nondominant shoulders in terms of kinematics. One should be aware of these differences when using the contralateral shoulder as a reference. LEVEL OF EVIDENCE Basic science study, kinematics

Validated extraction of gait events from 3D accelerometer recordings

This work is part of a project that deals with the three-dimensional (3D) analysis of normal and pathological gaits based on a newly developed system for clinical applications, using low-cost wireless accelerometers and a signal processing algorithm. This system automatically extracts relevant gait events such as the heel strikes (HS) and the toe-offs (TO), which characterize the stance and the swing phases of walking. The performances of the low-cost accelerometer hardware and related algorithm have been compared to those obtained by a kinematic 3D analysis system and a force plate, used as gold standard methods. The HS and TO times obtained from the gait data of 7 healthy volunteers (147 trials) have been found to be (mean ± standard deviation) 0.42±7.92 ms and 3.11±10.08 ms later than those determined by the force plate, respectively. The experimental results demonstrate that the new hardware and associated algorithm constitute an effective low-cost gait analysis system, which could thus be used for the assessment of mobility in routine clinical practice.

Shoulder motion analysis using simultaneous skin shape registration

A new non-invasive approach is proposed to study joint motions. It is based on dynamic tracking of the skin shape. A robust simultaneous registration algorithm (iterative median closest point) is used to follow the evolving shape and compute the rigid motion of the underlying bone structures. This new method relies on the differentiation of the rigid and elastic parts of the shape motion. A skin marker network is tracked by a set of infrared cameras. Unlike usual techniques, the algorithm tracks the instantaneous polyhedral shape embedding this network. This innovating approach is expected to minimize bias effect of skin sweeps and give some new information about the underlying soft tissue activities. Current application addresses the motion of the shoulder complex (humerus, clavicle and scapula). It is compared with two marker-based methods published in the literature. Preliminary results show significant differences between these three approaches. The new approach measurements give rise to greater rotations.

Detection of incoherent joint state due to inaccurate bone motion estimation

In biomechanical modelling and motion analysis, the use of personalised data such as bone geometry would provide more accurate and reliable results. However, there are still a limited number of tools used to measure the evolution of articular interactions. This paper proposes a coherence index to describe the articular status of contact surfaces during motion. The index relies on a robust estimation of the evolution of surfacic interactions between the joint surfaces. The index is first compared to distance maps on simulated motions. It is then used to compare two motion capture protocols (two different localisations of the markers for scapula tracking). The results show that the index detects progressive modifications in the joint and allows distinguishing the two protocols, in accordance with the literature. In the future, the index could, among other things, be used to compare/improve biomechanical models and motion analysis protocols.

Gender effect on the scapular 3D posture and kinematic in healthy subjects

Populations considered for shoulder analysis are often composed of various ratios of men and women. It is consequently hypothesized that gender has no significant effect on the joint kinematic. However, the literature reports, for the shoulder, differences in the range of motion between genders. The specific influence of gender on the scapulo‐thoracic kinematics has not been studied yet. The dominant shoulder of two populations of men and women composed of 11 subjects each were evaluated in three dimensions for three distinct motions: flexion in the sagittal plane, abduction in the frontal plane and gleno‐humeral internal/external rotation with the arm abducted at 90°. Posture, kinematics and range of motion were studied separately. For flexion and abduction and with regard to the scapular kinematic, external rotation was significantly larger for women than men. The differences were of at least 5° at 120° of humeral elevation. Upward rotations were identical. Women also showed larger average active humero‐thoracic range of motion. The mean differences were of 13°, 7°, 12° and 5° for abduction, flexion, internal rotation and external rotation, respectively. No difference was observed between the scapular resting positions of both populations. The observed differences concerning both the scapular and humeral patterns would indicate that the shoulder behaviour of men and women should not be expected to be similar.

Merging multi-camera data to reduce motion analysis instrumental errors using Kalman filters

In motion capture systems, markers are often seen by multiple cameras. All cameras do not measure the position of the markers with the same reliability because of environmental factors such as the position of the marker in the field of view or the light intensity received by the cameras. Kalman filters offer a general framework to take the reliability of the various cameras into account and consequently improve the estimation of the marker position. The proposed process can be applied to both passive and active systems. Several reliability models of the cameras are compared for the Codamotion active system, which is considered as a specific illustration. The proposed method significantly reduces the noise in the signal, especially at long-range distances. Therefore, it improves the confidence of the positions at the limits of the field of view.