Fabrizio Patanè

A novel HMM distributed classifier for the detection of gait phases by means of a wearable inertial sensor network

In this work, we decided to apply a hierarchical weighted decision, proposed and used in other research fields, for the recognition of gait phases. The developed and validated novel distributed classifier is based on hierarchical weighted decision from outputs of scalar Hidden Markov Models (HMM) applied to angular velocities of foot, shank, and thigh. The angular velocities of ten healthy subjects were acquired via three uni-axial gyroscopes embedded in inertial measurement units (IMUs) during one walking task, repeated three times, on a treadmill. After validating the novel distributed classifier and scalar and vectorial classifiers-already proposed in the literature, with a cross-validation, classifiers were compared for sensitivity, specificity, and computational load for all combinations of the three targeted anatomical segments. Moreover, the performance of the novel distributed classifier in the estimation of gait variability in terms of mean time and coefficient of variation was evaluated. The highest values of specificity and sensitivity (>0.98) for the three classifiers examined here were obtained when the angular velocity of the foot was processed. Distributed and vectorial classifiers reached acceptable values (>0.95) when the angular velocity of shank and thigh were analyzed. Distributed and scalar classifiers showed values of computational load about 100 times lower than the one obtained with the vectorial classifier. In addition, distributed classifiers showed an excellent reliability for the evaluation of mean time and a good/excellent reliability for the coefficient of variation. In conclusion, due to the better performance and the small value of computational load, the here proposed novel distributed classifier can be implemented in the real-time application of gait phases recognition, such as to evaluate gait variability in patients or to control active orthoses for the recovery of mobility of lower limb joints.

Experimental evaluation of indoor magnetic distortion effects on gait analysis performed with wearable inertial sensors

Magnetic inertial measurement unit systems (MIMU) offer the potential to perform joint kinematics evaluation as an alternative to optoelectronic systems (OS). Several studies have reported the effect of indoor magnetic field disturbances on the MIMUs heading output, even though the overall effect on the evaluation of lower limb joint kinematics is not yet fully explored. The aim of the study is to assess the influence of indoor magnetic field distortion on gait analysis trials conducted with a commercial MIMU system. A healthy adult performed gait analysis sessions both indoors and outdoors. Data collected indoors were post-processed with and without a heading correction methodology performed with OS at the start of the gait trial. The performance of the MIMU system is characterized in terms of indices, based on the mean value of lower limb joint angles and the associated ROM, quantifying the system repeatability. We find that the effects of magnetic field distortion, such as the one we experienced in our lab, were limited to the transverse plane of each joint and to the frontal plane of the ankle. Sagittal plane values, instead, showed sufficient repeatability moving from outdoors to indoors. Our findings provide indications to clinicians on MIMU performance in the measurement of lower limb kinematics.

Two calibration procedures for a gyroscope-free inertial measurement system based on a double-pendulum apparatus

This paper presents a novel calibration algorithm to be used with a gyro-free inertial measurement unit (GF-IMU) based on the use of linear accelerometers (AC). The analytical approach can be implemented in two calibration procedures. The first procedure (P-I) is articulated in the conduction of a static trial, to compute the sensitivity and the direction of the sensing axis of each AC, followed by a dynamic trial, to determine the AC locations. By contrast, the latter procedure (P-II) consists in the calculation of the previously indicated calibration parameters by means of a dynamic trial only. The feasibility of the two calibration procedures has been investigated by testing two GF-IMUs, equipped with ten and six bi-axial linear ACs, with an ad hoc instrumented double-pendulum apparatus. P-I and P-II were compared to a calibration procedure used as a reference (P-REF), which incorporates the AC positions measured with an optoelectronic system. The experimental results we present in this paper demonstrate that (i) P-I is able to determine the calibration parameters of the AC array with a higher accuracy than P-II; (ii) consequently, the errors associated with translational (a0 ? g) and rotational () acceleration components for the two GF-IMUs are significantly greater using P-II than P-I and (iii) the errors in (a0 ? g) and obtained with P-I are comparable with the ones obtainable by using P-REF. Thus, the proposed novel algorithm used in P-I, in conjunction with the double-pendulum apparatus, can be globally considered a viable tool in GF-IMU calibration.

A Continuous Loading Apparatus for Measuring Three-dimensional Stiffness of Ankle-Foot Orthoses

This paper describes a novel device to evaluate the mechanical properties of ankle foot orthoses (AFOs). The apparatus permits the application to AFOs of continuous three-dimensional (3D) movements between specified and settable endpoints. Using an x-y robot with a rotary stage and a six-component load cell, characteristic displacement versus reaction force curves can be generated and consequently the ankle moments can be determined as a function of dorsi/plantar flexion, inv/eversion and int/external rotation. Representative curves for two polypropylene lateral leaf AFOs, different in shape but produced for the same leg by a skilled orthotist, are presented to illustrate the capabilities of the novel testing system. The metrological investigation showed that the apparatus creates a highly repeatable data set (uncertainty < or = 1% FSO).

Moment Measurement Accuracy of a Parallel Spherical Robot for Dynamic Posturography

This paper characterizes the moment measurement accuracy for a novel parallel spherical robot (SR) for dynamic posturography, controllable by position or impedance. The SR consists of three linear motors placed on a support base, a moving base, and three passive arms equipped with uniaxial load cells permitting impedance controlled perturbations. To evaluate the accuracy, a subject stood still on the SR, set in position control mode, while selected sinusoidal trajectories were applied. The moments computed by the load cells were compared to the value measured by a six-component force platform, placed on top of the rotating base. For the intended application of the SR, the errors were negligible with the worse case of only 4 Nm in a total of 15 trials (five conditions, three repetitions). The observed moment error was related mainly to the intrinsic accuracy of the sensors, equal to about 7 N. To demonstrate clinical applicability, the platform was set to impedance control mode and a protocol was tested with a 12-year-old girl with brain injury and a group of four healthy subjects. In total, 24 trials (eight conditions, three repetitions) were recorded for each subject. The results of this pilot study identified distinctive postural behaviors and therefore showed that the SR can be considered as an effective tool for dynamic posturography.

Upper body balance control strategy during continuous 3D postural perturbation in young adults

We explored how changes in vision and perturbation frequency impacted upright postural control in healthy adults exposed to continuous multiaxial support-surface perturbation. Ten subjects were asked to maintain equilibrium in standing stance with eyes open (EO) and eyes closed (EC) during sinusoidal 3D rotations at 0.25 (L) and 0.50 Hz (H). We measured upper-body kinematics--head, trunk, and pelvis--and analyzed differences in horizontal displacements and roll, pitch, and yaw sways. The presence of vision significantly decreased upper-body displacements in the horizontal plane, especially at the head level, while in EC the head was the most unstable segment. H trials produced a greater segment stabilization compared to L ones in EO and EC. Analysis of sways showed that in EO participants stabilized their posture by reducing the variability of trunk angles; in H trials a sway decrease for the examined segments was observed in the yaw plane and, for the pelvis only, in the pitch plane. Our results suggest that, during continuous multiaxial perturbations, visual information induced: (i) in L condition, a continuous reconfiguration of multi-body-segments orientation to follow the perturbation; (ii) in H condition, a compensation for the ongoing perturbation. These findings were not confirmed in EC where the same strategy--that is, the use of the pelvis as a reference frame for the body balance was adopted both in L and H.

WAKE-up: A wearable ankle knee exoskeleton

In this paper we present the alpha-prototype of the WAKE-up, a wearable robotic device for the rehabilitation of locomotion of pediatric subjects with neurological diseases such as Cerebral Palsy. The WAKE-up is an active knee-ankle orthosis. It is composed of two robotic modules for the rehabilitation of knee and ankle, respectively. Each module can be utilized either alone or together with the other one. The working principle is based on series elastic actuators (SEA), i.e., dc motors equipped with a torsional spring mounted in series to avoid the direct connection of the actuator with the patients limb. A SEA permits the control of the force and the emulation of different orthoses with given value of stiffness. The torque transmission is achieved by a timing belt and it is mediated by a torsional spring. The experimental tests conducted on each modules confirmed a good precision of the spring deflection control (position error <; 2°) and good overall performances of the force control obtained with the spring stiffness chosen at the design phase.

Real-time gait detection based on Hidden Markov Model: Is it possible to avoid training procedure?

In this paper we present and validate a methodology to avoid the training procedure of a classifier based on an Hidden Markov Model (HMM) for a real-time gait recognition of two or four phases, implemented to control pediatric active orthoses of lower limb. The new methodology consists in the identification of a set of standardized parameters, obtained by a data set of angular velocities of healthy subjects age-matched. Sagittal angular velocities of lower limbs of ten typically developed children (TD) and ten children with hemiplegia (HC) were acquired by means of the tri-axial gyroscope embedded into Magnetic Inertial Measurement Units (MIMU). The actual sequence of gait phases was captured through a set of four foot switches. The experimental protocol consists in two walking tasks on a treadmill set at 1.0 and 1.5 km/h. We used the Goodness (G) as parameter, computed from Receiver Operating Characteristic (ROC) space, to compare the results obtained by the new methodology with the ones obtained by the subject-specific training of HMM via the Baum-Welch Algorithm. Paired-sample t-tests have shown no significant statistically differences between the two procedures when the gait phase detection was performed with the gyroscopes placed on the foot. Conversely, significant differences were found in data gathered by means of gyroscopes placed on shank. Actually, data relative to both groups presented G values in the range of good/optimum classifier (i.e. G ≤ 0.3), with better performance for the two-phase classifier model. In conclusion, the novel methodology here proposed guarantees the possibility to omit the off-line subject-specific training procedure for gait phase detection and it can be easily implemented in the control algorithm of active orthoses.

Reach-to-grasp interjoint coordination for moving objects in children with hemiplegia

OBJECTIVE To evaluate interjoint coordination in children with hemiplegia as they reach to grasp objects, in both static and dynamic conditions. An ad hoc robotic device was used to study the dynamic condition. DESIGN Observational study. PATIENTS Six children with hemiplegia and 6 young adults. METHODS Kinematics of the trunk and arm were studied using an optoelectronic system. In the dynamic condition the target object, a cup, was moved by the robotic device along clockwise and counterclockwise circular trajectories. RESULTS Two main strategies were used to study the onset and offset of shoulder and elbow movements and their maximum velocities. The hand velocity profile was bell-shaped in the static condition and compatible with ramp movements for the more affected side in the dynamic condition. The time to object contact was higher for the more affected side in the dynamic condition. The temporal coordination index illustrated an immature and less flexible behaviour in childrens reaching in all the examined conditions. CONCLUSION Study of the hand velocity profiles, the time to object contact and the temporal coordination index highlighted, first, the dependence of upper limb interjoint coordination on task, context, residual resources and individual solution, and secondly, the sensory-motor deficit characteristics of the childrens more affected side during dynamic reaching, raising the prospect of a promising training context in children with hemiplegia.

Technical quality assessment of an optoelectronic system for movement analysis

The Optoelectronic Systems (OS) are largely used in gait analysis to evaluate the motor performances of healthy subjects and patients. The accuracy of marker trajectories reconstruction depends on several aspects: the number of cameras, the dimension and position of the calibration volume, and the chosen calibration procedure. In this paper we propose a methodology to evaluate the effects of the mentioned sources of error on the reconstruction of marker trajectories. The novel contribution of the present work consists in the dimension of the tested calibration volumes, which is comparable with the ones normally used in gait analysis; in addition, to simulate trajectories during clinical gait analysis, we provide non-default paths for markers as inputs. Several calibration procedures are implemented and the same trial is processed with each calibration file, also considering different cameras configurations. The RMSEs between the measured trajectories and the optimal ones are calculated for each comparison. To investigate the significant differences between the computed indices, an ANOVA analysis is implemented. The RMSE is sensible to the variations of the considered calibration volume and the camera configurations and it is always inferior to 43 mm.