Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium

Micó-Amigo ME, Bonci T, Paraschiv-Ionescu A, Ullrich M, Kirk C, Soltani A, Küderle A, Gazit E, Salis F, Alcock L, Aminian K, Becker C, Bertuletti S, Brown P, Buckley E, Cantu A, Carsin AE, Caruso M, Caulfield B, Cereatti A, Chiari L, D’Ascanio I, Eskofier B, Fernstad S, Froehlich M, Garcia-Aymerich J, Hansen C, Hausdorff JM, Hiden H, Hume E, Keogh A, Kluge F, Koch S, Maetzler W, Megaritis D, Mueller A, Niessen M, Palmerini L, Schwickert L, Scott K, Sharrack B, Sillén H, Singleton D, Vereijken B, Vogiatzis I, Yarnall AJ, Rochester L, Mazzà C, Del Din S (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Book Volume: 20

Article Number: 78

Journal Issue: 1

DOI: 10.1186/s12984-023-01198-5

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 with CRIS profile

Involved external institutions

Instituto de Salud Global de Barcelona (ISGlobal) Spain (ES) University of Sheffield United Kingdom (GB) Politecnico di Torino Italy (IT) École Polytechnique Fédérale de Lausanne (EPFL) Switzerland (CH) Newcastle University United Kingdom (GB) Università degli Studi di Sassari (UNISS) Italy (IT) Newcastle upon Tyne Hospitals NHS Foundation Trust United Kingdom (GB) Robert Bosch GmbH Germany (DE) Tel Aviv Sourasky Medical Center / Ichilov Hospital Israel (IL) Sheffield Teaching Hospitals NHS Foundation Trust United Kingdom (GB) University of Bologna / Università di Bologna Italy (IT) University College Dublin (UCD) Ireland (IE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Northumbria University United Kingdom (GB) Novartis AG Switzerland (CH) NTNU Trondheim - Norwegian University of Science and Technology Norway (NO) McRoberts B.V. Netherlands (NL) Grünenthal GmbH Germany (DE) AstraZeneca Sweden Sweden (SE)

How to cite

APA:

Micó-Amigo, M.E., Bonci, T., Paraschiv-Ionescu, A., Ullrich, M., Kirk, C., Soltani, A.,... Del Din, S. (2023). Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium. Journal of neuroEngineering and rehabilitation, 20(1). https://dx.doi.org/10.1186/s12984-023-01198-5

MLA:

Micó-Amigo, M. Encarna, et al. "Assessing real-world gait with digital technology? Validation, insights and recommendations from the Mobilise-D consortium." Journal of neuroEngineering and rehabilitation 20.1 (2023).

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