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‘Outwalk’: a protocol for clinical gait analysis based on inertial and magnetic sensors

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Abstract

A protocol named Outwalk was developed to easily measure the thorax–pelvis and lower-limb 3D kinematics on children with cerebral palsy (CP) and amputees during gait in free-living conditions, by means of an Inertial and Magnetic Measurement System (IMMS). Outwalk defines the anatomical/functional coordinate systems (CS) for each body segment through three steps: (1) positioning the sensing units (SUs) of the IMMS on the subjects’ thorax, pelvis, thighs, shanks and feet, following simple rules; (2) computing the orientation of the mean flexion–extension axis of the knees; (3) measuring the SUs’ orientation while the subject’s body is oriented in a predefined posture, either upright or supine. If the supine posture is chosen, e.g. when spasticity does not allow to maintain the upright posture, hips and knees static flexion angles must be measured through a standard goniometer and input into the equations that define Outwalk anatomical CSs. In order to test for the inter-rater measurement reliability of these angles, a study was carried out involving nine healthy children (7.9 ± 2 years old) and two physical therapists as raters. Results showed RMS error of 1.4° and 1.8° and a negligible worst-case standard error of measurement of 2.0° and 2.5° for hip and knee angles, respectively. Results were thus smaller than those reported for the same measures when performed through an optoelectronic system with the CAST protocol and support the beginning of clinical trials of Outwalk with children with CP.

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Abbreviations

CP:

Cerebral palsy

CS:

Coordinate system

DR:

Right drop-rise

IMMS:

Inertial and magnetic measurement system

PAT:

Posterior–anterior tilting

RMS:

Root mean square

SEMse :

Standard error of measurement considering systematic errors

SU:

Sensing unit of an IMMS

TP:

Joint representing the movements of the Pelvis relative to the Thorax

h :

Hip static flexion angle during Outwalk calibration in supine posture

k :

Knee static flexion angle during Outwalk calibration in supine posture

T 1, T 2 :

Physical therapists involved in the reliability study of h and k

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Authors and Affiliations

  1. INAIL Prostheses Centre, Via Rabuina, 14, 40054, Vigorso di Budrio, BO, Italy

    Andrea Giovanni Cutti, Alberto Ferrari, Pietro Garofalo & Michele Raggi

  2. Department of Electronics, Computer Science and Systems, University of Bologna, Bologna, Italy

    Alberto Ferrari, Pietro Garofalo & Angelo Cappello

  3. Department of Neuroscience, University of Modena and Reggio Emilia, Reggio Emilia, Italy

    Adriano Ferrari

Authors
  1. Andrea Giovanni Cutti
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  2. Alberto Ferrari
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  3. Pietro Garofalo
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  4. Michele Raggi
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  5. Angelo Cappello
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  6. Adriano Ferrari
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Corresponding author

Correspondence to Andrea Giovanni Cutti.

Electronic supplementary material

Below is the link to the electronic supplementary material.

11517_2009_545_MOESM1_ESM.jpg

Xsens system. (a) Data-logger (Xbus Master) with two SUs connected; (b) an SU with its local CS, in the global (earth-based) CS (JPG 1554 kb)

Supplementary material 2 (DOC 59 kb)

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Cutti, A.G., Ferrari, A., Garofalo, P. et al. ‘Outwalk’: a protocol for clinical gait analysis based on inertial and magnetic sensors. Med Biol Eng Comput 48, 17–25 (2010). https://doi.org/10.1007/s11517-009-0545-x

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  • DOI: https://doi.org/10.1007/s11517-009-0545-x

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