Prediction of Intrinsically Caused Tripping Events in Individuals With Stroke.

Abstract

This study investigated the feasibility of predicting intrinsically caused trips (ICTs) in individuals with stroke. Gait kinematics collected from 12 individuals with chronic stroke, who demonstrated ICTs in treadmill walking, were analyzed. A prediction algorithm based on the outlier principle was employed. Sequential forward selection (SFS) and minimum-redundancy-maximum-relevance (mRMR) were used separately to identify the precursors for accurate ICT prediction. The results showed that it was feasible to predict ICTs around 50-260 ms before ICTs occurred in the swing phase by monitoring lower limb kinematics during the preceding stance phase. Both SFS and mRMR were effective in identifying the precursors of ICTs. For 9 out of the 12 subjects, the paretic lower limb's shank orientation in the sagittal plane and the vertical velocity of the paretic foot's center of gravity were important in predicting ICTs accurately; the averaged area under receiver operating characteristic curve achieved 0.95 and above. For the other three subjects, kinematics of the less affected limb or proximal joints in the paretic side were identified as the precursors to an ICT, potentially due to the variations of neuromotor deficits among stroke survivors. Although additional engineering efforts are still needed to address the challenges in making our design clinically practical, the outcome of this study may lead to further proactive engineering mechanisms for ICT avoidance and therefore reduce the risk of falls in individuals with stroke.