Abstract

BackgroundMany patients with neurological movement disorders fear to fall while performing postural transitions without assistance, which prevents them from participating in daily life. To overcome this limitation, multi-directional Body Weight Support (BWS) systems have been developed allowing them to perform training in a safe environment. In addition to overground walking, these innovative/novel systems can assist patients to train many more gait-related tasks needed for daily life under very realistic conditions. The necessary assistance during the users’ movements can be provided via task-dependent support designs. One remaining challenge is the manual switching between task-dependent supports. It is error-prone, cumbersome, distracts therapists and patients, and interrupts the training workflow. Hence, we propose a real-time motion onset recognition model that performs automatic support switching between standing-up and sitting-down transitions and other gait-related tasks (8 classes in total).MethodsTo predict the onsets of the gait-related tasks, three Inertial Measurement Units (IMUs) were attached to the sternum and middle of outer thighs of 19 controls without neurological movement disorders and two individuals with incomplete Spinal Cord Injury (iSCI). The data of IMUs obtained from different gait tasks was sent synchronously to a real-time data acquisition system through a custom-made Bluetooth-EtherCAT gateway. In the first step, data was applied offline for training five different classifiers. The best classifier was chosen based on F1-score results of a Leave-One-Participant-Out Cross-Validation (LOPOCV), which is an unbiased way of testing. In a final step, the chosen classifier was tested in real time with an additional control participant to demonstrate feasibility for real-time classification.ResultsTesting five different classifiers, the best performance was obtained in a single-layer neural network with 25 neurons. The F1-score of 86.83% pm 6.2% and 92.01% are achieved on testing using LOPOCV and test data (30%, participants = 20), respectively. Furthermore, the results from the implemented real-time classifier were compared with the offline classifier and revealed nearly identical performance (difference = 0.08 %).ConclusionsA neural network classifier was trained for identifying the onset of gait-related tasks in real time. Test data showed convincing performance for offline and real-time classification. This demonstrates the feasibility and potential for implementing real-time onset recognition in rehabilitation devices in future.

Highlights

  • Many patients with neurological movement disorders fear to fall while performing postural transitions without assistance, which prevents them from participating in daily life

  • Full list of author information is available at the end of the article

  • Statistical evaluation of the model choice based on the accuracy expressed in F1-score using Oneway ANOVA revealed a statistically significant effect F4,95 = 6.07, p < 0.0005

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Summary

Introduction

Many patients with neurological movement disorders fear to fall while performing postural transitions without assistance, which prevents them from participating in daily life To overcome this limitation, multi-directional Body Weight Support (BWS) systems have been developed allowing them to perform training in a safe environment. Haji Hassani et al Journal of NeuroEngineering and Rehabilitation (2022) 19:11 level of the lesion [1] This impairs or hinders the performance of daily activities like walking [2, 3]. The multidirectional BWS system “The FLOAT” can assist the patients while performing rehabilitation tasks by designing task-dependent support that works in harmony with the user’s movement. A force field in movement direction can assist the user’s motion while performing specific rehabilitation tasks such as sitting down, standing up, or walking. Choosing the right support in an automated way for each task can be realized by detecting the onset and the type of the movements

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