Reliability of IMU-Based Gait Assessment in Clinical Stroke Rehabilitation.

Richard A W Felius,Michiel Punt,Marieke Geerars,Sjoerd M Bruijn,Jaap H Van Dieën,Natasja C Wouda

doi:10.3390/s22030908

Abstract

Background: Gait is often impaired in people after stroke, restricting personal independence and affecting quality of life. During stroke rehabilitation, walking capacity is conventionally assessed by measuring walking distance and speed. Gait features, such as asymmetry and variability, are not routinely determined, but may provide more specific insights into the patient’s walking capacity. Inertial measurement units offer a feasible and promising tool to determine these gait features. Objective: We examined the test–retest reliability of inertial measurement units-based gait features measured in a two-minute walking assessment in people after stroke and while in clinical rehabilitation. Method: Thirty-one people after stroke performed two assessments with a test–retest interval of 24 h. Each assessment consisted of a two-minute walking test on a 14-m walking path. Participants were equipped with three inertial measurement units, placed at both feet and at the low back. In total, 166 gait features were calculated for each assessment, consisting of spatio-temporal (56), frequency (26), complexity (63), and asymmetry (14) features. The reliability was determined using the intraclass correlation coefficient. Additionally, the minimal detectable change and the relative minimal detectable change were computed. Results: Overall, 107 gait features had good–excellent reliability, consisting of 50 spatio-temporal, 8 frequency, 36 complexity, and 13 symmetry features. The relative minimal detectable change of these features ranged between 0.5 and 1.5 standard deviations. Conclusion: Gait can reliably be assessed in people after stroke in clinical stroke rehabilitation using three inertial measurement units.

Highlights

Walking dysfunction is a common problem in people after stroke, restricting personal independence and affecting quality of life [1,2]
We aim to explore the potential of measuring gait using inertial measurement units (IMUs) to closely monitor gait recovery in people after stroke
The key contributions of this study can be summarised as follows: firstly, we investigated if numerous gait features can reliably be measured using IMUs by clinicians in people after stroke; secondly, a stride-detection algorithm was developed to detect strides in the majority of people after stroke, including slow and asymmetric gaits; thirdly, a platform was created in which clinicians could upload measurement data that was automatically stored, processed, and returned gait features; lastly, the protocol was designed in collaboration with clinicians to promote feasibility of assessing gait using IMUs in stroke rehabilitation

Summary

Introduction

Walking dysfunction is a common problem in people after stroke, restricting personal independence and affecting quality of life [1,2]. Walking dysfunction in people after stroke is characterised by decreased walking speed, shorter stride length, and gait asymmetry [3,4]. Gait is often impaired in people after stroke, restricting personal independence and affecting quality of life. During stroke rehabilitation, walking capacity is conventionally assessed by measuring walking distance and speed Gait features, such as asymmetry and variability, are not routinely determined, but may provide more specific insights into the patient’s walking capacity. Objective: We examined the test–retest reliability of inertial measurement units-based gait features measured in a two-minute walking assessment in people after stroke and while in clinical rehabilitation. Each assessment consisted of a two-minute walking test on a 14-m walking path

Objectives

Methods

Discussion

Conclusion