Effect of walking speed during gait in water of healthy elderly.

BACKGROUND: Walking in water (WW) is frequently used as an aquatic exercise in rehabilitation programs for the elderly. Understanding gait characteristics of WW is of primary importance to effectively design specific water-based rehabilitation programs. Moreover, as walking speed in water is reduced with a possible effect on gait parameters, the age- and environment-related changes during WW have to be investigated considering the effects of instantaneous walking speed. RESEARCH QUESTION: how do gait kinematic characteristics differ in healthy elderly between WW and on land walking condition (LW)? Do elderly show different walking patterns compared to young adults? Can these kinematic changes be accounted only by the different environment/age or are they also related to walking speed? METHODS: Nine healthy elderly participants (73.5 ±â€¯5.8 years) were acquired during walking in WW and LW at two different speeds. Kinematic parameters were assessed with waterproofed inertial magnetic sensors using a validated protocol. The influence of environment, age and walking speed on gait parameters was investigated with linear mixed models. RESULTS: Shorter stride distances and longer stride durations were observed in WW compared to LW. In the sagittal plane, hip and knee joint showed larger flexion in WW (>10deg over the whole stride and ∼28deg at foot strike, respectively). Furthermore, lower walking speeds and stride distances were observed in elderly compared to young adults. In the sagittal plane, a slightly more flexed hip joint and a less plantarflexed ankle joint (∼9 deg) were observed in the elderly. SIGNIFICANCE: The results showed the importance of assessing the walking speed during WW, as gait parameters can vary not only for the effect environment but also due to different walking speeds.

Inertial Sensors in Swimming: Detection of Stroke Phases through 3D Wrist Trajectory.

Monitoring the upper arm propulsion is a crucial task for swimmer performance. The swimmer indeed can produce displacement of the body by modulating the upper limb kinematics. The present study proposes an approach for automatically recognize all stroke phases through three-dimensional (3D) wrist's trajectory estimated using inertial devices. Inertial data of 14 national-level male swimmer were collected while they performed 25 m front-crawl trial at intensity range from 75% to 100% of their 25 m maximal velocity. The 3D coordinates of the wrist were computed using the inertial sensors orientation and considering the kinematic chain of the upper arm biomechanical model. An algorithm that automatically estimates the duration of entry, pull, push, and recovery phases result from the 3D wrist's trajectory was tested using the bi-dimensional (2D) video-based systems as temporal reference system. A very large correlation (r = 0.87), low bias (0.8%), and reasonable Root Mean Square error (2.9%) for the stroke phases duration were observed using inertial devices versus 2D video-based system methods. The 95% limits of agreement (LoA) for each stroke phase duration were always lower than 7.7% of cycle duration. The mean values of entry, pull, push and recovery phases duration in percentage of the complete cycle detected using 3D wrist's trajectory using inertial devices were 34.7 (± 6.8)%, 22.4 (± 5.8)%, 14.2 (± 4.4)%, 28.4 (± 4.5)%. The swimmer's velocity and arm coordination model do not affect the performance of the algorithm in stroke phases detection. The 3D wrist trajectory can be used for an accurate and complete identification of the stroke phases in front crawl using inertial sensors. Results indicated the inertial sensor device technology as a viable option for swimming arm-stroke phase assessment.

The Use of IMMUs in a Water Environment: Instrument Validation and Application of 3D Multi-Body Kinematic Analysis in Medicine and Sport.

The aims of the present study were the instrumental validation of inertial-magnetic measurements units (IMMUs) in water, and the description of their use in clinical and sports aquatic applications applying customized 3D multi-body models. Firstly, several tests were performed to map the magnetic field in the swimming pool and to identify the best volume for experimental test acquisition with a mean dynamic orientation error lower than 5°. Successively, the gait and the swimming analyses were explored in terms of spatiotemporal and joint kinematics variables. The extraction of only spatiotemporal parameters highlighted several critical issues and the joint kinematic information has shown to be an added value for both rehabilitative and sport training purposes. Furthermore, 3D joint kinematics applied using the IMMUs provided similar quantitative information than that of more expensive and bulky systems but with a simpler and faster setup preparation, a lower time consuming processing phase, as well as the possibility to record and analyze a higher number of strides/strokes without limitations imposed by the cameras.

Assessment of three-dimensional joint kinematics of the upper limb during simulated swimming using wearable inertial-magnetic measurement units.

The analysis of the joint kinematics during swimming plays a fundamental role both in sports conditioning and in clinical contexts. Contrary to the traditional video analysis, wearable inertial-magnetic measurements units (IMMUs) allow to analyse both the underwater and aerial phases of the swimming stroke over the whole length of the swimming pool. Furthermore, the rapid calibration and short data processing required by IMMUs provide coaches and athletes with an immediate feedback on swimming kinematics during training. This study aimed to develop a protocol to assess the three-dimensional kinematics of the upper limbs during swimming using IMMUs. Kinematics were evaluated during simulated dry-land swimming trials performed in the laboratory by eight swimmers. A stereo-photogrammetric system was used as the gold standard. The results showed high coefficient of multiple correlation (CMC) values, with median (first-third quartile) of 0.97 (0.93-0.95) and 0.99 (0.97-0.99) for simulated front-crawl and breaststroke, respectively. Furthermore, the joint angles were estimated with an accuracy increasing from distal to proximal joints, with wrist indices showing median CMC values always higher than 0.90. The present findings represent an important step towards the practical use of technology based on IMMUs for the kinematic analysis of swimming in applied contexts.

Gait Kinematic Analysis in Water Using Wearable Inertial Magnetic Sensors.

Walking is one of the fundamental motor tasks executed during aquatic therapy. Previous kinematics analyses conducted using waterproofed video cameras were limited to the sagittal plane and to only one or two consecutive steps. Furthermore, the set-up and post-processing are time-consuming and thus do not allow a prompt assessment of the correct execution of the movements during the aquatic session therapy. The aim of the present study was to estimate the 3D joint kinematics of the lower limbs and thorax-pelvis joints in sagittal and frontal planes during underwater walking using wearable inertial and magnetic sensors. Eleven healthy adults were measured during walking both in shallow water and in dry-land conditions. Eight wearable inertial and magnetic sensors were inserted in waterproofed boxes and fixed to the body segments by means of elastic modular bands. A validated protocol (Outwalk) was used. Gait cycles were automatically segmented and selected if relevant intraclass correlation coefficients values were higher than 0.75. A total of 704 gait cycles for the lower limb joints were normalized in time and averaged to obtain the mean cycle of each joint, among participants. The mean speed in water was 40% lower than that of the dry-land condition. Longer stride duration and shorter stride distance were found in the underwater walking. In the sagittal plane, the knee was more flexed (≈ 23°) and the ankle more dorsiflexed (≈ 9°) at heel strike, and the hip was more flexed at toe-off (≈ 13°) in water than on land. On the frontal plane in the underwater walking, smoother joint angle patterns were observed for thorax-pelvis and hip, and ankle was more inversed at toe-off (≈ 7°) and showed a more inversed mean value (≈ 7°). The results were mainly explained by the effect of the speed in the water as supported by the linear mixed models analysis performed. Thus, it seemed that the combination of speed and environment triggered modifications in the joint angles in underwater gait more than these two factors considered separately. The inertial and magnetic sensors, by means of fast set-up and data analysis, can supply an immediate gait analysis report to the therapist during the aquatic therapy session.

Ambulatory measurement of shoulder and elbow kinematics through inertial and magnetic sensors.

Inertial and magnetic measurement systems (IMMSs) are a new generation of motion analysis systems which may diffuse the measurement of upper-limb kinematics to ambulatory settings. Based on the MT9B IMMS (Xsens Technologies, NL), we therefore developed a protocol that measures the scapulothoracic, humerothoracic and elbow 3D kinematics. To preliminarily evaluate the protocol, a 23-year-old subject performed six tasks involving shoulder and elbow single-joint-angle movements. Criteria for protocol validity were limited cross-talk with the other joint-angles during each task; scapulohumeral-rhythm close to literature results; and constant carrying-angle. To assess the accuracy of the MT9B when measuring the upper-limb kinematics through the protocol, we compared the MT9B estimations during the six tasks, plus other four, with the estimations of an optoelectronic system (the gold standard), in terms of RMS error, correlation coefficient (r), and the amplitude ratio (m). Results indicate that the criteria for protocol validity were met for all tasks. For the joint angles mainly involved in each movement, the MT9B estimations presented RMS errors <3.6 degrees , r > 0.99 and 0.9 < m < 1.09. It appears therefore that (1) the protocol in combination with the MT9B is valid for, and (2) the MT9B in combination with the protocol is accurate when, measuring shoulder and elbow kinematics, during the tasks tested, in ambulatory settings.

A simple test to assess the static and dynamic accuracy of an inertial sensors system for human movement analysis.

In the present study we introduced a simple test to assess the orientation error of an inertial sensors system for human movement analysis, both in static and dynamic conditions. In particular, the test was intended to quantify the sensitivity of the orientation error to direction and velocity of rotation. The test procedure was performed on a 5 MT9B sensors Xsens acquisition system, and revealed that the system orientation error, expressed by Euler angles decomposition, was sensitive both to direction and to velocity, being higher for fast movements: for mean rotation velocities of 180 degrees/s and 360 degrees/s, the worst case orientation error was 5.4 degrees and 11.6 degrees, respectively. The test can be suggested therefore as a useful tool to verify the user specific system accuracy without requiring any special equipment. In addition, the test provides further error information concerning direction and velocity of the movement which are not supplied by the producer, since they depend on the specific field of application.