Ambulatory assessment of walking balance after stroke using instrumented shoes

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Abstract

Background: For optimal guidance of walking rehabilitation therapy of stroke patients in an in-home setting, a small and easy to use wearable system is needed. In this paper we present a new shoe-integrated system that quantifies walking balance during activities of daily living and is not restricted to a lab environment. Quantitative parameters were related to clinically assessed level of balance in order to assess the additional information they provide. Methods: Data of 13 participants who suffered a stroke were recorded while walking 10 meter trials and wearing special instrumented shoes. The data from 3D force and torque sensors, 3D inertial sensors and ultrasound transducers were fused to estimate 3D (relative) position, velocity, orientation and ground reaction force of each foot. From these estimates, center of mass and base of support were derived together with a dynamic stability margin, which is the (velocity) extrapolated center of mass with respect to the front-line of the base of support in walking direction. Additionally, for each participant step lengths and stance times for both sides as well as asymmetries of these parameters were derived. Results: Using the proposed shoe-integrated system, a complete reconstruction of the kinematics and kinetics of both feet during walking can be made. Dynamic stability margin and step length symmetry were not significantly correlated with Berg Balance Scale (BBS) score, but participants with a BBS score below 45 showed a small-positive dynamic stability margin and more asymmetrical step lengths. More affected participants, having a lower BBS score, have a lower walking speed, make smaller steps, longer stance times and have more asymmetrical stance times. Conclusions: The proposed shoe-integrated system and data analysis methods can be used to quantify daily-life walking performance and walking balance, in an ambulatory setting without the use of a lab restricted system. The presented system provides additional insight about the balance mechanism, via parameters describing walking patterns of an individual subject. This information can be used for patient specific and objective evaluation of walking balance and a better guidance of therapies during the rehabilitation. Trial registration: The study protocol is a subset of a larger protocol and registered in the Netherlands Trial Registry, number NTR3636.
Original languageUndefined
Pages (from-to)1-10
Number of pages10
JournalJournal of neuroengineering and rehabilitation
Volume13
Issue number48
DOIs
Publication statusPublished - 19 May 2016

Keywords

  • BSS-Biomechatronics and rehabilitation technology
  • EWI-27031
  • Kinematics
  • Kinetics
  • METIS-316934
  • Stroke
  • IR-100456
  • Berg balance scale
  • Ambulatory assessment
  • Walking balance

Cite this

@article{9eb77f2b0bdf4237ac39d8358d4eb150,
title = "Ambulatory assessment of walking balance after stroke using instrumented shoes",
abstract = "Background: For optimal guidance of walking rehabilitation therapy of stroke patients in an in-home setting, a small and easy to use wearable system is needed. In this paper we present a new shoe-integrated system that quantifies walking balance during activities of daily living and is not restricted to a lab environment. Quantitative parameters were related to clinically assessed level of balance in order to assess the additional information they provide. Methods: Data of 13 participants who suffered a stroke were recorded while walking 10 meter trials and wearing special instrumented shoes. The data from 3D force and torque sensors, 3D inertial sensors and ultrasound transducers were fused to estimate 3D (relative) position, velocity, orientation and ground reaction force of each foot. From these estimates, center of mass and base of support were derived together with a dynamic stability margin, which is the (velocity) extrapolated center of mass with respect to the front-line of the base of support in walking direction. Additionally, for each participant step lengths and stance times for both sides as well as asymmetries of these parameters were derived. Results: Using the proposed shoe-integrated system, a complete reconstruction of the kinematics and kinetics of both feet during walking can be made. Dynamic stability margin and step length symmetry were not significantly correlated with Berg Balance Scale (BBS) score, but participants with a BBS score below 45 showed a small-positive dynamic stability margin and more asymmetrical step lengths. More affected participants, having a lower BBS score, have a lower walking speed, make smaller steps, longer stance times and have more asymmetrical stance times. Conclusions: The proposed shoe-integrated system and data analysis methods can be used to quantify daily-life walking performance and walking balance, in an ambulatory setting without the use of a lab restricted system. The presented system provides additional insight about the balance mechanism, via parameters describing walking patterns of an individual subject. This information can be used for patient specific and objective evaluation of walking balance and a better guidance of therapies during the rehabilitation. Trial registration: The study protocol is a subset of a larger protocol and registered in the Netherlands Trial Registry, number NTR3636.",
keywords = "BSS-Biomechatronics and rehabilitation technology, EWI-27031, Kinematics, Kinetics, METIS-316934, Stroke, IR-100456, Berg balance scale, Ambulatory assessment, Walking balance",
author = "{van Meulen}, Fokke and D. Weenk and Jaap Buurke and {van Beijnum}, {Bernhard J.F.} and Veltink, {Petrus H.}",
note = "eemcs-eprint-27031",
year = "2016",
month = "5",
day = "19",
doi = "10.1186/s12984-016-0146-5",
language = "Undefined",
volume = "13",
pages = "1--10",
journal = "Journal of neuroengineering and rehabilitation",
issn = "1743-0003",
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Ambulatory assessment of walking balance after stroke using instrumented shoes. / van Meulen, Fokke; Weenk, D.; Buurke, Jaap; van Beijnum, Bernhard J.F.; Veltink, Petrus H.

In: Journal of neuroengineering and rehabilitation, Vol. 13, No. 48, 19.05.2016, p. 1-10.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Ambulatory assessment of walking balance after stroke using instrumented shoes

AU - van Meulen, Fokke

AU - Weenk, D.

AU - Buurke, Jaap

AU - van Beijnum, Bernhard J.F.

AU - Veltink, Petrus H.

N1 - eemcs-eprint-27031

PY - 2016/5/19

Y1 - 2016/5/19

N2 - Background: For optimal guidance of walking rehabilitation therapy of stroke patients in an in-home setting, a small and easy to use wearable system is needed. In this paper we present a new shoe-integrated system that quantifies walking balance during activities of daily living and is not restricted to a lab environment. Quantitative parameters were related to clinically assessed level of balance in order to assess the additional information they provide. Methods: Data of 13 participants who suffered a stroke were recorded while walking 10 meter trials and wearing special instrumented shoes. The data from 3D force and torque sensors, 3D inertial sensors and ultrasound transducers were fused to estimate 3D (relative) position, velocity, orientation and ground reaction force of each foot. From these estimates, center of mass and base of support were derived together with a dynamic stability margin, which is the (velocity) extrapolated center of mass with respect to the front-line of the base of support in walking direction. Additionally, for each participant step lengths and stance times for both sides as well as asymmetries of these parameters were derived. Results: Using the proposed shoe-integrated system, a complete reconstruction of the kinematics and kinetics of both feet during walking can be made. Dynamic stability margin and step length symmetry were not significantly correlated with Berg Balance Scale (BBS) score, but participants with a BBS score below 45 showed a small-positive dynamic stability margin and more asymmetrical step lengths. More affected participants, having a lower BBS score, have a lower walking speed, make smaller steps, longer stance times and have more asymmetrical stance times. Conclusions: The proposed shoe-integrated system and data analysis methods can be used to quantify daily-life walking performance and walking balance, in an ambulatory setting without the use of a lab restricted system. The presented system provides additional insight about the balance mechanism, via parameters describing walking patterns of an individual subject. This information can be used for patient specific and objective evaluation of walking balance and a better guidance of therapies during the rehabilitation. Trial registration: The study protocol is a subset of a larger protocol and registered in the Netherlands Trial Registry, number NTR3636.

AB - Background: For optimal guidance of walking rehabilitation therapy of stroke patients in an in-home setting, a small and easy to use wearable system is needed. In this paper we present a new shoe-integrated system that quantifies walking balance during activities of daily living and is not restricted to a lab environment. Quantitative parameters were related to clinically assessed level of balance in order to assess the additional information they provide. Methods: Data of 13 participants who suffered a stroke were recorded while walking 10 meter trials and wearing special instrumented shoes. The data from 3D force and torque sensors, 3D inertial sensors and ultrasound transducers were fused to estimate 3D (relative) position, velocity, orientation and ground reaction force of each foot. From these estimates, center of mass and base of support were derived together with a dynamic stability margin, which is the (velocity) extrapolated center of mass with respect to the front-line of the base of support in walking direction. Additionally, for each participant step lengths and stance times for both sides as well as asymmetries of these parameters were derived. Results: Using the proposed shoe-integrated system, a complete reconstruction of the kinematics and kinetics of both feet during walking can be made. Dynamic stability margin and step length symmetry were not significantly correlated with Berg Balance Scale (BBS) score, but participants with a BBS score below 45 showed a small-positive dynamic stability margin and more asymmetrical step lengths. More affected participants, having a lower BBS score, have a lower walking speed, make smaller steps, longer stance times and have more asymmetrical stance times. Conclusions: The proposed shoe-integrated system and data analysis methods can be used to quantify daily-life walking performance and walking balance, in an ambulatory setting without the use of a lab restricted system. The presented system provides additional insight about the balance mechanism, via parameters describing walking patterns of an individual subject. This information can be used for patient specific and objective evaluation of walking balance and a better guidance of therapies during the rehabilitation. Trial registration: The study protocol is a subset of a larger protocol and registered in the Netherlands Trial Registry, number NTR3636.

KW - BSS-Biomechatronics and rehabilitation technology

KW - EWI-27031

KW - Kinematics

KW - Kinetics

KW - METIS-316934

KW - Stroke

KW - IR-100456

KW - Berg balance scale

KW - Ambulatory assessment

KW - Walking balance

U2 - 10.1186/s12984-016-0146-5

DO - 10.1186/s12984-016-0146-5

M3 - Article

VL - 13

SP - 1

EP - 10

JO - Journal of neuroengineering and rehabilitation

JF - Journal of neuroengineering and rehabilitation

SN - 1743-0003

IS - 48

ER -