Validity of shoe-type inertial measurement units for Parkinson’s disease patients during treadmill walking

How is your therapist objectively measuring your gait irregularities? If no measurements are being done, How the hell can any intervention be said to cause improvement?

Maybe one of these other ones;

Sensoria™ Fitness Socks  March 2014 

Sensor embedded socks  January 2014 

Markerless Human Motion Capture for Gait Analysis  October 2017 

Ambulatory assessment of walking balance after stroke using instrumented shoes

May 2016 

The Parkinson's shoe

 

Design of a biofeedback device for gait rehabilitation in post-stroke patients

October 2015

Insole plantar pressure systems in the gait analysis of post-stroke rehabilitation 

October 2015

The latest one here:

 Validity of shoe-type inertial measurement units for Parkinson’s disease patients during treadmill walking

Myeounggon Lee,
• Changhong YoumEmail authorView ORCID ID profile,
• Jeanhong Jeon,
• Sang-Myung Cheon and
• Hwayoung Park

Journal of NeuroEngineering and Rehabilitation201815:38

https://doi.org/10.1186/s12984-018-0384-9

©  The Author(s). 2018

Received: 9 June 2017

Accepted: 7 May 2018

Published: 15 May 2018

Abstract

Background

When examining participants with pathologies, a shoe-type inertial measurement unit (IMU) system with sensors mounted on both the left and right outsoles may be more useful for analysis and provide better stability for the sensor positions than previous methods using a single IMU sensor or attached to the lower back and a foot. However, there have been few validity analyses of shoe-type IMU systems versus reference systems for patients with Parkinson’s disease (PD) walking continuously with a steady-state gait in a single direction. Therefore, the purpose of this study is to assess the validity of the shoe-type IMU system versus a 3D motion capture system for patients with PD during 1 min of continuous walking on a treadmill.

Methods

Seventeen participants with PD successfully walked on a treadmill for 1 min. The shoe-type IMU system and a motion capture system comprising nine infrared cameras were used to collect the treadmill walking data with participants moving at their own preferred speeds. All participants took anti-parkinsonian medication at least 3 h before the treadmill walk. An intraclass correlation coefficient analysis and the associated 95% confidence intervals were used to evaluate the validity of the resultant linear acceleration and spatiotemporal parameters for the IMU and motion capture systems.

Results

The resultant linear accelerations, cadence, left step length, right step length, left step time, and right step time showed excellent agreement between the shoe-type IMU and motion capture systems.

Conclusions

The shoe-type IMU system provides reliable data and can be an alternative measurement tool for objective gait analysis of patients with PD in a clinical environment.

 

 

Head of stroke programme condemns HSE inertia - Ireland

 The whole world of stroke is condemned to less than mediocrity, INCOMPETENCE, and the poor outcomes are visited upon the stroke survivors, not the stroke medical world. 
https://www.irishtimes.com/news/health/head-of-stroke-programme-condemns-hse-inertia-1.3200224

Prof Joseph Harbison: ‘No one ever got fired in HSE for maintaining the status quo’

Widespread inertia in the health service is leaving Ireland unprepared to cope with a huge increase in the number of stroke patients over the next decade, the outgoing head of the national stroke programme has warned.

In a scathing review of progress in the programme he has led since 2010, Prof Joseph Harbison is strongly critical of resistance to change within the Health Service Executive.

Doctors have encountered “huge problems” progressing the aims of the programme, he says. Having been informed at the outset that implementation was “key” to the success of the programme, they were told by the HSE this was not their responsibility.

Crucial elements of the programme, even those fully supported by HSE management, were frequently ignored at local level, according to his review, seen by The Irish Times. “Like in many organisations, the ‘status quo’ can be terribly hard to change and ‘implementation-free zones’ can be encountered, but the status quo in stroke is often very poor and inadequate.”

Third biggest killer

Stroke is the third biggest killer of Irish people after heart disease and cancer, and the single biggest cause of severe physical disability. Up to 8,500 people a year suffer a stroke, and more than 800 die from the condition. The incidence of stroke is set to rise by up to 50 per cent over the next decade as the population ages.

Elaborating on his remarks, Prof Harbison told The Irish Times, “No one ever got fired in the HSE for maintaining the status quo. You get in more trouble doing something and screwing up than for doing nothing, which allows you to evade responsibility when things go wrong.”

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“We realised at a very early point that if we were not willing to implement, to agitate and pressurise people, little would be achieved.” the review says. “With current HSE structures, implementing and managing change is extremely challenging. Even when a plan is in place and resources found, it is our experience it is a mistake to assume that this will automatically happen without continued attention, intervention and agitation.”

It took three years to appoint 40 staff, he points out. “We have even found ourselves resorting to external political pressure to try to persuade hospitals to open stroke units.”

Six out of 27 hospitals have no stroke unit, the review points out. These are also the hospitals with the highest death rates.

Stroke represents a huge and looming challenge for the health service, Prof Harbison says. “We cannot properly cope with the numbers of stroke patients currently requiring treatment. The majority of patients suffering stroke in Ireland still cannot access what would be considered basic care in most developed countries.”

National clinical strategy

A separate national clinical strategy for stroke, such as there is for cancer, is now needed, he believes.

Prof Harbison says that although outcomes have improved substantially since the national stroke programme was developed, they are still worse than in comparable European countries.

“Demographic changes will result in a huge increase in stroke numbers in the next 10 to 15 years. Ireland is currently unprepared for this and I am not aware of any contingency plans in development.”

The existing stroke programme is inadequate to meet the demands of a condition costing the country €1 billion a year, he says.

The existing programme has shown that outcomes can be improved in the absence of resources with effort, reorganisation and a willingness to pull together. “However, there is a point where even innovation and imagination is insufficient. We cannot appropriately discharge patients who still need rehabilitation where there is nobody to provide rehabilitation in the community.

“We cannot expect good outcomes for stroke patients where the basic structures and systems necessary to achieve these are simply absent. These are not problems we can innovate past.”

 

Stroke inertia

No, not the amount of time it takes after standing up before you take a step. Which your therapist should have a protocol to solve.  The frozen in time and place inertia of our stroke medical professionals and fucking failures of stroke associations doing nothing to solve ANY of the problems in stroke.  Proven by not acknowledging the 88% failure rate of tPA for full recovery yet continuing to push tPA as the complete solution. I don't know how to get thru to them. Screaming on this blog is not doing one damn bit of good except to make me feel better.  With 10 million survivors a year screaming at their doctors for solutions that could easily cause some movement. But YOU have to scream at your doctor, don't accept their dumbed down recovery goals. 100% recovery is the only goal.

This is why a computer algorithm cannot ever fully replace a doctor’s judgment

If we had any objective diagnosis of damage from a stroke and then the protocols that address such damage then we could use Dr. Algorithm. But we have neither so we are left with the fuckingly stupid statement from our medical staff, 
'All strokes are different, all stroke recoveries are different'.
So our stroke leadership should be focusing on obtaining an objective diagnosis, creating stroke rehab protocols and correlating the two. This is so fucking simple, why hasn't it been accomplished yet?
Inertia or stupidity? Leaders tackle the hard problems, we seem to have no leaders.
This is why a computer algorithm cannot ever fully replace a doctor’s judgment