Estimation of Gait Parameters for Transfemoral Amputees Using Lower Limb Kinematics and Deterministic Algorithms

Accurate estimation of gait parameters depends on the prediction of key gait events of heel strike (HS) and toe-off (TO). Kinematics-based gait event estimation has shown potential in this regard, particularly using leg and foot velocity signals and gyroscopic sensors. However, existing algorithms demonstrate a varying degree of accuracy for different populations. Moreover, the literature lacks evidence for their validity for the amputee population. The purpose of this study is to evaluate this paradigm to predict TO and HS instants and to propose a new algorithm for gait parameter estimation for the amputee population. An open data set containing marker data of 12 subjects with unilateral transfemoral amputation during treadmill walking was used, containing around 3400 gait cycles. Five deterministic algorithms detecting the landmarks (maxima, minima, and zero-crossings [ZC]) in the foot, shank, and thigh angular velocity data indicating HS and TO events were implemented and their results compared against the reference data. Two algorithms based on foot and shank velocity minima performed exceptionally well for the HS prediction, with median accuracy in the range of 6-13 ms. However, both these algorithms produced inferior accuracy for the TO event with consistent early prediction. The peak in the thigh velocity produced the best result for the TO prediction with <25 ms median error. By combining the HS prediction using shank velocity and TO prediction from the thigh velocity, the algorithm produced the best results for temporal gait parameters (step, stride times, stance, and double support timings) with a median error of less than 25 ms. In conclusion, combined shank and thigh velocity-based prediction leads to improved gait parameter estimation than traditional algorithms for the amputee population.