Design and validation of a multi-task, multi-context protocol for real-world gait simulation

Area of Science:

• Biomechanics
• Clinical Gait Analysis
• Rehabilitation Engineering

Background:

• Daily life mobility measurement is complex due to confounding factors like pathology, individual strategies, environment, and task purpose.
• Existing methods often fail to capture the full spectrum of real-world gait variations.
• A need exists for a comprehensive and safe protocol to simulate diverse gait scenarios.

Purpose of the Study:

• To propose and validate a novel protocol for simulating real-world gait.
• To account for pathological characteristics, individual walking strategies, environmental context, and task purpose within a single observation set.
• To ensure participant safety and minimize burden while maximizing data richness.

Main Methods:

• Developed a protocol with eight motor tasks varying in speed, incline, surface, path, cognitive demand, and posture.
• Included a tiered difficulty approach within and across tasks.
• Recruited 108 participants from six cohorts: healthy older adults and individuals with Parkinson's disease, multiple sclerosis, proximal femoral fracture, COPD, or CHF.

Main Results:

• The protocol was demonstrated to be safe and feasible, with no adverse events recorded.
• Complex tasks increased the spread of walking speeds compared to standard trials.
• The protocol effectively represented various daily life mobility aspects, suitable for monitoring device validation.

Conclusions:

• The protocol enables gait measurement across diverse pathological conditions.
• It can be utilized to detect gait changes associated with disease onset/progression or therapeutic interventions.
• This approach offers a robust method for assessing gait in complex, real-world relevant scenarios.