Estimating hip impact velocity and acceleration from video-captured falls using a pose estimation algorithm

Analyzing video footage of falls in older adults has emerged as an alternative to traditional lab studies. However, this approach is limited by the labor-intensive process of manually labeling body parts. To address this limitation, we aimed to validate the use of the AI-based pose estimation algorithm (OpenPose) in assessing the hip impact velocity and acceleration of video-captured falls. We analyzed 110 videos of 13 older adults (64.0 ± 5.9 years old) falling sideways in an experimental setting. By applying OpenPose to each video, we generated a time series of hip positions in the video, which were then analyzed using custom MATLAB code to calculate hip impact velocity and acceleration. These calculations were compared against ground truth measurements obtained from motion capture systems (VICON for hip impact velocity) and inertial measurement units (MC10 for hip impact acceleration). We examined the agreement between the ground truth and OpenPose measurements in terms of mean of absolute error (MAE), mean of absolute percentage error (MAPE), and bias (mean of error). Results showed that OpenPose had a good accuracy in estimating hip impact velocity with minimal bias (MAE: 0.17 ± 0.13 m/s, MAPE: 7.28 ± 5.21%; percent bias: - 1.27%). However, its estimation of hip impact acceleration (i.e., peak vertical hip acceleration at impact) showed poor accuracy (MAPE: 26.3 ± 19.4%), showing substantial underestimation in instances of high acceleration impacts (> 3.0 g). Further ANOVA analysis revealed OpenPose's ability to discern significant differences in hip impact velocity and acceleration based on the movement response utilized during the fall (e.g., stick-like fall, tuck-and-roll, knee block). This is the first study to validate the use of a pose estimation algorithm for identifying the hip impact kinematics in video-captured falls among older adults. Future validation studies involving diverse camera settings, fall contexts, and biomechanical parameters are warranted to extend this support for using pose estimation algorithms in this field.