Step Detection and Parameterization for Gait Assessment Using a Single Waist-Worn Accelerometer.

One of the major reasons why the elderly lose their ability to live independently at home is the decline in gait performance. A measure to assess gait performance using accelerometers is step counting. The main problem with most step detection algorithms is the loss of accuracy at low speeds ( 0.8 m/s) which limits their use in frail elderly populations. In this paper, a step detection algorithm was developed and validated using data from 10 healthy adults and 21 institutionalized seniors, predominantly frail older adults. Data were recorded using a single waist-worn triaxial accelerometer as each of the subjects performed one 10-m-walk trial. The algorithm demonstrated high mean sensitivity (99 ± 1%) for gait speeds between 0.2-1.5 m/s. False positives were evaluated with a series of motion activities performed by one subject. These activities simulate acceleration patterns similar to those generated near the body's center of mass while walking in terms of amplitude signal and periodicity. Cycling was the activity which led to a higher number of false positives. By applying template matching, we reduced by 73% the number of false positives in the cycling activity and eliminated all false positives in the rest of activities. Using K-means clustering, we obtained two different characteristic step patterns, one for normal and one for frail walking, where particular gait events related to limb impacts and muscle flexions were recognized. The proposed system can help to identify seniors at high risk of functional decline and monitor the progress of patients undergoing exercise therapy interventions.