Walking-adaptability assessments with the Interactive Walkway: Between-systems agreement and sensitivity to task and subject variations.

The ability to adapt walking to environmental circumstances is an important aspect of walking, yet difficult to assess. The Interactive Walkway was developed to assess walking adaptability by augmenting a multi-Kinect-v2 10-m walkway with gait-dependent visual context (stepping targets, obstacles) using real-time processed markerless full-body kinematics. In this study we determined Interactive Walkway's usability for walking-adaptability assessments in terms of between-systems agreement and sensitivity to task and subject variations. Under varying task constraints, 21 healthy subjects performed obstacle-avoidance, sudden-stops-and-starts and goal-directed-stepping tasks. Various continuous walking-adaptability outcome measures were concurrently determined with the Interactive Walkway and a gold-standard motion-registration system: available response time, obstacle-avoidance and sudden-stop margins, step length, stepping accuracy and walking speed. The same holds for dichotomous classifications of success and failure for obstacle-avoidance and sudden-stops tasks and performed short-stride versus long-stride obstacle-avoidance strategies. Continuous walking-adaptability outcome measures generally agreed well between systems (high intraclass correlation coefficients for absolute agreement, low biases and narrow limits of agreement) and were highly sensitive to task and subject variations. Success and failure ratings varied with available response times and obstacle types and agreed between systems for 85-96% of the trials while obstacle-avoidance strategies were always classified correctly. We conclude that Interactive Walkway walking-adaptability outcome measures are reliable and sensitive to task and subject variations, even in high-functioning subjects. We therefore deem Interactive Walkway walking-adaptability assessments usable for obtaining an objective and more task-specific examination of one's ability to walk, which may be feasible for both high-functioning and fragile populations since walking adaptability can be assessed at various levels of difficulty.