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Accepted for/Published in: JMIR Biomedical Engineering

Date Submitted: Jul 8, 2025
Open Peer Review Period: Jul 8, 2025 - Sep 2, 2025
Date Accepted: Oct 2, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Thigh-Worn Sensor for Measuring Initial and Final Contact During Gait in a Mobility Impaired Population: Validation Study

Johnson T, Kuntapun J, Childs C, Kerr A

Thigh-Worn Sensor for Measuring Initial and Final Contact During Gait in a Mobility Impaired Population: Validation Study

JMIR Biomed Eng 2025;10:e80308

DOI: 10.2196/80308

PMID: 41166537

PMCID: 12574742

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Thigh-Worn Sensor For Measuring Initial And Final Contact During Gait In A Mobility Impaired Population: A Validation Study

  • Thomas Johnson; 
  • Janeesata Kuntapun; 
  • Craig Childs; 
  • Andrew Kerr

ABSTRACT

Background:

Measuring free-living gait with wearable sensors has great potential in supporting personalised rehabilitation. There are challenges meeting the accuracy levels of laboratory-based measurements in detecting initial and final contact, particularly in impaired populations.

Objective:

To test the criterion validity of a novel temporal gait measurement technique, combining the ActivPAL 4+ (PAL Technologies, Glasgow, UK) and the Teager-Kaiser Energy Operator, to measure stance phase duration in chronic stroke survivors through comparison with the Evoke cluster marker system (Vicon, Oxford, UK).

Methods:

Stroke participants (n=13, mean age = 59 years  14, time since stroke = 1.5 years  0.5) were assessed using the ACTIVPAL 4+ and a motion capture system. Two 10m walk tests were measured, while wearing two ActivPAL 4+ (located on anterior of both thighs) and clusters on the pelvis and ankles from the motion capture system. The Teager-Kaiser Energy Operator signal processing technique was used to extract the stance durations of the ActivPAL 4+, compared with a previously validated method.

Results:

There was a good agreement (bias: 0.07s, limits of agreement: -0.1 to 0.28s) between the ACTIVPAL 4+ and motion capture system despite a slight underestimation (mean stance time: 0.850s vs. motion capture system: 0.881s).

Conclusions:

Findings suggest the ACTIVPAL 4+, combined with Teager-Kaiser Energy Operator technique, provides valid stance time measurements when compared laboratory-based systems, supporting its use in free-living gait analysis and feedback during rehabilitation. Limitations include laboratory-only validation and a small population of chronic stroke patients. Future work should explore free-living gait, and larger, and broader, cross section of stroke populations.


 Citation

Please cite as:

Johnson T, Kuntapun J, Childs C, Kerr A

Thigh-Worn Sensor for Measuring Initial and Final Contact During Gait in a Mobility Impaired Population: Validation Study

JMIR Biomed Eng 2025;10:e80308

DOI: 10.2196/80308

PMID: 41166537

PMCID: 12574742

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