Spatiotemporal analysis of cane-assisted gait in post-stroke patients using inertial measurement units

Context Stroke is a worldwide and devastating disease, whose consecutive lesions can result in a constellation of impairment. In some cases, the disability is such that the patient will need a gait assistance for walking. Among the existing waking aids, the four-points cane is the most widely used in post-stroke rehabilitation. However, it has the major disadvantage of having to be lifted at every step, and of preventing the patient from walking smoothly in two phases as in normal gait. To deal with this problem, the physiotherapist G. Dellicour had the idea of creating the Wheeleo © cane, which is a four-legs cane equipped with wheels at each end extremities. Qualitative observations and an initial trial carried on post-stroke subjects have shown that patients walk significantly faster with the Wheeleo©. To quantify precisely the effects of the cane in terms of gait stability, symmetry, and fluidity, a measurement of the gait spatiotemporal parameters is necessary. However, such measurement requires laboratory equipment, such as force platforms, as the current existing wearable systems are not suitable for post-stroke patients walking with cane. Objective The main objectives of this thesis are articulated around three broad focuses: (1) the implementation of a new quantitative measurement technique suitable for post-stroke individuals walking with cane, (2) the assessment of the performance of this technique, and (3) the application of the implemented tool to measure the effect of the Wheeleo © cane on gait spatiotemporal parameters. Results The measurement technique was based on unsupervised clustering. Algorithm parameters were dependent to the mean gait velocity of the patient. It demonstrated good performance for detecting the gait events (fail rate of 1.55%), and an acceptable confidence interval of accuracy (CI = ± 0.101 seconds). The effects of the wheeled cane and classic cane were compared in six post-stroke individuals. It appeared that the Wheeleo © cane provides significant positive significant effect on the spatiotemporal parameters, and on the swing-stance symmetry ratio.