Measuring gait in the real world: challenges and solution for a laboratory based technical validation

Wearable motion sensors are leading the transition from the traditional laboratory or clinical based assessment, to quantifying mobility in free living environments. However, the validity of these so-called digital mobility assessment tools is limited, especially within patient populations. A primary reason for this it that there is the complexity in creating a validation protocol that encompasses all aspects of real-world while maintaining the integrity of validation measure. This is particularly crucial for the development of digital mobility assessments as a clinically valid tool in patient cohorts with slow walking speeds and abnormalities in gait.
This PhD will contribute to the development of a study for the technical validation of a digital mobility assessment device and subsequent quantification of the reliability and consistency of the calculated digital mobility outcomes (DMOs). Within this context, the specific aim of this thesis is to define, validate and deploy, as part of the above technical validation, an experimental protocol and the relevant algorithmic and laboratory tools needed to enable a robust multicentric collection of gait data from a wide range of disease groups.
Prior to the development of the validation study, a systematic review was completed to assess the current state of the art in validation protocols, with aim of highlighting common concepts and limitations within the literature to aid the development of a protocol framework. Which highlighted a need for standardisation of a gold standard solution and the use of a multi-stage and multi-context protocol to ensure a data collection that encompassed all aspects of real-world gait, while promoting a statistically strong validation.
In light of these requirements, standardisation of a gold standard solution for the validation of a wearable sensor within a lab environment and a multi-stage and multi-context protocol were developed and validated for creating this protocol framework and subsequently the successful validation of a wearable sensor solution for estimating real-world gait.