Atypical gait cycles from pressure insoles in real-life scenarios in people with gait disorders

Introduction. The most common sequence of gait phases is Heel-contact, Flat-foot contact, Push-off, and Swing (standard “HFPS” cycle). However, alternative sequences, referred to as “atypical” gait cycles (AGC), may also occur [1] and are relevant for evaluating instability and gait efficiency. This study aims to investigate AGC in people with different gait disorders during free daily living activities by employing a newly developed open toolbox for detecting gait phases from Pressure Insole (PI) signals. Methods. PI signals of 70 pathological subjects (from 5 cohorts) and 18 Healthy older Adults (HA), recorded during free-daily-living activities (lasting 2.5 hours) were extracted from the Mobilise-D open database [2]. Gait phases were identified through the PIN2GPI toolbox (https://github.com/Biolab-PoliTO/PIN2GPI) (Figure 1.A). AGC%_norm was computed as the maximum AGC percentage between the left and right sides (i.e., subject-specific “worst side”) normalized by the individual’s total walking time. Results. For each subject, we analyzed 1931±609 (mean±SE) gait cycles in CHF, 1068±113 in COPD, 1267±231 in MS, 1916±399 in PD, 1059±201 in PFF patients, and 2076±246 in HA. Higher AGC%_norm was found in PFF (8.8±4.1 %/min; p<0.001), COPD (1.9±0.2 %/min; p<0.001), and MS (3.7±0.9 %/min; p=0.007) patients compared to HA controls (0.8±0.1 %/min) (Figure 1.B). Discussion. The increased AGC%_norm in specific clinical populations suggests its potential as a quantitative marker of locomotor instability. Notably, this parameter was derived from data collected during unsupervised and free-living activities, underscoring its ecological validity. Its relevance for fall-risk assessment is currently being explored in the ongoing MOVEWISE project [3]. Acknowledgement. This proceeding is part of the project NODES, which has received funding from the MUR – M4C2 1.5 of PNRR funded by the European Union - NextGenerationEU (Grant agreement no. ECS00000036) – CUP E13B22000020001.