IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO.
5, SEPTEMBER 2009
Computational Intelligence in Gait Research:
A Perspective on Current Applications
and Future Challenges
Daniel T. H. Lai, Member, IEEE, Rezaul K. Begg, Senior Member, IEEE,
and Marimuthu Palaniswami, Senior Member, IEEE
Abstract—Our mobility is an important daily requirement so
much so that any disruption to it severely degrades our perceived
quality of life. Studies in gait and human movement sciences, there-
fore, play a significant role in maintaining the well-being of our
mobility. Current gait analysis involves numerous interdependent
gait parameters that are difficult to adequately interpret due to the
large volume of recorded data and lengthy assessment times in gait
laboratories. A proposed solution to these problems is computa-
tional intelligence (CI), which is an emerging paradigm in biomed-
ical engineering most notably in pathology detection and prosthesis
design. The integration of CI technology in gait systems facilitates
studies in disorders caused by lower limb defects, cerebral dis-
orders, and aging effects by learning data relationships through a
combination of signal processing and machine learning techniques.
Learning paradigms, such as supervised learning, unsupervised
learning, and fuzzy and evolutionary algorithms, provide advanced
modeling capabilities for biomechanical systems that in the past
have relied heavily on statistical analysis. CI offers the ability to
investigate nonlinear data relationships, enhance data interpre-
tation, design more efficient diagnostic methods, and extrapolate
model functionality. These are envisioned to result in more cost-
effective, efficient, and easy-to-use systems, which would address
global shortages in medical personnel and rising medical costs. This
paper surveys current signal processing and CI methodologies fol-
lowed by gait applications ranging from normal gait studies and
disorder detection to artificial gait simulation. We review recent
systems focusing on the existing challenges and issues involved in
making them successful. We also examine new research in sensor
technologies for gait that could be combined with these intelligent
systems to develop more effective healthcare solutions.
Index Terms—Artificial gait, computational intelligence (CI),
elderly gait, gait analysis, gait disorders, gait event detection,
pathology detection, prosthetic control, sensor technology.
I. INTRODUCTION
UR society’s growing demand for a better quality of life
O is posed to change global economic and industrial per-
ceptions. Health is now perceived as a major necessity for a
fulfilling life. The area of gait and human movement science
is gaining prominence with realization that movement disor-
ders warrant significant medical attention, incur high costs, and
Manuscript received November 30, 2007; revised April 1, 2008 and June 23,
2008. First published May 12, 2009; current version published September 2,
2009.
D. T. H. Lai and R. K. Begg are with the Biomechanics Unit, Victoria Uni-
versity, Melbourne, Vic. 8001, Australia (e-mail: daniel.lai@vu.edu.au).
M. Palaniswami is with the University of Melbourne, Melbourne, Vic. 3010,
Australia.
Color versions of one or more of the figures in this paper are available online
at http://ieeexplore.ieee.org.
Digital Object Identifier 10.1109/TITB.2009.2022913
1089-7771/$26.00 © 2009 IEEE
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687
may be fatal in certain cases. For example, 90% of adults with
cerebral palsy (CP) in the U.S. were alarmingly found to lack
access to periodic health checks [1] even though more than half
of CP hemiplegics were known to require constant personal as-
sistance [2]. The elderly population is faced with gait disorder
progression, which increases the risk of death precipitated by
falls and bone fractures [3]. Half of these fallers cannot get
backup without assistance and if left unattended for more than
two hours run the risk of dehydration, hypothermia, pneumo-
nia, pulmonary embolism (38% of deaths in hip fracture falls),
rhabdomyolysis (toxic breakdown of muscle fibers), and pres-
sure ulcers [4].
Gait analysis is the study of the biomechanics of human move-
ment aimed at quantifying factors governing the functionality of
the lower extremities. This is crucial for the detection of gait dis-
orders, identification of balance factors, and assessment of clin-
ical gait interventions and rehabilitation programs. In addition,
gait studies have contributed significantly to the design of artifi-
cial limbs (prostheses) for amputees and inspired artificial loco-
motor controllers used in exoskeletons and robotics. Clinicians
rely extensively on gait analysis for diagnosis and treatment op-
tions, but have been confronted by numerous complexities such
as high data dimensionality and volume, nonlinear data depen-
dencies, complex and nonunique correlations (every person’s
gait is different), and quasi-temporal dependencies among mea-
sured gait parameters [5]. These complexities are compounded
by long recording times in gait laboratories, and increasing pa-
tient populations result in delayed diagnosis leading to an in-
creased risk of disorder progression and further complications.
It is evident that classical gait analysis would benefit tremen-
dously from an infusion of more advanced analysis techniques
such as computational intelligence (CI). CI is a fusion of learn-
ing mechanisms and computing specifically suited for powerful
decision systems capable of interpreting and processing large
volumes of data. These techniques, which include supervised
learning, fuzzy classifiers, and evolutionary optimization meth-
ods, have been applied to pattern recognition and system model-
ing, thus making them suitable for gait studies. CI models built
through learning nonlinear data relationships promise more ro-
bust, efficient, and cost-effective diagnostic, monitoring, and
control systems requiring basic computing facilities, i.e., per-
sonal computers for implementation. These systems would re-
duce diagnosis times, aid in treatment selection, enhance patient
monitoring, reduce operation costs, and save countless lives. CI
has already gained popularity in other healthcare areas such as
688 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009
Fig. 1. Plan view of the major gait events, depicting stance and swing phases,
and single- and double-support times (percent gait cycle), which are marked by
toe and heel contacts (illustration based on information in C. L. Vaughan, B. L.
Davis, and J. C. O’Connor, Dynamics of Human Gait. Champaign, IL: Human
Kinetics, 1992).
the detection of cardiovascular and neuromuscular diseases [6],
[7], the study of protein structures for drug design [8], [9], and
more pervasive patient monitoring systems for tracking patient
recovery [10].
In this paper, we first review the fundamental gait biome-
chanics, gait pathologies, and common gait measurements in
order to situate this body of research. We then describe the sig-
nal processing and CI methodologies that are integral to every
intelligent system deployment, thus pointing out their strengths
and perceived limitations. This is followed by a perspective on
recent applications of CI to gait studies, which now range from
disorder detection to artificial gait where we highlight the issues,
system design, and reported performances. In the final section,
we discuss the challenges and emerging technologies that are
predicted to be integrated in future gait systems.
II. NORMAL AND PATHOLOGICAL GAIT
Gait is a complex integrated task requiring precise coordina-
tion of the neural and musculoskeletal systems to ensure correct
skeletal dynamics [11]. This is essential because the human me-
chanical system operates on two small bases of support (the feet)
with the center of mass about two-thirds of the body height from
the ground. During motion, the body is primarily supported by a
single foot (80% of the gait cycle, as depicted in Fig. 1), which
implies a state of continuous imbalance requiring a sophisti-
cated mechanism to ensure safe foot trajectory. Analysis of this
mechanism has sought to understand movement control, alter-
ations due to diseases, and the effects of surgical interventions
and prosthetics use.
A. Gait Cycle
The gait cycle is defined as the interval between two succes-
sive events, for example, heel contacts of the same foot. This
periodic event is characterized by a stance phase (60% of the
total gait cycle), where at least one foot is in contact with the
ground, and a swing phase (40% of the total gait cycle) dur-
ing which one limb swings through to the next heel contact
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Fig. 2. Gait cycle showing the three major tasks and the corresponding sub-
tasks, namely, weight acceptance (initial contact and loading response), single-
limb support (midstance, terminal stance, and preswing), and limb motion (ini-
tial swing, midswing, and terminal swing).
(see Fig. 1). Deviations in these relative timings are potentially
indicative of abnormalities or disorders [12].
There are three major tasks in the gait cycle. Weight accep-
tance occurs when body weight is transferred from one leg to
another, which requires careful coordination and proper shock
absorption because the leg that has just completed its motion is
in an unstable state. The next task is to support the entire body
weight on a single leg (single-limb support), and the final task is
limb motion where the leg swings forward to advance the body.
These major tasks are further divided into eight subphases, as
depicted in Fig. 2, beginning with initial contact (right foot for
example) in the stance phase, the hip is flexed, knee extended,
and ankle in a dorsiflexed neutral position. This is followed by
the loading response where both feet are on the ground and body
weight is transferred from one leg to the other. Midstance be-
gins halfway through single-limb support where weight passes
directly over the right leg while the left is in motion. The body
is in terminal stance when the right heel begins to rise before
the left foot touches the ground. The second double support
occurs when the left toe makes contact with the ground and
body weight is again briefly supported by both limbs (preswing
phase). Then, the right foot leaves the ground (initial swing
phase) and body weight is transferred this time from right to left
(midswing phase) before finally advancing completely (terminal
swing) forward and returning to initial contact.
B. Normal Gait
Research in healthy gait is important to determine the nor-
mal gait parameter ranges so that deviations could be used to
indicate disorders [13], [14]. Range determination has unfortu-
nately been complicated by the fact that individuals possess a
wide range of gait patterns. These variances make it difficult
to categorize and diagnose pathological gait based on single-
range deviations, thus forcing clinicians to measure groups of
parameters over large subject populations.
LAI et al.: COMPUTATIONAL INTELLIGENCE IN GAIT RESEARCH: A PERSPECTIVE ON CURRENT APPLICATIONS AND FUTURE CHALLENGES
TABLE I
EXAMPLES OF HEALTHY SPATIOTEMPORAL GAIT PARAMETER RANGES THAT HAVE BEEN INDEPENDENTLY OBSERVED
IN SEVERAL STUDIES ACROSS DIFFERENT AGE BRACKETS
Nevertheless, previous studies have been performed on young
gait to relate immature walking to pathological gait changes de-
noted by basic parameters such as walking velocity and stride
length [15]. Walking velocity, for example, increases progres-
sively with age, rapidly increasing from 0.64 to 1.14 m/s by
year 7 before achieving an average of 1.38 m/s in adulthood.
Parameters such as single- and double-support times remain al-
most constant across age brackets while other ranges depend on
specific gait cycle phases [4], [16], [17].
C. Clinical Gait Disorders
Clinical gait disorders afflict all age groups and can arise from
pathologies in the lower extremities such as patellofemoral pain
syndrome [18], [19], knee osteoarthritis [20], and tendon rap-
ture [21], which result in antalgic gait patterns. These patterns
resemble limping movements due to pain in weight bearing
structures such as the knee joints and ankle joints, and is char-
acterized by a short stance phase as weight is shifted quickly
from the injured limb.
Pathologies such as CP [22]–[24], Parkinson’s disease [25],
dementia [26], and stroke [27] lead to apraxic gait patterns
where there is loss of ability to move properly. This is due to
the disruption of the human locomotion control and sensory
feedback system, which controls balance allowing safe negoti-
ation of the environment. The third general disorder is ataxic
gait, where the gait is unsteady and uncoordinated causing the
feet to be pointed outward. This is normally encountered when
a person suffers loss of proprioception (sense of relative limb
positions) due to cerebral disease or chemical intoxication, e.g.,
alcohol and medicine [28].
D. Elderly Gait Disorders
Elderly gait disorders arise from age-related changes in the
locomotor control mechanisms for balance and stability. Se-
nile gait results from normal aging, which is characterized by
a broad stance and reduced walking velocity. Balance disor-
ders caused by cerebral disruptions lead to patterns such as
frontal lobe gait caused by injury of the frontopontocerebellar
tract (Arnold’s bundle), which connects the frontal lobe to the
cerebellum. Damage to the upper motor neurons in the corti-
cospinal tracts results in limb weaknesses such as hemiparesis,
paraparesis, and quadriparesis [29]. Age-related declines in the
vestibular system (e.g., loss of labyrinthine hair and nerve fibers)
cause sensory ataxic gait where the brain is prevented from re-
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689
ceiving sensory input, thus resulting in declines of visual acuity,
perception of depth and shades, and proprioception. In addition,
muscle atrophy (muscle breakdown) can lead to myopathic gait
that affects major muscles in the pelvis and back causing waddle
gait patterns common in senior citizens.
Elderly gait disorders lead to injuries (usually from falling)
that incur expensive medical costs and high mortality rates. The
elderly risk fractures in the distal radius, proximal humerus,
and tibia, hip, and vertebrae when they fall because their bones
are weakened by osteoporosis (reduced trabecular bone density
with age). For example, 32% of a sample of community dwelling
elderly persons were found to have sustained a fall at least
once a year, with 24% of them suffering serious injuries [30].
An estimated 30% of people aged 65 and above or 50% of
individuals over the age of 75 years sustain a fall at least once a
year, which is sufficient to cause serious injury [31].
III. GAIT DATA
Gait data are recorded from motion analysis systems (e.g.,
Vicon and Optotrak), force platforms [e.g., Advanced Mechan-
ical Technology, Inc. (AMTI), and Kistler], foot pressure (e.g.,
Tekscan), and electromyography (EMG; e.g., Noraxon) for mus-
cle activity. The following categorizes the frequently recorded
data in gait analysis.
A. Anthropometric Data
Physical human measurements (anthropometric) such as
height, weight, and limb length provide fundamental informa-
tion in gait studies. Most gait experiments are, however, con-
ducted on subject groups with similar anthropometric measures
to isolate their effects on gait biomechanics.
B. Spatiotemporal Data
Basic gait analysis measures spatiotemporal quantities such
as walking speed, stride and step lengths, step width, stance and
swing times, and cadence. Timing data such as the timing of
foot placement, stance, swing, single- and double-support times
can be measured using stopwatches and foot switches while
simultaneously observing the gait cycle [32]. Cadence or the
number of steps per unit time can be easily counted while using
it with stride length provides average walking speed. Temporal
data can be measured by stopwatches and spatial data with
measuring tapes, while commercial systems, e.g., GAITRite
[13], can measure both simultaneously. Table I depicts example
690 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009

parameter ranges expected in the healthy population across the ing intrasubject variabilities. In the following, we examine some
age groups. of these methods in greater detail.

A. Statistical Analysis
C. Kinematic Data
Statistical methods model gait variables as random variables
Kinematic measurements relate to the motion of body seg-
drawn from an unknown distribution P (x). Several measure-
ments, joints, and other body landmarks of interest. These mea-
ments of this variable are used to calculate statistical descrip-
sures yield joint/segment angles, angular range of motion, dis-
tors of P (x) such as moments and cumulants. In the case of a
placement, and velocity and acceleration values along various
discrete distribution, the moment about the point k is
axes. Measures of toe trajectory and clearance over the walk-

ing surface are examples of kinematic measurements from body µn (k) = (x − k)n P (x). (1)
landmarks. Markers are usually attached to anatomical points
of interest and monitored using motion capture systems [16]. The differences between these descriptors could be used to clas-
sify groups of data.
D. Kinetic Data
B. Signal Transforms
Kinetic variables include foot force measurements such as
Signal transforms extract signal components that may be
ground reaction forces (GRFs) and moments (torques): two vari-
used to highlight differences between groups of signals. These
ables most frequently examined in gait analysis. GRFs are reac-
transforms can be applied to data from continuous gait cycles
tion forces measured from foot contact with force platforms,
modeled as a time-series or digital (gait) signal. Though this
notably Kistler platforms (piezoelectric) and AMTI systems
approach is only beginning to be accepted in gait studies, appli-
(strain gauge) [13]. Force platform outputs provide three or-
cation of signal transforms will highlight distinctive character-
thogonal force components, namely the horizontal mediolateral
istics of a gait group due to signal variation over time (capturing
(M/L) force or M/L shear component, the horizontal anterior–
quasi-temporal dependencies).
posterior force, and the vertical force component, and their re-
The popular discrete Fourier transform is used to represent a
spective moments.
digital signal as a sum of fundamental functions given as [38]

E. EMG Data

N
X (k) = x (n) e−j ω k n (2)
Muscle activation levels denoted by the number of motor unit n =1
action potentials (MUAPs) can be assessed by EMG record- where the angular frequency is ωk = 2πk/N for k, n =
ings. Gait EMG is recorded using either needle or surface EMG 1, . . . , N . Fourier transforms provide information on frequency
electrodes with the latter being noninvasive and preferred. Sev- components in the signal, and the Fourier coefficients could be
eral factors affect EMG signal acquisition such as electrode used to characterize a signal.
location, electrode size and shape, electrode spacing, presence The wavelet transform is generally applied to nonstationary
of fat or other tissues, muscle area, and crosstalk from other signals providing frequency and position information of a signal
muscles [33]. x(t) with respect to a mother wavelet function ψ(t) [39]
 
1 t−u
F. Combined Data ψ(t) = √ ψ . (3)
s s
Motion data are frequently collected in conjunction with force
and EMG data before being processed to derive useful features. Here, s and u represent scale and translation parameters, respec-
These data may be combined using anthropometric measures tively. Wavelet transform coefficients are obtained by convolu-
to calculate internal joint moments or energy and power in the tion of the signal x(t) with these wavelets giving
 ∞  
ankle, knee, and hip joints using inverse dynamics [34]. There 1 t−u
have also been attempts to combine information from two or W x(u, s) = √ x(t)ψ ∗ dt. (4)
s −∞ s
more biomechanical measurement systems into an integrated
output to allow visualization of the motion and associated forces This is then the wavelet√transform of x(t) at scale s and position
[35]–[37]. u, while the factor 1/ s is a normalization factor to preserve
the energy in the transform. The wavelet coefficients give signal
information on the type of frequency components and where
IV. GAIT DATA PREPROCESSING they occur in x(t) [40]. The discrete wavelet transform (DWT)
When employing CI, raw gait data should be preprocessed is more commonly used in computer applications where dyadic
to extract more concise information, which better represent the grid for the scale s and translation u defined as
biomechanical system or gait disorder. Data preprocessing or
(sj , uk ) = (2j , k2j : j, k ∈ Z) (5)
information extraction is a vital component of CI systems be-
cause they act as information filters reducing the amount of raw is applied. One may use different scales and translation val-
data under consideration, removing noise artifacts, and averag- ues but the dyadic grid gives a uniform and systematic way of

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LAI et al.: COMPUTATIONAL INTELLIGENCE IN GAIT RESEARCH: A PERSPECTIVE ON CURRENT APPLICATIONS AND FUTURE CHALLENGES 691

viewing x(n). The DWT is calculated using matrix multipli-

cation or digital filter banks (Mallat’s algorithm [39]). Sev-
eral wavelet families have been proposed ranging from the
Haar, Daubechies, Coiflet, Symmlet, and Mexican Hat to Morlet
wavelets, each with different properties depending on the appli-
cation at hand. The Daubechies 4 (Db4) is known to be suitable
for signals that have linear approximation over four samples
while Db6 is appropriate for quadratic approximations over six
samples [39].

C. Predictive Linear Modeling

A more recent technique is to mathematically model the gait
signals and utilize model coefficients as information descriptors.
The gait signal, for example, could be modeled by a linear
predictor such as the autoregressive moving average (ARMA)
assuming that it is a wide-based stationary random signal. The
ARMA assumes a linear causal filter H(z) with the following
transfer function characteristic:
q −k
B(z) k =0 bk z
 Fig. 3. Diagram depicts the gait data preprocessing using statistical [46],
H(z) = = p . (6)
A(z) 1 + k =1 ak z −k wavelet [47], and AR [48] analysis on the same raw gait signal (MTC data).
Scatterplots show two extracted attributes from each technique plotted for 23
subjects [10 elderly with balance impairments (+1) and 13 elderly with normal
The inverse z-transform yields the difference equation gait (−1)]. It can be seen that statistical descriptors are features with poorest
separability while AR coefficients are linearly separable.


q

p
x(n) = bk w(n − k) − ak x(n − k) (7)
k =0 k =1

where x(n) is the estimated value of the nth sample and

w(n) is known as the innovation process [38]. The scalars
ai and bj are model coefficients that depict the relationship
between inputs w(n) and the estimated output while the sum-
mation indices indicate the number of previous samples used
in the estimation of x(n). The coefficient values depict aver-
age dependencies of x(n) on previous samples, i.e., x(n − 1),
x(n − 2), . . . , x(n − p), and have primary use in estimation of
discrete signal autocorrelation and power spectrum values [38].
If q = 0 and b0 = 1, the ARMA model reduces to the more
common autoregressive (AR) process of order p. AR model co-
efficients are estimated using methods such as the Yule–Walker,
Burg [41], covariance, and modified covariance methods. The
potential of this modeling technique has not been keenly ex-
plored in gait studies with few attempts including the design of
a postural stability criterion [42], capture of shape deformations
in gait [43], and modeling of energy transfers during normal
walking [44] and recently in a hybrid intelligent falls detection
system [45].
Fig. 3 provides a comparison between three different prepro-
cessing techniques for extracting information from gait signals
used to detect tripping gait patterns in the elderly [46]–[48]. The
calculated statistical descriptors, wavelet coefficients, and AR
Fig. 4. Gait disorders, balance impairments, and locomotion are examples of
biomechanical systems that can be represented by a nonlinear function f (x).
Gait parameters are used to represent inputs while system outputs may consist
of the type of disorder, the next gait event, or the next limb position. CI offers
new methods to estimate f (x) while accounting for issues such as large data
volumes, complex gait relationships, and noisy measurements.
V. CI TECHNIQUES
CI or artificial learning includes supervised, fuzzy, evolution-
ary algorithms to unsupervised and hybrid learning with the first
three paradigms being the most commonly deployed today. The
primary motivation of using CI in gait analysis is to model a
biomechanical system f (x) by learning data relationships be-
tween inputs and outputs possibly corrupted by external noise
η(t) (see Fig. 4). The model could represent, for example, a dis-
criminator between gait disorders, a predictor of gait succession,
or even a gait event generator.
Inputs consist of raw or processed gait data (Section III)
represented by Θ = {xi , yi }N i=1 , where xi ∈  denotes data of
k

coefficients represent the long minimum toe clearance (MTC)
gait signals (512 values) by a smaller number of values (4–8 val-
ues). Suitable preprocessing, e.g., AR, may produce linearly
separable features while nonseparable features, i.e., statistical
and wavelet, can be classified with CI techniques.
either a subject or walking trial while vector elements represent
data attributes, e.g., hip joint angle or walking velocity. These
feature vectors may be preclassified by assigning labels yi ∈
{. . . , −2, −1, 1, 2, . . .} with the integers denoting class types,
e.g., healthy gait, CP gait, or elderly tripping gait. The system

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692 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009
Fig. 5. Flowchart depicts design of the CI model in a general intelligent gait
system.
outputs may consist of these labels, e.g., disorder detection or
some decision rule.
Estimation of the biomechanical model f (x) using CI gener-
ally follows an iterative design process (see Fig. 5) where input
data are partitioned into training, validation, and test data. Using
a preselected CI technique, training data are used to build (train)
the model, validation data are used to determine the model’s
goodness of fit, while test data gauge the model performance to
new data (generalization). CI model parameters can be system-
atically adjusted during this time, and the process terminated
once the best performing model determined by a preselected
criterion, e.g., classification accuracy, is found.
A. Supervised Learning
The most common CI is supervised learning where feature
vectors are first labeled by a clinician (supervisor). The learning
objective is to estimate the function that best mimics the rela-
tionships between these feature vectors and the respective labels
over the dataset. Supervised learning includes artificial neural
networks (NNs) [49], radial basis function (RBF) networks,
support vector machines (SVMs) [50], and other distance-based
classifiers [51].
The NN paradigm inspired by Rosenblatt’s perceptron [52] is
the most prolific technique in gait studies [53] with architectures
ranging from feedforward networks, which include the single-
layer perceptron and multilayer perceptron (MLP), to recurrent
or feedback networks including Hopfield networks [54]. NNs
are trained using iterative algorithms, most notably the back-
propagation algorithm [55] and algorithms such as conjugate
gradient descent, quasi-Newton or trust-based methods. Most
NN architectures have been implemented in standard comput-
ing packages, e.g., MATLAB.1 This paradigm remains popular
due to the ease and availability of implementations but suffers
from high input data bias, local minima (the final classification
rule depends on initial conditions of the optimization algorithm),
and risk of poor generalization performance.
The limitations of NN prompted Vapnik [50] to propose struc-
tural risk minimization (SRM), which is a theory that enforced
the selection of the optimal learning model from a subset of
1 www.mathworks.com
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models. The SVM classifier was the first SRM implementation
that used kernel methods to deal with nonlinear problems [56],
which is implemented as a linear separating hyperplane in non-
linear (feature) space


m
f (x) = wi φi (x) + b (8)
i=1
where wi and b are the hyperplane weights and bias while φ(x)
is a nonlinear function. The hyperplane parameters were de-
termined by the solution of a convex mathematical program
constructed on the basis of margin (distance to hyperplane)
maximization between both classes. The SVM has been shown
to be a powerful classifier possessing good generalization ca-
pabilities even for small to medium datasets. The selection of
optimal model parameters is still very much combinatorial or
heuristic today, and thus is an active research problem.
B. Fuzzy Theory
Fuzzy theory describes knowledge-based aspects of data by
allowing varying degrees of uncertainty to be attached to ele-
ments in the form of membership grades. These grades assigned
through membership functions signify a degree of belongingness
to a group. For example, assuming a score si assigned to an el-
ement i, the membership grade mi calculated using a logistic
function is given as
eas i +c
mi = (9)
eas i +c + 1
for scalars a and c. In classification, fuzzy memberships are
useful for data with vague classifications [57] and allow prior
data knowledge to be incorporated into the learning tech-
nique. Fuzzy-rule-based classifiers are constructed using a set
of metarules, for example,
“If knee pain is high, disorder is knee osteoarthritis”
Fuzzy rules are, therefore, useful for incorporating linguis-
tic information that cannot be expressed numerically otherwise.
Drawbacks, however, include the requirement for optimal mem-
bership selection, more complicated implementation, and diffi-
culty in defining the number of linguistic variables.
C. Evolutionary Computation
The principal concept here revolves around evolution in bi-
ological systems as exemplified by genetic algorithms (GAs),
particle swarm optimization (PSO), and ant colony optimization
algorithms [58]. Though not widely deployed in gait studies
yet, we believe evolutionary concepts hold great potential for
gait parameter sensitivity and feature selection studies. In these
techniques, the main problem is decomposed into subproblems
known as particles or genes, and each subproblem is solved
to achieve a local criterion. The best subproblem solutions
(biggest improvements to the global problem) are then com-
bined according to a metric, and the process is continued until
the global optimum is reached. Secondary evolutionary elements
such as mutations (simulated by randomly dropping subproblem
LAI et al.: COMPUTATIONAL INTELLIGENCE IN GAIT RESEARCH: A PERSPECTIVE ON CURRENT APPLICATIONS AND FUTURE CHALLENGES
TABLE II
SUMMARY OF POSSIBLE APPLICATIONS, IMPLEMENTATION METHOD, AND COMPUTATIONAL AND RELIABILITY OF CURRENTLY DEPLOYED CI IN GAIT RESEARCH
solutions) and crossovers (mixing particle variables) in GA are
incorporated to ensure algorithm convergence.
In PSO, for example, the main problem is broken into particles
that are defined by position Xi (subobjective function values)
and velocity Vi (iterative step size) for the ith particle. The
velocity is generally defined as
Vit+1 = wVit + p1 (gbest − Xi ) + p2(pbest − Xi )
where w is an inertia weight, p1 and p2 are the scalars, pbest is
the best position of the particle, and gbest is the best position
of all particles (global best).
Evolutionary methods offer elegant methods to study rela-
tionships between gait attributes but potentially suffer from
uncertain and slow convergence, local minima, and high com-
putational complexity.
D. Unsupervised Learning
Unsupervised learning removes the presumption of labels and
attempts to learn structures within the data based on a predefined
metric. Clustering techniques are the more common methods
that focus on data structures obtained through the optimization
of a metric, e.g., Euclidean distance, and include, for example,
k-means and fuzzy c-means [59]. In k-means clustering, the
distance between all feature vectors is computed and the number
of preselected cluster means Cj is found by grouping vectors
close to each other. Specifically, the algorithm minimizes
1

n
q(C) = d(xi , Cj )
n i=1
where d(xi , Cj ) is the distance (usually Euclidean) and the
solutions are the centroids (means) Cj . Classification of new
data can be achieved by finding the closest centroid. Kohonen
self-organizing map (SOM) is another well-known method that
uses the concept of NN weights to display cluster relationships
within data [54].
A general difficulty of unsupervised learning is defining the
learning objectives accurately so that the algorithm learns the
expected relationships. As such, we believe this technique to
be more suitable for investigative gait studies [5], for example,
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693
studies looking at discovering distinct CP gait types in children
[60].
E. Hybrid Systems
Hybrid systems are a combination of several learning
paradigms resulting in techniques such as hybrid classi-
(10)
fiers, semisupervised learning, and mixtures of experts and
knowledge-based systems. Hybrid classifiers combine two or
more CI methodologies for pattern recognition, with the most
common being fuzzy supervised learning. The NN paradigm,
for example, has been fuzzified in almost every aspect from
the knowledge-oriented neuro-fuzzy classifier and fuzzifica-
tion of the backpropagation algorithm (metalearning) to fuzzy
SOMs [61]. In fuzzy SVMs (FSVMs), membership functions
such as the probit, logistic, and trapezoidal functions alter the ef-
fect of outliers on the hyperplane position by penalizing training
errors differently [62]. Good knowledge of the data distribution
facilitates membership function selection while suboptimal se-
lections degrade generalization performances and induce long
training durations.
Semisupervised learning constructs a CI model with labeled
data and uses distributional information of unlabeled data to
improve the model. Early work improved nearest neighbor clas-
sifiers by distance metric minimization [63] while recent work
focused on metric estimation in kernel spaces [64]. More re-
cently, an information theoretic measure, i.e., maximum entropy,
was used on unlabeled data to adjust a generative classifier built
(11) from labeled data [65].
More complex systems such as mixtures of experts or expert
systems consist of several cascaded CI techniques. For example,
a system for detecting gait disorder types could consist of highly
specialized CI techniques (local experts) for detecting different
gait disorders. The local decisions are then combined using a
global function to derive the overall decision or model.
Table II summarizes the potential applications, implemen-
tation methods, computational complexities, and interpretabil-
ity of the results for each learning paradigm. Interpretability
refers to how relevant the CI outputs are to the observed biome-
chanical systems, with the easiest being fuzzy techniques and
694 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009
unsupervised learning the hardest since learning objectives have
to be properly defined. The reliability of these techniques is
application-dependent and usually measured by accuracy on a
test set or correlation with expert opinion.
VI. GAIT FEATURE SELECTION
Feature selection is applied in conjunction with a selected CI
method to remove redundant information and improve model
accuracy. It consists of feature reduction and dimension reduc-
tion [66] where feature reduction removes several feature vec-
tors (pertaining to individual subject data), which is an unlikely
step in gait studies due to the often small subject sizes (<300)
available. Dimension reduction, on the other hand, removes fea-
ture vector attributes, which is more applicable to gait studies
due to the small subject sizes and the diversity of gait mea-
surements. Techniques such as the following allow detection of
influential gait parameters over redundant ones.
1) Principal component analysis (PCA): PCA projects fea-
tures onto a smaller dimensional space creating orthogonal
components with maximum variance [67]. This transfor-
mation constructs principal components Pk , which are
linear combinations of the original feature vectors as
follows:
Pk = ak 1 x1 + ak 2 x2 + · · · + an xk n

where i a2k i = 1. Data are first normalized to zero mean
and unit variance before application of the PCA algorithm.
2) GAs: This evolutionary method can be applied with a CI
classifier, e.g., clustering or SVM [68], [69], to determine
separability of individual attributes. The algorithm itera-
tively retains only the most separable attributes using the
principle of “survival of the best fitted.”
3) Hill climbing/descent: Assuming p number of attributes,
this method (also known as forward–backward selection)
begins by selecting the best single attribute with a classifier
choice. The attribute with highest accuracy is retained
and combined in step with the remaining p − 1 attributes.
The set with the highest accuracy is the optimal attribute
set [70]. The descent method is the reverse that starts
with all p attributes, and subsequently, removes those with
poorer performance.
4) Linear classifiers: Analysis of single attribute separabil-
ities may be conducted using simple thresholding meth-
ods, e.g., area of receiver operating characteristics (ROC)
curves, and linear classifiers, e.g., linear discriminant anal-
ysis (LDA). These techniques provide insights to the use-
fulness of an attribute as being representative of the biome-
chanical system or a discriminator of gait patterns.
Further dimension reduction techniques such as factor analy-
sis, independent component analysis, multidimensional scaling,
and information theoretic methods [71] remain promising for
gait studies. These reduction methods are implemented offline
due to the high computational requirements; however, proper
testing is required to avoid overfitting the model to initial data.
A bigger research challenge lies in interpreting the biomechan-
ical relationships between the “optimal” attributes and the class
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Fig. 6. Taxonomy of current and future CI applications in gait studies. In
general, the difficulty of application increases from left to right, while the
system design, data analysis, and computational complexity in each subcategory
increase from top to bottom.
of observed gait patterns, which is an intricate task more so for
nonlinear dimensional reduction methods.
(12)
VII. CI IN GAIT APPLICATIONS
The increased diversity of CI in gait can be observed by
applications ranging from the detection of gait disorders, gait
modeling to biometrics, prosthetic control, and artificial gait
simulation (see Fig. 6). In this section, we examine a selection
of the more recent applications (details given in Table III) while
noting that work on earlier systems has been documented in [5],
[40], [53], [72], and [73].
A. Normal Gait Studies
A fundamental study to illustrate the potential of CI was to
demonstrate recognition of normal gait. This led to detection of
motion from inertial sensors and video capture data, where, for
example, Aminian et al. [74] employed an NN to detect level,
downhill, and uphill walking from accelerometers located at the
hips and pelvic bone. It was found that statistical descriptors of
acceleration data provided detection accuracies of 84%–100%
depending on the activity. Barton and Lees [75] employed the
NN to identify normal walking, leg length difference, and leg
weight difference using joint kinematics. Data were collected
from reflective markers positioned at the shoulder, hip, knee, and
ankle joints to determine hip and knee angles. The joint angles
measured over a series of gait cycles were treated as digital sig-
nals, and Fourier coefficients were used as NN inputs. Recently,
Barton et al. [76], [77] proposed a gait index to quantify gait
normalcy derived from 43 gait variables fed into an SOM. The
inputs consisted of 18 subjects and 129 gait cycles per subject,
while the output results were plotted on a curve to measure gait
deviations from normalcy.
Studies into the biomechanics of gait have been instrumen-
tal in understanding gait pathologies and formulating treatment
LAI et al.: COMPUTATIONAL INTELLIGENCE IN GAIT RESEARCH: A PERSPECTIVE ON CURRENT APPLICATIONS AND FUTURE CHALLENGES
TABLE III
EXAMPLES OF CI IN THE MAJOR GROUP OF GAIT STUDIES, I.E., NORMAL GAIT MODELING, GAIT EVENT DETECTION, AND PATHOLOGY DETECTION
strategies. While mathematical models have captured physical
dynamics, the numerous input variables to a locomotor system
make their interaction difficult to characterize. In this case, CI
techniques have been used to model the implicit interactions
between the locomotor variables. Wang [78] employed a GA
to solve a multicriterion analysis optimization problem used to
model heel–toe running. The proposed algorithm used a Pareto
optimality criterion as opposed to classical weighted sum ap-
proaches. The evolutionary method meant that the scheme could
be solved more efficiently using parallel computing where each
computer solved a subproblem (gene). Prentice et al. [79] had
applied NN to learn the relationship between nerve activations
and the resulting gait patterns based on the assumption that
kinematic movement plans were related to muscle activations.
The time series of knee and hip kinematic measurements were
used as NN inputs and the outputs were activations of eight
muscles recorded using EMG. Dejnabadi et al. [80] applied
harmonic analysis, PCA, and NN to analyze interjoint coor-
dination during variable walking. Their model could predict
knee angles based on cadence and stride length for healthy
subjects and knee arthroplasty patients, but required many gait
cycles at different walking speeds to adequately train the NN.
Raw EMG data inputs and a dynamic recurrent NN (DRNN)
have recently been used to model lower limb coordination in
the thigh, shank, and foot elevation angles [81]. The DRNN
was selected because it captured the history of temporal de-
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695
pendencies between the six EMG recording locations during
motion.
B. Gait Event Detection
In some studies, detecting gait events is crucial; for exam-
ple, in functional electrical stimulation (FES) research, accu-
rate gait phase detection is required to correctly apply electri-
cal nerve stimulation. Ng and Chizeck [82] first investigated
fuzzy rules to detect five gait events, i.e., weight acceptance,
midstance, terminal stance, and early and late swings in para-
plegic subjects from inertial sensor data. These fuzzy rules were
shown to be more accurate than lookup tables; however, the
system was susceptible to intrinsic errors such as misdetec-
tions of gait phase transition due to delays and incorrect tran-
sition anticipation during gait phase change. Williamson and
Andrews [83] had used uniaxial accelerometer signals as in-
puts to design a rule-based detector using rough sets (RSs) and
adaptive logic networks (ALNs), which is a decision tree con-
structed from linear piecewise functions. Though the RS method
was the more accurate of the two techniques, their study re-
vealed that gait phase transitions were harder to detect than gait
events themselves. Following this, a fuzzy controller employ-
ing foot force information [84] to derive a rule base set was
developed. This incorporated the uncertainty in transition phase
detection, which not only improved overall detection accuracies
696 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009
but also allowed detection of unexpected gait events in-between
transitions.
Lauer et al. investigated the more intricate disorder of CP in
children, using a neuro-fuzzy network to detect gait events us-
ing leg quadriceps muscle EMG readings [85]. The digital EMG
readings (sampled at 300 Hz) and waveform derivatives were fed
into an adaptive neuro-fuzzy inference system (ANFIS) moder-
ated by three IF–THEN rules. These rules were required because
the ANFIS was memoryless, and control was needed to ensure
detected gait events logically matched sequential gait phases.
Hansen et al. [86] examined detection of heel strikes and liftoffs
from Sural electroneurogram, which is an important applica-
tion in work on using FES to treat ankle footdrop disorders.
Experimental studies conducted over long periods (>300 days)
and various footwear revealed that an ALN system for event
prediction suffered at the most 4% accuracy degradation. While
this was promising, it should be noted that subject variability
was not considered since the study was performed on a single
subject.
More recently, gait recognition has been used in biometrics,
i.e., automatic recognition of a person from physiological or
behavioral characteristics [87] for identity verification. Unlike
fingerprint and iris identification, gait is unobtrusive and can
be detected from greater distances allowing smoother secured
access to buildings and equipment, e.g., automated teller ma-
chines (ATMs). Most recognition is based on gait images, where
dimension reduction algorithms such as radon transforms and
Krawtchouk moments [88], Gabor functions and multitensor
analysis [89], and gait normalization [90] have been used on
2-D and 3-D silhouette images to extract discriminative infor-
mation. CI techniques are now being deployed to classify these
information, as seen in, for example, Lu and Zhang’s [91] appli-
cation of ICA to processed silhouette multiple-view images and
detection with a genetic fuzzy support vector classifier. Their
system required an additional product of sums algorithm to fuse
the classifications, which is a debatable technique since individ-
ual view classifications may not be entirely independent.
C. Gait Disorder Detection
Efforts to diagnose gait disorders resulted in criteria, e.g.,
Gillete index [92], for measuring gait normalcy/deterioration.
Without these quantifications, reassurances of successful patient
recovery and rehabilitation remained difficult especially when
patients had high expectations of gait improvement following
surgical interventions. Recent research is looking at the possi-
bility of CI in disorder detection and evaluation of treatment
measures.
Early work by Bekey et al. [93] had demonstrated that EMG
inputs could distinguish normal from pathological gaits when
used with NN. GRFs were used with NN by Holzreiter and
Kohle [94] and Wu et al. [95], [96] to detect ankle arthrodesis
with varying degrees of success. These studies provide proof
of concepts for the use of CI in pathology detection, mostly
consisting of applying NNs directly to preclassified kinetic or
kinematic measurements.
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More recent work has investigated specific disorders and a
more focused research objective for pathology detection. Toe
walking, for example, is a disorder indicative of more serious
pathologies such as CP, myopathy, and neuropathy but could
be idiopathic (unknown etiology), which makes it challenging
to detect. Armand et al. [97], [98] have applied fuzzy decision
trees to ankle kinematics in an effort to identify toe walking
phases based on muscle strength and range of motion scores.
The subjects were observed with video and their gait was clas-
sified into three groups from which 83 fuzzy rules were built to
classify them. Further analysis of these rules provided insights
to toe-walking biomechanics, where, for example, weakness in
the quadriceps explained the cause of toe walking while weak-
ness in the tibalis anterior muscle was detected by excessive
plantarflexion in the swing phase.
In pediatric CP, the challenge is to detect the type and severity
of the gait (types I–IV, hemiplegia, or diplegia) so that timely in-
tervention measures could be applied to the child [60]. O’Malley
et al. [99] attempted automatic classification using fuzzy clus-
tering and demonstrated that healthy and CP children could be
differentiated using stride length and cadence. Kamruzzaman
and Begg [100] found that SVM models provided better de-
tection compared to the statistical-based LDA and NNs using
the same two temporal–spatial parameters. Toro et al. [101] re-
cently applied cluster analysis on sagittal kinematic data from
the hip, knee, and ankle to investigate the number of gait types
in children with CP. They found 13 distinct clusters, which
were visually validated and consisted of gait with excessive
flexion at the hip in stance (crouch gait), degree of ankle plan-
tarflexion (equinus gait), and other varying flexion angles. This
finding seemed to challenge the general type I–IV classifica-
tions of CP children and demonstrated newer results with CI
techniques.
Studies in knee pathologies have focused on detection and
study of related biomechanical factors, where, for example, en-
semble NN classifiers have recently been used to detect knee
osteoarthritis from knee flexion and moment data [102]. The col-
lective performance of individual NNs substantially improved
detection of the knee pathology compared to individual MLP
classifiers. Lai et al. [103] applied SVMs to detect individuals
with patellafemoral pain syndrome (PFPS), which is a disorder
of the knee with unknown etiology. The SVM was trained using
30 features comprising rearfoot GRFs and kinematic data, of
which 6 features pertaining to the rearfoot kinematics and peak
GRFs were found to distinguish PFPS from normal gait. This
study marked an initial attempt at explaining the biomechan-
ical relationships of optimal selected features by a particular
feature selection algorithm. Levinger et al. [104] then inves-
tigated the recovery of single-knee osteoarthritis from surgery
using eight spatiotemporal features for preoperative, and 3 and
12 months postoperative subjects. The best two features were
related to single- and double-support time symmetries indicat-
ing that temporal footfall measures changed the most and were
important to monitor in postoperative recovery. The SVM pre-
dicted healthy gait patterns after 12 months of recovery, which
coincided with patient knee scores, indicating that it had po-
tential to be used for rehabilitative monitoring. However, the
LAI et al.: COMPUTATIONAL INTELLIGENCE IN GAIT RESEARCH: A PERSPECTIVE ON CURRENT APPLICATIONS AND FUTURE CHALLENGES
TABLE IV
INTELLIGENT GAIT SYSTEMS FOR DETECTING AND SCREENING ELDERLY GAIT DISORDERS
proposed system required further collection of subject data in
more frequent time intervals to improve recovery predictions.
D. Gait Screening for Prevention
Monitoring and screening for at-risk gait is becoming impor-
tant as detecting early warning signs would enable preventive
measures such as exercise and diet regimes to be prescribed.
Unfortunately, progression of most disorders such as knee os-
teoarthritis and elderly balance impairments occurs slowly over
time complicating efforts to detect or quantify changes. This
is, however, set to change with the application of CI toward
predictive, interpolative, and extrapolative investigations.
In geriatric studies, emphasis has been placed on balance
control studies, which are indicative of falls-risk gait in the el-
derly. Begg and Kamruzzaman [105] have looked at changes
between young and elderly gait using SVMs applied to joint
angles, GRF, and stride-phase features. Analysis revealed that
kinematic features provided better detection accuracies, while
feature selection revealed that 3 out of 24 features (knee range
of motion, normalized double-support time, and horizontal peak
push-off force) provided the best detection. Wu et al. [106]
used kernel PCA to extract features from eight spatiotempo-
ral and 27 kinematic features, which were classified with an
SVM. They showed that smaller transformed feature sets pro-
vided better separability between young and elderly gait. Hahn
et al. [107] studied the center of mass of the body to detect
elderly subjects with balance impairments and trained a three-
layered feedforward NN with spatiotemporal and EMG data.
Their NN model was able to predict the M/L motion of the
center of mass achieving similar trends where the velocity and
displacement of the center of mass in the elderly with balance
impairments were more pronounced than healthy elderly and
young adults.
Detection of elderly tripping (major type of elderly fall) gait
patterns is a complex issue, which has seen recent CI involve-
ment. Begg et al. [108] applied NNs to MTC data collected
during the swing phase of the gait cycle after earlier stud-
ies suggested that the MTC was a sensitive falls-risk predic-
tor [11], [109]. Hassan et al. [110] applied fuzzy logic to map
relationships between statistical descriptors of MTC histograms
and falls-risk gait achieving good classification performance.
MTC variability in a series of gait cycles has been modeled
by statistical descriptors [46], and wavelet analysis [47] and
SVMs where 512 gait cycles were required to produce high
accuracies (>90%) (Table IV). Khandoker et al. [47] applied
the hill-climbing algorithm to select optimal wavelet features
achieving good detection accuracies. Following this, a hybrid
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697
AR and SVM system [48] demonstrated higher detection accu-
racies in a significantly smaller number of steps (32 gait cycles
or less than a minute of walking) without the need for feature
selection. The authors demonstrated that in the case of MTC
signals, a linear predictor model better captured quasi-temporal
information that allowed faster detection (smaller number of
gait cycles). These results are encouraging since prior studies
had indicated that falls-risk gait patterns were not evident until
substantial walking had taken place [111].
E. Gait Prosthesis and Artificial Gait
The understanding of biomechanical factors in normal gait
has allowed development of artificial gait systems such as neural
protheses and robot navigation. In these areas, much modeling
work remains to be completed and CI is only just finding favor in
place of partial differential equation modeling or other explicit
techniques.
Neural prosthesis for walking refers to systems for producing
artificial gait when sensory and motor control is disrupted due
to paralysis (brain injury, stroke, or spinal cord injury) [112]. In
these protheses, neural activity from the cerebral cortex is trans-
lated to gait control signals for lower limb motion, which is a
highly complex process that requires advance signal processing
algorithms. These highly nonlinear and redundant systems have
started to benefit from CI such as NN to reproduce the complex
control required by approximately 30 muscles and 15 joints in
the lower extremities [113]. Strategies consisting of RBFs and
NN have been used to control elbow flexion/extensions and fore-
arm pronation/supinations [114] and could be directly applied
to lower limb motion. More exciting work has begun toward in-
vestigating brain-controlled interfaces (BCIs) for the prospects
of controlling gait prostheses (see recent survey [115]), an area
which would require immense CI contribution due to the diverse
nerve signal-to-motion relationships.
Apart from healthcare applications, CI has been used to
model artificial gait controllers. It has been recently proposed in
robotics that animal-legged locomotion is more suitable to nego-
tiate terrains than traditional wheels or tracks [116], prompting
researchers to examine central pattern generators (CPGs) and
adaptive gait simulators. CPGs are thought to control locomo-
tion, respiration, and heartbeat in animals [117] and have been
previously modeled by neural oscillators. Kim and Lee [118]
proposed a hybrid GA and NN CPG where the GA selected
CPG model parameters while the NN reproduced the gait pat-
terns. Earlier work used fuzzy NN controllers to model biped
human locomotion in combination with dynamic and linearized
walking models to simulate liftoff, stride, and touchdowns [119].
698 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009
F. Exercise and Sports
Sports biomechanics has only recently indulged in CI appli-
cations with work focusing mostly on the use of NN and expert
systems for analyzing the performance of cricket bowlers, soc-
cer players, and shot putters [120]. In cricket, expert systems
were used to recognize bowling patterns and relate them to the
type of bowl, while in soccer, the SOM was used to show that the
distance and accuracy of kicks could be captured by joint angle
motions. In athletics, Yan and Wu [121] have analyzed shot-put
throws to predict release angle and putt speeds. Reports of CI
applications in running and other track events have been scarce,
thus indicating room for further research in this field.
In exercise programs, Su et al. [122] have attempted to predict
oxygen uptakes during moderate treadmill exercises using a
Hammerstein system (static nonlinear block with dynamic linear
system) modeled by a support vector regressor. Evidence of CI
applications are still lacking in this area, but we are optimistic
that its potential for exercise monitoring, sports training, and
physiotherapy would be useful in the future for the well-being
of our mobility.
VIII. FUTURE CHALLENGES AND APPLICATIONS
A. Further Challenges
Despite successes in engineering applications, the uptake of
CI for gait applications such as disorder detection, rehabilitation
monitoring, and risk prediction has been slow. This is attributed
to black-box CI techniques, which frustrate the clinician’s abil-
ity to graphically visualize the relationships between disorder
and the CI model. While high performance accuracies (e.g.,
>90%) have been touted to demonstrate CI viability, the inabil-
ity to directly correlate the model to the relevant biomechanical
factors has caused clinical concern. Further research should be
emphasized on feature analysis methods such as dimension re-
duction to link and quantify the CI model to the underlying
biomechanics. Clinicians should be aware that CI techniques
learn implicit data relationships, which seldom can be quanti-
fied as in explicit modeling; hence, a different approach should
be adopted when trying to analyze the results. For example, if
the application is gait disorder detection with NN, focus should
be on gait data selection to improve detection and not question-
ing the model’s learning capabilities because the NN is limited
to the supervisory information provided.
We have previously presented a general design methodology
in Fig. 5; however, successful deployment still requires expert
knowledge and experience. Though extensions to multiclass
problems have been attempted, differentiating pathological gait
patterns rarely excludes the subject from disorders not learned
by the intelligent system. This is further complicated by the
heterogenous gait patterns in any disorder, which necessitates a
system with a high degree of robustness to subject variability.
These improvements would require deeper research into in-
put gait features, newer signal processing techniques, and more
advanced CI paradigms. The challenge is to design CI imple-
mentations deployable on personal computers with easy-to-use
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interfaces so that they provide clinicians or researchers with
more cost-effective and efficient analysis tools.
On the other side of the spectrum is the rush to adopt CI while
disregarding the original objective of clinical treatment, which
aims to optimize a patient’s gait and not to achieve normal gait
as defined by biometric models. Maximizing gait functionality
to the appropriateness of the environmental surroundings should
be the major goal of these intelligent systems. This is exception-
ally challenging as learning goals must be carefully designed,
notions of acceptable gait must be developed, and biasing a par-
ticular CI model to data must be avoided. These constraints open
up further research problems in the CI field as newer learning
paradigms are required.
More ambitious gait applications such as predicting disease
progression (prognosis) and rehabilitation rates would benefit
tremendously from CI. These endeavors require long-term data
collection, strenuous patient monitoring, and proper databases
for systematic data storage, factors that are paramount for train-
ing and validating CI systems.
The lack of subject diversity, excessively long recording
times, and unnatural walking environments imposed in gait lab-
oratories could be alleviated with emerging sensor-based tech-
nologies [123]. These technological integrations would allow
portability, continuous monitoring, and cost-effective solutions
for current gait studies. The challenge now is to integrate CI
techniques with these technologies onboard the hardware, so
that successful offline applications could be made real time.
B. Sensor Technology for Gait Studies
Sensor technologies have become more prominent in personal
healthcare, promising revolutionary devices that provide better
gait recording, more mobility (wireless sensor packages are
portable), navigation in natural environments, and biofeedback.
Besides several engineering issues such as power consumption,
detection accuracies, security, and privacy, these devices pose
additional research challenges such as sensor selection, sen-
sor mounting, information processing, and patient acceptance.
Sensor selection requires knowledge of the gait variable to be
measured while motion artifacts affect the quality of recorded
information. In addition, device construction (size, weight, and
robustness) is important for general patient acceptance, where
individuals are unlikely to use bulky devices or devices that in-
terfere with their natural motion. In these area, CI dimension
reduction methods could pinpoint important gait parameters,
thus minimizing the number of sensors required resulting in
cheaper and lighter devices, while onboard CI implementation
would allow real-time device biofeedback, e.g., corrective gait
training.
Early work by Miyazaki [123] monitored stride length and
walking velocity using a piezoelectric gyroscope and a data
logger. Gyroscopes, which measure angle variation, were also
used by Najafi et al. [124] to detect postural changes to deter-
mine potential elderly fallers. A portable logger was attached
to the waist, and a wavelet transform was applied to the pre-
processed gyroscope readings to infer postural body transitions.
The differences between transform coefficients facilitated the
LAI et al.: COMPUTATIONAL INTELLIGENCE IN GAIT RESEARCH: A PERSPECTIVE ON CURRENT APPLICATIONS AND FUTURE CHALLENGES
detection of low- and high-risk fallers. The system was later
extended [125] to monitoring activity of the elderly using a
combination of gyroscopes and dual-axis accelerometers. Ac-
celerometers measure the acceleration of a moving body and
can be used to infer velocity and displacement by integration
of the acceleration signal. Najafi et al. [125] were able detect a
subject lying down, sitting, standing, and walking by examin-
ing differences between wavelet coefficients obtained from the
accelerometer readings. It was found that this transform primar-
ily enhanced the differences between lying down and walking.
Dejnabadi et al. [126] extended the sensor system to joint an-
gles during walking and reported good performance when com-
pared to a reference motion measurement system. More recently,
Karantonis et al. [127] devised a classifier algorithm together
with a triaxis accelerometer for real-time monitoring of a per-
son’s gait. The device was positioned at the hip and the classifier
worked on simple thresholding rules, thus allowing real-time
detection of gait events such as standing and sitting.
IX. CONCLUSION
Progress made over the last decade in the application of CI
to recognize gait abnormalities has now established CI in gait
research, thus potentially leading to an expansion of gait appli-
cations with more CI involvement. Though the deployment of
intelligent gait systems in practical settings is still in its infancy,
the potential of cost-effective and more efficient techniques is
poised to deliver CI as a routine diagnostic, monitoring, and
control technique in gait research for the coming years. Future
intelligent gait systems integrated with sensor technology, for
example, wireless sensors, would enable online gait monitoring
with biofeedback in natural walking environments. The conver-
gence of these technologies is positioned toward becoming an
ubiquitous healthcare technology, promising vast benefits for
continued improvement of the global quality of life.
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Daniel T. H. Lai (M’08) received the B.Eng. degree
in electrical and computer systems and the Ph.D.
degree from Monash University, Melbourne, Vic.,
Australia, in 2002 and 2006, respectively.
He is currently a Research Fellow with the Biome-
chanics Unit, Victoria University, Melbourne. His
current research interests include application of sig-
nal processing and computational intelligence for gait
analysis, and wireless sensor networks for healthcare
engineering applications. He has authored or coau-
thored more than 25 peer-reviewed publications. He
is currently a Reviewer for the International Journal of Computational Intelli-
gence and Applications.
Dr. Lai is a currently a Reviewer for the IEEE TRANSACTIONS OF INFOR-
MATION TECHNOLOGY AND BIOMEDICINE. He has been actively involved in the
organization of several conferences and workshops.
702 IEEE TRANSACTIONS ON INFORMATION TECHNOLOGY IN BIOMEDICINE, VOL. 13, NO. 5, SEPTEMBER 2009
Rezaul K. Begg (M’94–SM’06) received the B.Sc.
and M.Sc.Eng. degrees in electrical and electronic en-
gineering from Bangladesh University of Engineer-
ing and Technology (BUET), Dhaka, Bangladesh,
and the Ph.D. degree in biomedical engineering from
the University of Aberdeen, Aberdeen, U.K.
He was with Deakin University and BUET. He
is currently an Associate Professor with the Biome-
chanics Unit, Victoria University, Melbourne, Vic.,
Australia. He has authored or coauthored more than
120 research papers. He is a regular reviewer for sev-
eral international journals. His current research interests include biomedical
engineering, biomechanics, and machine learning.
Dr. Begg has been actively involved in organizing a number of major inter-
national conferences. He has received several awards for academic excellence,
including the International Conference on Intelligent Sensing and Information
Processing (ICISIP) 2005 Best Paper Award, the Vice-Chancellor’s Citation
Award for Excellence in Research at Victoria University, the BUET Gold Medal,
and the Chancellor Prize.
Authorized licensed use limited to: Universidad Nacional de Colombia. Downloaded on July 17,2010 at 15:48:03 UTC from IEEE Xplore. Restrictions apply.
Marimuthu Palaniswami (S’84–M’85–SM’94)
received the B.E. (Hons.) degree from the Univer-
sity of Madras, Chennai, India, the M.E. degree from
the Indian Institute of Science, Bangalore, India, the
M.Eng.Sc. degree from the University of Melbourne,
Melbourne, Vic., Australia, and the Ph.D. degree
from the University of Newcastle, Callaghan, N.S.W.,
Australia.
He is with the University of Melbourne for more
than 16 years. He has authored or coauthored more
than 180 refereed papers. He was an Associate Editor
for the Journal of Computational Intelligence in Finance. He is also the Sub-
ject Editor for the International Journal on Distributed Sensor Networks. His
current research interests include support vector machines (SVMs), sensors and
sensor networks, machine learning, neural network, pattern recognition, and
signal processing and control.
Dr. Palaniswami received the Foreign Specialist Award by the Ministry of
Education, Japan, in recognition of his contributions to the field of machine
learning. He was an Associate Editor for the IEEE TRANSACTIONS ON NEURAL
NETWORKS.