Acceleration Gait Measures as Proxies for Motor Skill of Walking: A Narrative Review

Abstract

In adults 65 years or older, falls or other neuromotor dysfunctions are often framed as walking-related declines in motor skill; the frequent occurrence of such decline in walking-related motor skill motivates the need for an improved understanding of the motor skill of walking. Simple gait measurements, such as speed, do not provide adequate information about the quality of the body motion's translation during walking. Gait measures from accelerometers can enrich measurements of walking and motor performance. This review article will categorize the aspects of the motor skill of walking and review how trunk-acceleration gait measures during walking can be mapped to motor skill aspects, satisfying a clinical need to understand how well accelerometer measures assess gait. We will clarify how to leverage more complicated acceleration measures to make accurate motor skill decline predictions, thus furthering fall research in older adults.

Fig. 1.

An overview of the pipeline mapping AGMs to motor skills. From top to bottom, (A1) defining common real-world walking tasks which can be impacted by normal aging, illness, or injury that are then mapped to (A2) seven characteristics of the motor skill of walking performance. (B) Accelerometer data collection results in raw acceleration values, which (C) undergo signal pre-processing before deriving AGMs. (D) These AGMs are grouped into categories that can then be matched to motor skills of walking. The red arrows show this review’s main contribution, where AGMs and motor skills can be mapped to each other. (E1 and E2) Subsequently, this mapping has various applications in clinical fields.

Fig. 2.

Example of acceleration signals (ML, AP, and V) from an accelerometer placed on the lower back. A full gait cycle of the right foot (starting from a heel strike) is shaded (data and gait extraction done by Dasgupta et al. [67]).

Fig. 3.

Comparison between the current and future state of AGM use in research.