Despite the common focus of gait in rehabilitation, there are few tools that allow quantitatively characterizing gait in the clinic. We recently described an algorithm, trained on a large dataset from our clinical gait analysis laboratory, which produces accurate cycle-by-cycle estimates of spatiotemporal gait parameters including step timing and walking velocity. Here, we demonstrate this system generalizes well to clinical care with a validation study on prosthetic users seen in therapy and outpatient clinic. Specifically, estimated walking velocity was similar to annotated 10-meter walking velocities, and cadence and foot contact times closely mirrored our wearable sensor measurements. Additionally, we found that a 2D keypoint detector pretrained on largely able-bodied individuals struggles to localize prosthetic joints, particularly for those individuals with more proximal or bilateral amputations, but it is possible to train a prosthetic-specific joint detector. Further work is required to validate the other outputs from our algorithm including sagittal plane joint angles and step length. Code and trained weights will be released upon publication.

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Markerless pose estimation allows reconstructing human movement from multiple synchronized and calibrated views, and has the potential to make movement analysis easy and quick, including gait analysis. This could enable much more frequent and quantitative characterization of gait impairments, allowing better monitoring of outcomes and responses to interventions. However, the impact of different keypoint detectors and reconstruction algorithms on markerless pose estimation accuracy has not been thoroughly evaluated. We tested these algorithmic choices on data acquired from a multicamera system from a heterogeneous sample of 25 individuals seen in a rehabilitation hospital. We found that using a topdown keypoint detector and reconstructing trajectories with an implicit function enabled accurate, smooth and anatomically plausible trajectories, with a noise in the step width estimates compared to a GaitRite walkway of only 8mm.

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