Walking underwater reduces joint impacts, enhances stability and lowers the net body weight of the patient during rehabilitation. It is a recent rehabilitation method and few suitable methods exist to study underwater gait kinematics. We propose an underwater inertial measurement (IMU) system analogous to those used in land-based rehabilitation to investigate gait kinematics. The objective of this study was to test and validate the proposed system in two human trials by evaluating the knee angle during the gait. In the first trial, a three-way performance analysis was carried out between the IMU, optoelectronic and motion-capture systems in a traditional rehabilitation setting on land. In the second trial, the proposed underwater IMU is compared with camera-based motion-capture both inside and outside the water environment, using the same subjects in both phases of the trial. This allows for an evaluation of the walking gait in air and underwater as well as a cross-comparison of IMU-based knee angle estimates before and after Gaussian Process Regression. The major finding of this work is that the proposed underwater wearable IMU system provides reliable and repeatable measurements of the knee angle during the gait, both in air and underwater. Index Terms-gait analysis, inertial measurement unit (IMU), kinematics, rehabilitation, underwater, optoelectronic tracking, motion-capture
I. INTRODUCTIONW ATER provides a nearly ideal environment for physical rehabilitation. This is due to the additional forces acting on the submerged body, primarily caused by the dynamic pressure and drag. These hydrodynamic forces reduce the net body weight, lower joint loading and provide enhanced physical support and posture stabilization [1], [2]. Walking rehabilitation in water, shown in Figure 1, affects the muscular skeletal system [2], by reducing fatigue and pain, improving the physical recovery rate as well as joint