title: Musical Stairs: A motivational therapy tool for children with disabilities featuring automated detection of stair-climbing gait events via inertial sensors.
abstract: Stair-climbing is a key component of rehabilitation therapies for children with physical disabilities. This paper reports on the design of a system, Musical Stairs, to provide auditory feedback during stair-climbing therapies. Musical Stairs is composed of two foot-mounted inertial sensors, a step detection algorithm, and an auditory feedback response. In Phase 1, we establish its clinical feasibility via a Wizard-of-Oz AB/BA cross-over design with 17 children, aged 4-6 years, having diverse diagnoses and gait abilities. Self-, therapist- and blinded-observer reports indicated increased motivation with auditory feedback. Phase 2 describes the construction of a database comprised of synchronized video and inertial data associated with 1568 steps up and down stairs completed by 26 children aged 4-6 years with diverse diagnoses and gait. Lastly, in Phase 3, data from 18 children in the database were used to train a rule-based step detection algorithm based on local minima in the acceleration profile and the foot's swing angle. A step detection rate of 96% [SD=3%] and false positive rate of 6% [SD=5%] were achieved with an independent test set (n=8). Recommendations for future development and evaluation are discussed.
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario M4G 1R8, Canada. Electronic address: ajmal.khan@utoronto.ca.
authors.forename: Ajmal
authors.initials: A
authors.lastname: Khan
authors.affiliation: Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, 150 Kilgour Road, Toronto, Ontario M4G 1R8, Canada; The Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College St, Toronto, Ontario M5S 3G9, Canada. Electronic address: ebiddiss@hollandbloorview.ca.
authors.forename: Elaine
authors.initials: E
authors.lastname: Biddiss
mesh_terms: D001307:Auditory Perception; D001331:Automation; D001696:Biomechanical Phenomena; D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities / Q000523:psychology / Q000534:rehabilitation*; D025461:Feedback, Physiological; D005260:Female; D005684:Gait; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D009042:Motivation; D012046:Rehabilitation / Q000523:psychology*
keywords: Accelerometer; Algorithm; Auditory feedback; Biomechanics; Gait event; Gyroscope; Inertial sensors; Initial contact; Motivation; Rehabilitation; Stair-climbing; Therapy