Identifying Activity Levels and Steps in People with Stroke using a Novel Shoe-Based Sensor, G. Fulk and E. Sazonov, J Neurol Phys Ther. 2012 Jun;36(2):100-7.



Advances in sensory technologies provides a method to accurately assess activity levels of people with stroke in their community. This information could be used to determine the effectiveness of rehabilitation interventions as well as provide behavioral enhancing feedback. The purpose of this study was to assess the accuracy of a novel shoe-based sensor system (SmartShoe) to identify different functional postures and steps in people with stroke. The SmartShoe system consists of five force sensitive resistors built into a flexible insole and an accelerometer on the back of the shoe. Pressure and acceleration data are sent via Bluetooth to a smart phone.


Participants with stroke wore the SmartShoe while they performed activities of daily living (ADL) in sitting, standing and walking. Data from four participants were used to develop a multi-layer perceptron artificial neural network (ANN) to identify sitting, standing, and walking. A signal-processing algorithm used data from the pressure sensors to estimate number of steps taken while walking. The accuracy, precision and recall of the ANN for identifying the three functional postures were calculated using data from a different set of participants. Agreement between steps identified by SmartShoe and actual steps taken was analyzed using the Bland Altman method.


The SmartShoe was able to accurately identify sitting, standing and walking. Accuracy, precision and recall were all greater than 95%. The mean difference between steps identified by SmartShoe and actual steps was less than 1 step.


The SmartShoe was able to accurately identify different functional postures using a unique combination of pressure and acceleration data in people with stroke as they performed different ADLs. There was a strong level of agreement between actual steps taken and steps identified using the SmartShoe. Further study is needed to determine if the SmartShoe could be used to provide valid information on activity levels of people with stroke while they go about their daily lives in their home and community.

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