Moving from laboratory to real life conditions: Influence on the assessment of variability and stability of gait

The availability of wearable sensors allows shifting gait analysis from the traditional laboratory settings, to daily life conditions. However, limited knowledge is available about whether alterations associated to different testing environment (e.g. indoor or outdoor) and walking protocols (e.g. free or controlled), result from actual differences in the motor behaviour of the tested subjects or from the sensitivity to these changes of the indexes adopted for the assessment. In this context, it was hypothesized that testing environment and walking protocols would not modify motor control stability in the gait of young healthy adults, who have a mature and structured gait pattern, but rather the variability of their motor pattern. To test this hypothesis, data from trunk and shank inertial sensors were collected from 19 young healthy participants during four walking tasks in different environments (indoor and outdoor) and in both controlled (i.e. following a predefined straight path) and free conditions. Results confirmed what hypothesized: variability indexes (Standard deviation, Coefficient of variation and Poincaré plots) were significantly influenced by both environment and walking conditions. Stability indexes (Harmonic ratio, Short term Lyapunov exponents, Recurrence quantification analysis and Sample entropy), on the contrary, did not highlight any change in the motor control. In conclusion, this study highlighted an influence of environment and testing condition on the assessment of specific characteristics of gait (i.e. variability and stability). In particular, for young healthy adults, both environment and testing conditions affect gait variability indexes, whereas neither affect gait stability indexes.