A Gait Foundation Model Predicts Multi-System Health Phenotypes from 3D Skeletal Motion

Video-based Clinical Gait Analysis often suffers from poor generalization as models overfit environmental biases instead of capturing pathological motion. To address this, we propose BioGait-VLM, a tri-modal Vision-Language-Biomechanics framework for interpretable clinical gait assessment. Unlike standard video encoders, our architecture incorporates a Temporal Evidence Distillation branch to capture rhythmic dynamics and a Biomechanical Tokenization branch that projects 3D skeleton sequences into language-aligned semantic tokens. This enables the model to explicitly reason about joint mechanics independent of visual shortcuts. To ensure rigorous benchmarking, we augment the public GAVD dataset with a high-fidelity Degenerative Cervical Myelopathy (DCM) cohort to form a unified 8-class taxonomy, establishing a strict subject-disjoint protocol to prevent data leakage. Under this setting, BioGait-VLM achieves state-of-the-art recognition accuracy. Furthermore, a blinded expert study confirms that biomechanical tokens significantly improve clinical plausibility and evidence grounding, offering a path toward transparent, privacy-enhanced gait assessment.

Automated gait analysis requires accurate classification and interpretable outputs. We propose an integrated framework for classifying healthy gait and multiple musculoskeletal impairment groups using bilateral ground reaction force (GRF) and center-of-pressure (COP) signals. The signals were normalized over the stance phase and standardized using training-set statistics. The model achieved a validation accuracy of 99.00% and a test accuracy of 90.07% under a session-level split. Class-specific $ε$-LRP identified positive and negative contributions across both sides, multiple signal components, and different stance phases. Separately, the processed GRF signals and model predictions were synchronized within a Blender-based 3D visualization, enabling sample-level inspection of gait trials and classification results. The proposed framework integrates classification, explainability, and 3D visualization to improve model transparency. The source code is available in the following repository: https://github.com/nyoico/grf-gait-3d-visualization.git

This paper presents a biomechanically interpretable framework for gait analysis using 3D human reconstruction from video data. Unlike conventional keypoint based approaches, the proposed method extracts biomechanically meaningful markers analogous to motion capture systems and integrates them within OpenSim for joint kinematic estimation. To evaluate performance, both spatiotemporal and kinematic gait parameters were analysed against reference marker-based data. Results indicate strong agreement with marker-based measurements, with considerable improvements when compared with pose-estimation methods alone. The proposed framework offers a scalable, markerless, and interpretable approach for accurate gait assessment, supporting broader clinical and real world deployment of vision based biomechanics