Skeleton-Based Posture Classification to Promote Safer Walker-Assisted Gait in Older Adults
Authors: Sergio D. Sierra M., Monica Sinha, Marcela Múnera, Carlos A. Cifuentes
Abstract
Falls among older adults are a significant public health concern, leading to severe injuries, loss of independence, and increased healthcare costs. This study evaluates the effectiveness of various models, including a Geometric approach, XGBoost, SVM, and several deep learning architectures, in classifying walker usage, standing vs. sitting, and posture for smart walkers used. Geometric and XGBoost were the top performers. XGBoost achieved near-perfect training accuracy in binary classification tasks, with 99.84% for walker choice and 99.69% for standing vs. sitting. For posture classification, Geometric approach attained 89.9% accuracy for 8 postures, and XGBoost obtained 99.24% during training for 17 postures. Deep learning models such as the 4-layer CNN and Encoder-Decoder CNN also demonstrated strong performance in binary classification, with accuracies above 98%. This study underscores the potential of machine learning to enhance human-robot interaction in smart walkers, particularly for fall prevention.
Falls in older adults are often preceded by changes in mobility, balance, and postural transitions. This paper presents a wireless smart insole platform and machine-learning workflow for recognizing sitting, standing, walking, and unstable walking from plantar-pressure and inertial signals. Each insole integrates 16 active pressure-sensing locations and a six-dimensional IMU stream consisting of tri-axial acceleration and angular velocity. Data were collected from 15 healthy adults at 80~Hz and segmented into overlapping windows. Window length and candidate model families were first screened with stratified 10-fold cross-validation; the primary performance estimate was then obtained with participant-independent 5-fold Stratified Group cross-validation, ensuring that all windows from a participant remained in a single fold. Under this protocol, Histogram-Based Gradient Boosting (HGB) achieved macro-F1 scores of 0.954 and 0.959 for the left and right feet, respectively, and 0.980 with bilateral sensing. A compact 1D-CNN evaluated with the same participant-independent folds did not significantly outperform HGB (p=0.0625). The results show that low-profile footwear sensing can infer activity state from pressure and IMU measurements for participants unseen during training, establishing a basis for activity monitoring and fall prevention in elderly care.
The decline of human balance control due to aging and pathological conditions increases fall risk, a major concern in geriatric care and rehabilitation. Gait training is essential for balance recovery, enhancing walking ability and postural control. However, existing overground robotic gait trainers have limitations: body weight support systems are bulky and impractical for daily use, while end-effector-based systems often compromise transparency, altering natural gait dynamics. This paper presents the Dynamic Robotic Balance Assistant (DRBA), a novel gait trainer providing assist-as-needed body weight and balance support for various training scenarios. DRBA integrates a 3-degree-of-freedom (3-DoF) robotic arm for pelvic support with flexible motion, a compact sit-to-stand assistance module, and user-following and fall detection algorithms to ensure minimal interference and responsive support. Experimental results demonstrated high transparency, with minimal impact on natural gait dynamics. A patient trial with nine elderly patients with varying medical conditions and balance impairments (ranging from severe to mild) further validated DRBA's effectiveness. The results showed that DRBA-assisted training increased step length and walking speed compared to therapist-assisted gait training. Additionally, DRBA enabled users to perform tasks beyond their unaided ability, expanding rehabilitation possibilities. These findings highlight DRBA's potential to enhance rehabilitation outcomes by facilitating higher training intensity and enabling task-oriented exercises.
Smart healthcare monitoring systems require precise action recognition to ensure well-being and timely intervention in critical situations such as falls, particularly for mobility-challenged individuals. Existing datasets are often clip-based, lacking the frame-level detail needed to recognize actions online, as they unfold. To address this, we introduce SAFER-Activities, a dataset for fall detection and physical activity monitoring, with a dedicated subset for wheelchair use scenarios. It comprises over 66 hours of video data captured by multiple cameras, with 85,310 action instances and frame-level annotations for 30 action classes. We benchmark action recognition on SAFER-Activities with 2D and 3D skeleton models, RGB models with frozen backbones, and multimodal fusion strategies, and evaluate on in-lab, out-of-distribution, and cross-dataset test sets. Skeleton-based models generalize best under domain shift; fusing frozen RGB features with the skeleton stream improves in-domain recognition over the baseline CNN1D, most clearly on the wheelchair subset, but degrades out of distribution. Cross-dataset and qualitative evaluations confirm that models trained on SAFER-Activities transfer well to unseen environments and external fall data. To support research on robust fall detection and activity monitoring, we release the dataset and code at https://safer-activities.github.io/.