From Observed Viability to Internal Predictive Approximation: A Single-Subject Latent-Space Analysis of Gait Dynamics Under Occlusal Constraint

In biomechanical systems, observable performance is often used as a proxy for underlying organization, although similar outputs may arise from different adaptive configurations. This study considers the vertical dimension of occlusion (VDO) as a constraint applied to an adaptive neuromechanical system. A single-case design in a patient with Parkinson's disease enabled repeated intra-individual gait observations under six occlusal probes. Three complementary analytical levels were examined: (i) an aggregated scalar score of observable performance, (ii) a conceptual dynamical systems framework, and (iii) an exploratory UMAP representation of 55 standardized biomechanical variables from 270 M1 observations. The revised Level 1 analysis showed that the relative ranking of OC2.5 and OC3 depended on score construction, while their scalar distributions remained close. The Level 3 embedding showed substantial overlap among all six probes and did not identify independently separated condition-specific clusters. OC2.5 and OC3 displayed limited centroid displacement but broad observation-level overlap. The principal result is therefore representational non-identifiability: neither the aggregated score nor the selected low-dimensional embedding uniquely identifies an occlusal-condition-specific system state. VDO is interpreted as a constraint parameter rather than a causal determinant. The findings are exploratory, model dependent, and non causal. They do not establish distinct physiological states, an optimal VDO, clinical thresholds, or diagnostic, predictive, mechanistic, or prescriptive validity.

Estimating hip muscle forces and joint moments during gait typically relies on musculoskeletal simulation, which is informative but time-consuming and difficult to apply in clinical settings. This study developed a deep learning framework to predict these hip dynamics parameters directly from lower-limb gait kinematics and compared three representative sequence models under a unified protocol. Gait data were collected from 60 healthy adults under three metronome-guided cadence conditions. Ten bilateral lower-limb joint angles were used as inputs, and OpenSim-derived hip muscle forces and hip joint moments were used as reference outputs. Three deep learning models of LSTM, Transformer, and Mamba were trained and evaluated using the same subject-level split, preprocessing pipeline, and metrics. The best model was then directly tested on an external cohort of 9 patients with osteonecrosis of the femoral head (ONFH) without retraining. In the healthy-subject benchmark, Transformer achieved the best subject-level mean performance for both hip muscle force prediction (RMSE = 1.33 N/kg, MAE = 0.57 N/kg, R2 = 0.819) and hip joint moment prediction (RMSE = 0.11 Nm/kg, MAE = 0.07 Nm/kg, R2 = 0.862), with similar advantages across walking cadences. In zero-shot external validation, Transformer retained moderate predictive ability in ONFH for hip muscle force prediction (RMSE = 1.51 N/kg, MAE = 0.70 N/kg, R2 = 0.537) and hip joint moment prediction (RMSE = 0.17 Nm/kg, MAE = 0.12 Nm/kg, R2 = 0.569). These findings support the feasibility of estimating hip dynamics from gait kinematics, identify Transformer as a strong baseline, and highlight the need for broader pathological validation and improved generalization before clinical application.

Parkinson's disease is a progressive neurodegenerative disorder characterised by gradual deterioration of movement control. Automated freezing-of-gait (FOG) detection supports the objective assessment of gait-related motor impairment. Two common approaches are used for FOG prediction: (i) analysing video recordings of the patient's movements and (ii) analysing data collected using inertial measurement unit (IMU) wearable sensors attached to the patient's lower limbs. Video-based approaches may suffer detection errors during continuous turning-in-place tasks because the lower limbs undergo substantial geometric self-occlusion, degrading pose-estimation accuracy. IMU-based approaches are generally less affected by visual occlusion; however, they are difficult to deploy outside clinical or laboratory settings, as the sensors must be attached securely and remain in place throughout the assessment. Motivated by this, we propose a cross-modal subspace distillation framework to mitigate the limitations of unimodal FOG detection by combining IMU accuracy with video-based practicality. We extract invariant latent topologies from a pre-trained kinematic oracle to structurally supervise a non-encoded visual architecture during training. To resolve periods of severe spatial occlusion, a dual-stream visual model probabilistically fuses skeletal graph nodes and continuous spatial pixels, dynamically shifting reliance to uninterrupted pixel boundaries as joint tracking confidence drops. Evaluated against a public, multi-modal sequence dataset of Parkinson's individuals executing continuous $360^\circ$ turns, empirical results demonstrate that applying sensory boundary topologies strictly mitigates tracking evaluation entropy. Our constrained optimisation confirms that highly precise FOG prediction bounds can be achieved over zero-wearable inference environments.