Towards Context-Aware Clinical Motion Understanding in Daily Living at Home: Freezing of Gait Detection with Egocentric Vision

Objective assessment of Freezing of Gait (FoG) in Parkinson's disease (PD) relies predominantly on wearable Inertial Measurement Units (IMUs). While IMUs provide optimal kinematic precision, mandatory sensor attachment restricts continuous clinical deployment. Conversely, unobtrusive vision-based alternatives suffer substantial classification errors during turning-in-place tasks, where geometric self-occlusion degrades deterministic skeletal coordinates and obscures the high-frequency precursors required for FoG detection. To resolve these physical observation limits, we propose a supervised cross-modal subspace distillation framework. During optimisation, pre-trained kinematic data from IMU sensors and contextual clinical metadata act as oracles to guide a deployable visual architecture. By incorporating joint velocity and acceleration derivatives, utilising a confidence-based gating mechanism, the visual model mitigates some of the tracking errors during occlusion events. Empirical evaluations confirm this latent alignment transfers the predictive fidelity of hardware sensors directly into the visual representation, yielding $85.5\%$ accuracy, and $82.4\%$ balanced accuracy. All the while maintaining a vision only model at inference.

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.

Motor impairments, including tremor, bradykinesia, gait abnormalities, and postural instability, are common across many neurological and movement-related conditions. Conventional clinical assessments are often intermittent and may fail to capture subtle temporal variations in motor behavior. While wearable IMUs and third-person video have shown promise for objective motor assessment, third-person recordings raise privacy concerns and require constrained acquisition setups. In contrast, egocentric vision provides a more naturalistic and privacyaware alternative. In this work, we introduce EgoInertia-MI, a multimodal benchmark dataset combining synchronized egocentric video and wearable IMU signals for motor impairment analysis. The dataset contains 19 upper- and lower-body activities performed by healthy volunteers simulating varying levels of motor impairment severity levels: no impairment, mild impairment, and severe impairment. We establish two benchmark tasks: action recognition and motor impairment severity estimation, and evaluate multiple unimodal and multimodal baselines. Experimental results show that egocentric video provides strong cues for motor impairment assessment, while multimodal fusion achieves the best overall performance, reaching 0.78 Macro-F1 for severity estimation and 0.93 Macro-F1 for action recognition. These findings highlight the potential of combining egocentric vision and wearable sensing for ecologically valid and privacy-aware motor assessment. Code and data are available at:https://fatemah-alh.github.io/EgoInertia-MI-Page/.