More Motion Is Not Always Better Motion: Corpus Composition Governs Whether Augmentation Helps SMPL-Based Parkinsonian Gait Severity Estimation

In this work, we introduce language-aligned motion representations for domain-generalizable UPDRS-Gait severity estimation, aiming to learn semantically structured motion features that generalize across heterogeneous clinical domains. We first learn motion representations using a Bi-GRU backbone that captures the temporal dynamics of SMPL sequences. Prior to model training, motion captions are generated offline using Qwen2.5-7B-Instruct. The backbone is then trained with both classification and text-alignment objectives to learn discriminative and semantically structured motion representations while accounting for the class imbalance present in the training data. We subsequently adapt the learned backbone independently to each source domain so that the model can capture domain-specific motion characteristics. The resulting source-specific models are then merged at the parameter level to consolidate complementary knowledge across source domains into a single domain-generalized model. To further mitigate class imbalance, we perform GPT-5.5-based pseudo labeling, and our final merged models for each site do not use any class-prior correction during inference. The resulting model is evaluated under the unseen-site setting of the MoCha Challenge, using Macro F1 as the primary evaluation metric. Our method achieves a macro-F1 of 0.57 on the hidden test set with only 637K active parameters at inference, ranking 3rd among 58 leaderboard entries in the MoCha 2026 Challenge. The challenge attracted 1,669 submissions from 112 participants and offered monetary prizes sponsored by Machine Medicine Technologies.

We describe the winning entry to the MoCha 2026 Benchmark and Challenge on Parkinsonian Gait, which predicts MDS-UPDRS gait severity from canonicalized SMPL motion recorded at clinical sites unseen during training. The system reaches 0.6945 macro-F1 on the hidden test and ranked first of 58 entries, ahead of the runner-up at 0.5807 and the organizers' baseline at 0.4289, on a frozen public motion encoder with a single $4\times512$ linear layer. Nearly all of the margin comes from three stages usually treated as bookkeeping: reproducing the reference benchmark's exact head recipe, averaging per-walk posteriors within the subject grouping the organizers ship, and a label-free transductive calibration of the feature mean and the decision operating point. Fine-tuning the encoder lost in four distinct forms, and ten alternative encoders were worse. Every ablation number is a paid read on the hidden test, because our own leave-two-cohort-out cross-validation proved anti-correlated with the deciding score over eleven configurations. We give the negative record in full, and identify our largest gain, subject-level aggregation, as the binding ceiling on this benchmark.

Pathological gait datasets remain scarce due to privacy, recruitment, cost, and movement variability. Our work presents a multimodal LLM-guided framework for pathology-aware 3D gait data synthesis from structured textual descriptions. The proposed method generates fixed-length synthetic skeleton-based gait sequences for pathological gait classification tasks. The framework combines motion tokenisation, pathology-aware language conditioning, LLM-based semantic augmentation, and language-to-gait generation. A key contribution is the proposed pathological tokeniser, which is designed to preserve pathology-specific motion characteristics during discrete representation learning. Experiments suggest that the proposed synthetic sequences improve downstream classification for recurrent classifiers when combined with real data. The best result is obtained using a GRU classifier trained with real and synthetic samples, achieving 92.77% accuracy under a leave-one-subject-out protocol.