GaitFM: A Cross-Modal Foundation Model for Wearable Gait Assessment

Wearable motion sensing provides a continuous and scalable window into human behavior and health, making it a natural fit for foundation models, yet its pretraining and scaling principles remain poorly understood. Prior work studies isolated design choices, such as sensor placement or sampling frequency, often under fixed settings and narrow downstream tasks that fail to capture real-world sensing diversity. We introduce Inertia-1, a fully open exploration of wearable motion foundation models. Using massive corpora of accelerometer data from global sources spanning more than 18.2M hours, we build a controlled framework for studying the full lifecycle of wearable motion foundation models, covering data choices such as sensor modality, device placement, sampling rate, window length; model choices such as architectures and model size; and training choices such as pretraining objective and data scale. Extensive evaluations across 15 datasets spanning human activity recognition, freezing-of-gait detection, and disease prediction reveal intriguing findings for building motion foundation models that generalize across tasks and sensing conditions. Collectively, Inertia-1 not only presents state-of-the-art recipes for diverse downstream tasks, but also serves as a comprehensive, practical, and open cookbook for wearable motion representation learning.

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.

Foundation models (FMs) trained on large-scale accelerometer data have been proposed as general-purpose feature extractors for health monitoring, but systematic evidence of their advantages is lacking. We present the first comprehensive evaluation of four open-source accelerometer FMs against supervised baselines covering 19 tasks across the domains of activity recognition including activities of daily living, clinical monitoring, and physiological inference. We find task-dependent performance results: supervised models remain competitive with FMs on human action recognition (HAR), with no consistent advantage for either, while selected FMs lead on fall and stress detection and are the most robust to sensor-placement variation. As frozen feature extractors, FMs are strongest for demographic inference, whereas sleep staging performance remains near chance level for all models. The internal FM representations show strong similarity across layers, highlighting potential for future FM improvements. Linear and frozen probing reveals that UniMTS provides the strongest representations and is the only FM that surpasses the supervised baselines without finetuning. Concept discovery analysis shows all models capture high-intensity activities clearly but struggle with sedentary, complex or ambiguous activities. We provide scenario-based deployment recommendations. Furthermore, we identify FM-derived activity profile inference-moving beyond fixed category classification-as a promising research direction.