Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders

IntroductionThe onset of locomotion is a critical motor milestone in early childhood and increases engagement with the environment. Toddlers with neurodevelopmental disabilities often have atypical motor development that impacts later outcomes. Video-based gait analysis using pose estimation offers...

Full description

Saved in:
Bibliographic Details
Main Authors: Jeffrey T. Anderson, Jan Stenum, Ryan T. Roemmich, Rujuta B. Wilson
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-02-01
Series:Frontiers in Digital Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fdgth.2025.1542012/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850189626201866240
author Jeffrey T. Anderson
Jan Stenum
Ryan T. Roemmich
Ryan T. Roemmich
Rujuta B. Wilson
Rujuta B. Wilson
author_facet Jeffrey T. Anderson
Jan Stenum
Ryan T. Roemmich
Ryan T. Roemmich
Rujuta B. Wilson
Rujuta B. Wilson
author_sort Jeffrey T. Anderson
collection DOAJ
description IntroductionThe onset of locomotion is a critical motor milestone in early childhood and increases engagement with the environment. Toddlers with neurodevelopmental disabilities often have atypical motor development that impacts later outcomes. Video-based gait analysis using pose estimation offers an alternative to standardized motor assessments which are subjective and difficult to ascertain in some populations, yet very little work has been done to determine its accuracy in young children. To fill this gap, this study aims to assess the feasibility and accuracy of pose estimation for gait analysis in children with a range of developmental levels.MethodsWe analyzed the overground gait of 112 toddlers (M: 30 months, SD: 8 months) with and without developmental disabilities using the ProtoKinetics Zeno Walkway system. Simultaneously recorded videos were processed in OpenPose to perform pose estimation and a custom MATLAB workflow to calculate average spatiotemporal gait parameters. Pearson correlations were used to compare OpenPose with the Zeno Walkway for velocity, step length, and step time. A Bland-Altman analysis (difference vs. average) was used to assess the agreement between methodologies and determine the difference of means. Developmental levels were assessed using the Mullen Scales of Early Learning.ResultsOur analysis included children with autism (n = 77), non-autism developmental concerns (n = 6), tuberous sclerosis complex (n = 13), 22q deletion (n = 1), and typical development (n = 15). Mullen early learning composite scores ranged from 49 to 95 (m = 80.91, sd = 26.68). Velocity (r = 0.87, p < 0.0001), step length (r = 0.79, p < 0.0001), and step time (r = 0.96, p < 0.0001) were all highly correlated between OpenPose and the Zeno Walkway, with an absolute difference of means of 0.04 m/s, 0.03 m, and 0.01 s, respectively.DiscussionOur results suggest that video-based gait analysis using pose estimation is accurate in toddlers with a range of developmental levels. Video-based gait analysis is low cost and can be implemented for remote data collection in natural environments such as a participant's home. These advantages open possibilities for using repeated measures to increase our knowledge of how gait ability changes over time in pediatric populations and improve clinical screening tools, particularly in those with neurodevelopmental disabilities who exhibit motor impairments.
format Article
id doaj-art-106c002c4a8e4d6198d8e1ce9fe8a4fe
institution OA Journals
issn 2673-253X
language English
publishDate 2025-02-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Digital Health
spelling doaj-art-106c002c4a8e4d6198d8e1ce9fe8a4fe2025-08-20T02:15:34ZengFrontiers Media S.A.Frontiers in Digital Health2673-253X2025-02-01710.3389/fdgth.2025.15420121542012Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disordersJeffrey T. Anderson0Jan Stenum1Ryan T. Roemmich2Ryan T. Roemmich3Rujuta B. Wilson4Rujuta B. Wilson5Department of Medicine, University of California, Los Angeles, CA, United StatesDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesDepartment of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD, United StatesCenter for Movement Studies, Kennedy Krieger Institute, Baltimore, MD, United StatesDepartment of Medicine, University of California, Los Angeles, CA, United StatesSemel Institute for Neuroscience and Human Behavior, Los Angeles, CA, United StatesIntroductionThe onset of locomotion is a critical motor milestone in early childhood and increases engagement with the environment. Toddlers with neurodevelopmental disabilities often have atypical motor development that impacts later outcomes. Video-based gait analysis using pose estimation offers an alternative to standardized motor assessments which are subjective and difficult to ascertain in some populations, yet very little work has been done to determine its accuracy in young children. To fill this gap, this study aims to assess the feasibility and accuracy of pose estimation for gait analysis in children with a range of developmental levels.MethodsWe analyzed the overground gait of 112 toddlers (M: 30 months, SD: 8 months) with and without developmental disabilities using the ProtoKinetics Zeno Walkway system. Simultaneously recorded videos were processed in OpenPose to perform pose estimation and a custom MATLAB workflow to calculate average spatiotemporal gait parameters. Pearson correlations were used to compare OpenPose with the Zeno Walkway for velocity, step length, and step time. A Bland-Altman analysis (difference vs. average) was used to assess the agreement between methodologies and determine the difference of means. Developmental levels were assessed using the Mullen Scales of Early Learning.ResultsOur analysis included children with autism (n = 77), non-autism developmental concerns (n = 6), tuberous sclerosis complex (n = 13), 22q deletion (n = 1), and typical development (n = 15). Mullen early learning composite scores ranged from 49 to 95 (m = 80.91, sd = 26.68). Velocity (r = 0.87, p < 0.0001), step length (r = 0.79, p < 0.0001), and step time (r = 0.96, p < 0.0001) were all highly correlated between OpenPose and the Zeno Walkway, with an absolute difference of means of 0.04 m/s, 0.03 m, and 0.01 s, respectively.DiscussionOur results suggest that video-based gait analysis using pose estimation is accurate in toddlers with a range of developmental levels. Video-based gait analysis is low cost and can be implemented for remote data collection in natural environments such as a participant's home. These advantages open possibilities for using repeated measures to increase our knowledge of how gait ability changes over time in pediatric populations and improve clinical screening tools, particularly in those with neurodevelopmental disabilities who exhibit motor impairments.https://www.frontiersin.org/articles/10.3389/fdgth.2025.1542012/fullneurodevelopmental disabilitymotorpose estimationvaliditypediatricgait analysis
spellingShingle Jeffrey T. Anderson
Jan Stenum
Ryan T. Roemmich
Ryan T. Roemmich
Rujuta B. Wilson
Rujuta B. Wilson
Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
Frontiers in Digital Health
neurodevelopmental disability
motor
pose estimation
validity
pediatric
gait analysis
title Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
title_full Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
title_fullStr Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
title_full_unstemmed Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
title_short Validation of markerless video-based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
title_sort validation of markerless video based gait analysis using pose estimation in toddlers with and without neurodevelopmental disorders
topic neurodevelopmental disability
motor
pose estimation
validity
pediatric
gait analysis
url https://www.frontiersin.org/articles/10.3389/fdgth.2025.1542012/full
work_keys_str_mv AT jeffreytanderson validationofmarkerlessvideobasedgaitanalysisusingposeestimationintoddlerswithandwithoutneurodevelopmentaldisorders
AT janstenum validationofmarkerlessvideobasedgaitanalysisusingposeestimationintoddlerswithandwithoutneurodevelopmentaldisorders
AT ryantroemmich validationofmarkerlessvideobasedgaitanalysisusingposeestimationintoddlerswithandwithoutneurodevelopmentaldisorders
AT ryantroemmich validationofmarkerlessvideobasedgaitanalysisusingposeestimationintoddlerswithandwithoutneurodevelopmentaldisorders
AT rujutabwilson validationofmarkerlessvideobasedgaitanalysisusingposeestimationintoddlerswithandwithoutneurodevelopmentaldisorders
AT rujutabwilson validationofmarkerlessvideobasedgaitanalysisusingposeestimationintoddlerswithandwithoutneurodevelopmentaldisorders