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Purpose of Study Assessment of an individual's postural stability serves as an indirect measure for both physiological and biomechanical stresses placed on an individual. More recently, some individuals after COVID-19 (SARS-CoV-2) infection have been identified with neurological complaints (Post-Acute Sequelae of Covid - PASC). These individuals can also be predisposed to decreased postural stability and an increased risk for falls. The purpose of the project was to incorporate two different wearable technology (virtual reality (VR) based virtual immersive sensorimotor test - VIST and pressure senor-based smart sock) to assess postural stability among healthy and individuals with PASC to quantify the overall status of the postural control system. Methods Used All methods were conducted based on the University's Institutional Review Board (IRB# 21-296) with informed consent. A total of 12 males and females (six healthy and six with self-reported complaints of PASC) have completed the study so far. All participants were tested using the VIST, while standing on a force platform and wearing the smart sock simultaneously. The (VIST uses a VR headset and proprietary software to test an individual's integrated sensory, motor, and cognitive processes through eight unique tests (smooth pursuits, saccades, convergence, peripheral vision, object discrimination, gaze stability, head-eye coordination, cervical neuromotor control). Center of pressure (COP) data from force platform and pressure sensor data from the smart socks were used to calculate anterior-posterior and medial-lateral postural sway variables. These postural sway variables were analyzed using an independent samples t-test between the healthy and PASC groups at an alpha set at 0.05. Summary of 

Wearable stretch sensors have potential applications across many fields including medicine and sports, but the accuracy of the data produced by the sensors over repeated uses is largely unknown due to a paucity of high-cycle fatigue (HCF) studies on both the materials comprising the sensors and the signal produced by the sensors. To overcome these limitations, using human physiologically-based parameters, stretch sensors were subjected to quasi-static testing and HCF with simultaneous capture of the signal. The strain produced by the sensor was then compared to the strain produced by testing instrument, and the results suggest that the output from the stretch sensors is strongly correlated with output from the testing instrument under quasi-static conditions; however, this correlation deteriorates under fatigue conditions. Such deterioration may be the result of several factors, including a mismatch between the material response to fatiguing and the signal response to fatiguing. From a materials perspective, the shape of the stress-life curve for the polymers comprising the sensors conforms to the Rabinowitz-Beardmore model of polymer fatigue. Based on these results, consideration of the material properties of a stretch sensor are necessary to determine how accurate the output from the sensor will be for a given application. 

Abstract The development of wearable technology, which enables motion tracking analysis for human movement outside the laboratory, can improve awareness of personal health and performance. This study used a wearable smart sock prototype to track foot–ankle kinematics during gait movement. Multivariable linear regression and two deep learning models, including long short-term memory (LSTM) and convolutional neural networks, were trained to estimate the joint angles in sagittal and frontal planes measured by an optical motion capture system. Participant-specific models were established for ten healthy subjects walking on a treadmill. The prototype was tested at various walking speeds to assess its ability to track movements for multiple speeds and generalize models for estimating joint angles in sagittal and frontal planes. LSTM outperformed other models with lower mean absolute error (MAE), lower root mean squared error, and higher R -squared values. The average MAE score was less than 1.138° and 0.939° in sagittal and frontal planes, respectively, when training models for each speed and 2.15° and 1.14° when trained and evaluated for all speeds. These results indicate wearable smart socks to generalize foot–ankle kinematics over various walking speeds with relatively low error and could consequently be used to measure gait parameters without the need for a lab-constricted motion capture system. 

Motion capture is the current gold standard for assessing movement of the human body, but laboratory settings do not always mimic the natural terrains and movements encountered by humans. To overcome such limitations, a smart sock that is equipped with stretch sensors is being developed to record movement data outside of the laboratory. For the smart sock stretch sensors to provide valuable feedback, the sensors should have durability of both materials and signal. To test the durability of the stretch sensors, the sensors were exposed to high-cycle fatigue testing with simultaneous capture of the capacitance. Following randomization, either the fatigued sensor or an unfatigued sensor was placed in the plantarflexion position on the smart sock, and participants were asked to complete the following static movements: dorsiflexion, inversion, eversion, and plantarflexion. Participants were then asked to complete gait trials. The sensor was then exchanged for either an unfatigued or fatigued plantarflexion sensor, depending upon which sensor the trials began with, and each trial was repeated by the participant using the opposite sensor. Results of the tests show that for both the static and dynamic movements, the capacitive output of the fatigued sensor was consistently higher than that of the unfatigued sensor suggesting that an upwards drift of the capacitance was occurring in the fatigued sensors. More research is needed to determine whether stretch sensors should be pre-stretched prior to data collection, and to also determine whether the drift stabilizes once the cyclic softening of the materials comprising the sensor has stabilized. 

Abstract Computational approaches, especially finite element analysis (FEA), have been rapidly growing in both academia and industry during the last few decades. FEA serves as a powerful and efficient approach for simulating real-life experiments, including industrial product development, machine design, and biomedical research, particularly in biomechanics and biomaterials. Accordingly, FEA has been a “go-to” high biofidelic software tool to simulate and quantify the biomechanics of the foot–ankle complex, as well as to predict the risk of foot and ankle injuries, which are one of the most common musculoskeletal injuries among physically active individuals. This paper provides a review of the in silico FEA of the foot–ankle complex. First, a brief history of computational modeling methods and finite element (FE) simulations for foot–ankle models is introduced. Second, a general approach to build an FE foot and ankle model is presented, including a detailed procedure to accurately construct, calibrate, verify, and validate an FE model in its appropriate simulation environment. Third, current applications, as well as future improvements of the foot and ankle FE models, especially in the biomedical field, are discussed. Finally, a conclusion is made on the efficiency and development of FEA as a computational approach in investigating the biomechanics of the foot–ankle complex. Overall, this review integrates insightful information for biomedical engineers, medical professionals, and researchers to conduct more accurate research on the foot–ankle FE models in the future. 

Standards for the fatigue testing of wearable sensing technologies are lacking. The majority of published fatigue tests for wearable sensors are performed on proof-of-concept stretch sensors fabricated from a variety of materials. Due to their flexibility and stretchability, polymers are often used in the fabrication of wearable sensors. Other materials, including textiles, carbon nanotubes, graphene, and conductive metals or inks, may be used in conjunction with polymers to fabricate wearable sensors. Depending on the combination of the materials used, the fatigue behaviors of wearable sensors can vary. Additionally, fatigue testing methodologies for the sensors also vary, with most tests focusing only on the low-cycle fatigue (LCF) regime, and few sensors are cycled until failure or runout are achieved. Fatigue life predictions of wearable sensors are also lacking. These issues make direct comparisons of wearable sensors difficult. To facilitate direct comparisons of wearable sensors and to move proof-of-concept sensors from “bench to bedside”, fatigue testing standards should be established. Further, both high-cycle fatigue (HCF) and failure data are needed to determine the appropriateness in the use, modification, development, and validation of fatigue life prediction models and to further the understanding of how cracks initiate and propagate in wearable sensing technologies. 

Background: Wearable technology is used by clinicians and researchers and play a critical role in biomechanical assessments and rehabilitation. Objective: The purpose of this research is to validate a soft robotic stretch (SRS) sensor embedded in a compression knee brace (smart knee brace) against a motion capture system focusing on knee joint kinematics. Methods: Sixteen participants donned the smart knee brace and completed three separate tasks: non-weight bearing knee flexion/extension, bodyweight air squats, and gait trials. Adjusted R2 for goodness of fit (R2), root mean square error (RMSE), and mean absolute error (MAE) between the SRS sensor and motion capture kinematic data for all three tasks were assessed. Results: For knee flexion/extension: R2 = 0.799, RMSE = 5.470, MAE = 4.560; for bodyweight air squats: R2 = 0.957, RMSE = 8.127, MAE = 6.870; and for gait trials: R2 = 0.565, RMSE = 9.190, MAE = 7.530 were observed. Conclusions: The smart knee brace demonstrated a higher goodness of fit and accuracy during weight-bearing air squats followed by non-weight bearing knee flexion/extension and a lower goodness of fit and accuracy during gait, which can be attributed to the SRS sensor position and orientation, rather than range of motion achieved in each task.