Background: Estimation of temporospatial clinical features of gait (CFs), such as step count and length, step duration, step frequency, gait speed and distance traveled is an important component of community-based mobility evaluation using wearable accelerometers. However, challenges arising from device complexity and availability, cost and analytical methodology have limited widespread application of such tools. Research Question: Can accelerometer data from commercially-available smartphones be used to extract gait CFs across a broad range of attainable gait velocities in children with Duchenne muscular dystrophy (DMD) and typically developing controls (TDs) using machine learning (ML)-based methods Methods: Fifteen children with DMD and 15 TDs underwent supervised clinical testing across a range of gait speeds using 10 or 25m run/walk (10MRW, 25MRW), 100m run/walk (100MRW), 6-minute walk (6MWT) and free-walk (FW) evaluations while wearing a mobile phone-based accelerometer at the waist near the body's center of mass. Gait CFs were extracted from the accelerometer data using a multi-step machine learning-based process and results were compared to ground-truth observation data. Results: Model predictions vs. observed values for step counts, distance traveled, and step length showed a strong correlation (Pearson's r = -0.9929 to 0.9986, p<0.0001). The estimates demonstrated a mean (SD) percentage error of 1.49% (7.04%) for step counts, 1.18% (9.91%) for distance traveled, and 0.37% (7.52%) for step length compared to ground truth observations for the combined 6MWT, 100MRW, and FW tasks. Significance: The study findings indicate that a single accelerometer placed near the body's center of mass can accurately measure CFs across different gait speeds in both TD and DMD peers, suggesting that there is potential for accurately measuring CFs in the community with consumer-level smartphones.

Differences in gait patterns of children with Duchenne muscular dystrophy (DMD) and typically-developing (TD) peers are visible to the eye, but quantifications of those differences outside of the gait laboratory have been elusive. In this work, we measured vertical, mediolateral, and anteroposterior acceleration using a waist-worn iPhone accelerometer during ambulation across a typical range of velocities. Fifteen TD and fifteen DMD children from 3-16 years of age underwent eight walking/running activities, including five 25 meters walk/run speed-calibration tests at a slow walk to running speeds (SC-L1 to SC-L5), a 6-minute walk test (6MWT), a 100 meters fast-walk/jog/run (100MRW), and a free walk (FW). For clinical anchoring purposes, participants completed a Northstar Ambulatory Assessment (NSAA). We extracted temporospatial gait clinical features (CFs) and applied multiple machine learning (ML) approaches to differentiate between DMD and TD children using extracted temporospatial gait CFs and raw data. Extracted temporospatial gait CFs showed reduced step length and a greater mediolateral component of total power (TP) consistent with shorter strides and Trendelenberg-like gait commonly observed in DMD. ML approaches using temporospatial gait CFs and raw data varied in effectiveness at differentiating between DMD and TD controls at different speeds, with an accuracy of up to 100%. We demonstrate that by using ML with accelerometer data from a consumer-grade smartphone, we can capture DMD-associated gait characteristics in toddlers to teens.