ABSTRACT
Falls are the second leading cause of unintentional death worldwide and lower limb prosthesis users (LLPUs)
constitute an exceptionally high-risk group. Over half of LLPU fall annually with many falls resulting in injuries.1
Despite these alarming statistics, clinically accessible tools for predicting falls in LLPU are currently lacking. A
comprehensive fall prevention research program should address barriers, such as population heterogeneity and
specificity of measurements, and identify modifiable biomechanical risk factors across LLPUs subgroups using
methods easily translatable into clinical use.4 Gait analysis to as a screening tool for falls has the potential to
satisfy these requirements and markerless motion capture makes it possible that routine gait analysis could be
feasibly integrated into routine clinical visits. The overall objective of this proposal is to develop a sensitive and
specific fall screening protocol for lower limb prosthetic users that utilizes gait and kinematic analysis from
markerless motion capture and is applies to a representative population of lower limb prosthetic users. We will
work towards this objective by evaluating fall risk predictors from gait analysis and comparing their accuracy to
traditional performance-based clinical assessments. To do this, we will collect in clinic markerless motion capture
gait and kinematic data as well as common clinical assessments from 150 lower limb prosthetic users. We will
then collect prospective fall history from these individuals for 1 year to determine the subset of gait parameters
or clinical assessments that best predict an individual’s future fall risk. Finally, during this one-year collection
period, we will use wearable sensors to obtain further kinematic data on fall type, directionality, and
circumstances to develop a model for incident risk based on fall type. The results from this study will provide
important findings to predict fall risk for a representative, heterogeneous population of lower limb prosthetic
users. It will determine whether fall risk can be accurately predicted from 3D gait analysis using markerless
motion capture. If successful, our proposed work will produce a translatable approach for screening at-risk lower
limb prosthetic users and will identify biomechanical risk-factors for specific fall types. All models and tools for
this study will be made open source in our continued commitment to open access. Further, we anticipate that
our techniques may generalize to other populations at-risk for falls, such as older adults or stroke survivors.
Ultimately, we envision these tools being integrated into routine clinical encounters and a subsequent research
study testing whether fall-prevention interventions initiated from clinical gait analysis can reduce the frequency
of preventable falls.