Seth Donahue

Seth Donahue, J. D. Peiffer, R. Tyler Richardson et al.

To validate a clinically accessible approach for quantifying the Upper Extremity Reachable Workspace (UERW) using a single (monocular) camera and Artificial Intelligence (AI)-driven Markerless Motion Capture (MMC) for biomechanical analysis. Objective assessment and validation of these techniques for specific clinically oriented tasks are crucial for their adoption in clinical motion analysis. AI-driven monocular MMC reduces the barriers to adoption in the clinic and has the potential to reduce the overhead for analysis of this common clinical assessment. Nine adult participants with no impairments performed the standardized UERW task, which entails reaching targets distributed across a virtual sphere centered on the torso, with targets displayed in a VR headset. Movements were simultaneously captured using a marker-based motion capture system and a set of eight FLIR cameras. We performed monocular video analysis on two of these video camera views to compare a frontal and offset camera configurations. The frontal camera orientation demonstrated strong agreement with the marker-based reference, exhibiting a minimal mean bias of $0.61 \pm 0.12$ \% reachspace reached per octanct (mean $\pm$ standard deviation). In contrast, the offset camera view underestimated the percent workspace reached ($-5.66 \pm 0.45$ \% reachspace reached). Conclusion: The findings support the feasibility of a frontal monocular camera configuration for UERW assessment, particularly for anterior workspace evaluation where agreement with marker-based motion capture was highest. The overall performance demonstrates clinical potential for practical, single-camera assessments. This study provides the first validation of monocular MMC system for the assessment of the UERW task. By reducing technical complexity, this approach enables broader implementation of quantitative upper extremity mobility assessment.

Seth Donahue, Irina Djuraskovic, Kunal Shah et al.

Video-based human movement analysis holds potential for movement assessment in clinical practice and research. However, the clinical implementation and trust of multi-view markerless motion capture (MMMC) require that, in addition to being accurate, these systems produce reliable confidence intervals to indicate how accurate they are for any individual. Building on our prior work utilizing variational inference to estimate joint angle posterior distributions, this study evaluates the calibration and reliability of a probabilistic MMMC method. We analyzed data from 68 participants across two institutions, validating the model against an instrumented walkway and standard marker-based motion capture. We measured the calibration of the confidence intervals using the Expected Calibration Error (ECE). The model demonstrated reliable calibration, yielding ECE values generally < 0.1 for both step and stride length and bias-corrected gait kinematics. We observed a median step and stride length error of ~16 mm and ~12 mm respectively, with median bias-corrected kinematic errors ranging from 1.5 to 3.8 degrees across lower extremity joints. Consistent with the calibrated ECE, the magnitude of the model's predicted uncertainty correlated strongly with observed error measures. These findings indicate that, as designed, the probabilistic model reconstruction quantifies epistemic uncertainty, allowing it to identify unreliable outputs without the need for concurrent ground-truth instrumentation.

Lauhitya Reddy, Seth Donahue, Jeremy Bauer et al.

Cerebral Palsy (CP) is a neurological disorder of movement and the most common cause of lifelong physical disability in childhood. Approximately 75% of children with CP are ambulatory, and accurate gait assessment is central to preserving walking function, which deteriorates by mid-adulthood in a quarter to half of adults with CP. The Rodda and Graham classification system quantifies sagittal-plane gait deviations using ankle and knee z-scores derived from 3D Instrumented Gait Analysis (3D-IGA), but 3D-IGA is expensive and limited to specialized centers, while observational assessment shows only moderate inter-rater agreement. We developed a markerless gait analysis pipeline that quantifies Rodda and Graham knee and ankle z-scores directly from single-view clinical gait videos. Across 1,058 bilateral limb samples from 529 trials of 152 children (88 male, 63 female; age 12.1 $\pm$ 4.0 years; 60 distinct primary diagnoses, cerebral palsy the most common at $n=54$), the sagittal-view model achieved $R^2 = 0.80 \pm 0.02$ and CCC $= 0.89 \pm 0.02$ for knee z-scores and $R^2 = 0.57 \pm 0.02$ and CCC $= 0.72 \pm 0.02$ for ankle z-scores against 3D-IGA. Binary screening for excess knee flexion achieves AUROC $= 0.88$, correctly identifying 83% of affected children, and applying Rodda and Graham rules yields $43 \pm 1$% 7-class accuracy with macro-AUROC $= 0.78 \pm 0.01$, ankle prediction error remaining the primary bottleneck. Beyond cross-sectional screening, continuous z-scores support longitudinal trajectory tracking across visits, providing a quantitative substrate for monitoring disease progression and treatment response unavailable from observational scales. These results demonstrate the feasibility of video-based z-score estimation, excess-flexion screening, and longitudinal trajectory tracking as a path toward scalable, objective gait assessment in low-resource clinical settings.