Carlo Dindorf

Carlo Dindorf, Jonas Dully, Rebecca Keilhauer et al.

Background: Machine learning (ML) enhances gait analysis but often lacks the level of interpretability desired for clinical adoption. Large Language Models (LLMs) may offer explanatory capabilities and confidence-aware outputs when applied to structured kinematic data. This study therefore evaluated whether general-purpose LLMs can classify continuous gait kinematics when represented as textual numeric sequences and how their performance compares to conventional ML approaches. Methods: Lower-body kinematics were recorded from 20 participants performing seven gait patterns. A supervised KNN classifier and a class-independent One-Class SVM (OCSVM) were compared against zero-shot LLMs (GPT-5, GPT-5-mini, GPT-4.1, and o4-mini). Models were evaluated using Leave-One-Subject-Out (LOSO) cross-validation. LLMs were tested both with and without explicit reference gait statistics. Results: The supervised KNN achieved the highest performance (multiclass Matthews Correlation Coefficient, MCC = 0.88). The best-performing LLM (GPT-5) with reference grounding achieved a multiclass MCC of 0.70 and a binary MCC of 0.68, outperforming the class-independent OCSVM (binary MCC = 0.60). Performance of the LLM was highly dependent on explicit reference information and self-rated confidence; when restricted to high-confidence predictions, multiclass MCC increased to 0.83 on the filtered subset. Notably, the computationally efficient o4-mini model performed comparably to larger models. Conclusion: When continuous kinematic waveforms were encoded as textual numeric tokens, general-purpose LLMs, even with reference grounding, did not match supervised multiclass classifiers for precise gait classification and are better regarded as exploratory systems requiring cautious, human-guided interpretation rather than diagnostic use.

Carlo Dindorf, Fabian Horst, Djordje Slijepčević et al.

This chapter provides an overview of recent and promising Machine Learning applications, i.e. pose estimation, feature estimation, event detection, data exploration & clustering, and automated classification, in gait (walking and running) and sports biomechanics. It explores the potential of Machine Learning methods to address challenges in biomechanical workflows, highlights central limitations, i.e. data and annotation availability and explainability, that need to be addressed, and emphasises the importance of interdisciplinary approaches for fully harnessing the potential of Machine Learning in gait and sports biomechanics.

Carlo Dindorf, Jonas Dully, Steven Simon et al.

Plantar pressure mapping is essential in clinical diagnostics and sports science, yet large heterogeneous datasets often contain outliers from technical errors or procedural inconsistencies. Statistical Parametric Mapping (SPM) provides interpretable analyses but is sensitive to alignment and its capacity for robust outlier detection remains unclear. This study compares an SPM approach with an explainable machine learning (ML) approach to establish transparent quality-control pipelines for plantar pressure datasets. Data from multiple centers were annotated by expert consensus and enriched with synthetic anomalies resulting in 798 valid samples and 2000 outliers. We evaluated (i) a non-parametric, registration-dependent SPM approach and (ii) a convolutional neural network (CNN), explained using SHapley Additive exPlanations (SHAP). Performance was assessed via nested cross-validation; explanation quality via a semantic differential survey with domain experts. The ML model reached high accuracy and outperformed SPM, which misclassified clinically meaningful variations and missed true outliers. Experts perceived both SPM and SHAP explanations as clear, useful, and trustworthy, though SPM was assessed less complex. These findings highlight the complementary potential of SPM and explainable ML as approaches for automated outlier detection in plantar pressure data, and underscore the importance of explainability in translating complex model outputs into interpretable insights that can effectively inform decision-making.