Validation of a Sensorized Forearm Crutch for Quantifying Partial Weight-Bearing During Assisted Gait Using Optical Motion Capture and Instrumented Treadmill

Human gait analysis is a key component of rehabilitation medicine, enabling objective assessment of patient recovery. In crutch-assisted locomotion, however, conventional forearm crutches operate as passive devices, providing no quantitative information on load distribution or patient adherence to partial weight-bearing (PWB) prescriptions. This work presents the design and dynamic validation of a sensorized forearm crutch system for biomechanical monitoring during assisted gait. The proposed device combines a force-sensing module based on a full Wheatstone bridge strain-gauge configuration with a 6-axis inertial measurement unit (IMU) to capture both axial load and crutch orientation. Sensor fusion was implemented through a complementary filter to estimate pitch and roll angles under dynamic conditions. The system was calibrated through static loading procedures and validated against reference instrumentation, including an optoelectronic motion capture system and an instrumented dual-belt treadmill with force platforms. Unlike previous studies relying on stationary force platforms that capture discrete steps and may alter natural gait, this validation approach enabled continuous, stride-by-stride force and orientation measurements without restricting foot placement. Experimental trials were conducted with unimpaired participants performing assisted gait using 2-point and 3-point patterns at two partial weight-bearing levels (20% and 40% body weight) and two walking speeds (0.80 m/s and 1.20 m/s). Dynamic validation showed good agreement with the treadmill reference, with force RMSE values of 9.33±1.70 N for the left crutch and 12.90±2.85 N for the right crutch, and with coefficients of determination of R2=0.9956 and R2=0.9927, respectively. Orientation RMSE values were 1.08±0.44° (roll, right), 2.06±0.56° (roll, left), 1.79±0.55° (pitch, right), and 1.66±0.37° (pitch, left). Beyond validation accuracy, the system enabled extraction of a set of quantitative biomechanical descriptors directly from crutch signals, axial load, cadence, crutch contact variability, load asymmetry, pitch asymmetry, and crutch stance/swing asymmetries, characterizing walking stability, bilateral coordination, and gait regularity during continuous assisted locomotion. These results demonstrate the feasibility of integrating force and inertial sensors into forearm crutches to enable quantitative monitoring of assisted gait, with potential applications in rehabilitation assessment and real-time feedback.