Adaptive Gait Biofeedback With Participant-Held-Out Modeling and Participant-Specific Updating in Chronic Ankle Instability

Jaeyoon Kim, Veronika Lebisova, Jeniya Sultana, Jaeyoung Cho, Jaeho Jang

Adaptive gait biofeedback may support repeated practice in chronic ankle instability, but its evaluation must address model performance and human response. We evaluated a temporal convolutional classifier on protocol-defined, angle-derived GOOD/BAD gait-cycle labels using participant-held-out leave-one-subject-out (LOSO) cross-validation in 20 participants. Seven participants in the adaptive-intervention group completed nine sessions over three weeks, with one motion-capture recording analyzed per session. Models updated after failed sessions were compared offline with their parent models on the same-session validation subset used for candidate selection and the first subsequent adaptive-session recording. Frontal-plane ankle angle was compared between the adaptive group and 10 sequentially enrolled controls at Baseline, Post, and 7-day Retention. Across 20 held-out folds, mean fold-level area under the receiver operating characteristic curve (AUROC) was 0.948, sensitivity for angle-threshold-exceeding BAD cycles was 0.941, and specificity for angle-threshold-meeting GOOD cycles was 0.366. Mean BAD-class F1 was higher in candidate models by 0.187 on the same-session subset and…