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Recently proposed wearable solutions try to fill this gap, but their in-lab calibration requirement still hinders practical usage. This paper introduces KneeGuard, a calibration-free gait re-training monitoring system that can estimate knee loading and muscle forces via effortless wearing. We identify the main issue of current calibration-needed systems is insufficient biomechanical information retrieval and modeling. To address this, we propose a user-friendly wearable prototype incorporating inertial measurement unit (IMU) and surface electromyography (sEMG) to obtain comprehensive biomechanical information including body geometrical changes and muscle contractions. For modeling, we design a biomechanic-inspired fusion framework based on multi-task learning and cross-modality attention to capture inter-modality biomechanical correlations. Additionally, since precise sensor placement required by current sEMG-based solutions is difficult to locate, we develop a circular sEMG array and propose a spatial-aware feature extraction module, achieving effective biomechanical feature extraction under effortless wearing. We collaborate with a medical center and collect a dataset from 21 KOA patients and 17 healthy subjects at different speeds. Notably, our dataset includes six gait types for KOA gait re-training, making it the first gait dataset with comprehensive re-training strategies. Evaluation demonstrates that KneeGuard achieves an average normalized root-mean-square error (NRMSE) of 9.95% in knee loading estimation and an average NRMSE of 8.75% in the estimation of muscle forces, comparable to the with-calibration results in existing works. We have open-sourced the code and a sample dataset in https:\/\/github.com\/KneeGuard\/KneeGuard.<\/jats:p>","DOI":"10.1145\/3699768","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T17:23:32Z","timestamp":1732209812000},"page":"1-29","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["KneeGuard: A Calibration-free Wearable Monitoring System for Knee Osteoarthritis Gait Re-training via Effortless Wearing"],"prefix":"10.1145","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3031-2668","authenticated-orcid":false,"given":"Baichen","family":"Yang","sequence":"first","affiliation":[{"name":"The Hong Kong University of Science and Technology, Hong Kong SAR"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5673-1409","authenticated-orcid":false,"given":"Xinyi","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Hong Kong University of Science and Technology, Hong Kong SAR"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-7850","authenticated-orcid":false,"given":"Jiaxi","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Hong Kong University of Science and Technology, Hong Kong SAR and Southern University of Science and Technology, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9235-6607","authenticated-orcid":false,"given":"Zirui","family":"Huang","sequence":"additional","affiliation":[{"name":"The Hong Kong University of Science and Technology (Guangzhou), China"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-6040-8884","authenticated-orcid":false,"given":"Qiqi","family":"Lu","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2674-0918","authenticated-orcid":false,"given":"Jin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Southern University of Science and Technology, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4940-4044","authenticated-orcid":false,"given":"Hai","family":"Hu","sequence":"additional","affiliation":[{"name":"Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9205-1881","authenticated-orcid":false,"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[{"name":"The Hong Kong University of Science and Technology, Hong Kong SAR"}]}],"member":"320","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"e_1_2_1_1_1","unstructured":"2024. 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