Machine Learning for Gait Classification

Machine learning is a powerful tool for making predictions and has been widely used for solving various classification problems in last decades. As one of important applications of machine learning, gait classification focuses on distinguishing different gait patterns by investigating the quality of gait of individuals and categorizing them as belonging to particular classes. The most studied gait pattern classes are the normal gait patterns of healthy people, i.e., gait of people who do not have any gait disability caused by an illness or an injury, and the pathological gait of patients suffering from illnesses which cause gait disorders such as neurodegenerative diseases (NDDs). There has been significant research work trying to solve the gait classification problems using advanced machine learning techniques, as the results may be beneficial for the early detection of underlined NDDs and for the monitoring of the gait rehabilitation progress. Despite the huge development in the field of gait analysis and classification, there are still a number of challenges open to further research. One challenge is the optimization of applied machine learning strategies to achieve better classification results. Another challenge is to solve gait classification problems even in the case when only limited amount of data are available. Further, a challenge is the development of machine learning-based methods that could provide more precise results to evaluate the level of gait quality or gait disorder, in contrast of just classifying gait pattern as belonging to healthy or pathological gait. The focus of this thesis is on the development, implementation and evaluation of a novel and reliable solution for the complex gait classification problems by addressing the current challenges. This solution is presented as a classification framework that can be applied to different types of gait signals, such as lower-limbs joint angle signals, trunk acceleration signals, and stride interval signals. Developed framework incorporates a hybrid solution which combines two models to enhance the classification performance. In order to provide a large number of samples for training the models, a sample generation method is developed which could segments the gait signals into smaller fragments. Classification is firstly performed on the data sample level, and then the results are utilized to generate the subject-level results using a majority voting scheme. Besides the class labels, a confidence score is computed to interpret the level of gait quality. In order to significantly improve the gait classification performances, in this thesis a novel feature extraction methods are also proposed using statistical methods, as well as machine learning approaches. Gaussian mixture model (GMM), least square regression, and k-nearest neighbors (kNN) are employed to provide additional significant features. Promising classification results are achieved using the proposed framework and the extracted features. The framework is ultimately applied to the management of patients and their rehabilitation, and is proved to be feasible in many clinical scenarios, such as the evaluation of medication effect on Parkinsona s disease (PD) patientsa gait, the long-term gait monitoring of the hereditary spastic paraplegia (HSP) patient under physical therapy

Modelo de sistema de soporte a la diagnosis de trastornos osteoarticulares de miembros inferiores utilizando procesamiento de imágenes de rayos X

Los trastornos osteoarticulares aquejan a personas de todas las regiones del mundo sin distinción, ejemplos de ellas son: la osteoporosis y atrosis. La OMS determina la existencia de un incremento de casos en sociedades socioeconómicas más bajas y la Unión Europea establece una estrategia enfocada a entregar salud personalizada en el momento correcto, y brindar una alternativa de prevención oportuna y especifica denominada (PerMed). En este contexto nuestro país necesita aplicar la Medicina Personalizada para diagnosticar a tiempo enfermedades con alta incidencia. La presente investigación busca alinearse a los objetivos de la Medicina Personalizada proporcionando un modelo de sistema de soporte a la diagnosis de trastornos osteoarticulares de miembros inferiores utilizando procesamiento de imágenes de rayos X, teniendo presente la confidencialidad y protección de los datos. El pre-procesamiento de las imágenes de rayos X, permitió eliminar los desafíos de estas imágenes, y posibilito la generación de un gold-standard que sirvió como guía para la segmentación-registro de las estructuras óseas de miembros inferiores. Se utilizaron los modelos estadísticos como: SSM - Statistical Shape Model, SAM – Statistical Appeareance Model, ASM - Active Shape Model y Gradient Profiling en el refinamiento de la etapa de segmentación-registro como parte del entrenamiento y prueba. Estos modelos han sido validados con artículos de investigación presentados en el Capítulo IV con resultados de precisión en la segmentación entre el 74 % y 83 % y para la clasificación de las estructuras óseas dependiendo del objetivo a resolver sea: a) detectar fracturas en el acetábulo, o b) detectar osteoporosis en el fémur proximal, los resultados obtuvieron una precisión de: 73% y 87% respectivamente; y por ultimo para lograr el objetivo de: c) medir la distancia articular, se obtiene un error promedio equivalente a 2.4 px, este es un error aceptable para respaldar el diagnostico de desgaste articular de cadera llamado "osteoartritis de cadera". Asimismo, hubo una mejora significativa en el tiempo de procesamiento comparado con la literatura analizada

Body sensor networks: smart monitoring solutions after reconstructive surgery

Advances in reconstructive surgery are providing treatment options in the face of major trauma and cancer. Body Sensor Networks (BSN) have the potential to offer smart solutions to a range of clinical challenges. The aim of this thesis was to review the current state of the art devices, then develop and apply bespoke technologies developed by the Hamlyn Centre BSN engineering team supported by the EPSRC ESPRIT programme to deliver post-operative monitoring options for patients undergoing reconstructive surgery. A wireless optical sensor was developed to provide a continuous monitoring solution for free tissue transplants (free flaps). By recording backscattered light from 2 different source wavelengths, we were able to estimate the oxygenation of the superficial microvasculature. In a custom-made upper limb pressure cuff model, forearm deoxygenation measured by our sensor and gold standard equipment showed strong correlations, with incremental reductions in response to increased cuff inflation durations. Such a device might allow early detection of flap failure, optimising the likelihood of flap salvage. An ear-worn activity recognition sensor was utilised to provide a platform capable of facilitating objective assessment of functional mobility. This work evolved from an initial feasibility study in a knee replacement cohort, to a larger clinical trial designed to establish a novel mobility score in patients recovering from open tibial fractures (OTF). The Hamlyn Mobility Score (HMS) assesses mobility over 3 activities of daily living: walking, stair climbing, and standing from a chair. Sensor-derived parameters including variation in both temporal and force aspects of gait were validated to measure differences in performance in line with fracture severity, which also matched questionnaire-based assessments. Monitoring the OTF cohort over 12 months with the HMS allowed functional recovery to be profiled in great detail. Further, a novel finding of continued improvements in walking quality after a plateau in walking quantity was demonstrated objectively. The methods described in this thesis provide an opportunity to revamp the recovery paradigm through continuous, objective patient monitoring along with self-directed, personalised rehabilitation strategies, which has the potential to improve both the quality and cost-effectiveness of reconstructive surgery services.Open Acces

Automatic signal and image-based assessments of spinal cord injury and treatments.

Spinal cord injury (SCI) is one of the most common sources of motor disabilities in humans that often deeply impact the quality of life in individuals with severe and chronic SCI. In this dissertation, we have developed advanced engineering tools to address three distinct problems that researchers, clinicians and patients are facing in SCI research. Particularly, we have proposed a fully automated stochastic framework to quantify the effects of SCI on muscle size and adipose tissue distribution in skeletal muscles by volumetric segmentation of 3-D MRI scans in individuals with chronic SCI as well as non-disabled individuals. We also developed a novel framework for robust and automatic activation detection, feature extraction and visualization of the spinal cord epidural stimulation (scES) effects across a high number of scES parameters to build individualized-maps of muscle recruitment patterns of scES. Finally, in the last part of this dissertation, we introduced an EMG time-frequency analysis framework that implements EMG spectral analysis and machine learning tools to characterize EMG patterns resulting in independent or assisted standing enabled by scES, and identify the stimulation parameters that promote muscle activation patterns more effective for standing. The neurotechnological advancements proposed in this dissertation have greatly benefited SCI research by accelerating the efforts to quantify the effects of SCI on muscle size and functionality, expanding the knowledge regarding the neurophysiological mechanisms involved in re-enabling motor function with epidural stimulation and the selection of stimulation parameters and helping the patients with complete paralysis to achieve faster motor recovery

Automatic quantification of radiographic knee osteoarthritis severity and associated diagnostic features using deep convolutional neural networks

“Automatic Quantification of Radiographic Knee Osteoarthritis Severity and Associated Diagnostic Features using Deep Convolutional Neural Networks” A. Joseph Antony Due to the increasing prevalence of knee Osteoarthritis (OA), a debilitating kneejoint degradation, and total joint arthoplasty as a serious consequence, there is a need for effective clinical and scientific tools to assess knee OA in its early stages. This thesis investigates the use of machine learning algorithms and deep learning architectures, in particular convolutional neural networks (CNN), to quantify the severity and clinical radiographic features of knee OA. The goal is to offer novel and effective solutions to automatically assess the severity of knee OA achieving on par with human accuracy. Instead of conventional hand-crafted features, it is proposed in this thesis that automatically learning features in a supervised manner can be more effective for fine-grained knee OA image classification. The main contributions of this thesis are as follows. First, the use of off-the-shelf CNNs are investigated for classifying knee OA images through transfer learning by fine-tuning the CNNs. Second, CNNs are trained from scratch to quantify the knee OA severity optimising a weighted ratio of two loss functions: categorical cross entropy and mean-squared error. Third, CNNs are jointly trained to quantify the clinical features of knee OA: joint space narrowing (JSN) and osteophytes along with the KL grades. This improves the overall quantification of knee OA severity producing simultaneous predictions of KL grades, JSN and osteophytes. Two public datasets are used to evaluate the approaches, the OAI and the MOST, with extremely promising results that outperform existing approaches. In summary, this thesis primarily contributes to the field of automated methods for localisation and quantification of radiographic knee OA

Stratification of patellofemoral pain using clinical, biomechanical and imaging features

Patellofemoral pain (PFP) is a common musculoskeletal complaint and the efficacy of current therapies aimed at PFP is limited. The aetiology of PFP is widely considered to be multifactorial and as a result the clinical presentation is often heterogeneous. In an attempt to address this issue, an international PFP consensus statement, published in 2013, highlighted the need to sub-group patients with PFP to enable more stratified interventions. A multi-methodological approach was used in this thesis. A systematic review of the existing imaging literature in PFP demonstrated that PFP is associated with a number of imaging features in particular MRI bisect offset and CT congruence angle and that some of these features should be modifiable with conservative treatment. A retrospective analysis investigating the overall 3D shape and 3D equivalents of commonly used PFJ imaging features demonstrated no differences between a group with and without PFP, challenging the current perceptions on the structural associations to PFP. A cross-sectional cluster analysis using modifiable clinical, biomechanical and imaging features identified four subgroups that are present in PFP cohort with a Weak group showing the worst prognosis at 12 months. Lastly, a pragmatic randomised controlled feasibility study comparing matched treatment to usual care management showed that matching treatment to a specific subgroup is feasible in terms of adherence, retention and conversion to consent. In summary, the findings of this thesis improves our understanding of the structural associations to PFP; the subgroups that exist within the PFP population; the natural prognosis of these PFP subgroups; and the feasibility of targeting treatment at PFP subgroups within a clinical trial

Book of Abstracts 15th International Symposium on Computer Methods in Biomechanics and Biomedical Engineering and 3rd Conference on Imaging and Visualization

In this edition, the two events will run together as a single conference, highlighting the strong connection with the Taylor & Francis journals: Computer Methods in Biomechanics and Biomedical Engineering (John Middleton and Christopher Jacobs, Eds.) and Computer Methods in Biomechanics and Biomedical Engineering: Imaging and Visualization (JoãoManuel R.S. Tavares, Ed.). The conference has become a major international meeting on computational biomechanics, imaging andvisualization. In this edition, the main program includes 212 presentations. In addition, sixteen renowned researchers will give plenary keynotes, addressing current challenges in computational biomechanics and biomedical imaging. In Lisbon, for the first time, a session dedicated to award the winner of the Best Paper in CMBBE Journal will take place. We believe that CMBBE2018 will have a strong impact on the development of computational biomechanics and biomedical imaging and visualization, identifying emerging areas of research and promoting the collaboration and networking between participants. This impact is evidenced through the well-known research groups, commercial companies and scientific organizations, who continue to support and sponsor the CMBBE meeting series. In fact, the conference is enriched with five workshops on specific scientific topics and commercial software.info:eu-repo/semantics/draf

Quantitative Magnetic Resonance Imaging and Analysis of Articular Cartilage and Osteoarthritis

MRI plays an important role in the continuing search for a sensitive osteoarthritis (OA) imaging biomarker able to detect early, pre-morphological alterations in cartilage composition. Determining the compositional recovery pattern of cartilage following acute joint loading could potentially present a more sensitive biomarker for defining cartilage health [1]. However, only a limited amount of studies have assessed both the immediate effect of joint loading on cartilage, as well as its post-loading recovery. In addition, when assessing the compositional responses of cartilage to joint loading, previous studies usually did not incorporate the measurement error of the used quantitative MRI technique into their analysis. Therefore, an uncertainty persists whether or not compositional MRI techniques are sensitive enough to measure changes in water and macromolecular content of cartilage, or if previous studies were merely measuring noise. Consequently, an objective of this thesis is to increase our understanding of and reliability in quantitative T2 and T1ρ relaxation time mapping to detect compositional responses of cartilage following a joint loading activity. Furthermore, to obtain the quantitative morphological and compositional measures of cartilage, detailed region-specific delineation of cartilage is required. This delineation (or segmentation) of cartilage is laborious and time-consuming as it is usually performed manually by an expert observer. Many new advances in image analysis, particularly those in convolutional neural networks (CNNs) and deep learning, have enabled a time-efficient semi- or fully-automated alternative to this process [2, 3]. This thesis explores the utility of deep CNNs generated segmentations for accurate surface-based analysis of cartilage morphology and composition from knee MRIs as well as of cortical bone thickness from knee CTs. Chapter 1 will provide an introduction into the structure and biomechanics of articular cartilage and the role of MRI in imaging the degenerative joint disorder, osteoarthritis as well as the effects of different joint loading activities on cartilage morphology and composition. Chapter 2 explains the principle of MRI and the pulse sequences used in the following chapter for the morphometric and compositional assessment of articular cartilage. Chapter 3 describes the use of 3D Cartilage Surface Mapping (3D-CaSM) [3] to assess variations in cartilage T1ρ and T2 relaxation times of young, healthy participants following a mild, unilateral stepping activity. By evaluating and incorporating the intrasessional repeatability of the T1ρ and T2 mapping techniques, I aim to highlight those cartilage areas experiencing exercise-induced compositional changes greater than measurement error. A significant amount of time is needed to manually segment the regions-of-interest required to perform the 3D-CaSM used in Chapter 3. Therefore, in Chapter 4, I assessed the use of deep convolutional neural networks for automating the segmentation process for multiple knee joint tissues simultaneous and increase the time-efficiency for evaluating knee MR datasets. I evaluated the use of a conditional Generative Adversarial Network (cGAN) as a potentially improved method for automated segmentation compared to the widely used convolutional neural network, U-Net. In Chapter 5 I combined the 3D-CaSM and automated segmentation methods presented in Chapters 3 and 4, respectively to assess the use of fully automatic segmentations of femoral and tibial bone-cartilage structures for accurate surface-based analysis of cartilage morphology and composition on knee MR images. This was performed on publicly available data from the Osteoarthritis Initiative, a multicentre observational study with expert manual segmentations provided by the Zuse Institute in Berlin. Chapter 6 describes an automated pipeline for subchondral cortical bone thickness mapping from knee CT data. I developed a method of using automated segmentations of articular cartilage and bone from knee MRI data to determine the periarticular bone surface which is covered by cartilage. This surface was then used to perform cortical bone thickness measurements on corresponding CT data. I validated this pipeline using data from the EU-funded, multi-centre observational study called Applied Private-Public partneRship enabling OsteoArthritis Clinical Headway (APPROACH). Chapter 7 summarises the main conclusions and contributions of the works presented in this thesis as well as providing directions for future work.PhD Studentship funded by GlaxoSmithKlin

Analyzing fibrous tissue pattern in fibrous dysplasia bone images using deep R-CNN networks for segmentation

Predictive health monitoring systems help to detect human health threats in the early stage. Evolving deep learning techniques in medical image analysis results in efficient feedback in quick time. Fibrous dysplasia (FD) is a genetic disorder, triggered by the mutation in Guanine Nucleotide binding protein with alpha stimulatory activities in the human bone genesis. It slowly occupies the bone marrow and converts the bone cell into fibrous tissues. It weakens the bone structure and leads to permanent disability. This paper proposes the study of FD bone image analyzing techniques with deep networks. Also, the linear regression model is annotated for predicting the bone abnormality levels with observed coefficients. Modern image processing begins with various image filters. It describes the edges, shades, texture values of the receptive field. Different types of segmentation and edge detection mechanisms are applied to locate the tumor, lesion, and fibrous tissues in the bone image. Extract the fibrous region in the bone image using the region-based convolutional neural network algorithm. The segmented results are compared with their accuracy metrics. The segmentation loss is reduced by each iteration. The overall loss is 0.24% and the accuracy is 99%, segmenting the masked region produces 98% of accuracy, and building the bounding boxes is 99% of accuracy