The advantages of artificial intelligence-based gait assessment in detecting, predicting, and managing Parkinson’s disease

BackgroundParkinson’s disease is a neurological disorder that can cause gait disturbance, leading to mobility issues and falls. Early diagnosis and prediction of freeze episodes are essential for mitigating symptoms and monitoring the disease.ObjectiveThis review aims to evaluate the use of artificial intelligence (AI)-based gait evaluation in diagnosing and managing Parkinson’s disease, and to explore the potential benefits of this technology for clinical decision-making and treatment support.MethodsA thorough review of published literature was conducted to identify studies, articles, and research related to AI-based gait evaluation in Parkinson’s disease.ResultsAI-based gait evaluation has shown promise in preventing freeze episodes, improving diagnosis, and increasing motor independence in patients with Parkinson’s disease. Its advantages include higher diagnostic accuracy, continuous monitoring, and personalized therapeutic interventions.ConclusionAI-based gait evaluation systems hold great promise for managing Parkinson’s disease and improving patient outcomes. They offer the potential to transform clinical decision-making and inform personalized therapies, but further research is needed to determine their effectiveness and refine their use

The detection of freezing of gait in Parkinson's disease using asymmetric basis function TV-ARMA time-frequency spectral estimation method

Freezing of gait (FOG) is an episodic gait disturbance affecting locomotion in Parkinson’s disease. As a biomarker to detect FOG, the Freeze index (FI), which is defined as the ratio of the areas under power spectra in ‘freeze’ band and in ‘locomotion’ band, can negatively be affected by poor time and frequency resolution of time-frequency spectrum estimate when short-time Fourier transform (STFT) or Wavelet transform (WT) is used. In this study, a novel high-resolution parametric time-frequency spectral estimation method is proposed to improve the accuracy of FI. A time-varying autoregressive moving average model (TV-ARMA) is first identified where the time-varying parameters are estimated using an asymmetric basis function expansion method. The TV-ARMA model is then transformed into frequency domain to estimate the time-frequency spectrum and calculate the FI. Results evaluated on the Daphnet Freezing of Gait Dataset show that the new method improves the time and frequency resolutions of the time-frequency spectrum and the associate FI has better performance in the detection of FOG than its counterparts based on STFT and WT methods do. Moreover, FOGs can be predicted in advance of its occurrence in most cases using the new method

A wearable biofeedback device to improve motor symptoms in Parkinson’s disease

Dissertação de mestrado em Engenharia BiomédicaThis dissertation presents the work done during the fifth year of the course Integrated Master’s in Biomedical Engineering, in Medical Electronics. This work was carried out in the Biomedical & Bioinspired Robotic Devices Lab (BiRD Lab) at the MicroElectroMechanics Center (CMEMS) established at the University of Minho. For validation purposes and data acquisition, it was developed a collaboration with the Clinical Academic Center (2CA), located at Braga Hospital. The knowledge acquired in the development of this master thesis is linked to the motor rehabilitation and assistance of abnormal gait caused by a neurological disease. Indeed, this dissertation has two main goals: (1) validate a wearable biofeedback system (WBS) used for Parkinson's disease patients (PD); and (2) develop a digital biomarker of PD based on kinematic-driven data acquired with the WBS. The first goal aims to study the effects of vibrotactile biofeedback to play an augmentative role to help PD patients mitigate gait-associated impairments, while the second goal seeks to bring a step advance in the use of front-end algorithms to develop a biomarker of PD based on inertial data acquired with wearable devices. Indeed, a WBS is intended to provide motor rehabilitation & assistance, but also to be used as a clinical decision support tool for the classification of the motor disability level. This system provides vibrotactile feedback to PD patients, so that they can integrate it into their normal physiological gait system, allowing them to overcome their gait difficulties related to the level/degree of the disease. The system is based on a user- centered design, considering the end-user driven, multitasking and less cognitive effort concepts. This manuscript presents all steps taken along this dissertation regarding: the literature review and respective critical analysis; implemented tech-based procedures; validation outcomes complemented with results discussion; and main conclusions and future challenges.Esta dissertação apresenta o trabalho realizado durante o quinto ano do curso Mestrado Integrado em Engenharia Biomédica, em Eletrónica Médica. Este trabalho foi realizado no Biomedical & Bioinspired Robotic Devices Lab (BiRD Lab) no MicroElectroMechanics Center (CMEMS) estabelecido na Universidade do Minho. Para efeitos de validação e aquisição de dados, foi desenvolvida uma colaboração com Clinical Academic Center (2CA), localizado no Hospital de Braga. Os conhecimentos adquiridos no desenvolvimento desta tese de mestrado estão ligados à reabilitação motora e assistência de marcha anormal causada por uma doença neurológica. De facto, esta dissertação tem dois objetivos principais: (1) validar um sistema de biofeedback vestível (WBS) utilizado por doentes com doença de Parkinson (DP); e (2) desenvolver um biomarcador digital de PD baseado em dados cinemáticos adquiridos com o WBS. O primeiro objetivo visa o estudo dos efeitos do biofeedback vibrotáctil para desempenhar um papel de reforço para ajudar os pacientes com PD a mitigar as deficiências associadas à marcha, enquanto o segundo objetivo procura trazer um avanço na utilização de algoritmos front-end para biomarcar PD baseado em dados inerciais adquiridos com o dispositivos vestível. De facto, a partir de um WBS pretende-se fornecer reabilitação motora e assistência, mas também utilizá-lo como ferramenta de apoio à decisão clínica para a classificação do nível de deficiência motora. Este sistema fornece feedback vibrotáctil aos pacientes com PD, para que possam integrá-lo no seu sistema de marcha fisiológica normal, permitindo-lhes ultrapassar as suas dificuldades de marcha relacionadas com o nível/grau da doença. O sistema baseia-se numa conceção centrada no utilizador, considerando o utilizador final, multitarefas e conceitos de esforço menos cognitivo. Portanto, este manuscrito apresenta todos os passos dados ao longo desta dissertação relativamente a: revisão da literatura e respetiva análise crítica; procedimentos de base tecnológica implementados; resultados de validação complementados com discussão de resultados; e principais conclusões e desafios futuros

Detection and Prediction of Freezing of Gait in Parkinson’s Disease using Wearable Sensors and Machine Learning

Freezing of gait (FOG), is a brief episodic absence of forward body progression despite the intention to walk. Appearing mostly in mid-late stage Parkinson’s disease (PD), freezing manifests as a sudden loss of lower-limb function, and is closely linked to falling, decreased functional mobility, and loss of independence. Wearable-sensor based devices can detect freezes already in progress, and intervene by delivering auditory, visual, or tactile stimuli called cues. Cueing has been shown to reduce FOG duration and allow walking to continue. However, FOG detection and cueing systems require data from the freeze episode itself and are thus unable to prevent freezing. Anticipating the FOG episode before onset and supplying a timely cue could prevent the freeze from occurring altogether. FOG has been predicted in offline analyses by training machine learning models to identify wearable-sensor signal patterns known to precede FOG. The most commonly used sensors for FOG detection and prediction are inertial measurement units (IMU) that include an accelerometer, gyroscope and sometimes magnetometer. Currently, the best FOG prediction systems use data collected from multiple sensors on various body locations to develop person-specific models. Multi-sensor systems are more complex and may be challenging to integrate into real-life assistive devices. The ultimate goal of FOG prediction systems is a user-friendly assistive device that can be used by anyone experiencing FOG. To achieve this goal, person-independent models with high FOG prediction performance and a minimal number of conveniently located sensors are needed. The objectives of this thesis were: to develop and evaluate FOG detection and prediction models using IMU and plantar pressure data; determine if event-based or period of gait disruption FOG definitions have better classification performance for FOG detection and prediction; and evaluate FOG prediction models that use a single unilateral plantar pressure insole sensor or bilateral sensors. In this thesis, IMU (accelerometer and gyroscope) and plantar pressure insole sensors were used to collect data from 11 people with FOG while they walked a freeze provoking path. A custom-made synchronization and labeling program was used synchronize the IMU and plantar pressure data and annotate FOG episodes. Data were divided into overlapping 1 s windows with 0.2 s shift between consecutive windows. Time domain, Fourier transform based, and wavelet transform based features were extracted from the data. A total of 861 features were extracted from each of the 71,000 data windows. To evaluate the effectiveness of FOG detection and prediction models using plantar pressure and IMU data features, three feature sets were compared: plantar pressure, IMU, and both plantar pressure and IMU features. Minimum-redundancy maximum-relevance (mRMR) and Relief-F feature selection were performed prior to training boosted ensembles of decision trees. The binary classification models identified Total-FOG or Non-FOG states, wherein the Total-FOG class included windows with data from 2 s before the FOG onset until the end of the FOG episode. The plantar-pressure-only model had the greatest sensitivity, and the IMU-only model had the greatest specificity. The best overall model used the combination of plantar pressure and IMU features, achieving 76.4% sensitivity and 86.2% specificity. Next, the Total-FOG class components were evaluated individually (i.e., Pre-FOG windows, freeze windows, and transition windows between Pre-FOG and FOG). The best model, which used plantar pressure and IMU features, detected windows that contained both Pre-FOG and FOG data with 85.2% sensitivity, which is equivalent to detecting FOG less than 1 s after the freeze began. Models using both plantar pressure and IMU features performed better than models that used either sensor type alone. Datasets used to train machine learning models often generate ground truth FOG labels based on visual observation of specific lower limb movements (event-based definition) or an overall inability to walk effectively (period of gait disruption based definition). FOG definition ambiguity may affect FOG detection and prediction model performance, especially with respect to multiple FOG in rapid succession. This research examined the effects of defining FOG either as a period of gait disruption (merging successive FOG), or based on an event (no merging), on FOG detection and prediction. Plantar pressure and lower limb acceleration data were used to extract a set of features and train decision tree ensembles. FOG was labeled using an event-based definition. Additional datasets were then produced by merging FOG that occurred in rapid succession. A merging threshold was introduced where FOG that were separated by less than the merging threshold were merged into one episode. FOG detection and prediction models were trained for merging thresholds of 0, 1, 2, and 3 s. Merging had little effect on FOG detection model performance; however, for the prediction model, merging resulted in slightly later FOG identification and lower precision. FOG prediction models may benefit from using event-based FOG definitions and avoiding merging multiple FOG in rapid succession. Despite the known asymmetry of PD motor symptom manifestation, the difference between the more severely affected side (MSS) and less severely affected side (LSS) is rarely considered in FOG detection and prediction studies. The additional information provided by the MSS or LSS, if any, may be beneficial to FOG prediction models, especially if using a single sensor. To examine the effect of using data from the MSS, LSS, or both limbs, multiple FOG prediction models were trained and compared. Three datasets were created using plantar pressure data from the MSS, LSS, and both sides together. Feature selection was performed, and FOG prediction models were trained using the top 5, 10, 15, 20, 25 or 30 features for each dataset. The best models were the MSS model with 15 features, and the LSS and bilateral features with 5 features. The LSS model reached the highest sensitivity (79.5%) and identified the highest percentage of FOG episodes (94.9%). The MSS model achieved the highest specificity (84.9%) and the lowest false positive (FP) rate (2 FP/walking trial). Overall, the bilateral model was best. The bilateral model had 77.3% sensitivity, 82.9% specificity, and identified 94.3% of FOG episodes an average of 1.1 s before FOG onset. Compared to the bilateral model, the LSS model had a higher false positive rate; however, the bilateral and LSS models were similar in all other evaluation metrics. Therefore, using the LSS model instead of the bilateral model would produce similar FOG prediction performance at the cost of slightly more false positives. Given the advantages of single sensor systems, the increased FP rate may be acceptable. Therefore, a single plantar pressure sensor placed on the LSS could be used to develop a FOG prediction system and produce performance similar to a bilateral system

Koneoppimisen hyödyntäminen Parkinsonin taudin diagnosoinnissa

Parkinsonin tauti on yleinen ikääntyvien ihmisten pitkäaikainen parantumaton hermoston rappeumasairaus. Parkinsonin taudin potilaalle varhaisempi oikea diagnoosi on tärkeä, sillä parhaiten potilaan elämänlaatua voidaan ylläpitää, kun oikeanlainen hoito aloitetaan ajoissa. Tämänhetkiset diagnoosimenetelmät kärsivät epätarkkuudesta ja ovat myös kalliita. Apuna voisi olla koneoppimisen menetelmät. Koneoppimisen käyttö on lisääntynyt viime vuosina nopeasti, ja menetelmät ovat käytössä myös terveydenhuollossa. Työn tavoitteena on selvittää, mitä koneoppimisen menetelmiä voidaan soveltaa Parkinsonin taudin diagnosointiin, ja mistä oireista Parkinsonin tautia voidaan diagnosoida parhaiten näillä menetelmillä. Työssä tutkitaan tarkemmin puheen, käsialan ja kävelyliikkeen mittausdatoihin perustuvia koneoppimismalleja. Parhaat tulokset on saatu kävelyliikedataa käyttävillä malleilla, johtuen mahdollisesti kävelyoireiden kytkeytymisestä vahvasti perinteiseen Parkinsonin taudin diagnoosiin, jolloin oireita on tutkittu pitempään. Kaikkien mittauskohteiden vahvuutena on niiden matalat kustannukset ja helppous koehenkilölle. Puheen sekä kävelyliikkeen mittaamiseen voidaan hyödyntää älypuhelinta, jonka avulla myös puolijatkuva pitkäaikaisseuranta on mahdollista, esimerkiksi hoidon vasteen arvioimiseksi. Työssä tutkittujen koneoppimismenetelmien hyödyntäminen Parkinsonin taudin diagnosoinnissa on tarkempaa ja kustannustehokkaampaa kuin perinteiset menetelmät. Koneoppimismalleilla saavutettu tarkkuus on keskimääräisesti lääkärin arviota parempi. Menetelmien avulla myös objektiivinen hoidon vasteen arviointi olisi mahdollista. Mallien koulutukseen käytetyt otannat ovat kuitenkin suppeita, joka voi johtaa mallin puolueellisuuteen. Lisäksi johtuen tutkimuksien raportointistandardien puutteellisuudesta, malleista ei kaikkia tarpeellisia tietoja ole jaettu, jolloin on vaikeaa uudelleen toistaa tutkimukset. Koneoppimismenetelmillä on paljon potentiaalia olla tulevaisuudessa kliinisessä käytössä Parkinsonin taudin diagnosoinnin aputyökaluna terveydenhuollonammattilaisille. Perusteluina ovat aikaisempi, tarkempi ja kustannustehokkaampi diagnoosi, jonka avulla hoito voidaan aloittaa sairauden varhaisemmassa vaiheessa, mikä ylläpitää potilaan työkykyä ja elämänlaatua. Menetelmillä on mahdollista myös suorittaa pitkäaikaisseurantaa, jolla voidaan arvioida hoidon vastetta ja löytää uusia tehoavia hoitokeinoja. Tällä hetkellä kuitenkin tutkimuksien puolueellisuus ja huono uudelleentoistettavuus estävät mallien yleistämisen. Lisäksi kehitetyn koneoppimismallin pitää olla kokonaan jäljitettävä, jotta se täyttäisi lääketieteelliset standardit

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

Improving Access and Mental Health for Youth Through Virtual Models of Care

The overall objective of this research is to evaluate the use of a mobile health smartphone application (app) to improve the mental health of youth between the ages of 14–25 years, with symptoms of anxiety/depression. This project includes 115 youth who are accessing outpatient mental health services at one of three hospitals and two community agencies. The youth and care providers are using eHealth technology to enhance care. The technology uses mobile questionnaires to help promote self-assessment and track changes to support the plan of care. The technology also allows secure virtual treatment visits that youth can participate in through mobile devices. This longitudinal study uses participatory action research with mixed methods. The majority of participants identified themselves as Caucasian (66.9%). Expectedly, the demographics revealed that Anxiety Disorders and Mood Disorders were highly prevalent within the sample (71.9% and 67.5% respectively). Findings from the qualitative summary established that both staff and youth found the software and platform beneficial

The Impact of Digital Technologies on Public Health in Developed and Developing Countries

This open access book constitutes the refereed proceedings of the 18th International Conference on String Processing and Information Retrieval, ICOST 2020, held in Hammamet, Tunisia, in June 2020.* The 17 full papers and 23 short papers presented in this volume were carefully reviewed and selected from 49 submissions. They cover topics such as: IoT and AI solutions for e-health; biomedical and health informatics; behavior and activity monitoring; behavior and activity monitoring; and wellbeing technology. *This conference was held virtually due to the COVID-19 pandemic

Bio-Inspired Robotics

Modern robotic technologies have enabled robots to operate in a variety of unstructured and dynamically-changing environments, in addition to traditional structured environments. Robots have, thus, become an important element in our everyday lives. One key approach to develop such intelligent and autonomous robots is to draw inspiration from biological systems. Biological structure, mechanisms, and underlying principles have the potential to provide new ideas to support the improvement of conventional robotic designs and control. Such biological principles usually originate from animal or even plant models, for robots, which can sense, think, walk, swim, crawl, jump or even fly. Thus, it is believed that these bio-inspired methods are becoming increasingly important in the face of complex applications. Bio-inspired robotics is leading to the study of innovative structures and computing with sensory–motor coordination and learning to achieve intelligence, flexibility, stability, and adaptation for emergent robotic applications, such as manipulation, learning, and control. This Special Issue invites original papers of innovative ideas and concepts, new discoveries and improvements, and novel applications and business models relevant to the selected topics of ``Bio-Inspired Robotics''. Bio-Inspired Robotics is a broad topic and an ongoing expanding field. This Special Issue collates 30 papers that address some of the important challenges and opportunities in this broad and expanding field

Object Tracking

Object tracking consists in estimation of trajectory of moving objects in the sequence of images. Automation of the computer object tracking is a difficult task. Dynamics of multiple parameters changes representing features and motion of the objects, and temporary partial or full occlusion of the tracked objects have to be considered. This monograph presents the development of object tracking algorithms, methods and systems. Both, state of the art of object tracking methods and also the new trends in research are described in this book. Fourteen chapters are split into two sections. Section 1 presents new theoretical ideas whereas Section 2 presents real-life applications. Despite the variety of topics contained in this monograph it constitutes a consisted knowledge in the field of computer object tracking. The intention of editor was to follow up the very quick progress in the developing of methods as well as extension of the application