Reliable and robust detection of freezing of gait episodes with wearable electronic devices

A wearable wireless sensing system for assisting patients affected by Parkinson's disease is proposed. It uses integrated micro-electro-mechanical inertial sensors able to recognize the episodes of involuntary gait freezing. The system operates in real time and is designed for outdoor and indoor applications. Standard tests were performed on a noticeable number of patients and healthy persons and the algorithm demonstrated its reliability and robustness respect to individual specific gait and postural behaviors. The overall performances of the system are excellent with a specificity higher than 97%

Granular synthesis for display of time-varying probability densities

We present a method for displaying time-varying probabilistic information to users using an asynchronous granular synthesis technique. We extend the basic synthesis technique to include distribution over waveform source, spatial position, pitch and time inside waveforms. To enhance the synthesis in interactive contexts, we "quicken" the display by integrating predictions of user behaviour into the sonification. This includes summing the derivatives of the distribution during exploration of static densities, and using Monte-Carlo sampling to predict future user states in nonlinear dynamic systems. These techniques can be used to improve user performance in continuous control systems and in the interactive exploration of high dimensional spaces. This technique provides feedback from users potential goals, and their progress toward achieving them; modulating the feedback with quickening can help shape the users actions toward achieving these goals. We have applied these techniques to a simple nonlinear control problem as well as to the sonification of on-line probabilistic gesture recognition. We are applying these displays to mobile, gestural interfaces, where visual display is often impractical. The granular synthesis approach is theoretically elegant and easily applied in contexts where dynamic probabilistic displays are required

Sonification of probabilistic feedback through granular synthesis

We describe a method to improve user feedback, specifically the display of time-varying probabilistic information, through asynchronous granular synthesis. We have applied these techniques to challenging control problems as well as to the sonification of online probabilistic gesture recognition. We're using these displays in mobile, gestural interfaces where visual display is often impractical

Gait recognition and understanding based on hierarchical temporal memory using 3D gait semantic folding

Gait recognition and understanding systems have shown a wide-ranging application prospect. However, their use of unstructured data from image and video has affected their performance, e.g., they are easily influenced by multi-views, occlusion, clothes, and object carrying conditions. This paper addresses these problems using a realistic 3-dimensional (3D) human structural data and sequential pattern learning framework with top-down attention modulating mechanism based on Hierarchical Temporal Memory (HTM). First, an accurate 2-dimensional (2D) to 3D human body pose and shape semantic parameters estimation method is proposed, which exploits the advantages of an instance-level body parsing model and a virtual dressing method. Second, by using gait semantic folding, the estimated body parameters are encoded using a sparse 2D matrix to construct the structural gait semantic image. In order to achieve time-based gait recognition, an HTM Network is constructed to obtain the sequence-level gait sparse distribution representations (SL-GSDRs). A top-down attention mechanism is introduced to deal with various conditions including multi-views by refining the SL-GSDRs, according to prior knowledge. The proposed gait learning model not only aids gait recognition tasks to overcome the difficulties in real application scenarios but also provides the structured gait semantic images for visual cognition. Experimental analyses on CMU MoBo, CASIA B, TUM-IITKGP, and KY4D datasets show a significant performance gain in terms of accuracy and robustness

Swayed by sound: sonic guidance as a neurorehabilitation strategy in the cerebellar ataxias

Cerebellar disease leads to problems in controlling movement. The most common difficulties are dysmetria and instability when standing. Recent understanding of cerebellar function has expanded to include non -motor aspects such as emotional, cognitive and sensory processing. Deficits in the acquisition and processing of sensory information are one explanation for the movement problems observed in cerebellar ataxia. Sensory deficits result in an inability to make predictions about future events; a primary function of the cerebellum. A question therefore, is whether augmenting or replacing sensory information can improve motor performance in cerebellar disease. This question is tested in this thesis by augmenting sensory information through the provision of an auditory movement guide.A variable described in motor control theory (tau) was used to develop auditory guides that were continuous and dynamic. A reaching experiment using healthy individuals showed that the timing of peak velocity, audiomotor coordination accuracy, and velocity of approach, could be altered in line with the movement parameters embedded in the auditory guides. The thesis then investigated the use of these sonic guides in a clinical population with cerebellar disease. Performance on neurorehabilitation exercises for balance control was tested in twenty people with cerebellar atrophy, with and without auditory guides. Results suggested that continuous, predictive, dynamic auditory guidance is an effective way of improving iii movement smoothness in ataxia (as measured by jerk). In addition, generating and swaying with imaginary auditory guides was also found to increase movement smoothness in cerebellar disease.Following the tests of instantaneous effects, the thesis then investigated the longterm consequences on motor behaviour of following a two -month exercise with auditory guide programme. Seven people with cerebellar atrophy were assessed pre - and post -intervention using two measures, weight -shifting and walking. The results of the weight -shifting test indicated that the sonic -guide exercise programme does not initiate long -term changes in motor behaviour. Whilst there were minor, improvements in walking, because of the weight -shifting results, these could not be attributed to the sonic guides. This finding confirms the difficulties of motor rehabilitation in people with cerebellar disease.This thesis contributes original findings to the field of neurorehabilitation by first showing that on -going and predictive stimuli are an appropriate tool for improving motor behaviour. In addition, the thesis is the first of its kind to apply externally presented guides that convey continuous meaningful information within a clinical population. Finally, findings show that sensory augmentation using the auditory domain is an effective way of improving motor coordination in some forms of cerebellar disease

Different protocols for analyzing behavior and adaptability in obstacle crossing in Parkinson's disease

Imbalance and tripping over obstacles as a result of altered gait in older adults, especially in patients with Parkinson's disease (PD), are one of the most common causes of falls. During obstacle crossing, patients with PD modify their behavior in order to decrease the mechanical demands and enhance dynamic stability. Various descriptions of dynamic traits of gait that have been collected over longer periods, probably better synthesize the underlying structure and pattern of fluctuations in gait and can be more sensitive markers of aging or early neurological dysfunction and increased risk of falls. This confirmation challenges the clinimetric of different protocols and paradigms used for gait analysis up till now, in particular when analyzing obstacle crossing. The authors here present a critical review of current knowledge concerning the interplay between the cognition and gait in aging and PD, emphasizing the differences in gait behavior and adaptability while walking over different and challenging obstacle paradigms, and the implications of obstacle negotiation as a predictor of falls. Some evidence concerning the effectiveness of future rehabilitation protocols on reviving obstacle crossing behavior by trial and error relearning, taking advantage of dual-task paradigms, physical exercise, and virtual reality have been put forward in this article.Supported by the projects NORTE-01–0145-FEDER-000026 (DeM-Deus Ex Machina) financed by the Regional Operational Program of the North (NORTE2020) PORTUGAL2020 and FEDER, and FP7 Marie Curie ITN Neural Engineering Transformative Technologies (NETT) projectinfo:eu-repo/semantics/publishedVersio

Automated Intelligent Cueing Device to Improve Ambient Gait Behaviors for Patients with Parkinson\u27s Disease

Freezing of gait (FoG) is a common motor dysfunction in individuals with Parkinson’s disease (PD). FoG impairs walking and is associated with increased fall risk. Although pharmacological treatments have shown promise during ON-medication periods, FoG remains difficult to treat during medication OFF state and in advanced stages of the disease. External cueing therapy in the forms of visual, auditory, and vibrotactile, has been effective in treating gait deviations. Intelligent (or on-demand) cueing devices are novel systems that analyze gait patterns in real-time and activate cues only at moments when specific gait alterations are detected. In this study we developed methods to analyze gait signals collected through wearable sensors and accurately identify FoG episodes. We also investigated the potential of predicting the symptoms before their actual occurrence. We collected data from seven participants with PD using two Inertial Measurement Units (IMUs) on ankles. In our first study, we extracted engineered features from the signals and used machine learning (ML) methods to identify FoG episodes. We tested the performance of models using patient-dependent and patient-independent paradigms. The former models achieved 92.5% and 89.0% for average sensitivity and specificity, respectively. However, the conventional binary classification methods fail to accurately classify data if only data from normal gait periods are available. In order to identify FoG episodes in participants who did not freeze during data collection sessions, we developed a Deep Gait Anomaly Detector (DGAD) to identify anomalies (i.e., FoG) in the signals. DGAD was formed of convolutional layers and trained to automatically learn features from signals. The convolutional layers are followed by fully connected layers to reduce the dimensions of the features. A k-nearest neighbors (kNN) classifier is then used to classify the data as normal or FoG. The models identified 87.4% of FoG onsets, with 21.9% being predicted on average for each participant. This study demonstrates our algorithm\u27s potential for delivery of preventive cues. The DGAD algorithm was then implemented in an Android application to monitor gait patterns of PD patients in ambient environments. The phone triggered vibrotactile and auditory cues on a connected smartwatch if an FoG episode was identified. A 6-week in-home study showed the potentials for effective treatment of FoG severity in ambient environments using intelligent cueing devices