Recognition of elementary arm movements using orientation of a tri-axial accelerometer located near the wrist

In this paper we present a method for recognising three fundamental movements of the human arm (reach and retrieve, lift cup to mouth, rotation of the arm) by determining the orientation of a tri-axial accelerometer located near the wrist. Our objective is to detect the occurrence of such movements performed with the impaired arm of a stroke patient during normal daily activities as a means to assess their rehabilitation. The method relies on accurately mapping transitions of predefined, standard orientations of the accelerometer to corresponding elementary arm movements. To evaluate the technique, kinematic data was collected from four healthy subjects and four stroke patients as they performed a number of activities involved in a representative activity of daily living, 'making-a-cup-of-tea'. Our experimental results show that the proposed method can independently recognise all three of the elementary upper limb movements investigated with accuracies in the range 91–99% for healthy subjects and 70–85% for stroke patients

Recognizing upper limb movements with wrist worn inertial sensors using k-means clustering classification

In this paper we present a methodology for recognizing three fundamental movements of the human forearm (extension, flexion and rotation) using pattern recognition applied to the data from a single wrist-worn, inertial sensor. We propose that this technique could be used as a clinical tool to assess rehabilitation progress in neurodegenerative pathologies such as stroke or cerebral palsy by tracking the number of times a patient performs specific arm movements (e.g. prescribed exercises) with their paretic arm throughout the day. We demonstrate this with healthy subjects and stroke patients in a simple proof of concept study in whichthese arm movements are detected during an archetypal activity of daily-living (ADL) – ‘making-a-cup-of-tea’. Data is collected from a tri-axial accelerometer and a tri-axial gyroscope located proximal to the wrist. In a training phase, movements are initially performed in a controlled environment which are represented by a ranked set of 30 time-domain features. Using a sequential forward selection technique, for each set of feature combinations three clusters are formed using k-means clustering followed by 10 runs of 10-fold cross validation on the training data to determine the best feature combinations. For the testing phase, movements performed during the ADL are associated with each cluster label using a minimum distance classifier in a multi-dimensional feature space, comprised of the best ranked features, using Euclidean or Mahalanobis distance as the metric. Experiments were performed with four healthy subjects and four stroke survivors and our results showthat the proposed methodology can detect the three movements performed during the ADL with an overall average accuracy of 88% using the accelerometer data and 83% using the gyroscope data across all healthy subjects and arm movement types. The average accuracy across all stroke survivors was 70% using accelerometer data and 66% using gyroscope data. We also use a Linear Discriminant Analysis (LDA) classifier and a Support Vector Machine (SVM) classifier in association with the same set of features to detect the three arm movements and compare the results to demonstrate the effectiveness of our proposed methodology

Movement fluidity of the impaired arm during stroke rehabilitation

We present an initial study on the measure of movement fluidity of the upper arm for 4 stroke patients for a duration of 3 weeks as they performed an archetypal activity of daily living – ‘making-a-cup-of-tea’ in an uncontrolled environment. Results of two complimenting measures – jerk metric and peak number computed from accelerometer data on the wrist are in agreement with the clinical scores from the Box and Block test and the Nine Hole Peg tes

Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 3: Discussion and Conclusion

BACKGROUND: It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for later orthodontic or orthognathic treatment. As results on late consequences of prematurity are consistently contradictory, the necessity exists for a fundamental analysis of existing methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHOD: A search of the literature was conducted based on Cochrane search strategies including sources in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered in tables for comparison (Parts 1 and 2). RESULTS: Morphology assessment of the infant palate is subject to non-standardized visual and metrical measurements. Most methodologies are inadequate for measuring a three-dimensional shape. Several confounding factors were identified as causes contributing to disturbances of palatal and orofacial development. CONCLUSION: Taking into account the abovementioned shortcomings, the following conclusions may be drawn for practitioners and prospective investigators of clinical studies. 1) The lack of uniformity in the anatomical nomenclature of the infant's palate underlines the need for a uniform definition. 2) Metrically, non-intubated preterm infants do not exhibit different palatal width or height compared to matched term infants up to the corrected age of three months. Beyond that age, no data on the subject are currently available. 3) Oral intubation does not invariably alter palatal morphology of preterm and low birthweight infants. 4) The findings on palatal grooving, height, and asymmetry as a consequence of orotracheal intubation up to the age of 11 years are inconsistent. 5) Metrically, the palates of orally intubated infants remain narrower posteriorly, beginning at the second deciduous molar, until the age of 11 years. Beyond that age, no data on the subject are currently available. 6) There is a definite need for further, especially metrical, longitudinal and controlled trials on palatal morphology of preterm and low birthweight infants with reliable measuring techniques. 7) None of the raised confounding factors for developmental disturbances may be excluded until evident results are presented. Thus, early orthodontic and logopedic control of formerly premature infants is recommended up to the late mixed dentition stage

Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant

BACKGROUND: Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1). The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHODS: An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. RESULTS: Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. CONCLUSION: There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and logopedic control of formerly orally intubated preterm infants is recommended, as opposed to non-intubated infants. From the orthodontic point of view, nasal intubation should be favored. The role that palatal protection plates and pressure-dispersing pads for the head have in palatal development remains unclear

Real-time arm movement recognition using FPGA

In this paper we present a FPGA-based system to detect three elementary arm movements in real-time (reach and retrieve, lift cup to mouth, rotation of the arm) using data from a wrist-worn accelerometer. Recognition is carried out by accurately mapping transitions of predefined, standard orientations of an accelerometer to the corresponding arm movements. The algorithm is coded in HDL and synthesized on the Altera DE2-115 FPGA board. For real-time operation, interfacing between the streaming sensor unit, host PC and the FPGA was achieved through a combination of Bluetooth, RS232 and an application software developed in C# using the .NET framework to facilitate serial port controls. The synthesized design used 1804 logic elements and recognised the performed arm movement in 41.2 μs, @50 MHz clock on the FPGA. Our experimental results show that the system can recognise all three arm movements with accuracies ranging 85%-96% for healthy subjects and 63%-75% for stroke survivors involved in 'making-a-cup-of-tea', typical of an activity of daily living (ADL)

Low-complexity framework for movement classification using body-worn sensors

We present a low-complexity framework for classifying elementary arm-movements (reach-retrieve, lift-cup-to-mouth, rotate-arm) using wrist-worn, inertial sensors. We propose that this methodology could be used as a clinical tool to assess rehabilitation progress in neurodegenerative pathologies tracking occurrence of specific movements performed by patients with their paretic arm. Movements performed in a controlled training-phase are processed to form unique clusters in a multi-dimensional feature-space. Subsequent movements performed in an uncontrolled testing-phase are associated to the proximal cluster using a minimum distance classifier (MDC). The framework involves performing the compute-intensive clustering on the training-dataset offline (Matlab) whereas the computation of selected features on the testing-dataset and the minimum distance (Euclidean) from pre-computed cluster centroids are done in hardware with an aim of low-power execution on sensor nodes.The architecture for feature-extraction and MDC are realized using Coordinate Rotation Digital Computer based design which classifies a movement in (9n+31) clock cycles, n being number of data samples. The design synthesized in STMicroelectronics 130nm technology consumed 5.3 nW @50 HZ, besides being functionally verified upto 20 MHz, making it applicable for real-time high-speed operations. Our experimental results show that the system can recognize all three arm-movements with average accuracies of 86% and 72% for four healthy subjects using accelerometer and gyroscope data respectively, whereas for stroke survivors the average accuracies were 67% and 60%. The framework was further demonstrated as a FPGA-based real-time system, interfacing with a streaming sensor unit