Statistical Shape Analysis for the Human Back

A thesis submitted to the department of Engineering and Technology in partial fulfilment of the requirements for the degree of Master of Philosophy in Production and Manufacturing Engineering at the University of WolverhamptonIn this research, Procrustes and Euclidean distance matrix analysis (EDMA) have been investigated for analysing the three-dimensional shape and form of the human back. Procrustes analysis is used to distinguish deformed backs from normal backs. EDMA is used to locate the changes occurring on the back surface due to spinal deformity (scoliosis, kyphosis and lordosis) for back deformity patients. A surface topography system, ISIS2 (Integrated Shape Imaging System 2), is available to measure the three-dimensional back surface. The system presents clinical parameters, which are based on distances and angles relative to certain anatomical landmarks on the back surface. Location, rotation and scale definitely influence these parameters. Although the anatomical landmarks are used in the present system to take some account of patient stance, it is still felt that variability in the clinical parameters is increased by the use of length and angle data. Patients also grow and so their back size, shape and form change between appointments with the doctor. Instead of distances and angles, geometric shape that is independent of location, rotation and scale effects could be measured. This research is mainly focusing on the geometric shape and form change in the back surface, thus removing the unwanted effects. Landmarks are used for describing back information and an analysis of the variability in positioning the landmarks has been carried out for repeated measurements. Generalized Procrustes analysis has been applied to all normal backs to calculate a mean Procrustes shape, which is named the standard normal shape (SNS). Each back (normal and deformed) is then translated, rotated and scaled to give a best fit with the SNS using ordinary Procrustes analysis. Riemannian distances are then estimated between the SNS and all individual backs. The highest Riemannian distance value between the normal backs and the SNS is lower than the lowest Riemannian distance value between the deformed backs and the SNS. The results shows that deformed backs can be differentiated from normal backs. EDMA has been used to estimate a mean form, variance-covariance matrix and mean form difference from all the normal backs. This mean form is named the standard normal form (SNF). The influence of individual landmarks for form difference between each deformed back and the SNF is estimated. A high value indicates high deformity on the location of that landmark and a low value close to 1 indicates less deformity. The result is displayed in a graph that provides information regarding the degree and location of the deformity. The novel aspects of this research lie in the development of an effective method for assessing the three-dimensional back shape; extracting automatic landmarks; visualizing back shape and back form differences

An automatic wearable multi-sensor based gait analysis system for older adults.

Gait abnormalities in older adults are very common in clinical practice. They lead to serious adverse consequences such as falls and injury resulting in increased care cost. There is therefore a national imperative to address this challenge. Currently gait assessment is done using standardized clinical tools dependent on subjective evaluation. More objective gold standard methods (motion capture systems such as Qualisys and Vicon) to analyse gait rely on access to expensive complex equipment based in gait laboratories. These are not widely available for several reasons including a scarcity of equipment, need for technical staff, need for patients to attend in person, complicated time consuming procedures and overall expense. To broaden the use of accurate quantitative gait monitoring and assessment, the major goal of this thesis is to develop an affordable automatic gait analysis system that will provide comprehensive gait information and allow use in clinic or at home. It will also be able to quantify and visualize gait parameters, identify gait variables and changes, monitor abnormal gait patterns of older people in order to reduce the potential for falling and support falls risk management. A research program based on conducting experiments on volunteers is developed in collaboration with other researchers in Bournemouth University, The Royal Bournemouth Hospital and care homes. This thesis consists of five different studies toward addressing our major goal. Firstly, a study on the effects on sensor output from an Inertial Measurement Unit (IMU) attached to different anatomical foot locations. Placing an IMU over the bony prominence of the first cuboid bone is the best place as it delivers the most accurate data. Secondly, an automatic gait feature extraction method for analysing spatiotemporal gait features which shows that it is possible to extract gait features automatically outside of a gait laboratory. Thirdly, user friendly and easy to interpret visualization approaches are proposed to demonstrate real time spatiotemporal gait information. Four proposed approaches have the potential of helping professionals detect and interpret gait asymmetry. Fourthly, a validation study of spatiotemporal IMU extracted features compared with gold standard Motion Capture System and Treadmill measurements in young and older adults is conducted. The results obtained from three experimental conditions demonstrate that our IMU gait extracted features are highly valid for spatiotemporal gait variables in young and older adults. In the last study, an evaluation system using Procrustes and Euclidean distance matrix analysis is proposed to provide a comprehensive interpretation of shape and form differences between individual gaits. The results show that older gaits are distinguishable from young gaits. A pictorial and numerical system is proposed which indicates whether the assessed gait is normal or abnormal depending on their total feature values. This offers several advantages: 1) it is user friendly and is easy to set up and implement; 2) it does not require complex equipment with segmentation of body parts; 3) it is relatively inexpensive and therefore increases its affordability decreasing health inequality; and 4) its versatility increases its usability at home supporting inclusivity of patients who are home bound. A digital transformation strategy framework is proposed where stakeholders such as patients, health care professionals and industry partners can collaborate through development of new technologies, value creation, structural change, affordability and sustainability to improve the diagnosis and treatment of gait abnormalities

Gait Evaluation Using Procrustes and Euclidean Distance Matrix Analysis

Objective assessment of gait is important in the treatment and rehabilitation of patients with different diseases. In this paper, we propose a gait evaluation system using Procrustes and Euclidean distance matrix analysis. We design and develop an android app to collect real time synchronous accelerometer and gyroscope data from two Inertial Measurement Unit (IMU) sensors through Bluetooth connectivity. The data is collected from 12 young (10 for modelling and 2 for validation) and 20 older subjects. We analyse the data collected from real world for stride, step, stance and swing gait features. We validate our method with measurements of gait features. Generalized Procrustes analysis is used to estimate a standard normal mean gait shape (NMGS) for 10 young subjects. Each gait feature of both young and older subjects is then converted to find the best match with the NMGS using ordinary Procrustes analysis. The shape distance between the NMGS and each gait shape is estimated using Riemannian shape distance, Riemannian size-and-shape distance, Procrustes size-and-shape distance and Root mean square deviation. A t-test is performed to provide statistical evidence of gait shape differences between young and older gaits. A mean form which is considered as a standard normal mean gait form (NMGF) and inter-feature distances are estimated from the set of 10 young subjects. The form difference is estimated between the NMGF and individual gaits of young and older. The degree of abnormality is then estimated for individual features and the result is plotted to visualize the feature in a gait. Experimental results demonstrate the performance of the proposed method

Validity and Consistency of Concurrent Extraction of Gait Features Using Inertial Measurement Units and Motion Capture System

Conditions causing gait abnormalities are very common and their treatment requires the detailed assessment of gait. Currently such assessments are carried out in gait laboratories and require the use of complex and expensive equipment. To increase availability and use at home and clinics, we design and develop an affordable, user friendly, wireless, portable automatic system to extract spatiotemporal features of gait that can be used indoors and outdoors. This study determines the concurrent validity of extracted gait features from Inertial Measurement Units (IMUs) against ‘gold standard’ Motion Capture System (MoCap) using a hybrid gait features extraction method. The analysis of the proposed method is based on minimum prominence and abrupt transition points in the IMU signals. We also compare the degree of agreement for mean spatiotemporal gait features. The concurrent data from synchronized IMUs and MoCap are collected from 18 subjects. We validate our proposed system using two experiments; 1) IMU and MoCap with self-selected (free) walking and 2) IMU and MoCap at various walking speeds. Interclass correlations, Lin’s concordance correlation coefficients and Pearson’s correlation coefficients (r) are applied to determine the correlation between extracted gait features from IMU and MoCap measurements. Bland-Altman plots are also generated to evaluate any unknown bias between the mean extracted features. The experiments show that spatiotemporal features of gait extracted from IMUs are highly valid. Our methods facilitate gait assessment in clinics and at home including the possibility of self-assessment

An Enhanced Ensemble Deep Neural Network Approach for Elderly Fall Detection System Based on Wearable Sensors

Fatal injuries and hospitalizations caused by accidental falls are significant problems among the elderly. Detecting falls in real-time is challenging, as many falls occur in a short period. Developing an automated monitoring system that can predict falls before they happen, provide safeguards during the fall, and issue remote notifications after the fall is essential to improving the level of care for the elderly. This study proposed a concept for a wearable monitoring framework that aims to anticipate falls during their beginning and descent, activating a safety mechanism to minimize fall-related injuries and issuing a remote notification after the body impacts the ground. However, the demonstration of this concept in the study involved the offline analysis of an ensemble deep neural network architecture based on a Convolutional Neural Network (CNN) and a Recurrent Neural Network (RNN) and existing data. It is important to note that this study did not involve the implementation of hardware or other elements beyond the developed algorithm. The proposed approach utilized CNN for robust feature extraction from accelerometer and gyroscope data and RNN to model the temporal dynamics of the falling process. A distinct class-based ensemble architecture was developed, where each ensemble model identified a specific class. The proposed approach was evaluated on the annotated SisFall dataset and achieved a mean accuracy of 95%, 96%, and 98% for Non-Fall, Pre-Fall, and Fall detection events, respectively, outperforming state-of-the-art fall detection methods. The overall evaluation demonstrated the effectiveness of the developed deep learning architecture. This wearable monitoring system will prevent injuries and improve the quality of life of elderly individuals

Deep learning enabled fall detection exploiting gait analysis

Falls associated injuries often result not only increasing the medical-, social- and care-cost but also loss of mobility, impair chronic health and even potential risk of fatality. Because of elderly population growth, it is one of the major global public health problems. To address such issue, we present a Deep Learning enabled Fall Detection (DLFD) method exploiting Gait Analysis. More in details, firstly, we propose a framework for fall detection system. Secondly, we discussed the proposed DLFD method which exploits fall and non-fall RGB video to extract gait features using MediaPipe framework, applies normalization algorithm and classifies using bi-directional Long Short-Term Memory (bi-LSTM) model. Finally, the model is tested on collected three public datasets of 434mathrm{x}2 videos(more than 1 million frames) which consists of different activities and varieties of falls. The experimental results show that the model can achieve the accuracy of 96.35% and reveals the effectiveness of the proposal. This could play a significant role to alleviate falls problem by immediate alerting to emergency and relevant teams for taking necessary actions. This will speed up the assistance proceedings, reduce the risk of prolonged injury and save lives

Gait quantification and visualization for digital healthcare

Gait abnormalities are common in clinical practice and there is a global imperative to improve technologies that facilitate their detection, evaluation, monitoring and management. Real time evaluation using digital technology supports the development of digital healthcare. Currently gait assessment relies on visual observation of structured clinical tests such as the “Timed Get up and Go Test.” Gold standard methods such as “Qualisys Motion Capture System” require sophisticated equipment in gait laboratories. These are not widely available due to expense, analysis time and requirement of trained technicians. Developing low cost, portable, easy to use digital technology is important to enable sophisticated assessment of gait at home or in clinics. Common measures for quantification of gait include symmetry angle, ratio and index. These measurements may be difficult to interpret by users as stand-alone values. To facilitate the evaluation and interpretation of locomotive information, a tool to visualize gait in real-time is proposed. The proposed tool consists of five approaches (1: Real-time dial visualization, 2: Visualization of individual leg time variation, 3: Visualization of both legs asymmetry, 4: Boxplot visualization, and 5: Evaluation considering all features). Results show that wearable Inertial Measurement Unit (IMU) can be used for extraction of objective gait features. This system opens possibilities for home-based assessment of gait without the requirement and expense of an elaborate laboratory setup and supports the development of digital healthcare