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Maggio MG, Valeri MC, De Luca R, Di Iulio F, Ciancarelli I, De Francesco M, Calabrò RS, Morone G. The Role of Immersive Virtual Reality Interventions in Pediatric Cerebral Palsy: A Systematic Review across Motor and Cognitive Domains. Brain Sci 2024; 14:490. [PMID: 38790468 PMCID: PMC11120259 DOI: 10.3390/brainsci14050490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/30/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Background: In recent years, new technologies have been applied in cerebral palsy. Among these, immersive virtual reality is one with promising motor and cognitive effects along with the reduced costs of its application. The level of immersion of the subject in the illusional world gives the feeling of being a real part of the virtual environment. This study aims to investigate the safety and the efficacy of immersive virtual reality in children affected by cerebral palsy. Methods: PubMed, Embase, Cochrane Database of Systematic Reviews, RehabData, and Web of Science were screened up to February 2023 to identify eligible clinical studies. Results: Out of 788, we included 15 studies involving CP patients. There was high heterogeneity in the outcomes considered, and the results showed non-inferiority to conventional therapy and initial additional benefits in comparison with conventional rehabilitation. Conclusions: Immersive virtual reality emerges as a pivotal technological tool in rehabilitation, seamlessly integrating with conventional therapy within CP rehabilitation programs. Indeed, it not only enhances motivation but significantly increases children's functional capacity and abilities.
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Affiliation(s)
- Maria Grazia Maggio
- IRCCS Centro Neurolesi “Bonino Pulejo”, S.S. 113, Contrada Casazza, 98124 Messina, Italy; (M.G.M.); (R.D.L.); (M.D.F.)
| | - Maria Chiara Valeri
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.C.V.); (I.C.); (G.M.)
| | - Rosaria De Luca
- IRCCS Centro Neurolesi “Bonino Pulejo”, S.S. 113, Contrada Casazza, 98124 Messina, Italy; (M.G.M.); (R.D.L.); (M.D.F.)
| | | | - Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.C.V.); (I.C.); (G.M.)
| | - Morena De Francesco
- IRCCS Centro Neurolesi “Bonino Pulejo”, S.S. 113, Contrada Casazza, 98124 Messina, Italy; (M.G.M.); (R.D.L.); (M.D.F.)
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi “Bonino Pulejo”, S.S. 113, Contrada Casazza, 98124 Messina, Italy; (M.G.M.); (R.D.L.); (M.D.F.)
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (M.C.V.); (I.C.); (G.M.)
- San Raffaele Institute of Sulmona, 67039 Sulmona, Italy
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Bhat SG, Shin AY, Kaufman KR. Upper extremity asymmetry due to nerve injuries or central neurologic conditions: a scoping review. J Neuroeng Rehabil 2023; 20:151. [PMID: 37940959 PMCID: PMC10634143 DOI: 10.1186/s12984-023-01277-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/01/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND Peripheral nerve injuries and central neurologic conditions can result in extensive disabilities. In cases with unilateral impairment, assessing the asymmetry between the upper extremity has been used to assess outcomes of treatment and severity of injury. A wide variety of validated and novel tests and sensors have been utilized to determine the upper extremity asymmetry. The purpose of this article is to review the literature and define the current state of the art for describing upper extremity asymmetry in patients with peripheral nerve injuries or central neurologic conditions. METHOD An electronic literature search of PubMed, Scopus, Web of Science, OVID was performed for publications between 2000 to 2022. Eligibility criteria were subjects with neurological conditions/injuries who were analyzed for dissimilarities in use between the upper extremities. Data related to study population, target condition/injury, types of tests performed, sensors used, real-world data collection, outcome measures of interest, and results of the study were extracted. Sackett's Level of Evidence was used to judge the quality of the articles. RESULTS Of the 7281 unique articles, 112 articles met the inclusion criteria for the review. Eight target conditions/injuries were identified (Brachial Plexus Injury, Cerebral Palsy, Multiple Sclerosis, Parkinson's Disease, Peripheral Nerve Injury, Spinal Cord Injury, Schizophrenia, and stroke). The tests performed were classified into thirteen categories based on the nature of the test and data collected. The general results related to upper extremity asymmetry were listed for all the reviewed articles. Stroke was the most studied condition, followed by cerebral palsy, with kinematics and strength measurement tests being the most frequently used tests. Studies with a level of evidence level II and III increased between 2000 and 2021. The use of real-world evidence-based data, and objective data collection tests also increased in the same period. CONCLUSION Adequately powered randomized controlled trials should be used to study upper extremity asymmetry. Neurological conditions other than stroke should be studied further. Upper extremity asymmetry should be measured using objective outcome measures like motion tracking and activity monitoring in the patient's daily living environment.
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Affiliation(s)
- Sandesh G Bhat
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Alexander Y Shin
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kenton R Kaufman
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, 55905, USA.
- Motion Analysis Laboratory, Mayo Clinic, DAHLC 4-214A, 200 First Street SW, Rochester, MN, 55905, USA.
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Gatica-Rojas V, Cartes-Velásquez R, Soto-Poblete A, Lizama LEC. Postural control telerehabilitation with a low-cost virtual reality protocol for children with cerebral palsy: Protocol for a clinical trial. PLoS One 2023; 18:e0268163. [PMID: 37590295 PMCID: PMC10434878 DOI: 10.1371/journal.pone.0268163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/22/2022] [Indexed: 08/19/2023] Open
Abstract
OBJECTIVE To establish the feasibility and effectiveness of a rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy-spastic hemiplegia. It also aims to compare the effectiveness of this programme under two delivery modalities, telerehabilitation (TR) and face-to-face (FtF). METHODS This is a registered randomized controlled clinical trial protocol (ACTRN12621000117819). Eighteen sessions of low-cost virtual reality therapy will be provided through both, FtF and TR modalities using a Nintendo Wii balance board. Each programme will last for 6 weeks and will consist of 3 sessions per week of 25 minutes each. Twenty patients diagnosed with cerebral palsy-spastic hemiplegia will be recruited for each group: FtF or TR (n = 40). Participants will be assessed at baseline, by the end of weeks 2, 4, and 6, and at weeks 8 and 10 (post-intervention follow-ups). The primary outcome will be the Center of Pressure sway area (CoParea); secondary outcomes will be standard deviation and velocity of the CoP in the mediolateral and anterior-posterior directions; tertiary outcomes will include the Modified-Modified Ashworth Scale for lower limbs, Modified Ashworth Scale for upper limbs, timed up-and-go tests, the timed one-leg standing and 6-minute walk test. RESULTS This study provides an assessment of the feasibility and effectiveness of an affordable rehabilitation programme using low-cost virtual reality aimed at improving postural control in children with cerebral palsy. CONCLUSION The designed rehabilitation programme using low-cost virtual reality may improve postural control in children with cerebral palsy-spastic hemiplegia. The TR modality is likely to be as effective as the FtF modality. The TR programme has been designed to overcome access barriers to physiotherapy services for children with cerebral palsy in low-resource settings, remote areas, and in restricted mobility contexts.
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Affiliation(s)
- Valeska Gatica-Rojas
- Tele-rehabilitation Technology Center and Neurosciences in Human Movement, Faculty of Health Sciences, Universidad de Talca, Talca, Chile
| | | | - Alex Soto-Poblete
- Institute of Mathematics and Physics, Universidad de Talca, Talca, Chile
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Malerba G, Bellazzecca S, Urgesi C, Butti N, D'Angelo MG, Diella E, Biffi E. Is Social Training Delivered with a Head-Mounted Display Suitable for Patients with Hereditary Ataxia? Brain Sci 2023; 13:1017. [PMID: 37508949 PMCID: PMC10376992 DOI: 10.3390/brainsci13071017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/23/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
Social cognition is fundamental in everyday life to understand "others' behavior", which is a key feature of social abilities. Previous studies demonstrated the efficacy of a rehabilitative intervention in semi-immersive virtual reality (VR) controlled by whole-body motion to improve the ability of patients with cerebellar disorders to predict others' intentions (VR-SPIRIT). Patients with severe ataxia that have difficulties at multiple levels of social processing could benefit from this intervention in terms of improving their social prediction skills, but they may have difficulties in controlling VR with whole-body movements. Therefore, we implemented VR-SPIRIT on a wearable, affordable, and easy-to-use technology, such as the Oculus Quest, a head-mounted display. The aim of this work was to evaluate the usability and tolerability of this VR application. We recruited 10 patients (37.7 ± 14.8 years old, seven males) with different types of hereditary ataxia who performed a single VR-SPIRIT session using the Oculus Quest viewer. After the session, patients answered a series of questionnaires to investigate the overall usability of the system and its potential effects in terms of cyber sickness. The preliminary results demonstrated system usability and tolerability. Indeed, only three patients did not complete the session due to different problems (dizziness, nausea, and boredom). In future studies, more patients will be enrolled to assess the effectiveness of the application, paving the way for the implementation of social training that can also be delivered at home.
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Affiliation(s)
- Giorgia Malerba
- Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | | | - Cosimo Urgesi
- Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
- Laboratory of Cognitive Neuroscience, Department of Languages and Literatures, Communication, Education and Society, University of Udine, 33100 Udine, Italy
| | - Niccolò Butti
- Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
- PhD Program in Neural and Cognitive Sciences, Department of Life Sciences, University of Trieste, 34127 Trieste, Italy
| | | | - Eleonora Diella
- Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
| | - Emilia Biffi
- Scientific Institute, IRCCS E. Medea, 23842 Bosisio Parini, Italy
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Wang L, Huang M, Yang R, Liang HN, Han J, Sun Y. Survey of Movement Reproduction in Immersive Virtual Rehabilitation. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; 29:2184-2202. [PMID: 35015645 DOI: 10.1109/tvcg.2022.3142198] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Virtual reality (VR) has emerged as a powerful tool for rehabilitation. Many effective VR applications have been developed to support motor rehabilitation of people affected by motor issues. Movement reproduction, which transfers users' movements from the physical world to the virtual environment, is commonly used in VR rehabilitation applications. Three major components are required for movement reproduction in VR: (1) movement input, (2) movement representation, and (3) movement modulation. Until now, movement reproduction in virtual rehabilitation has not yet been systematically studied. This article aims to provide a state-of-the-art review on this subject by focusing on existing literature on immersive motor rehabilitation using VR. In this review, we provided in-depth discussions on the rehabilitation goals and outcomes, technology issues behind virtual rehabilitation, and user experience regarding movement reproduction. Similarly, we present good practices and highlight challenges and opportunities that can form constructive suggestions for the design and development of fit-for-purpose VR rehabilitation applications and can help frame future research directions for this emerging area that combines VR and health.
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Cacioppo M, Loos A, Lempereur M, Brochard S. Bimanual movements in children with cerebral palsy: a systematic review of instrumented assessments. J Neuroeng Rehabil 2023; 20:26. [PMID: 36849971 PMCID: PMC9972766 DOI: 10.1186/s12984-023-01150-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 02/14/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Assessment of bimanual movements, which are frequently impaired in children with cerebral palsy, is highly challenging in clinical practice. Instrumented measures have been developed to evaluate and help to understand impaired upper limb movement during bimanual tasks in these children. The aim of this review was to report instrumented measurement tools (3D motion analysis, sensors, etc.) used for bimanual task movement analysis, and the metrological properties of the measures in children with cerebral palsy. METHODS A systematic review was conducted (Prospero CRD42022308517). PubMed, Web of Science, Cochrane and Scopus databases were searched with relevant keywords and inclusion/exclusion criteria. Article quality and biomechanical methods were evaluated with a customized scale and metrological properties with the COSMIN checklist. RESULTS In total, 452 children, mostly with unilateral cerebral palsy, mean age 10.9 (SD 3.2) years, underwent quantitative bimanual assessments in the 31 included studies (mean quality score 22/32 points [SD 4.7]). The tools used were 3D motion analysis (n = 26), accelerometers (n = 2), and other instruments (cube, digitizer, etc.) (n = 3). Children performed 1-5 bimanual tasks in laboratory settings, mostly activities of daily living or game scenarios. Analyses focused mostly on spatiotemporal variables, 6 of which were specifically developed for bilateral measures (task completion time, goal synchronization, movement overlap time, interlimb coupling, continuous relative phase and asynchrony). These instrumented measurements had moderate to good discriminant and convergent validity, but reliability and responsiveness assessments were lacking. CONCLUSIONS A large number of quantitative bimanual assessments involving different tools, bimanual tasks and specific variables developed to evaluate bimanual function were found. Development of other relevant variables and validation of these tools are needed to further determine their usefulness, both as research outcomes and to guide therapies in clinical practice. Future research, involving younger children and real-life assessments, will improve our understanding of bimanual function in children with cerebral palsy.
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Affiliation(s)
- Marine Cacioppo
- Department of Physical Medicine and Rehabilitation, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France. .,Laboratoire de Traitement de L'information Médicale (LaTIM), Inserm U1101, Université de Bretagne-Occidentale, 29200, Brest, France. .,Pediatric Rehabilitation Department, Fondation ILDYS, 29200, Brest, France.
| | - Anthéa Loos
- Pediatric Rehabilitation Department, University Hospital of Rehabilitation (HU2R), Strasbourg, France
| | - Mathieu Lempereur
- Department of Physical Medicine and Rehabilitation, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France.,Laboratoire de Traitement de L'information Médicale (LaTIM), Inserm U1101, Université de Bretagne-Occidentale, 29200, Brest, France
| | - Sylvain Brochard
- Department of Physical Medicine and Rehabilitation, Brest University Hospital, 2 Avenue Foch, 29200, Brest, France.,Laboratoire de Traitement de L'information Médicale (LaTIM), Inserm U1101, Université de Bretagne-Occidentale, 29200, Brest, France.,Pediatric Rehabilitation Department, Fondation ILDYS, 29200, Brest, France
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Yan C, Chen Y, Zhang Y, Kong L, Durgin FH, Li Z. EXPRESS: Perceptual scale expansion: A natural design for improving the precision of motor control. Q J Exp Psychol (Hove) 2022:17470218221115075. [PMID: 35866338 DOI: 10.1177/17470218221115075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Space perception is systematically biased. Few theories of spatial bias address the possible functional advantages of mechanisms that produce spatial biases. The scale expansion hypothesis proposes that many spatial biases are due to the perceptual expansion of visual angles, which acts somewhat like a natural magnifying glass in vision. The present study examined the idea that visual expansion may improve motor precision (i.e., reduce motor variability) in movements when using closed-loop control but not when using open-loop control. Experiment 1 tested this idea in an online tracking task (closed-loop control), whereas Experiment 2 tested it in a fast-hitting task (open-loop control). The results were consistent with the hypothesis. To rule out the effect of the task difference (i.e., tracking vs. fast hitting), Experiment 3 examined the effect of visual expansion on the variability of motor performance in a line-reproduction task. The control type (closed-loop or open-loop) was manipulated by the form of visual feedback (online or offline). The results were again consistent with the present assumption. Taken together, the present data suggest that perceptual expansion in vision improves motor control precision when using closed-loop control (but not when using open-loop control), which supports the scale-expansion hypothesis. In addition, the present findings also improve our understanding of how visual error amplification affects motor control.
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Affiliation(s)
- Chenyu Yan
- Department of Psychology and Behavioral Sciences, Zhejiang University 12377.,These authors contributed equally as first authors
| | - Yilin Chen
- Department of Psychology and Behavioral Sciences, Zhejiang University 12377
| | - Yu Zhang
- Department of Psychology and Behavioral Sciences, Zhejiang University 12377
| | - Linghang Kong
- Department of Psychology and Behavioral Sciences, Zhejiang University 12377
| | | | - Zhi Li
- Department of Psychology and Behavioral Sciences, Zhejiang University 12377
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Goyal C, Vardhan V, Naqvi WM. Haptic Feedback-Based Virtual Reality Intervention for a Child With Infantile Hemiplegia: A Case Report. Cureus 2022; 14:e23489. [PMID: 35495018 PMCID: PMC9038603 DOI: 10.7759/cureus.23489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 01/08/2023] Open
Abstract
Virtual reality (VR) refers to an advanced technology that provides real life-like experience in a virtual environment. Numerous commercially available systems provide gaming opportunities with VR, while a few also provide haptic feedback along with VR. In the recent past, VR has been explored as a viable intervention in the field of neurorehabilitation. Although there are promising results for adults with hemiplegia, the research involving children with infantile hemiplegia is in the nascent stage. Infantile hemiplegia is manifested by sensory and motor deficits predominantly on one side of the body resulting in adverse effects on the functionality of the affected side since early life. VR gaming has an intense, motivational component that encourages children to put sustained voluntary effort to use both upper extremities. A six-year-old male with infantile hemiplegia presented with difficulty in using the left upper extremity. Pre-intervention scores of the nine-hole peg test (9HPT) and box and block test (BBT) were used to evaluate the manual dexterity, while those of ABILHAND-kids and functional independence measure for children (WeeFIM self-care section) assessed the functional independence. The child underwent treatment for six weeks (five days/week), with each session lasting for 60 minutes/day that included VR gaming with haptic feedback for 30 minutes and conventional physiotherapy for 30 minutes. Post-intervention scores were recorded and were compared with pre-intervention scores. Marked improvement in left upper extremity function was noted not only objectively by the outcome measures but also subjectively by the parents as well as by the child. Moreover, the child remarked that he enjoyed the therapy sessions. The findings of this report would facilitate the design of further research in this area in the form of larger trials.
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Goyal C, Vardhan V, Naqvi W. Virtual Reality-Based Intervention for Enhancing Upper Extremity Function in Children With Hemiplegic Cerebral Palsy: A Literature Review. Cureus 2022; 14:e21693. [PMID: 35237486 PMCID: PMC8882342 DOI: 10.7759/cureus.21693] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/25/2022] Open
Abstract
Cerebral palsy (CP) is the most common cause of motor disability in the pediatric population, with hemiplegia as one of the most widely seen subtypes of spastic CP. Although most of the children with hemiplegic CP are independent ambulators, deficits in hand function of the affected side remain a major concern of caregivers and children themselves. Children use the unaffected upper extremity to compensate for the weakness in the affected one, which consequently leads to the disuse of the hemiparetic upper extremity. Interactive virtual environments can enhance the activation of brain areas during training by providing feedback that can catalyze neuroplastic changes for improved function. Although numerous studies have been conducted on the impact of virtual reality (VR)-based rehabilitation in adults with stroke, studies on its use in the pediatric population are scarce. The three broad categories of VR systems based on the type of human-computer interactions are feedback-focused, gesture-based, and haptic-based. Preliminary studies have shown promising results of VR intervention in improving motor function, including upper extremity function, in children with hemiplegic CP. It is an engaging and entertaining intervention that adds an advantage of high compliance due to motivation. The current literature consists of studies with highly heterogeneous groups of participants and small sample sizes. Further investigation on children with a specific type of CP with advanced VR systems technology is warranted.
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Affiliation(s)
- Chanan Goyal
- Pediatric Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.,Pediatric Physiotherapy, Government Physiotherapy College, Raipur, IND
| | - Vishnu Vardhan
- Cardiorespiratory Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Waqar Naqvi
- Community Physiotherapy, N.K.P. Salve Institute of Medical Sciences, Nagpur, IND
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Low-Altitude Aerial Video Surveillance via One-Class SVM Anomaly Detection from Textural Features in UAV Images. INFORMATION 2021. [DOI: 10.3390/info13010002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
In recent years, small-scale Unmanned Aerial Vehicles (UAVs) have been used in many video surveillance applications, such as vehicle tracking, border control, dangerous object detection, and many others. Anomaly detection can represent a prerequisite of many of these applications thanks to its ability to identify areas and/or objects of interest without knowing them a priori. In this paper, a One-Class Support Vector Machine (OC-SVM) anomaly detector based on customized Haralick textural features for aerial video surveillance at low-altitude is presented. The use of a One-Class SVM, which is notoriously a lightweight and fast classifier, enables the implementation of real-time systems even when these are embedded in low-computational small-scale UAVs. At the same time, the use of textural features allows a vision-based system to detect micro and macro structures of an analyzed surface, thus allowing the identification of small and large anomalies, respectively. The latter aspect plays a key role in aerial video surveillance at low-altitude, i.e., 6 to 15 m, where the detection of common items, e.g., cars, is as important as the detection of little and undefined objects, e.g., Improvised Explosive Devices (IEDs). Experiments obtained on the UAV Mosaicking and Change Detection (UMCD) dataset show the effectiveness of the proposed system in terms of accuracy, precision, recall, and F1-score, where the model achieves a 100% precision, i.e., never misses an anomaly, but at the expense of a reasonable trade-off in its recall, which still manages to reach up to a 71.23% score. Moreover, when compared to classical Haralick textural features, the model obtains significantly higher performances, i.e., ≈20% on all metrics, further demonstrating the approach effectiveness.
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