Automatic Diagnosis of Cerebral Palsy Gait Using Computational Intelligence Techniques: A Low-Cost Multi-Sensor Approach

Development and Assessment of Artificial Intelligence-Empowered Gait Monitoring System Using Single Inertial Sensor

Gait instability is critical in medicine and healthcare, as it has associations with balance disorder and physical impairment. With the development of sensor technology, despite the fact that numerous wearable gait detection and recognition systems have been designed to monitor users' gait patterns, they commonly spend a lot of time and effort to extract gait metrics from signal data. This study aims to design an artificial intelligence-empowered and economic-friendly gait monitoring system. A pair of intelligent shoes with a single inertial sensor and a smartphone application were developed as a gait monitoring system to detect users' gait cycle, stand phase time, swing phase time, stride length, and foot clearance. We recruited 30 participants (24.09 ± 1.89 years) to collect gait data and used the Vicon motion capture system to verify the accuracy of the gait metrics. The results show that the gait monitoring system performs better on the assessment of the gait metrics. The accuracy of stride length and foot clearance is 96.17% and 92.07%, respectively. The artificial intelligence-empowered gait monitoring system holds promising potential for improving gait analysis and monitoring in the medical and healthcare fields.

Machine learning applied to gait analysis data in cerebral palsy and stroke: A systematic review

BACKGROUND

Among neurological pathologies, cerebral palsy and stroke are the main contributors to walking disorders. Machine learning methods have been proposed in the recent literature to analyze gait data from these patients. However, machine learning methods still fail to translate effectively into clinical applications. This systematic review addressed the gaps hindering the use of machine learning data analysis in the clinical assessment of cerebral palsy and stroke patients.

RESEARCH QUESTION

What are the main challenges in transferring proposed machine learning methods to clinical applications?

METHODS

PubMed, Web of Science, Scopus, and IEEE databases were searched for relevant publications on machine learning methods applied to gait analysis data from stroke and cerebral palsy patients until February the 23rd, 2023. Information related to the suitability, feasibility, and reliability of the proposed methods for their effective translation to clinical use was extracted, and quality was assessed based on a set of predefined questions.

RESULTS

From 4120 resulting references, 63 met the inclusion criteria. Thirty-one studies used supervised, and 32 used unsupervised machine learning methods. Artificial neural networks and k-means clustering were the most used methods in each category. The lack of rationale for features and algorithm selection, the use of unrepresentative datasets, and the lack of clinical interpretability of the clustering outputs were the main factors hindering the clinical reliability and applicability of these methods.

SIGNIFICANCE

The literature offers numerous machine learning methods for clustering gait data from cerebral palsy and stroke patients. However, the clinical significance of the proposed methods is still lacking, limiting their translation to real-world applications. The design of future studies must take into account clinical question, dataset significance, feature and model selection, and interpretability of the results, given their criticality for clinical translation.

Hybrid Deep Neural Network Framework Combining Skeleton and Gait Features for Pathological Gait Recognition

Human skeleton data obtained using a depth camera have been used for pathological gait recognition to support doctor or physician diagnosis decisions. Most studies for skeleton-based pathological gait recognition have used either raw skeleton sequences directly or gait features, such as gait parameters and joint angles, extracted from raw skeleton sequences. We hypothesize that using skeleton, joint angles, and gait parameters together can improve recognition performance. This study aims to develop a deep neural network model that effectively combines different types of input data. We propose a hybrid deep neural network framework composed of a graph convolutional network, recurrent neural network, and artificial neural network to effectively encode skeleton sequences, joint angle sequences, and gait parameters, respectively. The features extracted from three different input data types are fused and fed into the final classification layer. We evaluate the proposed model on two different skeleton datasets (a simulated pathological gait dataset and a vestibular disorder gait dataset) that were collected using an Azure Kinect. The proposed model, with multiple types of input, improved the pathological gait recognition performance compared to single input models on both datasets. Furthermore, it achieved the best performance among the state-of-the-art models for skeleton-based action recognition.

Evaluation of Muscle Function by Means of a Muscle-Specific and a Global Index

Gait analysis applications in clinics are still uncommon, for three main reasons: (1) the considerable time needed to prepare the subject for the examination; (2) the lack of user-independent tools; (3) the large variability of muscle activation patterns observed in healthy and pathological subjects. Numerical indices quantifying the muscle coordination of a subject could enable clinicians to identify patterns that deviate from those of a reference population and to follow the progress of the subject after surgery or completing a rehabilitation program. In this work, we present two user-independent indices. First, a muscle-specific index (MFI) that quantifies the similarity of the activation pattern of a muscle of a specific subject with that of a reference population. Second, a global index (GFI) that provides a score of the overall activation of a muscle set. These two indices were tested on two groups of healthy and pathological children with encouraging results. Hence, the two indices will allow clinicians to assess the muscle activation, identifying muscles showing an abnormal activation pattern, and associate a functional score to every single muscle as well as to the entire muscle set. These opportunities could contribute to facilitating the diffusion of surface EMG analysis in clinics.