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Liu W, Bai J. Meta-analysis of the quantitative assessment of lower extremity motor function in elderly individuals based on objective detection. J Neuroeng Rehabil 2024; 21:111. [PMID: 38926890 PMCID: PMC11202321 DOI: 10.1186/s12984-024-01409-7] [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: 11/09/2023] [Accepted: 06/20/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE To avoid deviation caused by the traditional scale method, the present study explored the accuracy, advantages, and disadvantages of different objective detection methods in evaluating lower extremity motor function in elderly individuals. METHODS Studies on lower extremity motor function assessment in elderly individuals published in the PubMed, Web of Science, Cochrane Library and EMBASE databases in the past five years were searched. The methodological quality of the included trials was assessed using RevMan 5.4.1 and Stata, followed by statistical analyses. RESULTS In total, 19 randomized controlled trials with a total of 2626 participants, were included. The results of the meta-analysis showed that inertial measurement units (IMUs), motion sensors, 3D motion capture systems, and observational gait analysis had statistical significance in evaluating the changes in step velocity and step length of lower extremity movement in elderly individuals (P < 0.00001), which can be used as a standardized basis for the assessment of motor function in elderly individuals. Subgroup analysis showed that there was significant heterogeneity in the assessment of step velocity [SMD=-0.98, 95%CI(-1.23, -0.72), I2 = 91.3%, P < 0.00001] and step length [SMD=-1.40, 95%CI(-1.77, -1.02), I2 = 86.4%, P < 0.00001] in elderly individuals. However, the sensors (I2 = 9%, I2 = 0%) and 3D motion capture systems (I2 = 0%) showed low heterogeneity in terms of step velocity and step length. The sensitivity analysis and publication bias test demonstrated that the results were stable and reliable. CONCLUSION observational gait analysis, motion sensors, 3D motion capture systems, and IMUs, as evaluation means, play a certain role in evaluating the characteristic parameters of step velocity and step length in lower extremity motor function of elderly individuals, which has good accuracy and clinical value in preventing motor injury. However, the high heterogeneity of observational gait analysis and IMUs suggested that different evaluation methods use different calculation formulas and indicators, resulting in the failure to obtain standardized indicators in clinical applications. Thus, multimodal quantitative evaluation should be integrated.
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Affiliation(s)
- Wen Liu
- Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China
- Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, China Rehabilitation Research Centre, Beijing, China
| | - Jinzhu Bai
- Rehabilitation Medicine Center, The Second Affiliated Hospital and Yuying Children's Hospital, Wenzhou Medical University, Wenzhou, China.
- Department of Spine and Spinal Cord Surgery, Beijing Boai Hospital, China Rehabilitation Research Centre, Beijing, China.
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China.
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Hong R, Wu Z, Peng K, Zhang J, He Y, Zhang Z, Gao Y, Jin Y, Su X, Zhi H, Guan Q, Pan L, Jin L. Kinect-based objective assessment of the acute levodopa challenge test in parkinsonism: a feasibility study. Neurol Sci 2024; 45:2661-2670. [PMID: 38183553 DOI: 10.1007/s10072-023-07296-5] [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: 11/11/2023] [Accepted: 12/28/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION The acute levodopa challenge test (ALCT) is an important and valuable examination but there are still some shortcomings with it. We aimed to objectively assess ALCT based on a depth camera and filter out the best indicators. METHODS Fifty-nine individuals with parkinsonism completed ALCT and the improvement rate (IR, which indicates the change in value before and after levodopa administration) of the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) was calculated. The kinematic features of the patients' movements in both the OFF and ON states were collected with an Azure Kinect depth camera. RESULTS The IR of MDS-UPDRS III was significantly correlated with the IRs of many kinematic features for arising from a chair, pronation-supination movements of the hand, finger tapping, toe tapping, leg agility, and gait (rs = - 0.277 ~ - 0.672, P < 0.05). Moderate to high discriminative values were found in the selected features in identifying a clinically significant response to levodopa with sensitivity, specificity, and area under the curve (AUC) in the range of 50-100%, 47.22%-97.22%, and 0.673-0.915, respectively. The resulting classifier combining kinematic features of toe tapping showed an excellent performance with an AUC of 0.966 (95% CI = 0.922-1.000, P < 0.001). The optimal cut-off value was 21.24% with sensitivity and specificity of 94.44% and 87.18%, respectively. CONCLUSION This study demonstrated the feasibility of measuring the effect of levodopa and objectively assessing ALCT based on kinematic data derived from an Azure Kinect-based system.
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Affiliation(s)
- Ronghua Hong
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Zhuang Wu
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Kangwen Peng
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Jingxing Zhang
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Yijing He
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Zhuoyu Zhang
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Yichen Gao
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Yue Jin
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Xiaoyun Su
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Hongping Zhi
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Qiang Guan
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China
| | - Lizhen Pan
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China.
| | - Lingjing Jin
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons' Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, School of Medicine, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University, Shanghai, China.
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, School of Medicine, Neurotoxin Research CenterTongji HospitalTongji University, Shanghai, China.
- Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China.
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Mifsud J, Embry KR, Macaluso R, Lonini L, Cotton RJ, Simuni T, Jayaraman A. Detecting the symptoms of Parkinson's disease with non-standard video. J Neuroeng Rehabil 2024; 21:72. [PMID: 38702705 PMCID: PMC11067123 DOI: 10.1186/s12984-024-01362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 04/20/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Neurodegenerative diseases, such as Parkinson's disease (PD), necessitate frequent clinical visits and monitoring to identify changes in motor symptoms and provide appropriate care. By applying machine learning techniques to video data, automated video analysis has emerged as a promising approach to track and analyze motor symptoms, which could facilitate more timely intervention. However, existing solutions often rely on specialized equipment and recording procedures, which limits their usability in unstructured settings like the home. In this study, we developed a method to detect PD symptoms from unstructured videos of clinical assessments, without the need for specialized equipment or recording procedures. METHODS Twenty-eight individuals with Parkinson's disease completed a video-recorded motor examination that included the finger-to-nose and hand pronation-supination tasks. Clinical staff provided ground truth scores for the level of Parkinsonian symptoms present. For each video, we used a pre-existing model called PIXIE to measure the location of several joints on the person's body and quantify how they were moving. Features derived from the joint angles and trajectories, designed to be robust to recording angle, were then used to train two types of machine-learning classifiers (random forests and support vector machines) to detect the presence of PD symptoms. RESULTS The support vector machine trained on the finger-to-nose task had an F1 score of 0.93 while the random forest trained on the same task yielded an F1 score of 0.85. The support vector machine and random forest trained on the hand pronation-supination task had F1 scores of 0.20 and 0.33, respectively. CONCLUSION These results demonstrate the feasibility of developing video analysis tools to track motor symptoms across variable perspectives. These tools do not work equally well for all tasks, however. This technology has the potential to overcome barriers to access for many individuals with degenerative neurological diseases like PD, providing them with a more convenient and timely method to monitor symptom progression, without requiring a structured video recording procedure. Ultimately, more frequent and objective home assessments of motor function could enable more precise telehealth optimization of interventions to improve clinical outcomes inside and outside of the clinic.
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Affiliation(s)
- Joseph Mifsud
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Kyle R Embry
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
| | - Rebecca Macaluso
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
| | - Luca Lonini
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
| | - R James Cotton
- Northwestern University, Chicago, IL, USA
- Center for Bionic Medicine, Shirley Ryan AbilityLab, Chicago, IL, USA
| | | | - Arun Jayaraman
- Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, IL, USA.
- Northwestern University, Chicago, IL, USA.
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Amo-Salas J, Olivares-Gil A, García-Bustillo Á, García-García D, Arnaiz-González Á, Cubo E. Computer Vision for Parkinson's Disease Evaluation: A Survey on Finger Tapping. Healthcare (Basel) 2024; 12:439. [PMID: 38391815 PMCID: PMC10888014 DOI: 10.3390/healthcare12040439] [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: 12/22/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/24/2024] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder whose prevalence has steadily been rising over the years. Specialist neurologists across the world assess and diagnose patients with PD, although the diagnostic process is time-consuming and various symptoms take years to appear, which means that the diagnosis is prone to human error. The partial automatization of PD assessment and diagnosis through computational processes has therefore been considered for some time. One well-known tool for PD assessment is finger tapping (FT), which can now be assessed through computer vision (CV). Artificial intelligence and related advances over recent decades, more specifically in the area of CV, have made it possible to develop computer systems that can help specialists assess and diagnose PD. The aim of this study is to review some advances related to CV techniques and FT so as to offer insight into future research lines that technological advances are now opening up.
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Affiliation(s)
- Javier Amo-Salas
- Escuela Politécnica Superior, Departamento de Ingeniería Informática, Universidad de Burgos, 09001 Burgos, Spain
| | - Alicia Olivares-Gil
- Escuela Politécnica Superior, Departamento de Ingeniería Informática, Universidad de Burgos, 09001 Burgos, Spain
| | - Álvaro García-Bustillo
- Facultad de Ciencias de la Salud, Departamento de Ciencias de la Salud, Universidad de Burgos, 09001 Burgos, Spain
| | - David García-García
- Escuela Politécnica Superior, Departamento de Ingeniería Informática, Universidad de Burgos, 09001 Burgos, Spain
| | - Álvar Arnaiz-González
- Escuela Politécnica Superior, Departamento de Ingeniería Informática, Universidad de Burgos, 09001 Burgos, Spain
| | - Esther Cubo
- Servicio de Neurología, Hospital Universitario de Burgos, 09006 Burgos, Spain
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Xie L, Hong R, Wu Z, Yue L, Peng K, Li S, Zhang J, Wang X, Jin L, Guan Q. Kinect-based objective assessment for early frailty identification in patients with Parkinson's disease. Aging Clin Exp Res 2023; 35:2507-2516. [PMID: 37639172 DOI: 10.1007/s40520-023-02525-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUND Frailty is common in Parkinson's disease (PD) and increases vulnerability to adverse outcomes. Early detection of this syndrome aids in early intervention. AIMS To objectively identify frailty at an early stage during routine motor tasks in PD patients using a Kinect-based system. METHODS PD patients were recruited and assessed with the Fried criteria to determine their frailty status. Each participant was recorded performing the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) extremity tasks with a Kinect-based system. Statistically significant kinematic parameters were selected to discriminate the pre-frail from the non-frail group. RESULTS Of the fifty-two participants, twenty were non-frail and thirty-two were pre-frail. Decreased frequency in finger tapping (P = 0.005), hand grasping (P = 0.002), toe tapping (P = 0.002), and leg agility (P = 0.019) alongside reduced hand grasping speed (P = 0.030), lifting (P < 0.001) and falling speed (P < 0.001) in leg agility were observed in the pre-frail group. Amplitude in leg agility (P = 0.048) and amplitude decrement rate (P = 0.046) in hand grasping showed marginally significant differences between two groups. Moderate discriminative values were found in frequency and speed of the extremity tasks to identify pre-frailty with sensitivity, specificity, and area under the curve (AUC) in the range of 45.00-85.00%, 68.75-100%, and 0.701-0.836, respectively. The combination of frequency and speed in extremity tasks showed moderate to high discriminatory ability, with AUC of 0.775 (95% CI 0.637-0.913, P < 0.001) for upper limb tasks and 0.909 (95% CI 0.832-0.987, P < 0.001) for lower limb tasks. When combining these features in both upper and lower limb tasks, the AUC increased to 0.942 (95% CI 0.886-0.999, P < 0.001). CONCLUSIONS Our findings demonstrated the promise of utilizing Kinect-based kinematic data from MDS-UPDRS III tasks as early indicators of frailty in PD patients.
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Affiliation(s)
- Ludi Xie
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ronghua Hong
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhuang Wu
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lei Yue
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kangwen Peng
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shuangfang Li
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jingxing Zhang
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xijin Wang
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lingjing Jin
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
- Department of Neurology and Neurological Rehabilitation, Shanghai Yangzhi Rehabilitation Hospital, School of Medicine, Tongji University, Shanghai, China.
- Shanghai Clinical Research Center for Aging and Medicine, Shanghai, China.
| | - Qiang Guan
- Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China.
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Dhanalakshmi S, Maanasaa RS, Maalikaa RS, Senthil R. A review of emergent intelligent systems for the detection of Parkinson's disease. Biomed Eng Lett 2023; 13:591-612. [PMID: 37872986 PMCID: PMC10590348 DOI: 10.1007/s13534-023-00319-2] [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: 05/25/2023] [Revised: 08/11/2023] [Accepted: 09/07/2023] [Indexed: 10/25/2023] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder affecting people worldwide. The PD symptoms are divided into motor and non-motor symptoms. Detection of PD is very crucial and essential. Such challenges can be overcome by applying artificial intelligence to diagnose PD. Many studies have also proposed the implementation of computer-aided diagnosis for the detection of PD. This systematic review comprehensively analyzed all appropriate algorithms for detecting and assessing PD based on the literature from 2012 to 2023 which are conducted as per PRISMA model. This review focused on motor symptoms, namely handwriting dynamics, voice impairments and gait, multimodal features, and brain observation using single photon emission computed tomography, magnetic resonance and electroencephalogram signals. The significant challenges are critically analyzed, and appropriate recommendations are provided. The critical discussion of this review article can be helpful in today's PD community in such a way that it allows clinicians to provide proper treatment and timely medication.
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Affiliation(s)
- Samiappan Dhanalakshmi
- Department of Electronics and Communication Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai, 603203 India
| | - Ramesh Sai Maanasaa
- Department of Electronics and Communication Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai, 603203 India
| | - Ramesh Sai Maalikaa
- Department of Electronics and Communication Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai, 603203 India
| | - Ramalingam Senthil
- Department of Mechanical Engineering, SRM Institute of Science and Technology, Kattankulathur, Chennai, 603203 India
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Kahlon AS, Verma K, Sage A, Lee SCK, Behboodi A. Enhancing Wearable Gait Monitoring Systems: Identifying Optimal Kinematic Inputs in Typical Adolescents. SENSORS (BASEL, SWITZERLAND) 2023; 23:8275. [PMID: 37837105 PMCID: PMC10575151 DOI: 10.3390/s23198275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/15/2023]
Abstract
Machine learning-based gait systems facilitate the real-time control of gait assistive technologies in neurological conditions. Improving such systems needs the identification of kinematic signals from inertial measurement unit wearables (IMUs) that are robust across different walking conditions without extensive data processing. We quantify changes in two kinematic signals, acceleration and angular velocity, from IMUs worn on the frontal plane of bilateral shanks and thighs in 30 adolescents (8-18 years) on a treadmills and outdoor overground walking at three different speeds (self-selected, slow, and fast). Primary curve-based analyses included similarity analyses such as cosine, Euclidean distance, Poincare analysis, and a newly defined bilateral symmetry dissimilarity test (BSDT). Analysis indicated that superior-inferior shank acceleration (SI shank Acc) and medial-lateral shank angular velocity (ML shank AV) demonstrated no differences to the control signal in BSDT, indicating the least variability across the different walking conditions. Both SI shank Acc and ML shank AV were also robust in Poincare analysis. Secondary parameter-based similarity analyses with conventional spatiotemporal gait parameters were also performed. This normative dataset of walking reports raw signal kinematics that demonstrate the least to most variability in switching between treadmill and outdoor walking to help guide future machine learning models to assist gait in pediatric neurological conditions.
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Affiliation(s)
| | - Khushboo Verma
- Pediatric Mobility Lab, Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA; (K.V.); (S.C.K.L.)
| | | | - Samuel C. K. Lee
- Pediatric Mobility Lab, Department of Physical Therapy, University of Delaware, Newark, DE 19716, USA; (K.V.); (S.C.K.L.)
| | - Ahad Behboodi
- Neurorehabilitation and Biomechanics Research Section, Rehabilitation Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD 20892, USA
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Li J, Zhu H, Wang H, Wang B, Cen Z, Yang D, Liu P, Luo W, Pan Y. A Three-Dimensional Finger-Tapping Framework for Recognition of Patients With Mild Parkinson's Disease. IEEE Trans Neural Syst Rehabil Eng 2023; 31:3331-3340. [PMID: 37494164 DOI: 10.1109/tnsre.2023.3296883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
The finger tapping test is a widely-used and important examination in the Movement Disorder Society Clinical Diagnosis for Parkinson's Disease. However, finger tapping motion could be affected by age, medication, and other conditions. As a result, Parkinson's disease patients with mild sign and healthy people could be rated as similar scores on the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale, making it difficult for community doctors to perform diagnosis. We therefore propose a three-dimensional finger tapping framework to recognize mild PD patients. Specifically, we first derive the three-dimensional finger-tapping motion using a self-designed three-dimensional finger-tapping measurement system. We then propose a three-dimensional finger-tapping segmentation algorithm to segment three-dimensional finger tapping motion. We next extract three-dimensional pattern features of motor coordination, imbalance impairment, and entropy. We finally adopted the support vector machine as the classifier to recognize PD patients. We evaluated the proposed framework on 49 PD patients and 29 healthy controls and reached an accuracy of 94.9% for the right hand and 89.4% for the left hand. Moreover, the proposed framework reached an accuracy of 95.0% for the right hand and 97.8% for the left hand on 17 mild PD patients and 28 healthy controls who were both rated as 0 or 1 on the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale. The results demonstrated that the proposed framework was less sensitive to traditional features and performed well in recognizing mild PD patients by involving three-dimensional patter features.
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Ravichandran V, Sadhu S, Convey D, Guerrier S, Chomal S, Dupre AM, Akbar U, Solanki D, Mankodiya K. iTex Gloves: Design and In-Home Evaluation of an E-Textile Glove System for Tele-Assessment of Parkinson's Disease. SENSORS (BASEL, SWITZERLAND) 2023; 23:2877. [PMID: 36991587 PMCID: PMC10054833 DOI: 10.3390/s23062877] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 06/19/2023]
Abstract
Parkinson's disease (PD) is a neurological progressive movement disorder, affecting more than 10 million people globally. PD demands a longitudinal assessment of symptoms to monitor the disease progression and manage the treatments. Existing assessment methods require patients with PD (PwPD) to visit a clinic every 3-6 months to perform movement assessments conducted by trained clinicians. However, periodic visits pose barriers as PwPDs have limited mobility, and healthcare cost increases. Hence, there is a strong demand for using telemedicine technologies for assessing PwPDs in remote settings. In this work, we present an in-home telemedicine kit, named iTex (intelligent Textile), which is a patient-centered design to carry out accessible tele-assessments of movement symptoms in people with PD. iTex is composed of a pair of smart textile gloves connected to a customized embedded tablet. iTex gloves are integrated with flex sensors on the fingers and inertial measurement unit (IMU) and have an onboard microcontroller unit with IoT (Internet of Things) capabilities including data storage and wireless communication. The gloves acquire the sensor data wirelessly to monitor various hand movements such as finger tapping, hand opening and closing, and other movement tasks. The gloves are connected to a customized tablet computer acting as an IoT device, configured to host a wireless access point, and host an MQTT broker and a time-series database server. The tablet also employs a patient-centered interface to guide PwPDs through the movement exam protocol. The system was deployed in four PwPDs who used iTex at home independently for a week. They performed the test independently before and after medication intake. Later, we performed data analysis of the in-home study and created a feature set. The study findings reported that the iTex gloves were capable to collect movement-related data and distinguish between pre-medication and post-medication cases in a majority of the participants. The IoT infrastructure demonstrated robust performance in home settings and offered minimum barriers for the assessment exams and the data communication with a remote server. In the post-study survey, all four participants expressed that the system was easy to use and poses a minimum barrier to performing the test independently. The present findings indicate that the iTex glove system has the potential for periodic and objective assessment of PD motor symptoms in remote settings.
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Affiliation(s)
- Vignesh Ravichandran
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Shehjar Sadhu
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Daniel Convey
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Sebastien Guerrier
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Shubham Chomal
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Anne-Marie Dupre
- Department of Physical Therapy, University of Rhode Island, Kingston, RI 02881, USA
| | - Umer Akbar
- Department of Neurology, Brown University, Rhode Island Hospital, Providence, RI 02903, USA
| | - Dhaval Solanki
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
| | - Kunal Mankodiya
- Department of Electrical, Computer and Biomedical Engineering, University of Rhode Island, Kingston, RI 02881, USA
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Zhu C, Hu B, Chen J, Ai X, Agrawal SK. SARN: Shifted Attention Regression Network for 3D Hand Pose Estimation. Bioengineering (Basel) 2023; 10:bioengineering10020126. [PMID: 36829620 PMCID: PMC9952393 DOI: 10.3390/bioengineering10020126] [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: 12/13/2022] [Revised: 01/08/2023] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Hand pose estimation (HPE) plays an important role during the functional assessment of the hand and in potential rehabilitation. It is a challenge to predict the pose of the hand conveniently and accurately during functional tasks, and this limits the application of HPE. In this paper, we propose a novel architecture of a shifted attention regression network (SARN) to perform HPE. Given a depth image, SARN first predicts the spatial relationships between points in the depth image and a group of hand keypoints that determine the pose of the hand. Then, SARN uses these spatial relationships to infer the 3D position of each hand keypoint. To verify the effectiveness of the proposed method, we conducted experiments on three open-source datasets of 3D hand poses: NYU, ICVL, and MSRA. The proposed method achieved state-of-the-art performance with 7.32 mm, 5.91 mm, and 7.17 mm of mean error at the hand keypoints, i.e., mean Euclidean distance between the predicted and ground-truth hand keypoint positions. Additionally, to test the feasibility of SARN in hand movement recognition, a hand movement dataset of 26K depth images from 17 healthy subjects was constructed based on the finger tapping test, an important component of neurological exams administered to Parkinson's patients. Each image was annotated with the tips of the index finger and the thumb. For this dataset, the proposed method achieved a mean error of 2.99 mm at the hand keypoints and comparable performance on three task-specific metrics: the distance, velocity, and acceleration of the relative movement of the two fingertips. Results on the open-source datasets demonstrated the effectiveness of the proposed method, and results on our finger tapping dataset validated its potential for applications in functional task characterization.
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Affiliation(s)
- Chenfei Zhu
- Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA
| | - Boce Hu
- Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA
| | - Jiawei Chen
- Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA
| | - Xupeng Ai
- Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA
| | - Sunil K. Agrawal
- Department of Mechanical Engineering, Columbia University, New York, NY 10027, USA
- Department of Rehabilitation Medicine, Columbia University, New York, NY 10027, USA
- Correspondence:
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Wu Z, Gu H, Hong R, Xing Z, Zhang Z, Peng K, He Y, Xie L, Zhang J, Gao Y, Jin Y, Su X, Zhi H, Guan Q, Pan L, Jin L. Kinect-based objective evaluation of bradykinesia in patients with Parkinson's disease. Digit Health 2023; 9:20552076231176653. [PMID: 37223774 PMCID: PMC10201004 DOI: 10.1177/20552076231176653] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 05/02/2023] [Indexed: 05/25/2023] Open
Abstract
Objective To quantify bradykinesia in Parkinson's disease (PD) with a Kinect depth camera-based motion analysis system and to compare PD and healthy control (HC) subjects. Methods Fifty PD patients and twenty-five HCs were recruited. The Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III) was used to evaluate the motor symptoms of PD. Kinematic features of five bradykinesia-related motor tasks were collected using Kinect depth camera. Then, kinematic features were correlated with the clinical scales and compared between groups. Results Significant correlations were found between kinematic features and clinical scales (P < 0.05). Compared with HCs, PD patients exhibited a significant decrease in the frequency of finger tapping (P < 0.001), hand movement (P < 0.001), hand pronation-supination movements (P = 0.005), and leg agility (P = 0.003). Meanwhile, PD patients had a significant decrease in the speed of hand movements (P = 0.003) and toe tapping (P < 0.001) compared with HCs. Several kinematic features exhibited potential diagnostic value in distinguishing PD from HCs with area under the curve (AUC) ranging from 0.684-0.894 (P < 0.05). Furthermore, the combination of motor tasks exhibited the best diagnostic value with the highest AUC of 0.955 (95% CI = 0.913-0.997, P < 0.001). Conclusion The Kinect-based motion analysis system can be applied to evaluate bradykinesia in PD. Kinematic features can be used to differentiate PD patients from HCs and combining kinematic features from different motor tasks can significantly improve the diagnostic value.
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Affiliation(s)
- Zhuang Wu
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Hongkai Gu
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ronghua Hong
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ziwen Xing
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhuoyu Zhang
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Kangwen Peng
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yijing He
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ludi Xie
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jingxing Zhang
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yichen Gao
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Yue Jin
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Xiaoyun Su
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Hongping Zhi
- IFLYTEK Suzhou Research Institute, Suzhou, China
| | - Qiang Guan
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lizhen Pan
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Lingjing Jin
- Department of Neurology and Neurological Rehabilitation, Shanghai Disabled Persons’ Federation Key Laboratory of Intelligent Rehabilitation Assistive Devices and Technologies, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China
- Neurotoxin Research Center, Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration of Ministry of Education, Department of Neurology, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Collaborative Innovation Center for Brain Science, Tongji University, Shanghai, China
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Hong R, Zhang T, Zhang Z, Wu Z, Lin A, Su X, Jin Y, Gao Y, Peng K, Li L, Pan L, Zhi H, Guan Q, Jin L. A summary index derived from Kinect to evaluate postural abnormalities severity in Parkinson’s Disease patients. NPJ Parkinsons Dis 2022; 8:96. [PMID: 35918362 PMCID: PMC9345864 DOI: 10.1038/s41531-022-00368-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 07/20/2022] [Indexed: 11/09/2022] Open
Abstract
AbstractPostural abnormalities are common disabling motor complications affecting patients with Parkinson’s disease (PD). We proposed a summary index for postural abnormalities (IPA) based on Kinect depth camera and explored the clinical value of this indicator. Seventy individuals with PD and thirty age-matched healthy controls (HCs) were enrolled. All participants were tested using a Kinect-based system with IPA automatically obtained by algorithms. Significant correlations were detected between IPA and the Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) total score (rs = 0.369, p = 0.002), MDS-UPDRS-III total score (rs = 0.431, p < 0.001), MDS-UPDRS-III 3.13 score (rs = 0.573, p < 0.001), MDS-UPDRS-III-bradykinesia score (rs = 0.311, p = 0.010), the 39-item Parkinson’s Disease Questionnaire (PDQ-39) (rs = 0.272, p = 0.0027) and the Berg Balance Scale (BBS) score (rs = −0.350, p = 0.006). The optimal cut-off value of IPA for distinguishing PD from HCs was 12.96 with a sensitivity of 97.14%, specificity of 100.00%, area under the curve (AUC) of 0.999 (0.997–1.002, p < 0.001), and adjusted AUC of 0.998 (0.993–1.000, p < 0.001). The optimal cut-off value of IPA for distinguishing between PD with and without postural abnormalities was 20.14 with a sensitivity, specificity, AUC and adjusted AUC of 77.78%, 73.53%, 0.817 (0.720–0.914, p < 0.001), and 0.783 (0.631–0.900, p < 0.001), respectively. IPA was significantly correlated to the clinical manifestations of PD patients, and could reflect the global severity of postural abnormalities in PD with important value in distinguishing PD from HCs and distinguishing PD with postural abnormalities from those without.
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Rana A, Dumka A, Singh R, Panda MK, Priyadarshi N. A Computerized Analysis with Machine Learning Techniques for the Diagnosis of Parkinson's Disease: Past Studies and Future Perspectives. Diagnostics (Basel) 2022; 12:2708. [PMID: 36359550 PMCID: PMC9689408 DOI: 10.3390/diagnostics12112708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 08/03/2023] Open
Abstract
According to the World Health Organization (WHO), Parkinson's disease (PD) is a neurodegenerative disease of the brain that causes motor symptoms including slower movement, rigidity, tremor, and imbalance in addition to other problems like Alzheimer's disease (AD), psychiatric problems, insomnia, anxiety, and sensory abnormalities. Techniques including artificial intelligence (AI), machine learning (ML), and deep learning (DL) have been established for the classification of PD and normal controls (NC) with similar therapeutic appearances in order to address these problems and improve the diagnostic procedure for PD. In this article, we examine a literature survey of research articles published up to September 2022 in order to present an in-depth analysis of the use of datasets, various modalities, experimental setups, and architectures that have been applied in the diagnosis of subjective disease. This analysis includes a total of 217 research publications with a list of the various datasets, methodologies, and features. These findings suggest that ML/DL methods and novel biomarkers hold promising results for application in medical decision-making, leading to a more methodical and thorough detection of PD. Finally, we highlight the challenges and provide appropriate recommendations on selecting approaches that might be used for subgrouping and connection analysis with structural magnetic resonance imaging (sMRI), DaTSCAN, and single-photon emission computerized tomography (SPECT) data for future Parkinson's research.
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Affiliation(s)
- Arti Rana
- Computer Science & Engineering, Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun 248007, Uttarakhand, India
| | - Ankur Dumka
- Department of Computer Science and Engineering, Women Institute of Technology, Dehradun 248007, Uttarakhand, India
- Department of Computer Science & Engineering, Graphic Era Deemed to be University, Dehradun 248001, Uttarakhand, India
| | - Rajesh Singh
- Division of Research and Innovation, Uttaranchal Institute of Technology, Uttaranchal University, Dehradun 248007, Uttarakhand, India
- Department of Project Management, Universidad Internacional Iberoamericana, Campeche 24560, Mexico
| | - Manoj Kumar Panda
- Department of Electrical Engineering, G.B. Pant Institute of Engineering and Technology, Pauri 246194, Uttarakhand, India
| | - Neeraj Priyadarshi
- Department of Electrical Engineering, JIS College of Engineering, Kolkata 741235, West Bengal, India
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Ferreira MIASN, Barbieri FA, Moreno VC, Penedo T, Tavares JMRS. Machine learning models for Parkinson's disease detection and stage classification based on spatial-temporal gait parameters. Gait Posture 2022; 98:49-55. [PMID: 36049418 DOI: 10.1016/j.gaitpost.2022.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 08/16/2022] [Accepted: 08/18/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Parkinson's disease (PD) is a chronic and progressive neurodegenerative disease with no cure, presenting a challenging diagnosis and management. However, despite a significant number of criteria and guidelines have been proposed to improve the diagnosis of PD and to determine the PD stage, the gold standard for diagnosis and symptoms monitoring of PD is still mainly based on clinical evaluation, which includes several subjective factors. The use of machine learning (ML) algorithms in spatial-temporal gait parameters is an interesting advance with easy interpretation and objective factors that may assist in PD diagnostic and follow up. RESEARCH QUESTION This article studies ML algorithms for: i) distinguish people with PD vs. matched-healthy individuals; and ii) to discriminate PD stages, based on selected spatial-temporal parameters, including variability and asymmetry. METHODS Gait data acquired from 63 people with PD with different levels of PD motor symptoms severity, and 63 matched-control group individuals, during self-selected walking speed, was study in the experiments. RESULTS In the PD diagnosis, a classification accuracy of 84.6 %, with a precision of 0.923 and a recall of 0.800, was achieved by the Naïve Bayes algorithm. We found four significant gait features in PD diagnosis: step length, velocity and width, and step width variability. As to the PD stage identification, the Random Forest outperformed the other studied ML algorithms, by reaching an Area Under the ROC curve of 0.786. We found two relevant gait features in identifying the PD stage: stride width variability and step double support time variability. SIGNIFICANCE The results showed that the studied ML algorithms have potential both to PD diagnosis and stage identification by analysing gait parameters.
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Affiliation(s)
| | | | - Vinícius Christianini Moreno
- São Paulo State University (Unesp), Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil
| | - Tiago Penedo
- São Paulo State University (Unesp), Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, Brazil
| | - João Manuel R S Tavares
- Faculdade de Engenharia, Universidade do Porto, Portugal; Instituto de Ciência e Inovação em Engenharia Mecânica e Engenharia Industrial, Departamento de Engenharia Mecânica, Faculdade de Engenharia, Universidade do Porto, Portugal
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Navarro-López V, Fernández-Vázquez D, Molina-Rueda F, Cuesta-Gómez A, García-Prados P, Del-Valle-Gratacós M, Carratalá-Tejada M. Arm-swing kinematics in Parkinson's disease: A systematic review and meta-analysis. Gait Posture 2022; 98:85-95. [PMID: 36088898 DOI: 10.1016/j.gaitpost.2022.08.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/10/2022] [Accepted: 08/22/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Parkinson's disease (PD) causes postural instability and gait abnormalities that may be associated with an arm swing reduction. OBJECTIVE To conduct systematic review and meta-analysis to determine the kinematic patterns of arm-swing during gait in people with PD METHODS: A computer literature search of the PubMed, EMBASE, WOS, PEDro, SCOPUS and SciELO databases was conducted. Terms related to PD and arm-swing were combined to find studies that performed a free walking evaluation of the arm-swing of PD patients on or off medication compared to healthy controls. After a standardized evaluation by three examiners, fifteen articles met inclusion criteria. Random effects meta-analysis models were utilized to quantify (1) the arm-swing range of motion (RoM); (2) the arm-swing amplitude; (3) the arm-swing velocity; and (4) the arm-swing asymmetry. RESULTS On average, arm-swing RoM (7.07°), amplitude (0.8 cm), and velocity (0.31 m/s) were significantly decreased in PD compared to healthy controls. Healthy subjects had significantly more symmetrical arm-swing (8.16%) than people with PD. Effect sizes were moderate-large. CONCLUSIONS People with PD have significant differences in RoM, amplitude, velocity, and asymmetry of arm-swing during gait compared to the healthy control group. Medication phase does not significantly influence arm-swing characteristics. Further studies will be needed to determine whether different disease characteristics influence the biomechanics of arm-swing during gait.
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Affiliation(s)
- Víctor Navarro-López
- International Doctoral School, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Diego Fernández-Vázquez
- International Doctoral School, Faculty of Health Sciences, Rey Juan Carlos University, 28922 Madrid, Spain; Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Francisco Molina-Rueda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Alicia Cuesta-Gómez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
| | - Pablo García-Prados
- EOS Health group S.L. Physiotherapy Center. Pozuelo de Alarcón, Madrid, Spain
| | | | - María Carratalá-Tejada
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, Madrid, Spain
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Xu Z, Shen B, Tang Y, Wu J, Wang J. Deep Clinical Phenotyping of Parkinson's Disease: Towards a New Era of Research and Clinical Care. PHENOMICS (CHAM, SWITZERLAND) 2022; 2:349-361. [PMID: 36939759 PMCID: PMC9590510 DOI: 10.1007/s43657-022-00051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
Despite recent advances in technology, clinical phenotyping of Parkinson's disease (PD) has remained relatively limited as current assessments are mainly based on empirical observation and subjective categorical judgment at the clinic. A lack of comprehensive, objective, and quantifiable clinical phenotyping data has hindered our capacity to diagnose, assess patients' conditions, discover pathogenesis, identify preclinical stages and clinical subtypes, and evaluate new therapies. Therefore, deep clinical phenotyping of PD patients is a necessary step towards understanding PD pathology and improving clinical care. In this review, we present a growing community consensus and perspective on how to clinically phenotype this disease, that is, to phenotype the entire course of disease progression by integrating capacity, performance, and perception approaches with state-of-the-art technology. We also explore the most studied aspects of PD deep clinical phenotypes, namely, bradykinesia, tremor, dyskinesia and motor fluctuation, gait impairment, speech impairment, and non-motor phenotypes.
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Affiliation(s)
- Zhiheng Xu
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Bo Shen
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Yilin Tang
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Jianjun Wu
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, 200040 China
| | - Jian Wang
- Department of Neurology and National Research Center for Aging and Medicine & National Center for Neurological Disorders, State Key Laboratory of Medical Neurobiology, Huashan Hospital, Fudan University, Shanghai, 200040 China
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B SB, Y BJ. Vision-based gait analysis for real-time Parkinson disease identification and diagnosis system. Health Syst (Basingstoke) 2022. [DOI: 10.1080/20476965.2022.2125838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Sathya Bama B
- Computer Science and Engineering, Sathyabama Institute of Science and Technology, Chennai, India
| | - Bevish Jinila Y
- Sathyabama Institute of Science and Technology, Chennai, India
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Kinect-Based Assessment of Lower Limbs during Gait in Post-Stroke Hemiplegic Patients: A Narrative Review. SENSORS 2022; 22:s22134910. [PMID: 35808426 PMCID: PMC9269781 DOI: 10.3390/s22134910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 06/27/2022] [Indexed: 12/25/2022]
Abstract
The aim of this review was to present an overview of the state of the art in the use of the Microsoft Kinect camera to assess gait in post-stroke individuals through an analysis of the available literature. In recent years, several studies have explored the potentiality, accuracy, and effectiveness of this 3D optical sensor as an easy-to-use and non-invasive clinical measurement tool for the assessment of gait parameters in several pathologies. Focusing on stroke individuals, some of the available studies aimed to directly assess and characterize their gait patterns. In contrast, other studies focused on the validation of Kinect-based measurements with respect to a gold-standard reference (i.e., optoelectronic systems). However, the nonhomogeneous characteristics of the participants, of the measures, of the methodologies, and of the purposes of the studies make it difficult to adequately compare the results. This leads to uncertainties about the strengths and weaknesses of this technology in this pathological state. The final purpose of this narrative review was to describe and summarize the main features of the available works on gait in the post-stroke population, highlighting similarities and differences in the methodological approach and primary findings, thus facilitating comparisons of the studies as much as possible.
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Muñoz-Ospina B, Alvarez-Garcia D, Clavijo-Moran HJC, Valderrama-Chaparro JA, García-Peña M, Herrán CA, Urcuqui CC, Navarro-Cadavid A, Orozco J. Machine Learning Classifiers to Evaluate Data From Gait Analysis With Depth Cameras in Patients With Parkinson’s Disease. Front Hum Neurosci 2022; 16:826376. [PMID: 35664343 PMCID: PMC9160309 DOI: 10.3389/fnhum.2022.826376] [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] [Received: 11/30/2021] [Accepted: 04/13/2022] [Indexed: 12/19/2022] Open
Abstract
IntroductionThe assessments of the motor symptoms in Parkinson’s disease (PD) are usually limited to clinical rating scales (MDS UPDRS III), and it depends on the clinician’s experience. This study aims to propose a machine learning technique algorithm using the variables from upper and lower limbs, to classify people with PD from healthy people, using data from a portable low-cost device (RGB-D camera). And can be used to support the diagnosis and follow-up of patients in developing countries and remote areas.MethodsWe used Kinect®eMotion system to capture the spatiotemporal gait data from 30 patients with PD and 30 healthy age-matched controls in three walking trials. First, a correlation matrix was made using the variables of upper and lower limbs. After this, we applied a backward feature selection model using R and Python to determine the most relevant variables. Three further analyses were done using variables selected from backward feature selection model (Dataset A), movement disorders specialist (Dataset B), and all the variables from the dataset (Dataset C). We ran seven machine learning models for each model. Dataset was divided 80% for algorithm training and 20% for evaluation. Finally, a causal inference model (CIM) using the DoWhy library was performed on Dataset B due to its accuracy and simplicity.ResultsThe Random Forest model is the most accurate for all three variable Datasets (Dataset A: 81.8%; Dataset B: 83.6%; Dataset C: 84.5%) followed by the support vector machine. The CIM shows a relation between leg variables and the arms swing asymmetry (ASA) and a proportional relationship between ASA and the diagnosis of PD with a robust estimator (1,537).ConclusionsMachine learning techniques based on objective measures using portable low-cost devices (Kinect®eMotion) are useful and accurate to classify patients with Parkinson’s disease. This method can be used to evaluate patients remotely and help clinicians make decisions regarding follow-up and treatment.
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Affiliation(s)
- Beatriz Muñoz-Ospina
- Fundación Valle del Lili, Departamento de Neurología, Cali, Colombia
- *Correspondence: Beatriz Muñoz-Ospina
| | - Daniela Alvarez-Garcia
- Fundación Valle del Lili, Departamento de Neurocirugía, Cali, Colombia
- Universidad Icesi, Lab i2t/CENIT, Cali, Colombia
| | | | | | | | | | | | | | - Jorge Orozco
- Fundación Valle del Lili, Departamento de Neurología, Cali, Colombia
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Guo Z, Zeng W, Yu T, Xu Y, Xiao Y, Cao X, Cao Z. Vision-based Finger Tapping Test in Patients with Parkinson's Disease via Spatial-temporal 3D Hand Pose Estimation. IEEE J Biomed Health Inform 2022; 26:3848-3859. [PMID: 35349459 DOI: 10.1109/jbhi.2022.3162386] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Finger tapping test is crucial for diagnosing Parkinson's Disease (PD), but manual visual evaluations can result in score discrepancy due to clinicians' subjectivity. Moreover, applying wearable sensors requires making physical contact and may hinder PD patient's raw movement patterns. Accordingly, a novel computer-vision approach is proposed using depth camera and spatial-temporal 3D hand pose estimation to capture and evaluate PD patients' 3D hand movement. Within this approach, a temporal encoding module is leveraged to extend A2J's deep learning framework to counter the pose jittering problem, and a pose refinement process is utilized to alleviate dependency on massive data. Additionally, the first vision-based 3D PD hand dataset of 112 hand samples from 48 PD patients and 11 control subjects is constructed, fully annotated by qualified physicians under clinical settings. Testing on this real-world data, this new model achieves 81.2% classification accuracy, even surpassing that of individual clinicians in comparison, fully demonstrating this proposition's effectiveness. The demo video can be ac-cessed at https://github.com/ZhilinGuo/ST-A2J.
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Salari N, Kazeminia M, Sagha H, Daneshkhah A, Ahmadi A, Mohammadi M. The performance of various machine learning methods for Parkinson’s disease recognition: a systematic review. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02949-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Giannakopoulou KM, Roussaki I, Demestichas K. Internet of Things Technologies and Machine Learning Methods for Parkinson's Disease Diagnosis, Monitoring and Management: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:1799. [PMID: 35270944 PMCID: PMC8915040 DOI: 10.3390/s22051799] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 12/15/2022]
Abstract
Parkinson's disease is a chronic neurodegenerative disease that affects a large portion of the population, especially the elderly. It manifests with motor, cognitive and other types of symptoms, decreasing significantly the patients' quality of life. The recent advances in the Internet of Things and Artificial Intelligence fields, including the subdomains of machine learning and deep learning, can support Parkinson's disease patients, their caregivers and clinicians at every stage of the disease, maximizing the treatment effectiveness and minimizing the respective healthcare costs at the same time. In this review, the considered studies propose machine learning models, trained on data acquired via smart devices, wearable or non-wearable sensors and other Internet of Things technologies, to provide predictions or estimations regarding Parkinson's disease aspects. Seven hundred and seventy studies have been retrieved from three dominant academic literature databases. Finally, one hundred and twelve of them have been selected in a systematic way and have been considered in the state-of-the-art systematic review presented in this paper. These studies propose various methods, applied on various sensory data to address different Parkinson's disease-related problems. The most widely deployed sensors, the most commonly addressed problems and the best performing algorithms are highlighted. Finally, some challenges are summarized along with some future considerations and opportunities that arise.
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Affiliation(s)
- Konstantina-Maria Giannakopoulou
- School of Electrical and Computer Engineering, National Technical University of Athens, 15773 Athens, Greece; (K.-M.G.); (K.D.)
- Institute of Communication and Computer Systems, 10682 Athens, Greece
| | - Ioanna Roussaki
- School of Electrical and Computer Engineering, National Technical University of Athens, 15773 Athens, Greece; (K.-M.G.); (K.D.)
- Institute of Communication and Computer Systems, 10682 Athens, Greece
| | - Konstantinos Demestichas
- School of Electrical and Computer Engineering, National Technical University of Athens, 15773 Athens, Greece; (K.-M.G.); (K.D.)
- Institute of Communication and Computer Systems, 10682 Athens, Greece
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O’Day J, Lee M, Seagers K, Hoffman S, Jih-Schiff A, Kidziński Ł, Delp S, Bronte-Stewart H. Assessing inertial measurement unit locations for freezing of gait detection and patient preference. J Neuroeng Rehabil 2022; 19:20. [PMID: 35152881 PMCID: PMC8842967 DOI: 10.1186/s12984-022-00992-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 01/13/2022] [Indexed: 12/28/2022] Open
Abstract
Background Freezing of gait, a common symptom of Parkinson’s disease, presents as sporadic episodes in which an individual’s feet suddenly feel stuck to the ground. Inertial measurement units (IMUs) promise to enable at-home monitoring and personalization of therapy, but there is a lack of consensus on the number and location of IMUs for detecting freezing of gait. The purpose of this study was to assess IMU sets in the context of both freezing of gait detection performance and patient preference. Methods Sixteen people with Parkinson’s disease were surveyed about sensor preferences. Raw IMU data from seven people with Parkinson’s disease, wearing up to eleven sensors, were used to train convolutional neural networks to detect freezing of gait. Models trained with data from different sensor sets were assessed for technical performance; a best technical set and minimal IMU set were identified. Clinical utility was assessed by comparing model- and human-rater-determined percent time freezing and number of freezing events. Results The best technical set consisted of three IMUs (lumbar and both ankles, AUROC = 0.83), all of which were rated highly wearable. The minimal IMU set consisted of a single ankle IMU (AUROC = 0.80). Correlations between these models and human raters were good to excellent for percent time freezing (ICC = 0.93, 0.89) and number of freezing events (ICC = 0.95, 0.86) for the best technical set and minimal IMU set, respectively. Conclusions Several IMU sets consisting of three IMUs or fewer were highly rated for both technical performance and wearability, and more IMUs did not necessarily perform better in FOG detection. We openly share our data and software to further the development and adoption of a general, open-source model that uses raw signals and a standard sensor set for at-home monitoring of freezing of gait. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-00992-x.
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Tang YM, Wang YH, Feng XY, Zou QS, Wang Q, Ding J, Shi RCJ, Wang X. Diagnostic value of a vision-based intelligent gait analyzer in screening for gait abnormalities. Gait Posture 2022; 91:205-211. [PMID: 34740057 DOI: 10.1016/j.gaitpost.2021.10.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 10/17/2021] [Accepted: 10/18/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Early detection of gait abnormalities is critical for preventing severe injuries in future falls. The timed up and go (TUG) test is a commonly used clinical gait screening test; however, the interpretation of its results is limited to the TUG total time. RESEARCH QUESTION What is diagnostic accuracy of the low-cost, markerless, automated gait analyzer, with the aid of vision-based artificial intelligence technology, which extract gait spatiotemporal features and screen for abnormal walking patterns through video recordings of the TUG test? METHODS Our dataset contained retrospective data from outpatients from the Department of Neurology or Rehabilitation of two tertiary hospitals in Shanghai. A panel of three expert neurologists specialized in movement disorders reviewed the gait performance in each TUG video, and labeled them separately, with the most commonly assigned label being used as the reference standard. The gait analyzer performed the AlphaPose algorithm to track the human joint position and calculated the spatiotemporal parameters by filtering and double-threshold signal detection. Gait spatiotemporal features and expert labels were input into machine learning models, and the accuracy of each model was tested with leave-one-out cross-validation (LOOCV). RESULTS A total of 284 participants were recruited. Among these, 100 were labeled as having abnormal gait performance by experts. The Naive Bayes classifier achieved the best performance with a full-data accuracy of 90.14% and a LOOCV accuracy of 89.08% for screening abnormal gait performance. SIGNIFICANCE This study is the first to investigate the accuracy of a vision-based intelligent gait analyzer for screening abnormal clinical gait performance. By virtue of a pose estimation algorithm and machine learning models, our intelligent gait analyzer can detect abnormal walking patterns approximate to judgements made by experienced neurologists, which is expected to be a supplementary gait assessment protocol for basic-level doctors in the future.
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Affiliation(s)
- Yan-Min Tang
- Department of Neurology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China.
| | - Yan-Hong Wang
- Institute of Brain-inspired Circuits and Systems, Fudan University, 825 Zhangheng Road, Shanghai 201203, China.
| | - Xin-Yu Feng
- Institute of Brain-inspired Circuits and Systems, Fudan University, 825 Zhangheng Road, Shanghai 201203, China.
| | - Qiao-Sha Zou
- Institute of Brain-inspired Circuits and Systems, Fudan University, 825 Zhangheng Road, Shanghai 201203, China.
| | - Qing Wang
- Institute of Brain-inspired Circuits and Systems, Fudan University, 825 Zhangheng Road, Shanghai 201203, China.
| | - Jing Ding
- Department of Neurology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China; Institute of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China.
| | - Richard Chuan-Jin Shi
- Institute of Brain-inspired Circuits and Systems, Fudan University, 825 Zhangheng Road, Shanghai 201203, China; Department of Electrical and Computer Engineering, University of Washington, Seattle, WA 98195-3770, USA.
| | - Xin Wang
- Department of Neurology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai 200032, China; Institute of Neuroscience, Chinese Academy of Sciences Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, 320 Yueyang Road, Shanghai 200031, China.
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Zhang Z, Hong R, Lin A, Su X, Jin Y, Gao Y, Peng K, Li Y, Zhang T, Zhi H, Guan Q, Jin L. Automated and accurate assessment for postural abnormalities in patients with Parkinson's disease based on Kinect and machine learning. J Neuroeng Rehabil 2021; 18:169. [PMID: 34863184 PMCID: PMC8643004 DOI: 10.1186/s12984-021-00959-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 11/11/2021] [Indexed: 11/10/2022] Open
Abstract
Background Automated and accurate assessment for postural abnormalities is necessary to monitor the clinical progress of Parkinson’s disease (PD). The combination of depth camera and machine learning makes this purpose possible. Methods Kinect was used to collect the postural images from 70 PD patients. The collected images were processed to extract three-dimensional body joints, which were then converted to two-dimensional body joints to obtain eight quantified coronal and sagittal features (F1-F8) of the trunk. The decision tree classifier was carried out over a data set established by the collected features and the corresponding doctors’ MDS-UPDRS-III 3.13 (the 13th item of the third part of Movement Disorder Society-Sponsored Revision of the Unified Parkinson’s Disease Rating Scale) scores. An objective function was implanted to further improve the human–machine consistency. Results The automated grading of postural abnormalities for PD patients was realized with only six selected features. The intraclass correlation coefficient (ICC) between the machine’s and doctors’ score was 0.940 (95%CI, 0.905–0.962), meaning the machine was highly consistent with the doctors’ judgement. Besides, the decision tree classifier performed outstandingly, reaching 90.0% of accuracy, 95.7% of specificity and 89.1% of sensitivity in rating postural severity. Conclusions We developed an intelligent evaluation system to provide accurate and automated assessment of trunk postural abnormalities in PD patients. This study demonstrates the practicability of our proposed method in the clinical scenario to help making the medical decision about PD.
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Affiliation(s)
- Zhuoyu Zhang
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ronghua Hong
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Ao Lin
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoyun Su
- IFLYTEK Suzhou Research Institute, E4, Artificial Intelligence Industrial Park, Suzhou Industrial Park, Suzhou, China
| | - Yue Jin
- IFLYTEK Suzhou Research Institute, E4, Artificial Intelligence Industrial Park, Suzhou Industrial Park, Suzhou, China
| | - Yichen Gao
- IFLYTEK Suzhou Research Institute, E4, Artificial Intelligence Industrial Park, Suzhou Industrial Park, Suzhou, China
| | - Kangwen Peng
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yudi Li
- IFLYTEK Suzhou Research Institute, E4, Artificial Intelligence Industrial Park, Suzhou Industrial Park, Suzhou, China
| | - Tianyu Zhang
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hongping Zhi
- IFLYTEK Suzhou Research Institute, E4, Artificial Intelligence Industrial Park, Suzhou Industrial Park, Suzhou, China
| | - Qiang Guan
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
| | - LingJing Jin
- Neurological Department of Tongji Hospital, Tongji University School of Medicine, Shanghai, China. .,Department of Neurorehabilitation, Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Shanghai, China.
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van Kersbergen J, Otte K, de Vries NM, Bloem BR, Röhling HM, Mansow-Model S, van der Kolk NM, Overeem S, Zinger S, van Gilst MM. Camera-based objective measures of Parkinson's disease gait features. BMC Res Notes 2021; 14:329. [PMID: 34446098 PMCID: PMC8393451 DOI: 10.1186/s13104-021-05744-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 08/16/2021] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE Parkinson's disease is a common, age-related, neurodegenerative disease, affecting gait and other motor functions. Technological developments in consumer imaging are starting to provide high-quality, affordable tools for home-based diagnosis and monitoring. This pilot study aims to investigate whether a consumer depth camera can capture changes in gait features of Parkinson's patients. The dataset consisted of 19 patients (tested in both a practically defined OFF phase and ON phase) and 8 controls, who performed the "Timed-Up-and-Go" test multiple times while being recorded with the Microsoft Kinect V2 sensor. Camera-derived features were step length, average walking speed and mediolateral sway. Motor signs were assessed clinically using the Movement Disorder Society Unified Parkinson's Disease Rating Scale. RESULTS We found significant group differences between patients and controls for step length and average walking speed, showing the ability to detect Parkinson's features. However, there were no differences between the ON and OFF medication state, so further developments are needed to allow for detection of small intra-individual changes in symptom severity.
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Affiliation(s)
| | - Karen Otte
- Motognosis GmbH, Schönhauser Allee 177, 10119, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | - Nienke M de Vries
- Department of Neurology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Bastiaan R Bloem
- Department of Neurology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Hanna M Röhling
- Motognosis GmbH, Schönhauser Allee 177, 10119, Berlin, Germany.,Experimental and Clinical Research Center, Charité - Universitätsmedizin Berlin Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health and Max Delbrück Center for Molecular Medicine, Berlin, Germany
| | | | - Nicolien M van der Kolk
- Department of Neurology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, The Netherlands
| | - Sebastiaan Overeem
- Eindhoven University of Technology, 5612 AJ, Eindhoven, The Netherlands.,Sleep Medicine Center Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, The Netherlands
| | - Svitlana Zinger
- Eindhoven University of Technology, 5612 AJ, Eindhoven, The Netherlands
| | - Merel M van Gilst
- Eindhoven University of Technology, 5612 AJ, Eindhoven, The Netherlands. .,Sleep Medicine Center Kempenhaeghe, Sterkselseweg 65, 5591 VE, Heeze, The Netherlands.
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Bortone I, Moretti L, Bizzoca D, Caringella N, Delmedico M, Piazzolla A, Moretti B. The importance of biomechanical assessment after Return to Play in athletes with ACL-Reconstruction. Gait Posture 2021; 88:240-246. [PMID: 34126566 DOI: 10.1016/j.gaitpost.2021.06.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/14/2021] [Accepted: 06/06/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Barriers to successful return to previous level of activity following Anterior Cruciate Ligament Reconstruction (ACLR) are multifactorial and recent research suggests that athletic performance deficits persist after completion of the rehabilitation course in a large percentage of patients. RESEARCH QUESTION Do technology-based biomechanical assessments reveal underneath differences in both recreational and competitive athletes in Return to Play after ACL-Reconstruction? METHODS Thirty soccer athletes (26.9 ± 5.7 years old, male) with ACL injury were surgically treated with all-inside technique and semitendinosus tendon autograft. Before 2 years from surgery, they were called back for clinical examination, self-reported psychological scores, and biomechanical outcomes (balance, strength, agility and velocity, and symmetry). Athletes were classified into recreational (n = 15) and competitive (n = 15) according to the self-reported Return to Play Level based on the TALS post-injury. Nonparametric statistical tests have been adopted for group comparisons in terms of age, concomitant presence of meniscus tear, injury on dominant leg, presence of knee laxity, presence of varus/valgus, body sides, and return to different levels of sports. RESULTS Competitive athletes showed better in terms of strength (45.3 ± 5.4 W kg-1 vs 39.3 ± 3.4 W kg-1, P ≤ 0.01) associated with good self-reported outcomes (TLKS, CRSQ) and low fear of reinjury (TSK). However, all the athletes had a functional deficit in at least one subtest, and a safe return to sports could not have been recommended. Our findings confirmed that demographics, physical function, and psychological factors were related to playing the preinjury level sport at mean 2 years after surgery, supporting the notion that returning to sport after surgery is multifactorial. SIGNIFICANCE A strict qualitative and quantitative assessment of athletes' status should be performed at different follow-ups after surgery to guarantee a safe and controlled RTP.
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Affiliation(s)
- Ilaria Bortone
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
| | - Lorenzo Moretti
- Orthopaedic & Trauma Unit, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Davide Bizzoca
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy.
| | - Nuccio Caringella
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Michelangelo Delmedico
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Andrea Piazzolla
- Orthopaedic & Trauma Unit, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
| | - Biagio Moretti
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, School of Medicine, University of Bari "Aldo Moro", AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy; Orthopaedic & Trauma Unit, AOU Consorziale Policlinico, Piazza Giulio Cesare 11, 70124 Bari, Italy
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Mei J, Desrosiers C, Frasnelli J. Machine Learning for the Diagnosis of Parkinson's Disease: A Review of Literature. Front Aging Neurosci 2021; 13:633752. [PMID: 34025389 PMCID: PMC8134676 DOI: 10.3389/fnagi.2021.633752] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/22/2021] [Indexed: 12/26/2022] Open
Abstract
Diagnosis of Parkinson's disease (PD) is commonly based on medical observations and assessment of clinical signs, including the characterization of a variety of motor symptoms. However, traditional diagnostic approaches may suffer from subjectivity as they rely on the evaluation of movements that are sometimes subtle to human eyes and therefore difficult to classify, leading to possible misclassification. In the meantime, early non-motor symptoms of PD may be mild and can be caused by many other conditions. Therefore, these symptoms are often overlooked, making diagnosis of PD at an early stage challenging. To address these difficulties and to refine the diagnosis and assessment procedures of PD, machine learning methods have been implemented for the classification of PD and healthy controls or patients with similar clinical presentations (e.g., movement disorders or other Parkinsonian syndromes). To provide a comprehensive overview of data modalities and machine learning methods that have been used in the diagnosis and differential diagnosis of PD, in this study, we conducted a literature review of studies published until February 14, 2020, using the PubMed and IEEE Xplore databases. A total of 209 studies were included, extracted for relevant information and presented in this review, with an investigation of their aims, sources of data, types of data, machine learning methods and associated outcomes. These studies demonstrate a high potential for adaptation of machine learning methods and novel biomarkers in clinical decision making, leading to increasingly systematic, informed diagnosis of PD.
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Affiliation(s)
- Jie Mei
- Chemosensory Neuroanatomy Lab, Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, QC, Canada
| | - Christian Desrosiers
- Laboratoire d'Imagerie, de Vision et d'Intelligence Artificielle (LIVIA), Department of Software and IT Engineering, École de Technologie Supérieure, Montreal, QC, Canada
| | - Johannes Frasnelli
- Chemosensory Neuroanatomy Lab, Department of Anatomy, Université du Québec à Trois-Rivières (UQTR), Trois-Rivières, QC, Canada
- Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal (CIUSSS du Nord-de-l'Île-de-Montréal), Montreal, QC, Canada
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Detection of Postural Control in Young and Elderly Adults Using Deep and Machine Learning Methods with Joint-Node Plots. SENSORS 2021; 21:s21093212. [PMID: 34063144 PMCID: PMC8124823 DOI: 10.3390/s21093212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/25/2021] [Accepted: 04/30/2021] [Indexed: 12/22/2022]
Abstract
Postural control decreases with aging. Thus, an efficient and accurate method of detecting postural control is needed. We enrolled 35 elderly adults (aged 82.06 ± 8.74 years) and 20 healthy young adults (aged 21.60 ± 0.60 years) who performed standing tasks for 40 s, performed six times. The coordinates of 15 joint nodes were captured using a Kinect device (30 Hz). We plotted joint positions into a single 2D figure (named a joint–node plot, JNP) once per second for up to 40 s. A total of 15 methods combining deep and machine learning for postural control classification were investigated. The accuracy, sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV), and kappa values of the selected methods were assessed. The highest PPV, NPV, accuracy, sensitivity, specificity, and kappa values were higher than 0.9 in validation testing. The presented method using JNPs demonstrated strong performance in detecting the postural control ability of young and elderly adults.
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Varrecchia T, Castiglia SF, Ranavolo A, Conte C, Tatarelli A, Coppola G, Di Lorenzo C, Draicchio F, Pierelli F, Serrao M. An artificial neural network approach to detect presence and severity of Parkinson's disease via gait parameters. PLoS One 2021; 16:e0244396. [PMID: 33606730 PMCID: PMC7894951 DOI: 10.1371/journal.pone.0244396] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/08/2020] [Indexed: 01/16/2023] Open
Abstract
Introduction Gait deficits are debilitating in people with Parkinson’s disease (PwPD), which inevitably deteriorate over time. Gait analysis is a valuable method to assess disease-specific gait patterns and their relationship with the clinical features and progression of the disease. Objectives Our study aimed to i) develop an automated diagnostic algorithm based on machine-learning techniques (artificial neural networks [ANNs]) to classify the gait deficits of PwPD according to disease progression in the Hoehn and Yahr (H-Y) staging system, and ii) identify a minimum set of gait classifiers. Methods We evaluated 76 PwPD (H-Y stage 1–4) and 67 healthy controls (HCs) by computerized gait analysis. We computed the time-distance parameters and the ranges of angular motion (RoMs) of the hip, knee, ankle, trunk, and pelvis. Principal component analysis was used to define a subset of features including all gait variables. An ANN approach was used to identify gait deficits according to the H-Y stage. Results We identified a combination of a small number of features that distinguished PwPDs from HCs (one combination of two features: knee and trunk rotation RoMs) and identified the gait patterns between different H-Y stages (two combinations of four features: walking speed and hip, knee, and ankle RoMs; walking speed and hip, knee, and trunk rotation RoMs). Conclusion The ANN approach enabled automated diagnosis of gait deficits in several symptomatic stages of Parkinson’s disease. These results will inspire future studies to test the utility of gait classifiers for the evaluation of treatments that could modify disease progression.
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Affiliation(s)
- Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone Rome, Rome, Italy
- * E-mail:
| | - Stefano Filippo Castiglia
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone Rome, Rome, Italy
| | | | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone Rome, Rome, Italy
- Department of Human Neurosciences, University of Rome Sapienza, Rome, Italy
| | - Gianluca Coppola
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Monte Porzio Catone Rome, Rome, Italy
| | - Francesco Pierelli
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
| | - Mariano Serrao
- Department of Medico-Surgical Sciences and Biotechnologies, University of Rome Sapienza, Latina, Italy
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Park DJ, Lee JW, Lee MJ, Ahn SJ, Kim J, Kim GL, Ra YJ, Cho YN, Jeong WB. Evaluation for Parkinsonian Bradykinesia by deep learning modeling of kinematic parameters. J Neural Transm (Vienna) 2021; 128:181-189. [PMID: 33507401 DOI: 10.1007/s00702-021-02301-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 01/05/2021] [Indexed: 01/20/2023]
Abstract
A wearable sensor system is available for monitoring of bradykinesia in patients with Parkinson's disease (PD), however, it remains unclear whether kinematic parameters would reflect clinical severity of PD, or would help clinical diagnosis of physicians. The present study investigated whether the classification model using kinematic parameters from the wearable sensor may show accordance with clinical rating and diagnosis in PD patients. Using the Inertial Measurement Units (IMU) sensor, we measured the movement of finger tapping (FT), hand movements (HM), and rapid alternating movements (RA) in 25 PD patients and 21 healthy controls. Through the analysis of the measured signal, 11 objective features were derived. In addition, a clinician who specializes in movement disorders viewed the test video and evaluated each of the Unified Parkinson's Disease Rating Scale (UPDRS) scores. In all items of FT, HM, RA, the correlation between the linear regression score obtained through objective features (angle, period, coefficient variances for angle and period, change rates of angle and period, angular velocity, total angle, frequency, magnitude, and frequency × magnitude) and the clinician's UPDRS score was analyzed, and there was a significant correlation (rho > 0.7, p < 0.001). PD patients and controls were classified by deep learning using objective features. As a result, it showed a high performance with an area under the curve (AUC) about as high as 0.9 (FT Total = 0.950, HM Total = 0.889, RA Total = 0.888, ALL Total = 0.926. This showed similar performance to the classification result of binary logistic regression and neurologist, and significantly higher than that of family medicine specialists. Our results suggest that the deep learning model using objective features from the IMU sensor can be usefully used to identify and evaluate bradykinesia, especially for general physicians not specializing in neurology.
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Affiliation(s)
- Dong Jun Park
- School of Mechanical Engineering, Pusan National University, Busan, Republic of Korea
| | - Jun Woo Lee
- Division of Energy and Electric Engineering, Uiduk University, Gyeongju, Republic of Korea
| | - Myung Jun Lee
- Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-gu, Busan, 49241, Republic of Korea.
| | - Se Jin Ahn
- Division of Energy and Electric Engineering, Uiduk University, Gyeongju, Republic of Korea
| | - Jiyoung Kim
- Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Gudeok-ro 179, Seo-gu, Busan, 49241, Republic of Korea
| | - Gyu Lee Kim
- Department of Family Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Young Jin Ra
- Department of Family Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Yu Na Cho
- Department of Neurology, Haeundae Bumin Hospital, Busan, Republic of Korea
| | - Weui Bong Jeong
- School of Mechanical Engineering, Pusan National University, Busan, Republic of Korea
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