1
|
Belli G, Russo L, Mauro M, Toselli S, Maietta Latessa P. Relation between Photogrammetry and Spinal Mouse for Lumbopelvic Assessment in Adolescents with Thoracic Kyphosis. Healthcare (Basel) 2024; 12:738. [PMID: 38610160 PMCID: PMC11012063 DOI: 10.3390/healthcare12070738] [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: 12/30/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 04/14/2024] Open
Abstract
The evaluation of the lumbopelvic region is a crucial point during postural assessment in childhood and adolescence. Photogrammetry (PG) and Spinal Mouse (SM) are two of the most debated tools to properly analyze postural alignment and avoid misleading data. This study aims to find out the best linear regression model that could relate the analytic measurements of the SM with one or more PG parameters in adolescents with kyphotic postures. Thirty-nine adolescents (female = 35.9%) with structural and non-structural kyphosis were analyzed (13.2 ± 1.8 years; 1.59 ± 0.12 m; 47.6 ± 11.8 kg) using the SM and PG on the sagittal plane in a standing and forward-bending position, allowing for the measurement of body vertical inclination, lumbar and pelvic alignment, trunk flexion, sacral inclination during bending, and hip position during bending. Lordosis lumbar angles (SM) were significantly (r = -0.379, r = -0.328) correlated with the SIPS-SIAS angle (PG) during upright standing, while in the bending position, the highest correlation appeared among the sacral-hip (SM) and the sacral tangent (ST_PG; r = -0.72) angles. The stepwise backward procedure was assessed to estimate the SM variability in the bending and standing positions. Only in the bending position did the linear regression model reach high goodness-of-fit values with two regressors (ST_PG η2=0.504, BMI η2=0.252; adjusted- R2 =0.558, p < 0.001, CCC = 0.972, r = 0.763). Despite gold-standard methods reducing error evaluation, physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction.
Collapse
Affiliation(s)
- Guido Belli
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy; (G.B.); (S.T.); (P.M.L.)
| | - Luca Russo
- Department of Human Sciences, IUL Telematic University, 50122 Florence, Italy;
| | - Mario Mauro
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy; (G.B.); (S.T.); (P.M.L.)
| | - Stefania Toselli
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy; (G.B.); (S.T.); (P.M.L.)
| | - Pasqualino Maietta Latessa
- Department of Sciences for Life Quality Studies, University of Bologna, 47921 Rimini, Italy; (G.B.); (S.T.); (P.M.L.)
| |
Collapse
|
2
|
Dindorf C, Dully J, Konradi J, Wolf C, Becker S, Simon S, Huthwelker J, Werthmann F, Kniepert J, Drees P, Betz U, Fröhlich M. Enhancing biomechanical machine learning with limited data: generating realistic synthetic posture data using generative artificial intelligence. Front Bioeng Biotechnol 2024; 12:1350135. [PMID: 38419724 PMCID: PMC10899878 DOI: 10.3389/fbioe.2024.1350135] [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: 12/05/2023] [Accepted: 01/22/2024] [Indexed: 03/02/2024] Open
Abstract
Objective: Biomechanical Machine Learning (ML) models, particularly deep-learning models, demonstrate the best performance when trained using extensive datasets. However, biomechanical data are frequently limited due to diverse challenges. Effective methods for augmenting data in developing ML models, specifically in the human posture domain, are scarce. Therefore, this study explored the feasibility of leveraging generative artificial intelligence (AI) to produce realistic synthetic posture data by utilizing three-dimensional posture data. Methods: Data were collected from 338 subjects through surface topography. A Variational Autoencoder (VAE) architecture was employed to generate and evaluate synthetic posture data, examining its distinguishability from real data by domain experts, ML classifiers, and Statistical Parametric Mapping (SPM). The benefits of incorporating augmented posture data into the learning process were exemplified by a deep autoencoder (AE) for automated feature representation. Results: Our findings highlight the challenge of differentiating synthetic data from real data for both experts and ML classifiers, underscoring the quality of synthetic data. This observation was also confirmed by SPM. By integrating synthetic data into AE training, the reconstruction error can be reduced compared to using only real data samples. Moreover, this study demonstrates the potential for reduced latent dimensions, while maintaining a reconstruction accuracy comparable to AEs trained exclusively on real data samples. Conclusion: This study emphasizes the prospects of harnessing generative AI to enhance ML tasks in the biomechanics domain.
Collapse
Affiliation(s)
- Carlo Dindorf
- Department of Sports Science, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Jonas Dully
- Department of Sports Science, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Becker
- Department of Sports Science, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Steven Simon
- Department of Sports Science, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| | - Janine Huthwelker
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Frederike Werthmann
- Department of Orthopedics and Trauma Surgery, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Johanna Kniepert
- Department of Orthopedics and Trauma Surgery, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Michael Fröhlich
- Department of Sports Science, University of Kaiserslautern-Landau, Kaiserslautern, Germany
| |
Collapse
|
3
|
Dindorf C, Ludwig O, Simon S, Becker S, Fröhlich M. Machine Learning and Explainable Artificial Intelligence Using Counterfactual Explanations for Evaluating Posture Parameters. Bioengineering (Basel) 2023; 10:bioengineering10050511. [PMID: 37237581 DOI: 10.3390/bioengineering10050511] [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: 03/28/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 05/28/2023] Open
Abstract
Postural deficits such as hyperlordosis (hollow back) or hyperkyphosis (hunchback) are relevant health issues. Diagnoses depend on the experience of the examiner and are, therefore, often subjective and prone to errors. Machine learning (ML) methods in combination with explainable artificial intelligence (XAI) tools have proven useful for providing an objective, data-based orientation. However, only a few works have considered posture parameters, leaving the potential for more human-friendly XAI interpretations still untouched. Therefore, the present work proposes an objective, data-driven ML system for medical decision support that enables especially human-friendly interpretations using counterfactual explanations (CFs). The posture data for 1151 subjects were recorded by means of stereophotogrammetry. An expert-based classification of the subjects regarding the presence of hyperlordosis or hyperkyphosis was initially performed. Using a Gaussian progress classifier, the models were trained and interpreted using CFs. The label errors were flagged and re-evaluated using confident learning. Very good classification performances for both hyperlordosis and hyperkyphosis were found, whereby the re-evaluation and correction of the test labels led to a significant improvement (MPRAUC = 0.97). A statistical evaluation showed that the CFs seemed to be plausible, in general. In the context of personalized medicine, the present study's approach could be of importance for reducing diagnostic errors and thereby improving the individual adaptation of therapeutic measures. Likewise, it could be a basis for the development of apps for preventive posture assessment.
Collapse
Affiliation(s)
- Carlo Dindorf
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Oliver Ludwig
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Steven Simon
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Stephan Becker
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| | - Michael Fröhlich
- Department of Sport Science, Rheinland-Pfälzische Technische Universität Kaiserslautern-Landau (RPTU), 67663 Kaiserslautern, Germany
| |
Collapse
|