Identifying Free-Living Physical Activities Using Lab-Based Models with Wearable Accelerometers

Preliminary Validity and Acceptability of Motion Tape for Measuring Low Back Movement: Mixed Methods Study

BACKGROUND

Low back pain (LBP) is a significant public health problem that can result in physical disability and financial burden for the individual and society. Physical therapy is effective for managing LBP and includes evaluation of posture and movement, interventions directed at modifying posture and movement, and prescription of exercises. However, physical therapists have limited tools for objective evaluation of low back posture and movement and monitoring of exercises, and this evaluation is limited to the time frame of a clinical encounter. There is a need for a valid tool that can be used to evaluate low back posture and movement and monitor exercises outside the clinic. To address this need, a fabric-based, wearable sensor, Motion Tape (MT), was developed and adapted for a low back use case. MT is a low-profile, disposable, self-adhesive, skin-strain sensor developed by spray coating piezoresistive graphene nanocomposites directly onto commercial kinesiology tape.

OBJECTIVE

The objectives of this study were to (1) validate MT for measuring low back posture and movement and (2) assess the acceptability of MT for users.

METHODS

A total of 10 participants without LBP were tested. A 3D optical motion capture system was used as a reference standard to measure low back kinematics. Retroreflective markers and a matrix of MTs were placed on the low back to measure kinematics (motion capture) and strain (MT) simultaneously during low back movements in the sagittal, frontal, and axial planes. Cross-correlation coefficients were calculated to evaluate the concurrent validity of MT strain in reference motion capture kinematics during each movement. The acceptability of MT was assessed using semistructured interviews conducted with each participant after laboratory testing. Interview data were analyzed using rapid qualitative analysis to identify themes and subthemes of user acceptability.

RESULTS

Visual inspection of concurrent MT strain and kinematics of the low back indicated that MT can distinguish between different movement directions. Cross-correlation coefficients between MT strain and motion capture kinematics ranged from -0.915 to 0.983, and the strength of the correlations varied across MT placements and low back movement directions. Regarding user acceptability, participants expressed enthusiasm toward MT and believed that it would be helpful for remote interventions for LBP but provided suggestions for improvement.

CONCLUSIONS

MT was able to distinguish between different low back movements, and most MTs demonstrated moderate to high correlation with motion capture kinematics. This preliminary laboratory validation of MT provides a basis for future device improvements, which will also involve testing in a free-living environment. Overall, users found MT acceptable for use in physical therapy for managing LBP.

Body activity grading strategy for cervical rehabilitation training

A body activity grading strategy is proposed for computer-assisted cervical rehabilitation training, which employs hidden Markov model to partition an exercise into independently assessable phases and a scoring reference to rate respective kinematic features. Samples of 34 cervical rehabilitation exercises are evaluated by both manual and the proposed approaches, where the average phase segmentation difference is 93 ms, the phase scoring difference is 0.045, and the grading difference for overall samples is 5.5% between the approaches. It indicates that the proposed method has similar accuracy as physical therapists and is thus capable of performing online supervision for cervical rehabilitation training.

Employing body-fixed sensors and machine learning to predict physical activity in military personnel

INTRODUCTION

This was a feasibility pilot study aiming to develop and validate an activity recognition system based on a custom-made body-fixed sensor and driven by an algorithm for recognising basic kinetic movements in military personnel. The findings of this study are deemed essential in informing our development process and contributing to our ultimate aim which is to develop a low-cost and easy-to-use body-fixed sensor for military applications.

METHODS

Fifty military participants performed a series of trials involving walking, running and jumping under laboratory conditions in order to determine the optimal, among five machine learning (ML), classifiers. Thereafter, the accuracy of the classifier was tested towards the prediction of these movements (15 183 measurements) and in relation to participants' gender and fitness level.

RESULTS

Random forest classifier showed the highest training and validation accuracy (98.5% and 92.9%, respectively) and classified participants with differences in type of activity, gender and fitness level with an accuracy level of 83.6%, 70.0% and 62.2%, respectively.

CONCLUSIONS

The study showed that accurate prediction of various dynamic activities can be achieved with high sensitivity using a low-cost easy-to-use sensor and a specific ML model. While this technique is in a development stage, our findings demonstrate that our body-fixed sensor prototype alongside a fully trained validated algorithm can strategically support military operations and offer valuable information to commanders controlling operations remotely. Further stages of our developments include the validation of our refined technique on a larger range of military activities and groups by combining activity data with physiological variables to predict phenomena relating to the onset of fatigue and performance decline.

Gait Phase Detection in Walking and Stairs Using Machine Learning

Activity and gait phase recognition algorithms are used in powered motion assistive devices to inform control of motorized components. The objective of this study was to develop a machine learning-based algorithm using inertial measurement data from the thigh and shank to simultaneously detect activity and gait phase (stance, swing) in real-world walking, stair ascent, and stair descent, with the intent of such an algorithm to be used in the control of a motion assistive device local to the knee. Using data from 80 participants, two decision tree and ten long short-term memory (LSTM) models that each used different feature sets and input data were tested and evaluated using a novel performance metric: proportion of perfectly classified strides (PPCS). Separate models were developed to classify i) both activity and gait phase simultaneously (one model predicting six states), and ii) activity-specific models (three individual binary classifiers predicting stance/swing phases). The superior activity-specific model had an accuracy of 98.0% and PPCS of 55.7%. The superior six-phase model used filtered inertial measurement data as its features and a median filter on its predictions and had an accuracy of 92.1% and PPCS of 22.9%. Pooling stance and swing phases from all activities and treating this model as a binary classifier, this model had an accuracy of 97.1%, which may be acceptable for real-world lower limb exoskeleton control if only stance and swing gait phases must be detected.

Towards Human Stress and Activity Recognition: A Review and a First Approach Based on Low-Cost Wearables

Detecting stress when performing physical activities is an interesting field that has received relatively little research interest to date. In this paper, we took a first step towards redressing this, through a comprehensive review and the design of a low-cost body area network (BAN) made of a set of wearables that allow physiological signals and human movements to be captured simultaneously. We used four different wearables: OpenBCI and three other open-hardware custom-made designs that communicate via bluetooth low energy (BLE) to an external computer—following the edge-computingconcept—hosting applications for data synchronization and storage. We obtained a large number of physiological signals (electroencephalography (EEG), electrocardiography (ECG), breathing rate (BR), electrodermal activity (EDA), and skin temperature (ST)) with which we analyzed internal states in general, but with a focus on stress. The findings show the reliability and feasibility of the proposed body area network (BAN) according to battery lifetime (greater than 15 h), packet loss rate (0% for our custom-made designs), and signal quality (signal-noise ratio (SNR) of 9.8 dB for the ECG circuit, and 61.6 dB for the EDA). Moreover, we conducted a preliminary experiment to gauge the main ECG features for stress detection during rest.

Assessment of Physical Activity in Adults using Wrist Accelerometers

The health benefits of physical activity have been widely recognized, yet traditional measures of physical activity including questionnaires and category-based assessments of volume and intensity provide only broad estimates of daily activities. Accelerometers have advanced epidemiologic research on physical activity by providing objective and continuous measurement of physical activity in free-living conditions. Wrist-worn accelerometers have become especially popular due to low participant burden. However, the validity and reliability of wrist-worn devices for adults have yet to be summarized. Moreover, accelerometer data provide rich information on how physical activity is accumulated throughout the day, but only a small portion of these rich data have been utilized by researchers. Lastly, new methodological developments that aim to overcome some of the limitations of accelerometers are emerging. The purpose of this review is to provide an overview of accelerometry research, with a special focus on wrist-worn accelerometers. We describe briefly how accelerometers work, summarize the validity and reliability of wrist-worn accelerometers, discuss the benefits of accelerometers including measuring light-intensity physical activity, and discuss pattern metrics of daily physical activity recently introduced in the literature. A summary of large-scale cohort studies and randomized trials that implemented wrist-worn accelerometry is provided. We conclude the review by discussing new developments and future directions of research using accelerometers, with a focus on wrist-worn accelerometers.

Site-specific Concurrent Validity of the ActiGraph GT9X Link in the Estimation of Activity-related Skeletal Loading

PURPOSE

The aims of this project were twofold: 1) to assess the concurrent validity of raw accelerometer outputs with ground reaction forces (GRF) and loading rates (LR) calculated from force plate across a range of simulated habitual PA and 2) to identify the optimal wear site among the ankle, hip, and wrist with the strongest relationships between accelerometer and force plate and/or skeletal outcomes.

METHODS

Thirty healthy young adults (23.0 ± 4.5 yr, 50% female) wore a triaxial accelerometer at the right ankle, hip, and wrist while performing eight trials of walking, jogging, running, low box drops, and high box drops over an in-ground force plate. Repeated-measures correlations and linear mixed models were used to assess concurrent validity of accelerometer and force plate outcomes across wear sites.

RESULTS

Strong repeated-measures associations were observed between peak hip resultant acceleration and resultant LR (rrm 1169 = 0.74, P < 0.001, 95% confidence interval = 0.718, 0.769) and peak hip resultant accelerations and resultant GRF (rrm 1169 = 0.69, P < 0.001, 95% confidence interval = 0.660, 0.720) when data were combined across activities. By contrast, small to moderate associations were seen between ankle-based outcomes and corresponding GRF and LR during walking and jogging (rrm 209 = 0.17-0.34, all P < 0.001). No significant associations were seen with wrist-based outcomes during any activity. In addition, linear mixed models suggested that 24%-50% of the variability in peak GRF and LR could be attributed to measured accelerations at the hip.

CONCLUSION

Peak accelerations measured at the hip were identified as the strongest proxies for skeletal loading assessed via force plate.

Reliability and validity of the physical activity monitor for assessing energy expenditures in sedentary, regularly exercising, non-endurance athlete, and endurance athlete adults

Background

Inertial sensors, such as accelerometers, serve as convenient devices to predict the energy expenditures (EEs) during physical activities by a predictive equation. Although the accuracy of estimate EEs especially matter to athletes receive physical training, most EE predictive equations adopted in accelerometers are based on the general population, not athletes. This study included the heart rate reserve (HRR) as a compensatory parameter for physical intensity and derived new equations customized for sedentary, regularly exercising, non-endurance athlete, and endurance athlete adults.

Methods

With indirect calorimetry as the criterion measure (CM), the EEs of participants on a treadmill were measured, and vector magnitudes (VM), as well as HRR, were simultaneously recorded by a waist-worn accelerometer with a heart rate monitor. Participants comprised a sedentary group (SG), an exercise-habit group (EHG), a non-endurance group (NEG), and an endurance group (EG), with 30 adults in each group.

Results

EE predictive equations were revised using linear regression with cross-validation on VM, HRR, and body mass (BM). The modified model demonstrates valid and reliable predictions across four populations (Pearson correlation coefficient, r: 0.922 to 0.932; intraclass correlation coefficient, ICC: 0.919 to 0.930).

Conclusion

Using accelerometers with a heart rate monitorcan accurately predict EEs of athletes and non-athletes with an optimized predictive equation integrating the VM, HRR, and BM parameters.

An Experimental Test Proposal to Study Human Behaviour in Fires Using Virtual Environments

Human behavior in an emergency situation is the starting point for all evacuation planning projects. A better understanding of the decisions made by the occupants during an emergency can help to develop calculation tools that can create more efficient forms of visual and audio communication and implement better procedures for evacuating people. The difficulty in studying human behavior lies in the very nature of emergencies, as they are unpredictable, somewhat exceptional and not reproducible. Fire drills play a role in training emergency teams and building occupants, but they cannot be used to collect real data on people’s behavior unless the drill is so realistic that it could endanger the occupants’ safety. In the procedure described here, through the use of a Virtual Reality device that encompasses all critical phases, including user characterization data before the virtual experience, building design parameters and fire scenario, key variables of human behavior can be recorded in order to evaluate each user’s experience satisfactorily. This research shows that the average delay in starting an evacuation is greater than one minute, that anxiety levels and heart rates increase during a fire and that people do not pay attention to evacuation signals. Further analysis of the quantitative data may also provide the causes for decision-making. The use of devices that create realistic virtual environments is a solution for conducting “what if” tests to study and record the decisions taken by the users who undergo the experience in a way that is completely safe for them.

Motion Assessment for Accelerometric and Heart Rate Cycling Data Analysis

Motion analysis is an important topic in the monitoring of physical activities and recognition of neurological disorders. The present paper is devoted to motion assessment using accelerometers inside mobile phones located at selected body positions and the records of changes in the heart rate during cycling, under different body loads. Acquired data include 1293 signal segments recorded by the mobile phone and the Garmin device for uphill and downhill cycling. The proposed method is based upon digital processing of the heart rate and the mean power in different frequency bands of accelerometric data. The classification of the resulting features was performed by the support vector machine, Bayesian methods, k-nearest neighbor method, and neural networks. The proposed criterion is then used to find the best positions for the sensors with the highest discrimination abilities. The results suggest the sensors be positioned on the spine for the classification of uphill and downhill cycling, yielding an accuracy of 96.5% and a cross-validation error of 0.04 evaluated by a two-layer neural network system for features based on the mean power in the frequency bands 〈 3 , 8 〉 and 〈 8 , 15 〉 Hz. This paper shows the possibility of increasing this accuracy to 98.3% by the use of more features and the influence of appropriate sensor positioning for motion monitoring and classification.

Automated Home Oxygen Delivery for Patients with COPD and Respiratory Failure: A New Approach

Long-term oxygen therapy (LTOT) has become standard care for the treatment of patients with chronic obstructive pulmonary disease (COPD) and other severe hypoxemic lung diseases. The use of new portable O₂ concentrators (POC) in LTOT is being expanded. However, the issue of oxygen titration is not always properly addressed, since POCs rely on proper use by patients. The robustness of algorithms and the limited reliability of current oximetry sensors are hindering the effectiveness of new approaches to closed-loop POCs based on the feedback of blood oxygen saturation. In this study, a novel intelligent portable oxygen concentrator (iPOC) is described. The presented iPOC is capable of adjusting the O₂ flow automatically by real-time classifying the intensity of a patient’s physical activity (PA). It was designed with a group of patients with COPD and stable chronic respiratory failure. The technical pilot test showed a weighted accuracy of 91.1% in updating the O₂ flow automatically according to medical prescriptions, and a general improvement in oxygenation compared to conventional POCs. In addition, the usability achieved was high, which indicated a significant degree of user satisfaction. This iPOC may have important benefits, including improved oxygenation, increased compliance with therapy recommendations, and the promotion of PA.

Motion Symmetry Evaluation Using Accelerometers and Energy Distribution

Analysis of motion symmetry constitutes an important area with many applications in engineering, robotics, neurology and biomedicine. This paper presents the use of microelectromechanical sensors (MEMS), including accelerometers and gyrometers, to acquire data via mobile devices so as to monitor physical activities and their irregularities. Special attention is devoted to the analysis of the symmetry of the motion of the body when the same exercises are performed by the right and the left limb. The analyzed data include the motion of the legs on a home exercise bike under different levels of load. The method is based on signal analysis using the discrete wavelet transform and the evaluation of signal segment features such as the relative energy at selected decomposition levels. The subsequent classification of the evaluated features is performed by k-nearest neighbours, a Bayesian approach, a support vector machine, and neural networks. The highest average classification accuracy attained is 91.0% and the lowest mean cross-validation error is 0.091, resulting from the use of a neural network. This paper presents the advantages of the use of simple sensors, their combination and intelligent data processing for the numerical evaluation of motion features in the rehabilitation and monitoring of physical activities.

Software and Hardware Requirements and Trade-Offs in Operating Systems for Wearables: A Tool to Improve Devices' Performance

Wearable device requirements currently vary from soft to hard real-time constraints. Frequently, hardware improvements are a way to speed-up the global performance of a solution. However, changing some parts or the whole hardware may increase device complexity, raising the costs and leading to development delays of products or research prototypes. This paper focuses on software improvements, presenting a tool designed to create different versions of operating systems (OSs) fitting the specifications of wearable devices projects. Authors have developed a software tool allowing the end-user to craft a new OS in just a few steps. In order to validate the generated OS, an original wearable prototype for mining environments is outlined. Resulting data presented here allows for measuring the actual impact an OS has in different variables of a solution. Finally, the analysis also allows for evaluating the performance impact associated with each hardware part. Results suggest the viability of using the proposed solution when searching for performance improvements on wearables.