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      Auto detection and segmentation of daily living activities during a Timed Up and Go task in people with Parkinson’s disease using multiple inertial sensors

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          Abstract

          Background

          Wearable sensors have the potential to provide clinicians with access to motor performance of people with movement disorder as they undergo intervention. However, sensor data often have to be manually classified and segmented before they can be processed into clinical metrics. This process can be time consuming. We recently proposed detection and segmentation algorithms based on peak detection using Inertial Measurement Units (IMUs) to automatically identify and isolate common activities during daily living such as standing up, walking, turning, and sitting down. These algorithms were developed using a homogenous population of healthy older adults. The aim of this study was to investigate the transferability of these algorithms in people with Parkinson’s disease (PD).

          Methods

          A modified Timed Up And Go task was used since it is comprised of these activities, all performed in a continuous fashion. Twelve older adults diagnosed with early PD (Hoehn & Yahr ≤ 2) were recruited for the study and performed three trials of a 10 and 5-m TUG during OFF state. They were outfitted with 17 IMUs covering each body segment. Raw data from IMUs were detrended, normalized and filtered to reveal kinematics peaks that corresponded to different activities. Segmentation was accomplished by identifying the first minimum or maximum to the right and the left of these peaks. Segmentation times were compared to results from two examiners who visually segmented the activities. Specificity and sensitivity were used to evaluate the accuracy of the detection algorithms.

          Results

          Using the same IMUs and algorithms developed in the previous study, we were able to detect these activities with 97.6% sensitivity and 92.7% specificity ( n = 432) in PD population. However, with modifications to the IMUs selection, we were able to detect these activities with 100% accuracy. Similarly, applying the same segmentation to PD population, we were able to isolate these activities within ~500  ms of the visual segmentation. Re-optimizing the filtering frequencies, we were able to reduce this difference to ~400  ms.

          Conclusions

          This study demonstrates the agility and transferability of using a system of IMUs to accurately detect and segment activities in daily living in people with movement disorders.

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          Most cited references36

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          A threshold selection method from gray-level histograms

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            Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly.

            A new method of evaluating the characteristics of postural transition (PT) and their correlation with falling risk in elderly people is described. The time of sit-to-stand and stand-to-sit transitions and their duration were measured using a miniature gyroscope attached to the chest and a portable recorder placed on the waist. Based on a simple model and the discrete wavelet transform, three parameters related to the PT were measured, namely, the average and standard deviation of transition duration and the occurrence of abnormal successive transitions (number of attempts to have a successful transition). The comparison between two groups of elderly subjects (with high and low fall-risk) showed that the computed parameters were significantly correlated with the falling risk as determined by the record of falls during the previous year, balance and gait disorders (Tinetti score), visual disorders, and cognitive and depressive disorders (p < 0.01). In this study, the wavelet transform has provided a powerful technique for enhancing the pattern of PT, which was mainly concentrated into the frequency range of 0.04-0.68 Hz. The system is especially adapted for long-term ambulatory monitoring of elderly people.
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              Continuous Monitoring of Turning in Patients with Movement Disability

              Difficulty with turning is a major contributor to mobility disability and falls in people with movement disorders, such as Parkinson's disease (PD). Turning often results in freezing and/or falling in patients with PD. However, asking a patient to execute a turn in the clinic often does not reveal their impairments. Continuous monitoring of turning with wearable sensors during spontaneous daily activities may help clinicians and patients determine who is at risk of falls and could benefit from preventative interventions. In this study, we show that continuous monitoring of natural turning with wearable sensors during daily activities inside and outside the home is feasible for people with PD and elderly people. We developed an algorithm to detect and characterize turns during gait, using wearable inertial sensors. First, we validate the turning algorithm in the laboratory against a Motion Analysis system and against a video analysis of 21 PD patients and 19 control (CT) subjects wearing an inertial sensor on the pelvis. Compared to Motion Analysis and video, the algorithm maintained a sensitivity of 0.90 and 0.76 and a specificity of 0.75 and 0.65, respectively. Second, we apply the turning algorithm to data collected in the home from 12 PD and 18 CT subjects. The algorithm successfully detects turn characteristics, and the results show that, compared to controls, PD subjects tend to take shorter turns with smaller turn angles and more steps. Furthermore, PD subjects show more variability in all turn metrics throughout the day and the week.
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                Author and article information

                Contributors
                hpnguyen@utexas.edu
                Karina.Lebel@usherbrooke.ca
                Patrick.Boissy@usherbrooke.ca
                sarah.bogard.sb@gmail.com
                etienne.goubault@yahoo.fr
                (514) 987-3000 , duval.christian@uqam.ca
                Journal
                J Neuroeng Rehabil
                J Neuroeng Rehabil
                Journal of NeuroEngineering and Rehabilitation
                BioMed Central (London )
                1743-0003
                7 April 2017
                7 April 2017
                2017
                : 14
                : 26
                Affiliations
                [1 ]Département des Sciences de l’activité Physique, Université du Québec àMontréal, 141 Avenue du Président -Kennedy, Montréal, Québec Canada
                [2 ]GRID grid.294071.9, , Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, ; Montréal, Québec Canada
                [3 ]GRID grid.86715.3d, Faculty of Medicine and Health Sciences, Department of Surgery, , Université de Sherbrooke, ; Sherbrooke, Québec Canada
                [4 ]Research Center on Aging, Sherbrooke, Québec Canada
                [5 ]GRID grid.86715.3d, Interdisciplinary Institute for Technological Innovation (3IT), , Université de Sherbrooke, ; Sherbrooke, Québec Canada
                Author information
                http://orcid.org/0000-0001-5906-1041
                Article
                241
                10.1186/s12984-017-0241-2
                5384139
                28388939
                87c3be3c-f4f0-41b1-b154-6045759cd489
                © The Author(s). 2017

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 19 June 2016
                : 1 April 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100000024, Canadian Institutes of Health Research;
                Categories
                Research
                Custom metadata
                © The Author(s) 2017

                Neurosciences
                accelerometer,movement disorders,sitting,turning,walking,parkinson’s disease,activity detection,inertial measurement unit

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