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      Interpretable evaluation for the Brunnstrom recovery stage of the lower limb based on wearable sensors

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          Abstract

          With the increasing number of stroke patients, there is an urgent need for an accessible, scientific, and reliable evaluation method for stroke rehabilitation. Although many rehabilitation stage evaluation methods based on the wearable sensors and machine learning algorithm have been developed, the interpretable evaluation of the Brunnstrom recovery stage of the lower limb (BRS-L) is still lacking. The paper propose an interpretable BRS-L evaluation method based on wearable sensors. We collected lower limb motion data and plantar pressure data of 20 hemiplegic patients and 10 healthy individuals using seven Inertial Measurement Units (IMUs) and two plantar pressure insoles. Then we extracted gait features from the motion data and pressure data. By using feature selection based on feature importance, we improved the interpretability of the machine learning-based evaluation method. Several machine learning models are evaluated on the dataset, the results show that k-Nearest Neighbor has the best prediction performance and achieves 94.2% accuracy with an input of 18 features. Our method provides a feasible solution for precise rehabilitation and home-based rehabilitation of hemiplegic patients.

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          Most cited references24

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          Global Stroke Statistics 2019

          Data on stroke epidemiology and availability of hospital-based stroke services around the world are important for guiding policy decisions and healthcare planning. To provide the most current incidence, mortality and case–fatality data on stroke and describe current availability of stroke units around the world by country. We searched multiple databases (based on our existing search strategy) to identify new original manuscripts and review articles published between 1 June 2016 and 31 October 2018 that met the ideal criteria for data on stroke incidence and case–fatality. For data on the availability of hospital-based stroke services, we searched PubMed for all literature published up until 31 June 2018. We further screened reference lists, citation history of manuscripts and gray literature for this information. Mortality codes for International Classification of Diseases-9 and International Classification of Diseases-10 were extracted from the World Health Organization mortality database for each country providing these data. Population denominators were obtained from the World Health Organization, and when these were unavailable within a two-year period of mortality data, population denominators within a two-year period were obtained from the United Nations. Using country-specific population denominators and the most recent years of mortality data available for each country, we calculated both the crude mortality from stroke and mortality adjusted to the World Health Organization world population. Since our last report in 2017, there were two countries with new incidence studies, China ( n = 1) and India ( n = 2) that met the ideal criteria. New data on case–fatality were found for Estonia and India. The most current mortality data were available for the year 2015 (39 countries), 2016 (43 countries), and 2017 (7 countries). No new data on mortality were available for six countries. Availability of stroke units was noted for 63 countries, and the proportion of patients treated in stroke units was reported for 35/63 countries. Up-to-date data on stroke incidence, case–fatality, and mortality statistics provide evidence of variation among countries and changing magnitudes of burden among high and low–middle income countries. Reporting of hospital-based stroke units remains limited and should be encouraged.
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            Motor testing procedures in hemiplegia: based on sequential recovery stages.

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              A Machine Learning Framework for Gait Classification Using Inertial Sensors: Application to Elderly, Post-Stroke and Huntington’s Disease Patients

              Machine learning methods have been widely used for gait assessment through the estimation of spatio-temporal parameters. As a further step, the objective of this work is to propose and validate a general probabilistic modeling approach for the classification of different pathological gaits. Specifically, the presented methodology was tested on gait data recorded on two pathological populations (Huntington’s disease and post-stroke subjects) and healthy elderly controls using data from inertial measurement units placed at shank and waist. By extracting features from group-specific Hidden Markov Models (HMMs) and signal information in time and frequency domain, a Support Vector Machines classifier (SVM) was designed and validated. The 90.5% of subjects was assigned to the right group after leave-one-subject–out cross validation and majority voting. The long-term goal we point to is the gait assessment in everyday life to early detect gait alterations.
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                Author and article information

                Contributors
                Journal
                Front Neuroinform
                Front Neuroinform
                Front. Neuroinform.
                Frontiers in Neuroinformatics
                Frontiers Media S.A.
                1662-5196
                08 September 2022
                2022
                : 16
                : 1006494
                Affiliations
                [1] 1Department of Rehabilitation Medicine, The Second Affiliated Hospital of Nanchang University , Nanchang, China
                [2] 2Fuzhou Medical College, Nanchang University , Nanchang, China
                [3] 3Shien-Ming Wu School of Intelligent Engineering, South China University of Technology , Guangzhou, China
                Author notes

                Edited by: Dmitrii Kaplun, Saint Petersburg State Electrotechnical University, Russia

                Reviewed by: Aleksandr Sinitca, Saint Petersburg State Electrotechnical University, Russia; Kandarpa Kumar Sarma, Gauhati University, India

                *Correspondence: Jun Luo, jscut@ 123456foxmail.com

                These authors have contributed equally to this work and share first authorship

                Article
                10.3389/fninf.2022.1006494
                9493089
                36156985
                cae7058e-a6ba-48b2-83f4-4e1d04cb839e
                Copyright © 2022 Chen, Hu, Zhang, Pan, Chen, Xie, Luo and Zhu.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 29 July 2022
                : 16 August 2022
                Page count
                Figures: 10, Tables: 5, Equations: 7, References: 25, Pages: 14, Words: 7447
                Categories
                Neuroscience
                Original Research

                Neurosciences
                rehabilitation evaluation,brunnstrom recovery stage,wearable sensor,machine learning,feature importance

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