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Published in: Journal of NeuroEngineering and Rehabilitation 1/2015

Open Access 01-12-2015 | Research

Improving activity recognition using a wearable barometric pressure sensor in mobility-impaired stroke patients

Authors: Fabien Massé, Roman R. Gonzenbach, Arash Arami, Anisoara Paraschiv-Ionescu, Andreas R. Luft, Kamiar Aminian

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2015

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Abstract

Background

Stroke survivors often suffer from mobility deficits. Current clinical evaluation methods, including questionnaires and motor function tests, cannot provide an objective measure of the patients’ mobility in daily life. Physical activity performance in daily-life can be assessed using unobtrusive monitoring, for example with a single sensor module fixed on the trunk. Existing approaches based on inertial sensors have limited performance, particularly in detecting transitions between different activities and postures, due to the inherent inter-patient variability of kinematic patterns. To overcome these limitations, one possibility is to use additional information from a barometric pressure (BP) sensor.

Methods

Our study aims at integrating BP and inertial sensor data into an activity classifier in order to improve the activity (sitting, standing, walking, lying) recognition and the corresponding body elevation (during climbing stairs or when taking an elevator). Taking into account the trunk elevation changes during postural transitions (sit-to-stand, stand-to-sit), we devised an event-driven activity classifier based on fuzzy-logic.
Data were acquired from 12 stroke patients with impaired mobility, using a trunk-worn inertial and BP sensor. Events, including walking and lying periods and potential postural transitions, were first extracted. These events were then fed into a double-stage hierarchical Fuzzy Inference System (H-FIS). The first stage processed the events to infer activities and the second stage improved activity recognition by applying behavioral constraints. Finally, the body elevation was estimated using a pattern-enhancing algorithm applied on BP. The patients were videotaped for reference. The performance of the algorithm was estimated using the Correct Classification Rate (CCR) and F-score. The BP-based classification approach was benchmarked against a previously-published fuzzy-logic classifier (FIS-IMU) and a conventional epoch-based classifier (EPOCH).

Results

The algorithm performance for posture/activity detection, in terms of CCR was 90.4 %, with 3.3 % and 5.6 % improvements against FIS-IMU and EPOCH, respectively. The proposed classifier essentially benefits from a better recognition of standing activity (70.3 % versus 61.5 % [FIS-IMU] and 42.5 % [EPOCH]) with 98.2 % CCR for body elevation estimation.

Conclusion

The monitoring and recognition of daily activities in mobility-impaired stoke patients can be significantly improved using a trunk-fixed sensor that integrates BP, inertial sensors, and an event-based activity classifier.
Appendix
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Literature
1.
go back to reference Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383:245–55.PubMedCrossRefPubMedCentral Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014;383:245–55.PubMedCrossRefPubMedCentral
2.
go back to reference Blum L, Korner-Bitensky N. Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88:559–66.PubMedCrossRef Blum L, Korner-Bitensky N. Usefulness of the Berg balance scale in stroke rehabilitation: a systematic review. Phys Ther. 2008;88:559–66.PubMedCrossRef
3.
go back to reference Salarian A, Horak FB, Zampieri C, Carlson-Kuhta P, Nutt JG, Aminian K. iTUG, a sensitive and reliable measure of mobility. IEEE Trans Neural Syst Rehabil Eng. 2010;18:303–10.PubMedCrossRefPubMedCentral Salarian A, Horak FB, Zampieri C, Carlson-Kuhta P, Nutt JG, Aminian K. iTUG, a sensitive and reliable measure of mobility. IEEE Trans Neural Syst Rehabil Eng. 2010;18:303–10.PubMedCrossRefPubMedCentral
4.
go back to reference Duncan PW, Bode RK, Min Lai S, Perera S. Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale. Arch Phys Med Rehabil. 2003;84:950–63.PubMedCrossRef Duncan PW, Bode RK, Min Lai S, Perera S. Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale. Arch Phys Med Rehabil. 2003;84:950–63.PubMedCrossRef
5.
go back to reference Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30:1362–9.PubMedCrossRef Williams LS, Weinberger M, Harris LE, Clark DO, Biller J. Development of a stroke-specific quality of life scale. Stroke. 1999;30:1362–9.PubMedCrossRef
6.
go back to reference Paraschiv-Ionescu A, Buchser EE, Rutschmann B, Najafi B, Aminian K. Ambulatory system for the quantitative and qualitative analysis of gait and posture in chronic pain patients treated with spinal cord stimulation. Gait Posture. 2004;20:113–25.PubMedCrossRef Paraschiv-Ionescu A, Buchser EE, Rutschmann B, Najafi B, Aminian K. Ambulatory system for the quantitative and qualitative analysis of gait and posture in chronic pain patients treated with spinal cord stimulation. Gait Posture. 2004;20:113–25.PubMedCrossRef
7.
go back to reference Schasfoort F, Busmann J, Martens W, Stam H. Objective measurement of upper limb activity and mobility during everyday behavior using ambulatory accelerometry: the upper limb activity monitor. Behav Res Methods. 2006;38:439–46.PubMedCrossRef Schasfoort F, Busmann J, Martens W, Stam H. Objective measurement of upper limb activity and mobility during everyday behavior using ambulatory accelerometry: the upper limb activity monitor. Behav Res Methods. 2006;38:439–46.PubMedCrossRef
8.
go back to reference Fulk GD, Edgar SR, Bierwirth R, Hart P, Lopez-Meyer P, Sazonov E. Identifying activity levels and steps in people with stroke using a novel shoe-based sensor. J Neurol Phys Ther. 2012;36:100.PubMedCrossRefPubMedCentral Fulk GD, Edgar SR, Bierwirth R, Hart P, Lopez-Meyer P, Sazonov E. Identifying activity levels and steps in people with stroke using a novel shoe-based sensor. J Neurol Phys Ther. 2012;36:100.PubMedCrossRefPubMedCentral
9.
go back to reference Ganea R, Paraschiv-Ionescu A, Büla C, Rochat S, Aminian K. Multi-parametric evaluation of sit-to-stand and stand-to-sit transitions in elderly people. Med Eng Phys. 2011;33:1086–93.PubMedCrossRef Ganea R, Paraschiv-Ionescu A, Büla C, Rochat S, Aminian K. Multi-parametric evaluation of sit-to-stand and stand-to-sit transitions in elderly people. Med Eng Phys. 2011;33:1086–93.PubMedCrossRef
10.
go back to reference Ada L, Westwood P. A kinematic analysis of recovery of the ability to stand up following stroke. Aust J Physiother. 1992;38:135–42.PubMedCrossRef Ada L, Westwood P. A kinematic analysis of recovery of the ability to stand up following stroke. Aust J Physiother. 1992;38:135–42.PubMedCrossRef
11.
go back to reference Janssen WGM. The sit-to-stand movement recovery after stroke and objective assessment. Rotterdam: Doctorate Degree, Erasmus MC, University Medical Center Rotterdam; 2008. Janssen WGM. The sit-to-stand movement recovery after stroke and objective assessment. Rotterdam: Doctorate Degree, Erasmus MC, University Medical Center Rotterdam; 2008.
12.
go back to reference Salarian A, Russmann H, Vingerhoets FJG, Dehollain C, Blanc Y, Burkhard PR, et al. Gait assessment in Parkinson’s disease: toward an ambulatory system for long-term monitoring. IEEE Trans Biomed Eng. 2004;51:1434–43.PubMedCrossRef Salarian A, Russmann H, Vingerhoets FJG, Dehollain C, Blanc Y, Burkhard PR, et al. Gait assessment in Parkinson’s disease: toward an ambulatory system for long-term monitoring. IEEE Trans Biomed Eng. 2004;51:1434–43.PubMedCrossRef
13.
go back to reference Ganea R, Paraschiv-lonescu A, Aminian K. Detection and classification of postural transitions in real-world conditions. IEEE Trans Neural Syst Rehabil Eng. 2012;20:688–96.PubMedCrossRef Ganea R, Paraschiv-lonescu A, Aminian K. Detection and classification of postural transitions in real-world conditions. IEEE Trans Neural Syst Rehabil Eng. 2012;20:688–96.PubMedCrossRef
14.
go back to reference Godfrey A, Bourke AK, Ólaighin GM, van de Ven P, Nelson J. Activity classification using a single chest mounted tri-axial accelerometer. Med Eng Phys. 2011;33:1127–35.PubMedCrossRef Godfrey A, Bourke AK, Ólaighin GM, van de Ven P, Nelson J. Activity classification using a single chest mounted tri-axial accelerometer. Med Eng Phys. 2011;33:1127–35.PubMedCrossRef
15.
go back to reference Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40:992–7.PubMedCrossRefPubMedCentral Grant PM, Ryan CG, Tigbe WW, Granat MH. The validation of a novel activity monitor in the measurement of posture and motion during everyday activities. Br J Sports Med. 2006;40:992–7.PubMedCrossRefPubMedCentral
16.
go back to reference Steeves JA, Bowles HR, McClain JJ, Dodd KW, Brychta RJ, Wang J, et al. Ability of thigh-worn actigraph and activPAL monitors to classify posture and motion. Med Sci Sports Exerc. 2014;47:952–9.CrossRef Steeves JA, Bowles HR, McClain JJ, Dodd KW, Brychta RJ, Wang J, et al. Ability of thigh-worn actigraph and activPAL monitors to classify posture and motion. Med Sci Sports Exerc. 2014;47:952–9.CrossRef
17.
go back to reference Gyllensten IC, Bonomi AG. Identifying types of physical activity with a single accelerometer: evaluating laboratory-trained algorithms in daily life. IEEE Trans Biomed Eng. 2011;58:2656–63.PubMedCrossRef Gyllensten IC, Bonomi AG. Identifying types of physical activity with a single accelerometer: evaluating laboratory-trained algorithms in daily life. IEEE Trans Biomed Eng. 2011;58:2656–63.PubMedCrossRef
18.
go back to reference Novak AC, Brouwer B. Strength and aerobic requirements during stair ambulation in persons with chronic stroke and healthy adults. Arch Phys Med Rehabil. 2012;93:683–9.PubMedCrossRef Novak AC, Brouwer B. Strength and aerobic requirements during stair ambulation in persons with chronic stroke and healthy adults. Arch Phys Med Rehabil. 2012;93:683–9.PubMedCrossRef
19.
go back to reference Lester J, Choudhury T, Borriello G. A practical approach to recognizing physical activities. In: Pervasive Computing. Heidelberg: Springer; 2006. p. 1–16.CrossRef Lester J, Choudhury T, Borriello G. A practical approach to recognizing physical activities. In: Pervasive Computing. Heidelberg: Springer; 2006. p. 1–16.CrossRef
20.
go back to reference Moncada-Torres A, Leuenberger K, Gonzenbach R, Luft A, Gassert R. Activity classification based on inertial and barometric pressure sensors at different anatomical locations. Physiol Meas. 2014;35:1245.PubMedCrossRef Moncada-Torres A, Leuenberger K, Gonzenbach R, Luft A, Gassert R. Activity classification based on inertial and barometric pressure sensors at different anatomical locations. Physiol Meas. 2014;35:1245.PubMedCrossRef
21.
go back to reference Yang C-C, Hsu Y-L. A review of accelerometry-based wearable motion detectors for physical activity monitoring. Sensors. 2010;10:7772–88.PubMedCrossRef Yang C-C, Hsu Y-L. A review of accelerometry-based wearable motion detectors for physical activity monitoring. Sensors. 2010;10:7772–88.PubMedCrossRef
22.
go back to reference Salarian A, Russmann H, Vingerhoets FJG, Burkhard PR, Aminian K. Ambulatory monitoring of physical activities in patients with Parkinson’s disease. IEEE Trans Biomed Eng. 2007;54:2296–9.PubMedCrossRef Salarian A, Russmann H, Vingerhoets FJG, Burkhard PR, Aminian K. Ambulatory monitoring of physical activities in patients with Parkinson’s disease. IEEE Trans Biomed Eng. 2007;54:2296–9.PubMedCrossRef
23.
go back to reference Lindemann U, Zijlstra W, Aminian K, Chastin S, de Bruin E, Helbostad J, et al. Recommendations for standardizing validation procedures assessing physical activity of older persons by monitoring body postures and movements. Sensors. 2014;14:1267–77.PubMedCrossRefPubMedCentral Lindemann U, Zijlstra W, Aminian K, Chastin S, de Bruin E, Helbostad J, et al. Recommendations for standardizing validation procedures assessing physical activity of older persons by monitoring body postures and movements. Sensors. 2014;14:1267–77.PubMedCrossRefPubMedCentral
25.
go back to reference Najafi B, Aminian K, Loew F, Blanc Y, Robert PA. Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly. IEEE Trans Biomed Eng. 2002;49:843–51.PubMedCrossRef Najafi B, Aminian K, Loew F, Blanc Y, Robert PA. Measurement of stand-sit and sit-stand transitions using a miniature gyroscope and its application in fall risk evaluation in the elderly. IEEE Trans Biomed Eng. 2002;49:843–51.PubMedCrossRef
26.
go back to reference Favre J, Jolles B, Siegrist O, Aminian K. Quaternion-based fusion of gyroscopes and accelerometers to improve 3D angle measurement. Electron Lett. 2006;42:612–4.CrossRef Favre J, Jolles B, Siegrist O, Aminian K. Quaternion-based fusion of gyroscopes and accelerometers to improve 3D angle measurement. Electron Lett. 2006;42:612–4.CrossRef
27.
go back to reference Najafi B, Aminian K, Paraschiv-Ionescu A, Loew F, Bula CJ, Robert P. Ambulatory system for human motion analysis using a kinematic sensor: monitoring of daily physical activity in the elderly. IEEE Trans Biomed Eng. 2003;50:711–23.PubMedCrossRef Najafi B, Aminian K, Paraschiv-Ionescu A, Loew F, Bula CJ, Robert P. Ambulatory system for human motion analysis using a kinematic sensor: monitoring of daily physical activity in the elderly. IEEE Trans Biomed Eng. 2003;50:711–23.PubMedCrossRef
29.
go back to reference Raju G, Zhou J, Kisner RA. Hierarchical fuzzy control. Int J Control. 1991;54:1201–16.CrossRef Raju G, Zhou J, Kisner RA. Hierarchical fuzzy control. Int J Control. 1991;54:1201–16.CrossRef
30.
go back to reference Cheong F, Lai R. Designing a hierarchical fuzzy logic controller using the differential evolution approach. Appl Soft Comput. 2007;7:481–91.CrossRef Cheong F, Lai R. Designing a hierarchical fuzzy logic controller using the differential evolution approach. Appl Soft Comput. 2007;7:481–91.CrossRef
31.
go back to reference Mamdani EH, Assilian S. An experiment in linguistic synthesis with a fuzzy logic controller. Int J Man–machine Stud. 1975;7:1–13.CrossRef Mamdani EH, Assilian S. An experiment in linguistic synthesis with a fuzzy logic controller. Int J Man–machine Stud. 1975;7:1–13.CrossRef
32.
go back to reference Orendurff MS, Schoen JA, Bernatz GC, Segal AD, Klute GK. How humans walk: bout duration, steps per bout, and rest duration. J Rehabil Res Dev. 2008;45:1077–89.PubMedCrossRef Orendurff MS, Schoen JA, Bernatz GC, Segal AD, Klute GK. How humans walk: bout duration, steps per bout, and rest duration. J Rehabil Res Dev. 2008;45:1077–89.PubMedCrossRef
33.
go back to reference Berberan-Santos MN, Bodunov EN, Pogliani L. On the barometric formula. Am J Phys. 1997;65:404–12.CrossRef Berberan-Santos MN, Bodunov EN, Pogliani L. On the barometric formula. Am J Phys. 1997;65:404–12.CrossRef
34.
go back to reference Powell MJ. A FORTRAN subroutine for solving systems of nonlinear algebraic equations. Harwell (England): Atomic Energy Research Establishment; 1968. Powell MJ. A FORTRAN subroutine for solving systems of nonlinear algebraic equations. Harwell (England): Atomic Energy Research Establishment; 1968.
35.
go back to reference Robnik-Sikonja M, Kononenko I. Theoretical and empirical analysis of ReliefF and RReliefF. Mach Learn. 2003;53:23–69.CrossRef Robnik-Sikonja M, Kononenko I. Theoretical and empirical analysis of ReliefF and RReliefF. Mach Learn. 2003;53:23–69.CrossRef
36.
go back to reference Breiman L, Friedman J, Stone CJ, Olshen RA. Classification and regression trees. Boca Raton: CRC press; 1984. Breiman L, Friedman J, Stone CJ, Olshen RA. Classification and regression trees. Boca Raton: CRC press; 1984.
37.
go back to reference Labatut V, Cherifi H. Accuracy measures for the comparison of classifiers, presented at the The 5th International Conference on Information Technology, Amman, Jordanie. 2012. Labatut V, Cherifi H. Accuracy measures for the comparison of classifiers, presented at the The 5th International Conference on Information Technology, Amman, Jordanie. 2012.
38.
go back to reference Friedman M. A comparison of alternative tests of significance for the problem of m rankings. Ann Math Stat. 1940;11:86–92.CrossRef Friedman M. A comparison of alternative tests of significance for the problem of m rankings. Ann Math Stat. 1940;11:86–92.CrossRef
39.
go back to reference Demšar J. Statistical comparisons of classifiers over multiple data sets. J Mach Learn Res. 2006;7:1–30. Demšar J. Statistical comparisons of classifiers over multiple data sets. J Mach Learn Res. 2006;7:1–30.
40.
go back to reference Lindemann U, Jamour M, Nicolai S, Benzinger P, Klenk J, Aminian K, et al. Physical activity of moderately impaired elderly stroke patients during rehabilitation. Physiol Meas. 2012;33:1923.PubMedCrossRef Lindemann U, Jamour M, Nicolai S, Benzinger P, Klenk J, Aminian K, et al. Physical activity of moderately impaired elderly stroke patients during rehabilitation. Physiol Meas. 2012;33:1923.PubMedCrossRef
41.
go back to reference Alzahrani MA, Ada L, Dean CM. Duration of physical activity is normal but frequency is reduced after stroke: an observational study. J Physiother. 2011;57:47–51.PubMedCrossRef Alzahrani MA, Ada L, Dean CM. Duration of physical activity is normal but frequency is reduced after stroke: an observational study. J Physiother. 2011;57:47–51.PubMedCrossRef
42.
go back to reference Chastin SFM, Granat MH. Methods for objective measure, quantification and analysis of sedentary behaviour and inactivity. Gait Posture. 2010;31:82–6.PubMedCrossRef Chastin SFM, Granat MH. Methods for objective measure, quantification and analysis of sedentary behaviour and inactivity. Gait Posture. 2010;31:82–6.PubMedCrossRef
43.
go back to reference Hall M, Frank E, Holmes G, Pfahringer B, Reutemann P, Witten IH. The WEKA data mining software: an update. ACM SIGKDD explorations newsletter. 2009;11:10–8.CrossRef Hall M, Frank E, Holmes G, Pfahringer B, Reutemann P, Witten IH. The WEKA data mining software: an update. ACM SIGKDD explorations newsletter. 2009;11:10–8.CrossRef
44.
go back to reference Lam L, Suen CY. Application of majority voting to pattern recognition: an analysis of its behavior and performance. IEEE Trans Syst Man Cybern Syst Hum. 1997;27:553–68.CrossRef Lam L, Suen CY. Application of majority voting to pattern recognition: an analysis of its behavior and performance. IEEE Trans Syst Man Cybern Syst Hum. 1997;27:553–68.CrossRef
45.
go back to reference van Hees VT, Golubic R, Ekelund U, Brage S. Impact of study design on development and evaluation of an activity type classifier. J Appl Physiol. 2013;114:1042–51.PubMedCrossRefPubMedCentral van Hees VT, Golubic R, Ekelund U, Brage S. Impact of study design on development and evaluation of an activity type classifier. J Appl Physiol. 2013;114:1042–51.PubMedCrossRefPubMedCentral
Metadata
Title
Improving activity recognition using a wearable barometric pressure sensor in mobility-impaired stroke patients
Authors
Fabien Massé
Roman R. Gonzenbach
Arash Arami
Anisoara Paraschiv-Ionescu
Andreas R. Luft
Kamiar Aminian
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2015
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/s12984-015-0060-2

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