Electrical and Electronic Engineering - Research Publications
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ItemNovel Measures of Similarity and Asymmetry in Upper Limb Activities for Identifying Hemiparetic Severity in Stroke Survivors(IEEE-INST ELECTRICAL ELECTRONICS ENGINEERS INC, 2021-06)Stroke survivors are often characterized by hemiparesis, i.e., paralysis in one half of the body, severely affecting upper limb movements. Monitoring the progression of hemiparesis requires manual observation of limb movements at regular intervals, and hence is a labour intensive process. In this work, we use wrist-worn accelerometers for automated assessment of hemiparesis in acute stroke. We propose novel measures of similarity and asymmetry in hand activities through bivariate Poincaré analysis between two-hand accelerometer data for quantifying hemiparetic severity. The proposed descriptors characterize the distribution of activity surrogates derived from acceleration of the two hands, on a 2D bivariate Poincaré Plot. Experiments show that while the descriptors CSD1 and CSD2 can identify hemiparetic patients from control subjects, their normalized difference CSDR and the descriptors Complex Cross-Correlation Measure ( C3M) and Activity Asymmetry Index ( AAI) can distinguish between mild, moderate and severe hemiparesis. These measures are compared with traditional measures of cross-correlation and evaluated against the National Institutes of Health Stroke Scale (NIHSS), the clinical gold standard for hemiparetic severity estimation. This study, undertaken on 40 acute stroke patients with varying levels of hemiparesis and 15 healthy controls, validates the use of short length ( 5 minutes) wearable accelerometry data for identifying hemiparesis with greater clinical sensitivity. Results show that the proposed descriptors with a hierarchical classification model outperform state-of-the-art methods with overall accuracy of 0.78 and 0.85 for 4-class and 3-class hemiparesis identification respectively.
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ItemNo Preview AvailableSHAPELET BASED VISUAL ASSESSMENT OF CLUSTER TENDENCY IN ANALYZING COMPLEX UPPER LIMBMOTION(IEEE, 2021)The evolution of ubiquitous sensors has led to the generation of copious amounts of waveform data. Human motion waveform analysis has found significance in clinical and home-based activity monitoring. Exploration of cluster structure in such waveform data prior to developing learning models is an important pattern recognition problem. A prominent category of algorithms in this direction, known as Visual Assessment of (cluster) Tendency (VAT), employs visual approaches to study cluster evolution through heat maps. This paper proposes shape-iVAT, a new relative of an improved VAT model, that captures local time-series characteristics through representative subsequences, known as shapelets, to identify interesting patterns in motion data. We propose an unsupervised method for shapelet extraction using maximin shape sampling and shape-based distance computation for selecting key shapelets representing characteristic motion patterns. These shapelets are used to transform waveform data into a dissimilarity matrix for VAT evaluation. We demonstrate that the proposed method outperforms standard VAT with global distance measures for identifying complex upper limb motion captured using a camera-based motion sensing device. We also show that our method has significance in efficient and interpretable cluster tendency assessment for anomaly detection and continuous motion monitoring.
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ItemMeasures of Bipedal Toe-Ground Clearance Asymmetry to Characterize Gait in Stroke Survivors.(IEEE, 2021-11)Post-stroke hemiparesis often impairs gait and increases the risks of falls. Low and variable Minimum Toe Clearance (MTC) from the ground during the swing phase of the gait cycle has been identified as a major cause of such falls. In this paper, we study MTC characteristics in 30 chronic stroke patients, extracted from gait patterns during treadmill walking, using infrared sensors and motion analysis camera units. We propose objective measures to quantify MTC asymmetry between the paretic and non-paretic limbs using Poincaré analysis. We show that these subject independent Gait Asymmetry Indices (GAIs) represent temporal variations of relative MTC differences between the two limbs and can distinguish between healthy and stroke participants. Compared to traditional measures of cross-correlation between the MTC of the two limbs, these measures are better suited to automate gait monitoring during stroke rehabilitation. Further, we explore possible clusters within the stroke data by analysing temporal dispersion of MTC features, which reveals that the proposed GAIs can also be potentially used to quantify the severity of lower limb hemiparesis in chronic stroke.
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ItemAutomated Scoring of Hemiparesis in Acute Stroke From Measures of Upper Limb Co-Ordination Using Wearable Accelerometry.(Institute of Electrical and Electronics Engineers, 2020-04)Stroke survivors usually experience paralysis in one half of the body, i.e., hemiparesis, and the upper limbs are severely affected. Continuous monitoring of hemiparesis progression hours after the stroke attack involves manual observation of upper limb movements by medical experts in the hospital. Hence it is resource and time intensive, in addition to being prone to human errors and inter-rater variability. Wearable devices have found significance in automated continuous monitoring of neurological disorders like stroke. In this paper, we use accelerometer signals acquired using wrist-worn devices to analyze upper limb movements and identify hemiparesis in acute stroke patients, while they perform a set of proposed spontaneous and instructed movements. We propose novel measures of time (and frequency) domain coherence between accelerometer data from two arms at different lags (and frequency bands). These measures correlate well with the clinical gold standard of measurement of hemiparetic severity in stroke, the National Institutes of Health Stroke Scale (NIHSS). The study, undertaken on 32 acute stroke patients with varying levels of hemiparesis and 15 healthy controls, validates the use of short length (< 10 minutes) accelerometry data to identify hemiparesis through leave-one-subject-out cross-validation based hierarchical discriminant analysis. The results indicate that the proposed approach can distinguish between controls, moderate and severe hemiparesis with an average accuracy of 91%.
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ItemUpper limb movement profiles during spontaneous motion in acute stroke(IOP Publishing, 2021-05-11)Objective: The clinical assessment of upper limb hemiparesis in acute stroke involves repeated manual examination of hand movements during instructed tasks. This process is labour-intensive and prone to human error as well as being strenuous for the patient. Wearable motion sensors can automate the process by measuring characteristics of hand activity. Existing work in this direction either uses multiple sensors or complex instructed movements, or analyzes only the quantity of upper limb motion. These methods are obtrusive and strenuous for acute stroke patients and are also sensitive to noise. In this work, we propose to use only two wrist-worn accelerometer sensors to study the quality of completely spontaneous upper limb motion and investigate correlation with clinical scores for acute stroke care. Approach: The velocity time series estimated from acquired acceleration data during spontaneous motion is decomposed into smaller movement elements. Measures of density, duration and smoothness of these component elements are extracted and their disparity is studied across the two hands. Main results: Spontaneous upper limb motion in acute stroke can be decomposed into movement elements that resemble point-to-point reaching tasks. These elements are smoother and sparser in the normal hand than in the hemiparetic hand, and the amount of smoothness correlates with hemiparetic severity. Features characterizing the disparity of these movement elements between the two hands show statistical significance in differentiating mild-to-moderate and severe hemiparesis. Using data from 67 acute stroke patients, the proposed method can classify the two levels of hemiparetic severity with 85% accuracy. Additionally, compared to activity-based features, the proposed method is robust to the presence of noise in acquired data. Significance: This work demonstrates that the quality of upper limb motion can characterize and identify hemiparesis in stroke survivors. This is clinically significant towards the continuous automated assessment of hemiparesis in acute stroke using minimally intrusive wearable sensors.