Decision support for stroke rehabilitation therapy via describable attribute-based decision trees

This paper proposes a computational framework for movement quality assessment using a decision tree model that can potentially assist a physical therapist in a telereha-bilitation context. Using a dataset of key kinematic attributes collected from eight stroke survivors, we demonstrate that the framework can be reliably used for movement quality assessment of a reach-to-grasp cone task, an activity commonly used in upper extremity stroke rehabilitation therapy. The proposed framework is capable of providing movement quality scores that are highly correlated to the ratings provided by therapists, who used a custom rating rubric created by rehabilitation experts. Our hypothesis is that a decision tree model could be easily utilized by therapists as a potential assistive tool, especially in evaluating movement quality on a large-scale dataset collected during unsupervised rehabilitation (e.g., training at the home), thereby reducing the time and cost of rehabilitation treatment.

[1]  S. Wolf,et al.  Exploring the bases for a mixed reality stroke rehabilitation system, Part I: A unified approach for representing action, quantitative evaluation, and interactive feedback , 2011, Journal of NeuroEngineering and Rehabilitation.

[2]  Jiping He,et al.  Low-cost, at-home assessment system with Wii Remote based motion capture , 2008, 2008 Virtual Rehabilitation.

[3]  Albert A. Rizzo,et al.  Beyond the standard clinical rating scales: Fine-grained assessment of post-stroke motor functionality using wearable inertial sensors , 2012, 2012 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[4]  Thanassis Rikakis,et al.  Adaptive Mixed Reality Rehabilitation Improves Quality of Reaching Movements More Than Traditional Reaching Therapy Following Stroke , 2013, Neurorehabilitation and neural repair.

[5]  Jiping He,et al.  A Computational Framework for Quantitative Evaluation of Movement during Rehabilitation , 2011 .

[6]  S. Wolf,et al.  Assessing Wolf Motor Function Test as Outcome Measure for Research in Patients After Stroke , 2001, Stroke.

[7]  J. Bussmann,et al.  The stroke upper-limb activity monitor: its sensitivity to measure hemiplegic upper-limb activity during daily life. , 2007, Archives of physical medicine and rehabilitation.

[8]  D. Beevers,et al.  The atlas of heart disease and stroke , 2005, Journal of Human Hypertension.

[9]  Alexander W Dromerick,et al.  Relationships between upper-limb functional limitation and self-reported disability 3 months after stroke. , 2006, Journal of rehabilitation research and development.

[10]  George A. Mensah,et al.  The atlas of heart disease and stroke , 2005 .

[11]  G. Kwakkel,et al.  Understanding the pattern of functional recovery after stroke: facts and theories. , 2004, Restorative neurology and neuroscience.

[12]  J. Sage,et al.  Nonmotor fluctuations in patients with Parkinson's disease , 1996, Neurology.

[13]  Thanassis Rikakis,et al.  A Novel Adaptive Mixed Reality System for Stroke Rehabilitation: Principles, Proof of Concept, and Preliminary Application in 2 Patients , 2011, Topics in stroke rehabilitation.

[14]  M. Duff,et al.  Exploring the bases for a mixed reality stroke rehabilitation system, Part II: Design of Interactive Feedback for upper limb rehabilitation , 2011, Journal of NeuroEngineering and Rehabilitation.

[15]  Loren Olson,et al.  A real-time, multimodal biofeedback system for stroke patient rehabilitation , 2006, MM '06.

[16]  Tharam S. Dillon,et al.  Application of Tree Mining to Matching of Knowledge Structures of Decision Tree Type , 2007, OTM Workshops.

[17]  Pavan K. Turaga,et al.  Attractor-Shape for Dynamical Analysis of Human Movement: Applications in Stroke Rehabilitation and Action Recognition , 2013, 2013 IEEE Conference on Computer Vision and Pattern Recognition Workshops.

[18]  Paolo Bonato,et al.  Monitoring Motor Fluctuations in Patients With Parkinson's Disease Using Wearable Sensors , 2009, IEEE Transactions on Information Technology in Biomedicine.

[19]  Todd Ingalls,et al.  Design of a home-based adaptive mixed reality rehabilitation system for stroke survivors , 2011, 2011 Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[20]  E. Taub,et al.  Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review. , 1999, Journal of rehabilitation research and development.

[21]  Albert A. Rizzo,et al.  Towards pervasive physical rehabilitation using Microsoft Kinect , 2012, 2012 6th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops.

[22]  M. Perc The dynamics of human gait , 2005 .

[23]  N. Stergiou,et al.  Human movement variability, nonlinear dynamics, and pathology: is there a connection? , 2011, Human movement science.

[24]  Shyamal Patel,et al.  A Novel Approach to Monitor Rehabilitation Outcomes in Stroke Survivors Using Wearable Technology , 2010, Proceedings of the IEEE.

[25]  Todd Ingalls,et al.  A home-based adaptive mixed reality rehabilitation system , 2011, ACM Multimedia.

[26]  Leo Breiman,et al.  Classification and Regression Trees , 1984 .