Detection of tripping gait patterns in the elderly using autoregressive features and support vector machines.

Elderly tripping falls cost billions annually in medical funds and result in high mortality rates often perpetrated by pulmonary embolism (internal bleeding) and infected fractures that do not heal well. In this paper, we propose an intelligent gait detection system (AR-SVM) for screening elderly individuals at risk of suffering tripping falls. The motivation of this system is to provide early detection of elderly gait reminiscent of tripping characteristics so that preventive measures could be administered. Our system is composed of two stages, a predictor model estimated by an autoregressive (AR) process and a support vector machine (SVM) classifier. The system input is a digital signal constructed from consecutive measurements of minimum toe clearance (MTC) representative of steady-state walking. The AR-SVM system was tested on 23 individuals (13 healthy and 10 having suffered at least one tripping fall in the past year) who each completed a minimum of 10 min of walking on a treadmill at a self-selected pace. In the first stage, a fourth order AR model required at least 64 MTC values to correctly detect all fallers and non-fallers. Detection was further improved to less than 1 min of walking when the model coefficients were used as input features to the SVM classifier. The system achieved a detection accuracy of 95.65% with the leave one out method using only 16 MTC samples, but was reduced to 69.57% when eight MTC samples were used. These results demonstrate a fast and efficient system requiring a small number of strides and only MTC measurements for accurate detection of tripping gait characteristics.

[1]  Marimuthu Palaniswami,et al.  Support vector machines for automated gait classification , 2005, IEEE Transactions on Biomedical Engineering.

[2]  H. Akaike Autoregressive model fitting for control , 1971 .

[3]  R Begg,et al.  A machine learning approach for automated recognition of movement patterns using basic, kinetic and kinematic gait data. , 2005, Journal of biomechanics.

[4]  D. Winter Foot trajectory in human gait: a precise and multifactorial motor control task. , 1992, Physical therapy.

[5]  J B Dingwell,et al.  Neuropathic gait shows only trends towards increased variability of sagittal plane kinematics during treadmill locomotion. , 1999, Gait & posture.

[6]  Dimitri P. Bertsekas,et al.  Constrained Optimization and Lagrange Multiplier Methods , 1982 .

[8]  Vladimir N. Vapnik,et al.  The Nature of Statistical Learning Theory , 2000, Statistics for Engineering and Information Science.

[9]  Nello Cristianini,et al.  An Introduction to Support Vector Machines and Other Kernel-based Learning Methods , 2000 .

[10]  Arnold Neumaier,et al.  Estimation of parameters and eigenmodes of multivariate autoregressive models , 2001, TOMS.

[11]  F Gider,et al.  A quantitative gait assessment method based on energy exchange analysis during walking: a normal gait study , 2005, Journal of medical engineering & technology.

[12]  Kevin Kinsella,et al.  An aging world: 2001 , 2001 .

[13]  A. Atiya,et al.  Learning with Kernels: Support Vector Machines, Regularization, Optimization, and Beyond , 2005, IEEE Transactions on Neural Networks.

[14]  Arnold Neumaier,et al.  Algorithm 808: ARfit—a matlab package for the estimation of parameters and eigenmodes of multivariate autoregressive models , 2001, TOMS.

[15]  Rama Chellappa,et al.  Ieee Transactions on Pattern Analysis and Machine Intelligence 1 Matching Shape Sequences in Video with Applications in Human Movement Analysis. Ieee Transactions on Pattern Analysis and Machine Intelligence 2 , 2022 .

[16]  G. Gehlsen,et al.  Falls in the elderly: Part I, Gait. , 1990, Archives of physical medicine and rehabilitation.

[17]  R. Baker Gait analysis methods in rehabilitation , 2006, Journal of NeuroEngineering and Rehabilitation.

[18]  M Kuczyński The second order autoregressive model in the evaluation of postural stability. , 1999, Gait & posture.

[19]  Richard A. Brand,et al.  The biomechanics and motor control of human gait: Normal, elderly, and pathological , 1992 .

[20]  M. Palaniswami,et al.  SVM Models in the Diagnosis of Balance Impairments , 2005, 2005 3rd International Conference on Intelligent Sensing and Information Processing.

[21]  L. Draganich,et al.  Placing the trailing foot closer to an obstacle reduces flexion of the hip, knee, and ankle to increase the risk of tripping. , 1998, Journal of biomechanics.

[22]  Emanuel Todorov,et al.  Evidence for the Flexible Sensorimotor Strategies Predicted by Optimal Feedback Control , 2007, The Journal of Neuroscience.

[23]  M. Bobbert,et al.  Push-off reactions in recovery after tripping discriminate young subjects, older non-fallers and older fallers. , 2005, Gait & posture.

[24]  D. Oliver,et al.  Development and evaluation of evidence based risk assessment tool (STRATIFY) to predict which elderly inpatients will fall: case-control and cohort studies , 1997, BMJ.

[25]  B. Cohen,et al.  Three-dimensional kinematics and dynamics of the foot during walking: a model of central control mechanisms , 2006, Experimental Brain Research.

[26]  John G. Proakis,et al.  Digital Signal Processing: Principles, Algorithms, and Applications , 1992 .

[27]  Alexander J. Smola,et al.  Learning with Kernels: support vector machines, regularization, optimization, and beyond , 2001, Adaptive computation and machine learning series.

[28]  R. Begg,et al.  Minimum foot clearance during walking: strategies for the minimisation of trip-related falls. , 2007, Gait & posture.

[29]  R. Elble,et al.  Stride-dependent changes in gait of older people , 1991, Journal of Neurology.

[30]  Thomas G. Dietterich Adaptive computation and machine learning , 1998 .

[31]  Maarten F. Bobbert,et al.  Age-related intrinsic limitations in preventing a trip and regaining balance after a trip , 2005 .

[32]  M. Tinetti Performance‐Oriented Assessment of Mobility Problems in Elderly Patients , 1986, Journal of the American Geriatrics Society.

[33]  A.H. Khandoker,et al.  A Wavelet-Based Approach for Screening Falls Risk in the Elderly using Support Vector Machines , 2006, 2006 Fourth International Conference on Intelligent Sensing and Information Processing.

[34]  V Dubost,et al.  Is low lower-limb kinematic variability always an index of stability? , 2007, Gait & posture.

[35]  K. M. Jackson,et al.  Fitting of Mathematical Functions to Biomechanical Data , 1979, IEEE Transactions on Biomedical Engineering.