Classification of foot drop gait characteristic due to lumbar radiculopathy using machine learning algorithms.

BACKGROUND Recently, the study of walking gait has received significant attention due to the importance of identifying disorders relating to gait patterns. Characterisation and classification of different common gait disorders such as foot drop in an effective and accurate manner can lead to improved diagnosis, prognosis assessment, and treatment. However, currently visual inspection is the main clinical method to evaluate gait disorders, which is reliant on the subjectivity of the observer, leading to inaccuracies. RESEARCH QUESTION This study examines if it is feasible to use commercial off-the-shelf Inertial measurement unit sensors and supervised learning methods to distinguish foot drop gait disorder from the normal walking gait pattern. METHOD The gait data collected from 56 adults diagnosed with foot drop due to L5 lumbar radiculopathy (with MRI verified compressive pathology), and 30 adults with normal gait during multiple walking trials on a flat surface. Machine learning algorithms were applied to the inertial sensor data to investigate the feasibility of classifying foot drop disorder. RESULTS The best three performing results were 88.45%, 86.87% and 86.08% accuracy derived from the Random Forest, SVM, and Naive Bayes classifiers respectively. After applying the wrapper feature selection technique, the top performance was from the Random Forest classifier with an overall accuracy of 93.18%. SIGNIFICANCE It is demonstrated that the combination of inertial sensors and machine learning algorithms, provides a promising and feasible solution to differentiating L5 radiculopathy related foot drop from normal walking gait patterns. The implication of this finding is to provide an objective method to help clinical decision making.

[1]  H. Herr,et al.  Adaptive control of a variable-impedance ankle-foot orthosis to assist drop-foot gait , 2004, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[2]  R Williamson,et al.  Gait event detection for FES using accelerometers and supervised machine learning. , 2000, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[3]  M.R. Popovic,et al.  A reliable gyroscope-based gait-phase detection sensor embedded in a shoe insole , 2004, IEEE Sensors Journal.

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

[5]  B. Auvinet,et al.  Reference data for normal subjects obtained with an accelerometric device. , 2002, Gait & posture.

[6]  Laila Benhlima,et al.  Review on wrapper feature selection approaches , 2016, 2016 International Conference on Engineering & MIS (ICEMIS).

[7]  R A Olshen,et al.  Statistical analysis of gait patterns of persons with cerebral palsy. , 2015, Statistics in medicine.

[8]  Xinyuan Zhang,et al.  Collective feature selection to identify crucial epistatic variants , 2018, BioData Mining.

[9]  Matjaz Gams,et al.  Automatic recognition of gait-related health problems in the elderly using machine learning , 2012, Multimedia Tools and Applications.

[10]  Catherine Sackley,et al.  Rehabilitation interventions for foot drop in neuromuscular disease. , 2015, The Cochrane database of systematic reviews.

[11]  M H Granat,et al.  A practical gait analysis system using gyroscopes. , 1999, Medical engineering & physics.

[12]  Bin Hu,et al.  Self-esteem recognition based on gait pattern using Kinect. , 2017, Gait & posture.

[13]  Ian H. Witten,et al.  Weka-A Machine Learning Workbench for Data Mining , 2005, Data Mining and Knowledge Discovery Handbook.

[14]  Robert LeMoyne,et al.  Wearable body and wireless inertial sensors for machine learning classification of gait for people with Friedreich's ataxia , 2016, 2016 IEEE 13th International Conference on Wearable and Implantable Body Sensor Networks (BSN).

[15]  Vijay Bhaskar Semwal,et al.  An optimized feature selection technique based on incremental feature analysis for bio-metric gait data classification , 2017, Multimedia Tools and Applications.

[16]  Sinziana Mazilu,et al.  Online detection of freezing of gait with smartphones and machine learning techniques , 2012, 2012 6th International Conference on Pervasive Computing Technologies for Healthcare (PervasiveHealth) and Workshops.

[17]  Cornie Scheffer,et al.  Repeatability of an off-the-shelf, full body inertial motion capture system during clinical gait analysis , 2010, 2010 Annual International Conference of the IEEE Engineering in Medicine and Biology.

[18]  P H Veltink,et al.  Ambulatory measurement of arm orientation. , 2007, Journal of biomechanics.

[19]  Billur Barshan,et al.  Detecting Falls with Wearable Sensors Using Machine Learning Techniques , 2014, Sensors.

[20]  Huosheng Hu,et al.  Human motion tracking for rehabilitation - A survey , 2008, Biomed. Signal Process. Control..

[21]  Terrence J. Sejnowski,et al.  Comparison of machine learning and traditional classifiers in glaucoma diagnosis , 2002, IEEE Transactions on Biomedical Engineering.

[22]  Dimitrios I. Fotiadis,et al.  Machine learning applications in cancer prognosis and prediction , 2014, Computational and structural biotechnology journal.

[23]  P. Tsairis,et al.  Improvement of Preoperative Foot Drop After Lumbar Surgery , 2002, Journal of spinal disorders & techniques.

[24]  Pedro M. Domingos A few useful things to know about machine learning , 2012, Commun. ACM.

[25]  Chris Yakopcic,et al.  Deep Versus Wide Convolutional Neural Networks for Object Recognition on Neuromorphic System , 2018, 2018 International Joint Conference on Neural Networks (IJCNN).

[26]  Robert Koprowski,et al.  Machine learning, medical diagnosis, and biomedical engineering research - commentary , 2014, Biomedical engineering online.

[27]  Shiva Sharif Bidabadi,et al.  The application of inertial measurements unit for the clinical evaluation and assessment of gait events , 2017, Journal of medical engineering & technology.

[28]  Kamiar Aminian,et al.  Spatio-temporal parameters of gait measured by an ambulatory system using miniature gyroscopes. , 2002, Journal of biomechanics.

[29]  Angelo M. Sabatini,et al.  A Machine Learning Framework for Gait Classification Using Inertial Sensors: Application to Elderly, Post-Stroke and Huntington’s Disease Patients , 2016, Sensors.

[30]  Jian Zhang,et al.  Classifying Lower Extremity Muscle Fatigue During Walking Using Machine Learning and Inertial Sensors , 2013, Annals of Biomedical Engineering.

[31]  Tao Liu,et al.  Gait Analysis Using Wearable Sensors , 2012, Sensors.

[32]  Massimo Panella,et al.  Selection of clinical features for pattern recognition applied to gait analysis , 2017, Medical & Biological Engineering & Computing.

[33]  Shiva Sharif Bidabadi,et al.  Validation of foot pitch angle estimation using inertial measurement unit against marker-based optical 3D motion capture system , 2018, Biomedical Engineering Letters.

[34]  Mark S. Nixon,et al.  Model-driven statistical analysis of human gait motion , 2002, Proceedings. International Conference on Image Processing.

[35]  Sheldon R Simon,et al.  Quantification of human motion: gait analysis-benefits and limitations to its application to clinical problems. , 2004, Journal of biomechanics.

[36]  J. M. Donelan,et al.  Walking speed and slope estimation using shank-mounted inertial measurement units , 2009, 2009 IEEE International Conference on Rehabilitation Robotics.