Frailty Level Classification of the Community Elderly Using Microsoft Kinect-Based Skeleton Pose: A Machine Learning Approach

Frailty is one of the most important geriatric syndromes, which can be associated with increased risk for incident disability and hospitalization. Developing a real-time classification model of elderly frailty level could be beneficial for designing a clinical predictive assessment tool. Hence, the objective of this study was to predict the elderly frailty level utilizing the machine learning approach on skeleton data acquired from a Kinect sensor. Seven hundred and eighty-seven community elderly were recruited in this study. The Kinect data were acquired from the elderly performing different functional assessment exercises including: (1) 30-s arm curl; (2) 30-s chair sit-to-stand; (3) 2-min step; and (4) gait analysis tests. The proposed methodology was successfully validated by gender classification with accuracies up to 84 percent. Regarding frailty level evaluation and prediction, the results indicated that support vector classifier (SVC) and multi-layer perceptron (MLP) are the most successful estimators in prediction of the Fried’s frailty level with median accuracies up to 97.5 percent. The high level of accuracy achieved with the proposed methodology indicates that ML modeling can identify the risk of frailty in elderly individuals based on evaluating the real-time skeletal movements using the Kinect sensor.

[1]  C. Jessie Jones,et al.  Development and Validation of a Functional Fitness Test for Community-Residing Older Adults , 1999 .

[2]  L. Fried,et al.  Frailty in older adults: evidence for a phenotype. , 2001, The journals of gerontology. Series A, Biological sciences and medical sciences.

[3]  A. Zhang,et al.  Feature selection for classifying high-dimensional numerical data , 2004, Proceedings of the 2004 IEEE Computer Society Conference on Computer Vision and Pattern Recognition, 2004. CVPR 2004..

[4]  Aaron Aragaki,et al.  Frailty: Emergence and Consequences in Women Aged 65 and Older in the Women's Health Initiative Observational Study , 2005, Journal of the American Geriatrics Society.

[5]  I. McDowell,et al.  A global clinical measure of fitness and frailty in elderly people , 2005, Canadian Medical Association Journal.

[6]  Chih-Jen Lin,et al.  Combining SVMs with Various Feature Selection Strategies , 2006, Feature Extraction.

[7]  Pedro Larrañaga,et al.  A review of feature selection techniques in bioinformatics , 2007, Bioinform..

[8]  Ming Zhang,et al.  Dynamic Fall Detection and Pace Measurement in Walking Sticks , 2007, 2007 Joint Workshop on High Confidence Medical Devices, Software, and Systems and Medical Device Plug-and-Play Interoperability (HCMDSS-MDPnP 2007).

[9]  Kellie J. Archer,et al.  Empirical characterization of random forest variable importance measures , 2008, Comput. Stat. Data Anal..

[10]  Thomas M Gill,et al.  Prognostic Significance of Potential Frailty Criteria , 2008, Journal of the American Geriatrics Society.

[11]  Stephen R. Marsland,et al.  Machine Learning - An Algorithmic Perspective , 2009, Chapman and Hall / CRC machine learning and pattern recognition series.

[12]  Bjoern H. Menze,et al.  A comparison of random forest and its Gini importance with standard chemometric methods for the feature selection and classification of spectral data , 2009, BMC Bioinformatics.

[13]  Yutaka Kuroda,et al.  DROP: an SVM domain linker predictor trained with optimal features selected by random forest , 2011, Bioinform..

[14]  Q. Xue The frailty syndrome: definition and natural history. , 2011, Clinics in geriatric medicine.

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

[16]  R. Fielding,et al.  Exercise as an intervention for frailty. , 2011, Clinics in geriatric medicine.

[17]  Martin Wolf,et al.  An Efficient Algorithm for Automatic Peak Detection in Noisy Periodic and Quasi-Periodic Signals , 2012, Algorithms.

[18]  Yoshua Bengio,et al.  Random Search for Hyper-Parameter Optimization , 2012, J. Mach. Learn. Res..

[19]  Konrad Paul Kording,et al.  Fall Classification by Machine Learning Using Mobile Phones , 2012, PloS one.

[20]  Yoshida Hiroaki,et al.  Rapid Feature Selection Based on Random Forests for High-Dimensional Data , 2012 .

[21]  Dimitris Kastaniotis,et al.  Gait-based gender recognition using pose information for real time applications , 2013, 2013 18th International Conference on Digital Signal Processing (DSP).

[22]  Jonathan Wheat,et al.  The potential of the Microsoft Kinect in sports analysis and biomechanics , 2013 .

[23]  G David Batty,et al.  Measures of frailty in population-based studies: an overview , 2013, BMC Geriatrics.

[24]  Huiru Zheng,et al.  Assessing Gait Patterns of Healthy Adults Climbing Stairs Employing Machine Learning Techniques , 2013, Int. J. Intell. Syst..

[25]  Winson C.C. Lee,et al.  Evaluation of the Microsoft Kinect as a clinical assessment tool of body sway. , 2014, Gait & posture.

[26]  Zaid A. Mundher,et al.  A Real-Time Fall Detection System in Elderly Care Using Mobile Robot and Kinect Sensor , 2014 .

[27]  Michael Schwenk,et al.  Wearable Sensor-Based In-Home Assessment of Gait, Balance, and Physical Activity for Discrimination of Frailty Status: Baseline Results of the Arizona Frailty Cohort Study , 2014, Gerontology.

[28]  Surapa Thiemjarus,et al.  Automatic Fall Monitoring: A Review , 2014, Sensors.

[29]  Miguel A. Labrador,et al.  Survey on Fall Detection and Fall Prevention Using Wearable and External Sensors , 2014, Sensors.

[30]  Barry R Greene,et al.  Frailty status can be accurately assessed using inertial sensors and the TUG test. , 2014, Age and ageing.

[31]  Dimitris Kastaniotis,et al.  A framework for gait-based recognition using Kinect , 2015, Pattern Recognit. Lett..

[32]  V. Ezeugwu,et al.  Mobility disability and the pattern of accelerometer-derived sedentary and physical activity behaviors in people with multiple sclerosis , 2015, Preventive medicine reports.

[33]  Ricardo Matsumura de Araújo,et al.  Person Identification Using Anthropometric and Gait Data from Kinect Sensor , 2015, AAAI.

[34]  Amit Konar,et al.  Ensemble Classifier-Based Physical Disorder Recognition System Using Kinect Sensor , 2015 .

[35]  T. Hortobágyi,et al.  Multivariate Analyses and Classification of Inertial Sensor Data to Identify Aging Effects on the Timed-Up-and-Go Test , 2016, PloS one.

[36]  Muhammad Badruddin Khan,et al.  Machine Learning: Algorithms and Applications , 2016 .

[37]  Dimitris Kastaniotis,et al.  Gait based recognition via fusing information from Euclidean and Riemannian manifolds , 2016, Pattern Recognit. Lett..

[38]  William S Marras,et al.  Accuracy map of an optical motion capture system with 42 or 21 cameras in a large measurement volume. , 2017, Journal of biomechanics.

[39]  Khaled M. Elleithy,et al.  Sensor-Based Assistive Devices for Visually-Impaired People: Current Status, Challenges, and Future Directions , 2017, Sensors.

[40]  María Dolores Rodríguez-Moreno,et al.  Machine Learning Approach to Detect Falls on Elderly People Using Sound , 2017, IEA/AIE.

[41]  Marina L. Gavrilova,et al.  Kinect gait skeletal joint feature-based person identification , 2017, 2017 IEEE 16th International Conference on Cognitive Informatics & Cognitive Computing (ICCI*CC).

[42]  Bijan Najafi,et al.  Postural Transitions during Activities of Daily Living Could Identify Frailty Status: Application of Wearable Technology to Identify Frailty during Unsupervised Condition , 2017, Gerontology.

[43]  Mohammad Sohel Rahman,et al.  isGPT: An optimized model to identify sub-Golgi protein types using SVM and Random Forest based feature selection , 2017, Artif. Intell. Medicine.

[44]  Joana Figueiredo,et al.  Automatic recognition of gait patterns in human motor disorders using machine learning: A review. , 2018, Medical engineering & physics.

[45]  Steffi L. Colyer,et al.  A Review of the Evolution of Vision-Based Motion Analysis and the Integration of Advanced Computer Vision Methods Towards Developing a Markerless System , 2018, Sports Medicine - Open.

[46]  J. Alcazar,et al.  The sit-to-stand muscle power test: An easy, inexpensive and portable procedure to assess muscle power in older people , 2018, Experimental Gerontology.

[47]  Moataz A. Eltoukhy,et al.  Validation of Static and Dynamic Balance Assessment Using Microsoft Kinect for Young and Elderly Populations , 2018, IEEE Journal of Biomedical and Health Informatics.

[48]  Madalina Fiterau,et al.  Machine learning in human movement biomechanics: Best practices, common pitfalls, and new opportunities. , 2018, Journal of biomechanics.

[49]  Yanxin Zhang,et al.  Application of supervised machine learning algorithms in the classification of sagittal gait patterns of cerebral palsy children with spastic diplegia , 2019, Comput. Biol. Medicine.

[50]  Etienne Burdet,et al.  Prediction of Gait Freezing in Parkinsonian Patients: A Binary Classification Augmented With Time Series Prediction , 2019, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[51]  Marina L. Gavrilova,et al.  Artificial Neural Network Based Gait Recognition Using Kinect Sensor , 2019, IEEE Access.

[52]  A. Sayer,et al.  The feasibility of assessing frailty and sarcopenia in hospitalised older people: a comparison of commonly used tools , 2019, BMC Geriatrics.

[53]  Fazel Naghdy,et al.  Assessment of frailty: a survey of quantitative and clinical methods , 2019, BMC biomedical engineering.

[54]  Rung-Ching Chen,et al.  Selecting critical features for data classification based on machine learning methods , 2020, Journal of Big Data.

[55]  Mario Giacobini,et al.  Predictive Modeling for Frailty Conditions in Elderly People: Machine Learning Approaches , 2019, JMIR medical informatics.

[56]  Stefano Ramat,et al.  Skeleton data pre-processing for human pose recognition using Neural Network* , 2020, 2020 42nd Annual International Conference of the IEEE Engineering in Medicine & Biology Society (EMBC).

[57]  R. T. Moura,et al.  Kinect v2 based system for gait assessment of children with cerebral palsy in rehabilitation settings , 2020, Journal of medical engineering & technology.

[58]  M. Nikkhoo,et al.  Reliability and Validity of a Mobile Device for Assessing Head Control Ability , 2020, Journal of Medical and Biological Engineering.

[59]  Bertram Taetz,et al.  General method for automated feature extraction and selection and its application for gender classification and biomechanical knowledge discovery of sex differences in spinal posture during stance and gait , 2020, Computer methods in biomechanics and biomedical engineering.

[60]  Michael H. Schwartz,et al.  Deep neural networks enable quantitative movement analysis using single-camera videos , 2020, Nature Communications.

[61]  Oskar Stamm,et al.  Accuracy of Monocular Two-Dimensional Pose Estimation Compared With a Reference Standard for Kinematic Multiview Analysis: Validation Study , 2020, JMIR mHealth and uHealth.

[62]  Neelesh Kumar,et al.  Role of machine learning in gait analysis: a review , 2020, Journal of medical engineering & technology.

[63]  L. Peng,et al.  Comparisons Between Hypothesis- and Data-Driven Approaches for Multimorbidity Frailty Index: A Machine Learning Approach , 2020, Journal of medical Internet research.

[64]  R C Ambagtsheer,et al.  The application of artificial intelligence (AI) techniques to identify frailty within a residential aged care administrative data set , 2020, Int. J. Medical Informatics.

[65]  Maria Rosa Baeza-Barragán,et al.  The Use of Virtual Reality Technologies in the Treatment of Duchenne Muscular Dystrophy: Systematic Review , 2020, JMIR mHealth and uHealth.

[66]  J. Alcazar,et al.  Sit-to-stand muscle power test: Comparison between estimated and force plate-derived mechanical power and their association with physical function in older adults , 2020, Experimental Gerontology.