Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study

BACKGROUND:Rehabilitation has an established role in the management of a wide range of musculoskeletal conditions. Much of this treatment relies on self-directed exercises at home, where adherence of execution is unknown. Demonstrating treatment fidelity is necessary to draw conclusions about the ef...

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Main Authors: Bavan, L, Surmacz, K, Beard, D, Mellon, S, Rees, J
Format: Journal article
Language:English
Published: Elsevier 2019
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author Bavan, L
Surmacz, K
Beard, D
Mellon, S
Rees, J
author_facet Bavan, L
Surmacz, K
Beard, D
Mellon, S
Rees, J
author_sort Bavan, L
collection OXFORD
description BACKGROUND:Rehabilitation has an established role in the management of a wide range of musculoskeletal conditions. Much of this treatment relies on self-directed exercises at home, where adherence of execution is unknown. Demonstrating treatment fidelity is necessary to draw conclusions about the efficacy of rehabilitation interventions in both clinical and research settings. There is a lack of tools and methods to achieve this. RESEARCH QUESTION:This study aims to evaluate the feasibility of using a single inertial sensor to recognise and classify shoulder rehabilitation activity using supervised machine learning techniques. METHODS:Twenty patients with shoulder pain were monitored performing five rehabilitation exercises routinely prescribed for their condition. Accelerometer, gyroscope and magnetometer data were collected via a device mounted onto an arm sleeve. Non-specific motion data was included in the analysis. Time and frequency domain features were calculated from labelled data segments and ranked in terms of their predictive importance using the ReliefF algorithm. Selected features were used to train four supervised learning algorithms: decision tree, k-nearest neighbour, support vector machine and random forests. Performance of algorithms in accurately classifying exercise activity was evaluated with ten-fold cross-validation and leave-one-subject-out-validation methods. RESULTS:Optimal predictive accuracies for ten-fold cross-validation (97.2%) and leave-one-subject-out-validation (80.5%) were achieved by support vector machine and random forests algorithms, respectively. Time domain features derived from accelerometer, magnetometer and orientation data streams were shown to have the highest predictive value for classifying rehabilitation activity. SIGNIFICANCE:Classification models performed well in differentiating patient exercise activity from non-specific movement and identifying specific exercise type using inertial sensor data. A clinically useful account of home rehabilitation activity will help guide treatment strategies and facilitate methods to improve patient engagement. Future work should focus on evaluating the performance of such systems in natural and unsupervised settings.
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spelling oxford-uuid:31857c55-bf12-404f-8ba7-d5b6b23771f82022-03-26T13:08:30ZAdherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:31857c55-bf12-404f-8ba7-d5b6b23771f8EnglishSymplectic Elements at OxfordElsevier2019Bavan, LSurmacz, KBeard, DMellon, SRees, JBACKGROUND:Rehabilitation has an established role in the management of a wide range of musculoskeletal conditions. Much of this treatment relies on self-directed exercises at home, where adherence of execution is unknown. Demonstrating treatment fidelity is necessary to draw conclusions about the efficacy of rehabilitation interventions in both clinical and research settings. There is a lack of tools and methods to achieve this. RESEARCH QUESTION:This study aims to evaluate the feasibility of using a single inertial sensor to recognise and classify shoulder rehabilitation activity using supervised machine learning techniques. METHODS:Twenty patients with shoulder pain were monitored performing five rehabilitation exercises routinely prescribed for their condition. Accelerometer, gyroscope and magnetometer data were collected via a device mounted onto an arm sleeve. Non-specific motion data was included in the analysis. Time and frequency domain features were calculated from labelled data segments and ranked in terms of their predictive importance using the ReliefF algorithm. Selected features were used to train four supervised learning algorithms: decision tree, k-nearest neighbour, support vector machine and random forests. Performance of algorithms in accurately classifying exercise activity was evaluated with ten-fold cross-validation and leave-one-subject-out-validation methods. RESULTS:Optimal predictive accuracies for ten-fold cross-validation (97.2%) and leave-one-subject-out-validation (80.5%) were achieved by support vector machine and random forests algorithms, respectively. Time domain features derived from accelerometer, magnetometer and orientation data streams were shown to have the highest predictive value for classifying rehabilitation activity. SIGNIFICANCE:Classification models performed well in differentiating patient exercise activity from non-specific movement and identifying specific exercise type using inertial sensor data. A clinically useful account of home rehabilitation activity will help guide treatment strategies and facilitate methods to improve patient engagement. Future work should focus on evaluating the performance of such systems in natural and unsupervised settings.
spellingShingle Bavan, L
Surmacz, K
Beard, D
Mellon, S
Rees, J
Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study
title Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study
title_full Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study
title_fullStr Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study
title_full_unstemmed Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study
title_short Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study
title_sort adherence monitoring of rehabilitation exercise with inertial sensors a clinical validation study
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