The article proposes a new framework for assessment of physical rehabilitation exercises based on a deep learning approach. The objective of the framework is automated quantification of patient performance in completing prescribed rehabilitation exercises, based on captured whole-body joint trajectories. The main components of the framework are metrics for measuring movement performance, scoring functions for mapping the performance metrics into numerical scores of movement quality, and deep neural network models for regressing quality scores of input movements via supervised learning. Furthermore, an overview of the existing methods for modeling and evaluation of rehabilitation movements is presented, encompassing various distance functions, dimensionality-reduction techniques, and movement models employed for this problem in prior studies. To the best of our knowledge, this is the first work that implements deep neural network for assessment of rehabilitation performance. Multiple deep network architectures are repurposed for the task in hand and are validated on a dataset of rehabilitation exercises.
The majority of related studies employed for deriving movement quality scores. Concretely, @cite_22 used a variant of the Mahalanobis distance to quantify the level of correctness of rehabilitation movements, based on a calculated distance between patient-performed repetitions and a set of repetitions performed by a group of healthy individuals. Similarly, a body of work utilized the dynamic time warping (DTW) algorithm @cite_35 for calculating the distance between a patients performance and healthy subjects performance @cite_34 -- @cite_17 . The advantage of the distance functions is that they are not exercise-specific, and thus can be applied for assessment of new types of exercises. However, the distance functions also have shortcomings, because they do not attempt to derive a model of the rehabilitation data, and the distances are calculated at the level of individual time-steps in the raw measurements.
@cite_35 @cite_34 @cite_22 @cite_17
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Dynamic time warping (DTW), which finds the minimum path by providing non-linear alignments between two time series, has been widely used as a distance measure for time series classification and clustering. However, DTW does not account for the relative importance regarding the phase difference between a reference point and a testing point. This may lead to misclassification especially in applications where the shape similarity between two sequences is a major consideration for an accurate recognition. Therefore, we propose a novel distance measure, called a weighted DTW (WDTW), which is a penalty-based DTW. Our approach penalizes points with higher phase difference between a reference point and a testing point in order to prevent minimum distance distortion caused by outliers. The rationale underlying the proposed distance measure is demonstrated with some illustrative examples. A new weight function, called the modified logistic weight function (MLWF), is also proposed to systematically assign weights as a function of the phase difference between a reference point and a testing point. By applying different weights to adjacent points, the proposed algorithm can enhance the detection of similarity between two time series. We show that some popular distance measures such as DTW and Euclidean distance are special cases of our proposed WDTW measure. We extend the proposed idea to other variants of DTW such as derivative dynamic time warping (DDTW) and propose the weighted version of DDTW. We have compared the performances of our proposed procedures with other popular approaches using public data sets available through the UCR Time Series Data Mining Archive for both time series classification and clustering problems. The experimental results indicate that the proposed approaches can achieve improved accuracy for time series classification and clustering problems. Abstract In this paper, a Hidden Semi-Markov Model (HSMM) based approach is proposed to evaluate and monitor body motion during a rehabilitation training program. The approach extracts clinically relevant motion features from skeleton joint trajectories, acquired by the RGB-D camera, and provides a score for the subject’s performance. The approach combines different aspects of rule and template based methods. The features have been defined by clinicians as exercise descriptors and are then assessed by a HSMM, trained upon an exemplar motion sequence. The reliability of the proposed approach is studied by evaluating its correlation with both a clinical assessment and a Dynamic Time Warping (DTW) algorithm, while healthy and neurological disabled people performed physical exercises. With respect to the discrimination between healthy and pathological conditions, the HSMM based method correlates better with the physician’s score than DTW. The study supports the use of HSMMs to assess motor performance providing a quantitative feedback to physiotherapist and patients. This result is particularly appropriate and useful for a remote assessment in the home. The accuracy of k-nearest neighbor (kNN) classification depends significantly on the metric used to compute distances between different examples. In this paper, we show how to learn a Mahalanobis distance metric for kNN classification from labeled examples. The Mahalanobis metric can equivalently be viewed as a global linear transformation of the input space that precedes kNN classification using Euclidean distances. In our approach, the metric is trained with the goal that the k-nearest neighbors always belong to the same class while examples from different classes are separated by a large margin. As in support vector machines (SVMs), the margin criterion leads to a convex optimization based on the hinge loss. Unlike learning in SVMs, however, our approach requires no modification or extension for problems in multiway (as opposed to binary) classification. In our framework, the Mahalanobis distance metric is obtained as the solution to a semidefinite program. On several data sets of varying size and difficulty, we find that metrics trained in this way lead to significant improvements in kNN classification. Sometimes these results can be further improved by clustering the training examples and learning an individual metric within each cluster. We show how to learn and combine these local metrics in a globally integrated manner. It has long been known that Dynamic Time Warping (DTW) is superior to Euclidean distance for classification and clustering of time series. However, until lately, most research has utilized Euclidean distance because it is more efficiently calculated. A recently introduced technique that greatly mitigates DTWs demanding CPU time has sparked a flurry of research activity. However, the technique and its many extensions still only allow DTW to be applied to moderately large datasets. In addition, almost all of the research on DTW has focused exclusively on speeding up its calculation; there has been little work done on improving its accuracy. In this work, we target the accuracy aspect of DTW performance and introduce a new framework that learns arbitrary constraints on the warping path of the DTW calculation. Apart from improving the accuracy of classification, our technique as a side effect speeds up DTW by a wide margin as well. We show the utility of our approach on datasets from diverse domains and demonstrate significant gains in accuracy and efficiency. E u clid ean D istan c e D yn am ic T im e W arp in g D is tan ce Figure 1: Note that while the two time series have an overall similar shape, they are not aligned in the time axis. Euclidean distance, which assumes the i point in one sequence is aligned with the i point in the other, will produce a pessimistic dissimilarity measure. The non-linear Dynamic Time Warped alignment allows a more intuitive distance measure to be calculated.