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Estimation of temporospatial clinical features of gait (CFs), such as step count and length, step duration, step frequency, gait speed, and distance traveled, is an important component of community-based mobility evaluation using wearable accelerometers. However, accurate unsupervised computerized measurement of CFs of individuals with Duchenne muscular dystrophy (DMD) who have progressive loss of ambulatory mobility is difficult due to differences in patterns and magnitudes of acceleration across their range of attainable gait velocities. This paper proposes a novel calibration method. It aims to detect steps, estimate stride lengths, and determine travel distance. The approach involves a combination of clinical observation, machine-learning-based step detection, and regression-based stride length prediction. The method demonstrates high accuracy in children with DMD and typically developing controls (TDs) regardless of the participant's level of ability. Fifteen children with DMD and fifteen TDs underwent supervised clinical testing across a range of gait speeds using 10 m or 25 m run/walk (10 MRW, 25 MRW), 100 m run/walk (100 MRW), 6-min walk (6 MWT), and free-walk (FW) evaluations while wearing a mobile-phone-based accelerometer at the waist near the body's center of mass. Following calibration by a trained clinical evaluator, CFs were extracted from the accelerometer data using a multi-step machine-learning-based process and the results were compared to ground-truth observation data. Model predictions vs. observed values for step counts, distance traveled, and step length showed a strong correlation. Our study findings indicate that a single waist-worn accelerometer calibrated to an individual's stride characteristics using our methods accurately measures CFs and estimates travel distances across a common range of gait speeds in both DMD and TD peers.

We introduce Walk4Me, a telehealth community mobility assessment system designed to facilitate early diagnosis, severity, and progression identification. Our system achieves this by 1) enabling early diagnosis, 2) identifying early indicators of clinical severity, and 3) quantifying and tracking the progression of the disease across the ambulatory phase of the disease. To accomplish this, we employ an Artificial Intelligence (AI)-based detection of gait characteristics in patients and typically developing peers. Our system remotely and in real-time collects data from device sensors (e.g., acceleration from a mobile device, etc.) using our novel Walk4Me API. Our web application extracts temporal/spatial gait characteristics and raw data signal characteristics and then employs traditional machine learning and deep learning techniques to identify patterns that can 1) identify patients with gait disturbances associated with disease, 2) describe the degree of mobility limitation, and 3) identify characteristics that change over time with disease progression. We have identified several machine learning techniques that differentiate between patients and typically-developing subjects with 100% accuracy across the age range studied, and we have also identified corresponding temporal/spatial gait characteristics associated with each group. Our work demonstrates the potential of utilizing the latest advances in mobile device and machine learning technology to measure clinical outcomes regardless of the point of care, inform early clinical diagnosis and treatment decision-making, and monitor disease progression.

With the development of the Internet of Things(IoT) and Artificial Intelligence(AI) technologies, human activity recognition has enabled various applications, such as smart homes and assisted living. In this paper, we target a new healthcare application of human activity recognition, early mobility recognition for Intensive Care Unit(ICU) patients. Early mobility is essential for ICU patients who suffer from long-time immobilization. Our system includes accelerometer-based data collection from ICU patients and an AI model to recognize patients' early mobility. To improve the model accuracy and stability, we identify features that are insensitive to sensor orientations and propose a segment voting process that leverages a majority voting strategy to recognize each segment's activity. Our results show that our system improves model accuracy from 77.78\% to 81.86\% and reduces the model instability (standard deviation) from 16.69\% to 6.92\%, compared to the same AI model without our feature engineering and segment voting process.

Differences in gait patterns of children with Duchenne muscular dystrophy (DMD) and typically-developing (TD) peers are visible to the eye, but quantifications of those differences outside of the gait laboratory have been elusive. In this work, we measured vertical, mediolateral, and anteroposterior acceleration using a waist-worn iPhone accelerometer during ambulation across a typical range of velocities. Fifteen TD and fifteen DMD children from 3-16 years of age underwent eight walking/running activities, including five 25 meters walk/run speed-calibration tests at a slow walk to running speeds (SC-L1 to SC-L5), a 6-minute walk test (6MWT), a 100 meters fast-walk/jog/run (100MRW), and a free walk (FW). For clinical anchoring purposes, participants completed a Northstar Ambulatory Assessment (NSAA). We extracted temporospatial gait clinical features (CFs) and applied multiple machine learning (ML) approaches to differentiate between DMD and TD children using extracted temporospatial gait CFs and raw data. Extracted temporospatial gait CFs showed reduced step length and a greater mediolateral component of total power (TP) consistent with shorter strides and Trendelenberg-like gait commonly observed in DMD. ML approaches using temporospatial gait CFs and raw data varied in effectiveness at differentiating between DMD and TD controls at different speeds, with an accuracy of up to 100%. We demonstrate that by using ML with accelerometer data from a consumer-grade smartphone, we can capture DMD-associated gait characteristics in toddlers to teens.

With the rapid development of the internet of things (IoT) and artificial intelligence (AI) technologies, human activity recognition (HAR) has been applied in a variety of domains such as security and surveillance, human-robot interaction, and entertainment. Even though a number of surveys and review papers have been published, there is a lack of HAR overview papers focusing on healthcare applications that use wearable sensors. Therefore, we fill in the gap by presenting this overview paper. In particular, we present our projects to illustrate the system design of HAR applications for healthcare. Our projects include early mobility identification of human activities for intensive care unit (ICU) patients and gait analysis of Duchenne muscular dystrophy (DMD) patients. We cover essential components of designing HAR systems including sensor factors (e.g., type, number, and placement location), AI model selection (e.g., classical machine learning models versus deep learning models), and feature engineering. In addition, we highlight the challenges of such healthcare-oriented HAR systems and propose several research opportunities for both the medical and the computer science community.

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease of the brain and the spinal cord, which leads to paralysis of motor functions. Patients retain their ability to blink, which can be used for communication. Here, We present an Artificial Intelligence (AI) system that uses eye-blinks to communicate with the outside world, running on real-time Internet-of-Things (IoT) devices. The system uses a Convolutional Neural Network (CNN) to find the blinking pattern, which is defined as a series of Open and Closed states. Each pattern is mapped to a collection of words that manifest the patient's intent. To investigate the best trade-off between accuracy and latency, we investigated several Convolutional Network architectures, such as ResNet, SqueezeNet, DenseNet, and InceptionV3, and evaluated their performance. We found that the InceptionV3 architecture, after hyper-parameter fine-tuning on the specific task led to the best performance with an accuracy of 99.20% and 94ms latency. This work demonstrates how the latest advances in deep learning architectures can be adapted for clinical systems that ameliorate the patient's quality of life regardless of the point-of-care., Comment: 8 pages, 4 figures