Your Turn: Real-World Turning Angle Estimation for Parkinson's Disease Severity Assessment

People with Parkinson's Disease (PD) often experience progressively worsening gait, including changes in how they turn around, as the disease progresses. Existing clinical rating tools are not capable of capturing hour-by-hour variations of PD symptoms, as they are confined to brief assessments within clinic settings. Measuring real-world gait turning angles continuously and passively is a component step towards using gait characteristics as sensitive indicators of disease progression in PD. This paper presents a deep learning-based approach to automatically quantify turning angles by extracting 3D skeletons from videos and calculating the rotation of hip and knee joints. We utilise state-of-the-art human pose estimation models, Fastpose and Strided Transformer, on a total of 1386 turning video clips from 24 subjects (12 people with PD and 12 healthy control volunteers), trimmed from a PD dataset of unscripted free-living videos in a home-like setting (Turn-REMAP). We also curate a turning video dataset, Turn-H3.6M, from the public Human3.6M human pose benchmark with 3D ground truth, to further validate our method. Previous gait research has primarily taken place in clinics or laboratories evaluating scripted gait outcomes, but this work focuses on real-world settings where complexities exist, such as baggy clothing and poor lighting. Due to difficulties in obtaining accurate ground truth data in a free-living setting, we quantise the angle into the nearest bin $45^\circ$ based on the manual labelling of expert clinicians. Our method achieves a turning calculation accuracy of 41.6%, a Mean Absolute Error (MAE) of 34.7{\deg}, and a weighted precision WPrec of 68.3% for Turn-REMAP. This is the first work to explore the use of single monocular camera data to quantify turns by PD patients in a home setting.

Multimodal Indoor Localisation in Parkinson's Disease for Detecting Medication Use: Observational Pilot Study in a Free-Living Setting

Parkinson's disease (PD) is a slowly progressive, debilitating neurodegenerative disease which causes motor symptoms including gait dysfunction. Motor fluctuations are alterations between periods with a positive response to levodopa therapy ("on") and periods marked by re-emergency of PD symptoms ("off") as the response to medication wears off. These fluctuations often affect gait speed and they increase in their disabling impact as PD progresses. To improve the effectiveness of current indoor localisation methods, a transformer-based approach utilising dual modalities which provide complementary views of movement, Received Signal Strength Indicator (RSSI) and accelerometer data from wearable devices, is proposed. A sub-objective aims to evaluate whether indoor localisation, including its in-home gait speed features (i.e. the time taken to walk between rooms), could be used to evaluate motor fluctuations by detecting whether the person with PD is taking levodopa medications or withholding them. To properly evaluate our proposed method, we use a free-living dataset where the movements and mobility are greatly varied and unstructured as expected in real-world conditions. 24 participants lived in pairs (consisting of one person with PD, one control) for five days in a smart home with various sensors. Our evaluation on the resulting dataset demonstrates that our proposed network outperforms other methods for indoor localisation. The sub-objective evaluation shows that precise room-level localisation predictions, transformed into in-home gait speed features, produce accurate predictions on whether the PD participant is taking or withholding their medications.

Multimodal Indoor Localisation for Measuring Mobility in Parkinson's Disease using Transformers

Parkinson's disease (PD) is a slowly progressive debilitating neurodegenerative disease which is prominently characterised by motor symptoms. Indoor localisation, including number and speed of room to room transitions, provides a proxy outcome which represents mobility and could be used as a digital biomarker to quantify how mobility changes as this disease progresses. We use data collected from 10 people with Parkinson's, and 10 controls, each of whom lived for five days in a smart home with various sensors. In order to more effectively localise them indoors, we propose a transformer-based approach utilizing two data modalities, Received Signal Strength Indicator (RSSI) and accelerometer data from wearable devices, which provide complementary views of movement. Our approach makes asymmetric and dynamic correlations by a) learning temporal correlations at different scales and levels, and b) utilizing various gating mechanisms to select relevant features within modality and suppress unnecessary modalities. On a dataset with real patients, we demonstrate that our proposed method gives an average accuracy of 89.9%, outperforming competitors. We also show that our model is able to better predict in-home mobility for people with Parkinson's with an average offset of 1.13 seconds to ground truth.

A Spatio-temporal Attention-based Model for Infant Movement Assessment from Videos

The absence or abnormality of fidgety movements of joints or limbs is strongly indicative of cerebral palsy in infants. Developing computer-based methods for assessing infant movements in videos is pivotal for improved cerebral palsy screening. Most existing methods use appearance-based features and are thus sensitive to strong but irrelevant signals caused by background clutter or a moving camera. Moreover, these features are computed over the whole frame, thus they measure gross whole body movements rather than specific joint/limb motion. Addressing these challenges, we develop and validate a new method for fidgety movement assessment from consumer-grade videos using human poses extracted from short clips. Human poses capture only relevant motion profiles of joints and limbs and are thus free from irrelevant appearance artifacts. The dynamics and coordination between joints are modeled using spatio-temporal graph convolutional networks. Frames and body parts that contain discriminative information about fidgety movements are selected through a spatio-temporal attention mechanism. We validate the proposed model on the cerebral palsy screening task using a real-life consumer-grade video dataset collected at an Australian hospital through the Cerebral Palsy Alliance, Australia. Our experiments show that the proposed method achieves the ROC-AUC score of 81.87%, significantly outperforming existing competing methods with better interpretability.