A store-and-forward cloud-based telemonitoring system for automatic assessing dysarthria evolution in neurological diseases from video-recording analysis

Background and objectives: Patients suffering from neurological diseases may develop dysarthria, a motor speech disorder affecting the execution of speech. Close and quantitative monitoring of dysarthria evolution is crucial for enabling clinicians to promptly implement patient management strategies and maximizing effectiveness and efficiency of communication functions in term of restoring, compensating or adjusting. In the clinical assessment of orofacial structures and functions, at rest condition or during speech and non-speech movements, a qualitative evaluation is usually performed, throughout visual observation. Methods: To overcome limitations posed by qualitative assessments, this work presents a store-and-forward self-service telemonitoring system that integrates, within its cloud architecture, a convolutional neural network (CNN) for analyzing video recordings acquired by individuals with dysarthria. This architecture, called facial landmark Mask RCNN, aims at locating facial landmarks as a prior for assessing the orofacial functions related to speech and examining dysarthria evolution in neurological diseases. Results: When tested on the Toronto NeuroFace dataset, a publicly available annotated dataset of video recordings from patients with amyotrophic lateral sclerosis (ALS) and stroke, the proposed CNN achieved a normalized mean error equal to 1.79 on localizing the facial landmarks. We also tested our system in a real-life scenario on 11 bulbar-onset ALS subjects, obtaining promising outcomes in terms of facial landmark position estimation. Discussion and conclusions: This preliminary study represents a relevant step towards the use of remote tools to support clinicians in monitoring the evolution of dysarthria.

Deep learning-based approaches for human motion decoding in smart walkers for rehabilitation

Gait disabilities are among the most frequent worldwide. Their treatment relies on rehabilitation therapies, in which smart walkers are being introduced to empower the user's recovery and autonomy, while reducing the clinicians effort. For that, these should be able to decode human motion and needs, as early as possible. Current walkers decode motion intention using information of wearable or embedded sensors, namely inertial units, force and hall sensors, and lasers, whose main limitations imply an expensive solution or hinder the perception of human movement. Smart walkers commonly lack a seamless human-robot interaction, which intuitively understands human motions. A contactless approach is proposed in this work, addressing human motion decoding as an early action recognition/detection problematic, using RGB-D cameras. We studied different deep learning-based algorithms, organised in three different approaches, to process lower body RGB-D video sequences, recorded from an embedded camera of a smart walker, and classify them into 4 classes (stop, walk, turn right/left). A custom dataset involving 15 healthy participants walking with the device was acquired and prepared, resulting in 28800 balanced RGB-D frames, to train and evaluate the deep networks. The best results were attained by a convolutional neural network with a channel attention mechanism, reaching accuracy values of 99.61% and above 93%, for offline early detection/recognition and trial simulations, respectively. Following the hypothesis that human lower body features encode prominent information, fostering a more robust prediction towards real-time applications, the algorithm focus was also evaluated using Dice metric, leading to values slightly higher than 30%. Promising results were attained for early action detection as a human motion decoding strategy, with enhancements in the focus of the proposed architectures.