Abstract

BackgroundFreezing of gait (FoG) is one of the most disturbing and least understood symptoms in Parkinson disease (PD). Although the majority of existing assistive systems assume accurate detections of FoG episodes, the detection itself is still an open problem. The specificity of FoG is its dependency on the context of a patient, such as the current location or activity. Knowing the patient's context might improve FoG detection. One of the main technical challenges that needs to be solved in order to start using contextual information for FoG detection is accurate estimation of the patient's position and orientation toward key elements of his or her indoor environment.ObjectiveThe objectives of this paper are to (1) present the concept of the monitoring system, based on wearable and ambient sensors, which is designed to detect FoG using the spatial context of the user, (2) establish a set of requirements for the application of position and orientation tracking in FoG detection, (3) evaluate the accuracy of the position estimation for the tracking system, and (4) evaluate two different methods for human orientation estimation.MethodsWe developed a prototype system to localize humans and track their orientation, as an important prerequisite for a context-based FoG monitoring system. To setup the system for experiments with real PD patients, the accuracy of the position and orientation tracking was assessed under laboratory conditions in 12 participants. To collect the data, the participants were asked to wear a smartphone, with and without known orientation around the waist, while walking over a predefined path in the marked area captured by two Kinect cameras with non-overlapping fields of view.ResultsWe used the root mean square error (RMSE) as the main performance measure. The vision based position tracking algorithm achieved RMSE = 0.16 m in position estimation for upright standing people. The experimental results for the proposed human orientation estimation methods demonstrated the adaptivity and robustness to changes in the smartphone attachment position, when the fusion of both vision and inertial information was used.ConclusionsThe system achieves satisfactory accuracy on indoor position tracking for the use in the FoG detection application with spatial context. The combination of inertial and vision information has the potential for correct patient heading estimation even when the inertial wearable sensor device is put into an a priori unknown position.

Highlights

  • BackgroundFreezing of Gait (FoG) is a temporary, involuntary inability to initiate or continue movement lasting just a few seconds, or on some occasions, several minutes [1]

  • The combination of inertial and vision information has the potential for correct patient heading estimation even when the inertial wearable sensor device is put into an a priori unknown position. (JMIR Mhealth Uhealth 2013;1(2):e14) doi:10.2196/mhealth

  • The observation of on-the-spot turns can be achieved only by precisely estimating angular velocity of the person, which requires additional tracking of the heading angle. This is the reason why we propose the two-dimensional 3D (2D) pose, expressed by two floor position coordinates (x, y) and one heading angle (θ), as the minimal tracking representation to be used in the spatial context inference process for Freezing of gait (FoG) detection

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Summary

Introduction

BackgroundFreezing of Gait (FoG) is a temporary, involuntary inability to initiate or continue movement lasting just a few seconds, or on some occasions, several minutes [1]. FoG is experienced by approximately 50% of patients with advanced Parkinson disease (PD) [2]. It is described by the patients as a feeling of having the feet glued to the ground and being temporarily unable to start walking again. FoG usually depends on the walking situation. It often occurs at turns, start of walking, upon reaching the destination, and in open spaces [3]. One of the main technical challenges that needs to be solved in order to start using contextual information for FoG detection is accurate estimation of the patient's position and orientation toward key elements of his or her indoor environment

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