IMU-Based Approach to Detect Spastic Cerebral Palsy in Infants at Early Stages
DOI:
https://doi.org/10.4108/eetpht.10.5258Keywords:
Cerebral Palsy, Spastic Cerebral Palsy, Fidgety Movements, Inertial Measurement Unit, General Movement AssesmentAbstract
INTRODUCTION: Cerebral Palsy (CP) is a non-progressive neurological disorder affecting muscle control in early childhood, leading to permanent alterations in body posture and movement. Early identification is crucial for accurate diagnosis and therapy-based interventions. In recent years, an automated monitoring system has been developed to facilitate the health assessment of infants, enabling early recognition of neurological dysfunctions in high-risk infants. However, the interpretation of these assessments lacks standardization and is subject to examiner bias.
OBJECTIVES: Many infants with CP exhibit increased tonic stretch reflexes due to Upper Motor Neuron Syndrome (UMNS), resulting from motor neuron damage that disrupts muscle signalling.
METHOD: To detect abnormal muscle reactions, our team employed an Inertial Measurement Unit (IMU) sensor, comprising three tri-axial sensors (accelerometer, gyroscope, magnetometer) that capture movement data continuously and unobtrusively. IMU sensors are compact, cost-effective, and have low processing requirements, requiring attachment to the infant's body to measure inter-body part angles. Our team analyzed muscle activity and posture using IMU sensors, collecting tri-axial data from 43 infants in real-time. Additional factors like age, stride length, and leg length were incorporated into the dataset.
RESULTS: Our team has applied various supervised machine learning approaches to predict CP in infants due to the limited dataset size, validating models through k-fold cross-validation. Among the models, Naive Bayes (NB) outperformed Logistic Regression (LR), Decision Tree (DT), Linear Discriminant Analysis (LDA), k-Nearest Neighbors (kNN), and Support Vector Machine (SVM), achieving an accuracy of 88%. CONCLUSION: This research contributes to the early detection and intervention of CP in infants, potentially improving their long-term outcomes.
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https://www.who.int/pmnch/media/press_materials/fs/fs_newborndealth_illness/en
Amiel-Tison,C. Neurological evaluation of the maturity of newborn infants. Archives of Disease in Childhood. 1963; Vol. 43, pp. 89–93. DOI: https://doi.org/10.1136/adc.43.227.89
A, Cardoso, L, Gomes, C, Silva, R, Soares, M, Abreu, W, Padilha, A, Cavalcanti. Dental Caries and Periodontal Disease in Brazilian Children and Adolescents with Cerebral Palsy, International Journal of Environmental Research and Public Health. 2014; Vol. 12, no. 1, pp. 335. DOI: https://doi.org/10.3390/ijerph120100335
Kieviet, JF, Piek, JP, Aarnoudse-Moens, CS, Oosterlaan, J. Motor development in very preterm and very low-birth-weight children from birth to adolescence. JAMA. 2009; Vol. 302, pp. 2235–2242. DOI: https://doi.org/10.1001/jama.2009.1708
Ali, A, Al-Mayahi.: Early Markers for Cerebral Palsy, Cerebral Palsy - Clinical and Therapeutic Aspects. 2018. DOI: https://doi.org/10.5772/intechopen.79466
Prechtl, HFR, Einspieler, C, Cioni, G. An early marker for neurological deficits after perinatal brain lesions. Lancet. 1997; Vol. 349, pp. 1361–1363. DOI: https://doi.org/10.1016/S0140-6736(96)10182-3
Prechtl, HFR. General movement assessment as a method of developmental neurology: new paradigms and their consequences. Dev Med Child Neurol. 2001; Vol.43, pp.836–842. DOI: https://doi.org/10.1111/j.1469-8749.2001.tb00173.x
Dubowitz, LMS, Dubowitz,D, Mercuri,E. The Neurological Assessment of the PreTerm and Full-Term Newborn Infant. 2nd ed. London, United Kingdom: MacKeith Press. 1999. DOI: https://doi.org/10.1016/S0387-7604(80)80003-9
Hadders-Algra, M.: Evaluation of motor function in young infants by means of the assessment of general movements: a review. Pediatr Phys Ther. 2001; Vol. 13, pp. 27–36. DOI: https://doi.org/10.1097/00001577-200113010-00005
Palmer, FB.: Strategies for the early diagnosis of cerebral palsy. J Pediatr.2004; Vol.145, pp. S8 –S11. DOI: https://doi.org/10.1016/j.jpeds.2004.05.016
Cans, C. Surveillance of cerebral palsy in Europe: a collaboration of cerebral palsy surveys and registers. Dev Med Child Neurol. 2000; Vol. 42, pp. 816–824. DOI: https://doi.org/10.1111/j.1469-8749.2000.tb00695.x
Bosanquet, M, Copeland, L, Ware, R, Boyd, R. : A systematic review of tests to predict cerebral palsy in young children. Developmental Medicine and Child Neurology. 2013; Vol. 55, pp. 418-426. DOI: https://doi.org/10.1111/dmcn.12140
Hadders-Algra, M.: Putative neural substrate of normal and abnormal general movements. Neuroscience and Biobehavioral Reviews. 2017; Vol. 31, pp. 1181-1190. DOI: https://doi.org/10.1016/j.neubiorev.2007.04.009
Machireddy, A ,Santen, J, Wilson, J, Myers, J, Hadders-Algra, A, Song, X. A video/IMU hybrid system for movement estimation in infants, 39th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). 2017. DOI: https://doi.org/10.1109/EMBC.2017.8036928
Lyons, K, Brashear, H, Westeyn, T, Kim, J, Starner, T. GART - The gesture and activity recognition toolkit. Human-Computer Interaction. HCI Intelligent Multimodal Interaction Environments. 2007; pp. 718–727. DOI: https://doi.org/10.1007/978-3-540-73110-8_78
Zinnen, A, Laerhoven, K, Schiele, B. Toward recognition of short and non-repetitive activities from wearable sensors. Ambient Intelligence. 2007; pp.142–158. DOI: https://doi.org/10.1007/978-3-540-76652-0_9
Junker, H, Amft, O, Lukowicz, P, Trster, G. Gesture spotting with body-worn inertial sensors to detect user activities. Pattern Recognition. 2008; Vol.41, pp.2010 2024. DOI: https://doi.org/10.1016/j.patcog.2007.11.016
Minnen, D, Starner, T, Essa, M, Isbell, C. Discovering characteristic actions from on-body sensor data. In ISWC, 2006; pp. 11–18. DOI: https://doi.org/10.1109/ISWC.2006.286337
Choi, S, Shin, Y, Kim, Y and Kim, J. A novel sensor based assessment of lower limb spasticity in children with cerebral palsy, Journal of Neuro Engineering and Rehabilitation. 2018; Vol. 15. DOI: https://doi.org/10.1186/s12984-018-0388-5
Tang.L, Fei, Li, Shuai, C, Zhang, X, Wu, D, Xiang, C.: Muscle synergy analysis in children with cerebral palsy, Journal of Neural Engineering.2015; Vol.12. DOI: https://doi.org/10.1088/1741-2560/12/4/046017
Lee, H, Bhat, A, Scholz, J, Galloway, J.: Toy-oriented changes during early arm movements: Iv: shoulder–elbow coordination. Infant Behav Dev. 2008; Vol.31, pp.:447–469. DOI: https://doi.org/10.1016/j.infbeh.2007.12.018
Meinecke, L, Breitbach-Faller, N, Bartz, C, Damen, R, Rau G, Disselhorst-Klug, C. Movement analysis in the early detection of newborns at risk for developing spasticity due to infantile cerebral palsy. HumMovement Sci. 2006; Vol.25, pp. 125–144. DOI: https://doi.org/10.1016/j.humov.2005.09.012
Fallang, B, Saugstad, O, Grogaard, J, Hadders-Algra, M.: Kinematic quality of reaching movements in preterm infants.2003; Vol. 53, pp. 836–842. DOI: https://doi.org/10.1203/01.PDR.0000058925.94994.BC
Lee, H, Galloway, J. Early intensive postural and movement training advances head control in very young infants. 2012; Vol. 92, pp. 935–947. DOI: https://doi.org/10.2522/ptj.20110196
Berthouze, L, Mayston, M. Design and validation of surface-marker clusters for the quantification of joint rotations in general movements in early infancy. 2011. Vol. 44, pp. 1212–1215. DOI: https://doi.org/10.1016/j.jbiomech.2011.01.016
Harbourne, R, Lobo, M, Karst, G, Galloway, J. Sit happens: does sitting development perturb reaching development, or vice versa? Infant Behav Dev. 2013; Vol. 36, pp. 438–450. DOI: https://doi.org/10.1016/j.infbeh.2013.03.011
Kianifar, R, Joukov, V, Lee, A, Raina, S, Kulić, D. Inertial measurement unit-based pose estimation: Analyzing and reducing sensitivity to sensor placement and body measures, Journal of Rehabilitation and Assistive Technologies Engineering.2019; Vol. 6. DOI: https://doi.org/10.1177/2055668318813455
Singh.M, Patterson, D. Involuntary gesture recognition for predicting cerebral palsy in high-risk infants, International Symposium on Wearable Computers (ISWC).2010. DOI: https://doi.org/10.1109/ISWC.2010.5665873
Rihar, A, Mihelj, M, Pašič, J, Kolar, J, Munih, M. Infant trunk posture and arm movement assessment using pressure mattress, inertial and magnetic measurement units (IMUs), Journal of NeuroEngineering and Rehabilitation. 2014; Vol. 11, no. 1, pp. 133. DOI: https://doi.org/10.1186/1743-0003-11-133
Ahmad, N, Ghazilla, R, Khairi, M, Kasi, V. Reviews on Various Inertial Measurement Unit (IMU) Sensor Applications, International Journal of Signal Processing Systems. 2013; pp. 256–262. DOI: https://doi.org/10.12720/ijsps.1.2.256-262
Kamruzzaman, J, Begg, R. Support Vector Machines and Other Pattern Recognition Approaches to the Diagnosis of Cerebral Palsy Gait, IEEE Transactions on Biomedical Engineering. 2006; Vol. 53, pp. 2479–2490. DOI: https://doi.org/10.1109/TBME.2006.883697
Zhang, B, Zhang, Y. Classification of cerebral palsy gait by Kernel Fisher Discriminant Analysis, International Journal of Hybrid Intelligent Systems. 2008; Vol.5,pp. 209–218. DOI: https://doi.org/10.3233/HIS-2008-5405
Qingqiang, W, Penglin, Q, Jiachen, K, Fan, W, Zejiang, L, Ruping, B, Chengcheng, H, Uanghua, X. A Training-Free Infant Spontaneous Movement Assessment Method for Cerebral Palsy Prediction Based on Videos, IEEE Transactions On Neural Systems And Rehabilitation Engineering.2023; Vol. 31, pp. 1670–1679. DOI: https://doi.org/10.1109/TNSRE.2023.3255639
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