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Classifying Residual Stroke Severity Using Robotics-Assisted Stroke Rehabilitation: Machine Learning Approach.

作者信息

Jeter Russell, Greenfield Raymond, Housley Stephen N, Belykh Igor

机构信息

Department of Mathematics and Statistics, Georgia State University, Atlanta, GA, United States.

Motus Nova, LLC, Atlanta, GA, United States.

出版信息

JMIR Biomed Eng. 2024 Oct 7;9:e56980. doi: 10.2196/56980.


DOI:10.2196/56980
PMID:39374054
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11494252/
Abstract

BACKGROUND: Stroke therapy is essential to reduce impairments and improve motor movements by engaging autogenous neuroplasticity. Traditionally, stroke rehabilitation occurs in inpatient and outpatient rehabilitation facilities. However, recent literature increasingly explores moving the recovery process into the home and integrating technology-based interventions. This study advances this goal by promoting in-home, autonomous recovery for patients who experienced a stroke through robotics-assisted rehabilitation and classifying stroke residual severity using machine learning methods. OBJECTIVE: Our main objective is to use kinematics data collected during in-home, self-guided therapy sessions to develop supervised machine learning methods, to address a clinician's autonomous classification of stroke residual severity-labeled data toward improving in-home, robotics-assisted stroke rehabilitation. METHODS: In total, 33 patients who experienced a stroke participated in in-home therapy sessions using Motus Nova robotics rehabilitation technology to capture upper and lower body motion. During each therapy session, the Motus Hand and Motus Foot devices collected movement data, assistance data, and activity-specific data. We then synthesized, processed, and summarized these data. Next, the therapy session data were paired with clinician-informed, discrete stroke residual severity labels: "no range of motion (ROM)," "low ROM," and "high ROM." Afterward, an 80%:20% split was performed to divide the dataset into a training set and a holdout test set. We used 4 machine learning algorithms to classify stroke residual severity: light gradient boosting (LGB), extra trees classifier, deep feed-forward neural network, and classical logistic regression. We selected models based on 10-fold cross-validation and measured their performance on a holdout test dataset using F-score to identify which model maximizes stroke residual severity classification accuracy. RESULTS: We demonstrated that the LGB method provides the most reliable autonomous detection of stroke severity. The trained model is a consensus model that consists of 139 decision trees with up to 115 leaves each. This LGB model boasts a 96.70% F-score compared to logistic regression (55.82%), extra trees classifier (94.81%), and deep feed-forward neural network (70.11%). CONCLUSIONS: We showed how objectively measured rehabilitation training paired with machine learning methods can be used to identify the residual stroke severity class, with efforts to enhance in-home self-guided, individualized stroke rehabilitation. The model we trained relies only on session summary statistics, meaning it can potentially be integrated into similar settings for real-time classification, such as outpatient rehabilitation facilities.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/57108d5f7d1c/biomedeng_v9i1e56980_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/4837bfa0fb11/biomedeng_v9i1e56980_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/c7edc742a5ef/biomedeng_v9i1e56980_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/7757a5ea9f0c/biomedeng_v9i1e56980_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/0dbf99a8984a/biomedeng_v9i1e56980_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/ee516fb2948a/biomedeng_v9i1e56980_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/57108d5f7d1c/biomedeng_v9i1e56980_fig6.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/4837bfa0fb11/biomedeng_v9i1e56980_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/c7edc742a5ef/biomedeng_v9i1e56980_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/7757a5ea9f0c/biomedeng_v9i1e56980_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/0dbf99a8984a/biomedeng_v9i1e56980_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/ee516fb2948a/biomedeng_v9i1e56980_fig5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/151a/11494252/57108d5f7d1c/biomedeng_v9i1e56980_fig6.jpg

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Explainable machine learning model for predicting decline in platelet count after interventional closure in children with patent ductus arteriosus.

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本文引用的文献

[1]
Predicting mortality in brain stroke patients using neural networks: outcomes analysis in a longitudinal study.

Sci Rep. 2023-10-28

[2]
Examining Usability, Acceptability, and Adoption of a Self-Directed, Technology-Based Intervention for Upper Limb Rehabilitation After Stroke: Cohort Study.

JMIR Rehabil Assist Technol. 2023-8-21

[3]
Technologies in Home-Based Digital Rehabilitation: Scoping Review.

JMIR Rehabil Assist Technol. 2023-7-27

[4]
Use of the Digital Assistant Vigo in the Home Environment for Stroke Recovery: Focus Group Discussion With Specialists Working in Neurorehabilitation.

JMIR Rehabil Assist Technol. 2023-4-14

[5]
Predicting Outcome in Patients with Brain Injury: Differences between Machine Learning versus Conventional Statistics.

Biomedicines. 2022-9-13

[6]
Machine learning methods for functional recovery prediction and prognosis in post-stroke rehabilitation: a systematic review.

J Neuroeng Rehabil. 2022-6-3

[7]
Remote Assessments of Hand Function in Neurological Disorders: Systematic Review.

JMIR Rehabil Assist Technol. 2022-3-9

[8]
A Novel Extra Tree Ensemble Optimized DL Framework (ETEODL) for Early Detection of Diabetes.

Front Public Health. 2021

[9]
Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019.

Lancet Neurol. 2021-10

[10]
Prediction of Motor Function in Stroke Patients Using Machine Learning Algorithm: Development of Practical Models.

J Stroke Cerebrovasc Dis. 2021-8

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