cbms 2016 - a game-based approach to monitor parkinson's disease: the bradykinesia symptom...
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Motivation Objectives System Requirements System Development Experiments Conclusion
A Game-Based Approach to Monitor Parkinson’sDisease: The bradykinesia symptom classification
CBMS 2016
Leonardo Medeiros, Hyggo Almeida, Leandro da Silva, MirkoPerkusich and Robert Fischer
Federal University Of Campina Grande - BRAZIL
23/06/2016
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Motivation Objectives System Requirements System Development Experiments Conclusion
Summary
Motivation
Objectives
System Requirements
System Development
Experiments
Conclusion
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Motivation Objectives System Requirements System Development Experiments Conclusion
Health Monitoring Systems (HMS)
Designed to support continuous treatment by moving healthcareservices from the hospital to the patients’ home.
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Motivation Objectives System Requirements System Development Experiments Conclusion
The HMS’s Major Challenge
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Motivation Objectives System Requirements System Development Experiments Conclusion
Parkinson Disease (PD)
The symptoms associated with PD are caused by a degenerationof dopaminergic neurons in the substantia nigra. Commontreatment focuses on drugs that activate dopamine receptors.However, the medication’s effectiveness decreases over the yearsrequiring higher dosages
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Motivation Objectives System Requirements System Development Experiments Conclusion
PD’s Treatment and Disease Management
I Clinical trial evaluation: subjectively and sporadically;
I Motor fluctuations (on/off phenomenon).
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Motivation Objectives System Requirements System Development Experiments Conclusion
Bradykinesia Symptom
I Bradykinesia describes a slowness in the execution ofmovement. It is one of the four key symptoms ofparkinsonism, which are bradykinesia, tremor, rigidity, andpostural instability
I The tremmor is the most visible PD’s motor symptom, butthe bradykinesia is the most
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Motivation Objectives System Requirements System Development Experiments Conclusion
Main Objective
A non-invasive HMS for Parkinson’s Disease motor symptomsbased on games to continuously provide data regarding patient,without reminding the disease’s treatment
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Motivation Objectives System Requirements System Development Experiments Conclusion
Main Requirements
1. A contactless measurement of patient motor symptoms insidethe game environment;
2. Use of a popular consumer electronic device as input to havea non-invasive, cost-effective solution for home use.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Main Requirements
1. A contactless measurement of patient motor symptoms insidethe game environment;
2. Use of a popular consumer electronic device as input to havea non-invasive, cost-effective solution for home use.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Who will use the Game-Based Health Monitor Approach
I A person with age above 55 years old;
I A person with Parkinson’s disease;
I Neurologist and physiotherapist responsible for patient’streatment.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Who will use the Game-Based Health Monitor Approach
I A person with age above 55 years old;
I A person with Parkinson’s disease;
I Neurologist and physiotherapist responsible for patient’streatment.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Who will use the Game-Based Health Monitor Approach
I A person with age above 55 years old;
I A person with Parkinson’s disease;
I Neurologist and physiotherapist responsible for patient’streatment.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Use Scenario
I A PD’ patient play the HGM Client in home and seamlesslyprovide the motor data;
I So, the motor signs are sent to HGM Server;
I The HGM Server process the user’s data and identify theoccurrence of the PD’s disease bradykinesia symptom;
I Then, the neurologist visualize the user’s healthinformation to assess the patient’s level of motordeficiency.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Use Scenario
I A PD’ patient play the HGM Client in home and seamlesslyprovide the motor data;
I So, the motor signs are sent to HGM Server;
I The HGM Server process the user’s data and identify theoccurrence of the PD’s disease bradykinesia symptom;
I Then, the neurologist visualize the user’s healthinformation to assess the patient’s level of motordeficiency.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Use Scenario
I A PD’ patient play the HGM Client in home and seamlesslyprovide the motor data;
I So, the motor signs are sent to HGM Server;
I The HGM Server process the user’s data and identify theoccurrence of the PD’s disease bradykinesia symptom;
I Then, the neurologist visualize the user’s healthinformation to assess the patient’s level of motordeficiency.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Use Scenario
I A PD’ patient play the HGM Client in home and seamlesslyprovide the motor data;
I So, the motor signs are sent to HGM Server;
I The HGM Server process the user’s data and identify theoccurrence of the PD’s disease bradykinesia symptom;
I Then, the neurologist visualize the user’s healthinformation to assess the patient’s level of motordeficiency.
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Motivation Objectives System Requirements System Development Experiments Conclusion
What was developed?
I A semi-structured interview with healthcare professionalsassociated to scientific references to identify the systemrequirements;
I The development of the Health Game Monitor (HGM) Client(Catch the Spheres’ game);
I The development of the HGM Server, responsible forprocessing the data and making the results available to thehealth professional;
I Experimental studies with target users.
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Motivation Objectives System Requirements System Development Experiments Conclusion
What was developed?
I A semi-structured interview with healthcare professionalsassociated to scientific references to identify the systemrequirements;
I The development of the Health Game Monitor (HGM) Client(Catch the Spheres’ game);
I The development of the HGM Server, responsible forprocessing the data and making the results available to thehealth professional;
I Experimental studies with target users.
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Motivation Objectives System Requirements System Development Experiments Conclusion
What was developed?
I A semi-structured interview with healthcare professionalsassociated to scientific references to identify the systemrequirements;
I The development of the Health Game Monitor (HGM) Client(Catch the Spheres’ game);
I The development of the HGM Server, responsible forprocessing the data and making the results available to thehealth professional;
I Experimental studies with target users.
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Motivation Objectives System Requirements System Development Experiments Conclusion
What was developed?
I A semi-structured interview with healthcare professionalsassociated to scientific references to identify the systemrequirements;
I The development of the Health Game Monitor (HGM) Client(Catch the Spheres’ game);
I The development of the HGM Server, responsible forprocessing the data and making the results available to thehealth professional;
I Experimental studies with target users.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Qualitative Research Analysis
The respondents suggested focusing on the bradykinesia motorsymptom due to its debilitating progress. Thus, treatment benefitscould be correlated with the increase of amplitude and angularvelocities of an arm’s adduction and abduction movements.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
System Architecture
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Motivation Objectives System Requirements System Development Experiments Conclusion
Biomechanical signal processing
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Motivation Objectives System Requirements System Development Experiments Conclusion
Ms-Kinect Joints Acquisition
Adduction and Abduction involves: wrist, shoulder, and hipjoints.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Angle over time with the peak and valley detectiontechnique
The cycle movement and transform the MS-Kinect data intoangles. Thus, we calculate the angular motion of the adductionand abduction movements. 18 / 24
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Some Elicited Requirements
I Easy and safe to use equipment
I Incite the player to perform specific movements that arerequired for the measurement
I Game with clear and entertaining goal and adapted to theuser’s skills
I Provide a informative visual way to the healthcare professional
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Motivation Objectives System Requirements System Development Experiments Conclusion
Developed Health Game Monitor: Catch the Spheres
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Motivation Objectives System Requirements System Development Experiments Conclusion
Case Control Study
A total number of 30 subjects participated where 15 subjects foreach group.
I PD’ Group: 10 men and 5 women, between 51 and 65 years(mean: 58);
I Control Group: 11 men and 4 women, between 50 and 65years (mean: 57).
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Motivation Objectives System Requirements System Development Experiments Conclusion
Procedure for Data Collection
The subject stands at distance of 2 meters from the motion sensorat a place marked for that purpose on the ground;
The subject faces a projection of the game on a wall, centered overthe motion sensor;
The subject plays the game Catch the Spheres for 5 minutes;
The subjects end the game by reaching the virtual exit button.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Data Classifier: SVM
In this work, we used Support Vector Machine (SVM) as thesupervised learning method. SVM seeks to find a margin thatseparates all positive and negative example.We choice this algorithm because he has a good generalizationto discriminate between two classes.
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Motivation Objectives System Requirements System Development Experiments Conclusion
SVM Classifier Performance
Predictive ClassParkinson Control
Parkinson 12 3
Control 1 14
Classifier MetricsTpRate 80.00%
FpRate 6.67%
Accuracy 86.67%
F-score 85.71%
Precision 92.31%
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Motivation Objectives System Requirements System Development Experiments Conclusion
Goal Question Metric (GQM) for User Acceptance
Based on the GQM paradigm, we defined two goals:
G1 : Analyze our HMS PD approach for the purpose ofevaluating with respect to usability from the viewpoint of the patients in the context of the gameCatch the Spheres
G2 : Analyze our HMS PD approach for the purpose ofevaluating with respect to fit to daily routine fromthe view point of the patients in the context of thegame Catch the Spheres
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Motivation Objectives System Requirements System Development Experiments Conclusion
GQM Results
The measurements were collected we obtained the following resultindicating:
I 90% of the users felt motivated with the game;
I 80% would add this game-based monitoring approach intotheir daily routine;
I 75% considered it safe for elderly users.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Conclusion
In this work we presented a game-based approach to monitor witha symptom classification Precision of 92.31%. Moreover, 90,00%of the patients considered our approach non-invasive and easy tointegrate into their routine.
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Motivation Objectives System Requirements System Development Experiments Conclusion
Questions ?
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