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

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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