Patient-dependent Freezing of Gait Detection using

Signals from Multi- accelerometer Sensors in

Parkinson's Disease
Amira S. Ashour*
Department of Electronics and
Electrical Communications
Engineering, Faculty of
Engineering,Tanta University
Tanta, Egypt
amirasashour@yahoo.com
Amira El-Attar
Department of Electronics and
Electrical Communications
Engineering, Faculty of
Engineering,Tanta University
Tanta, Egypt
eng_amira81@yahoo.com
Mostafa M. Abd El-Naby
Nilanjan Dey
Department of Electronics and
Department of Information
Electrical Communications
Technology, Techno India
Engineering, Faculty of
College of Technology
Engineering, Tanta University
India
neelanjan.dey@gmail.com Tanta, Egypt
mnaby45@yahoo.com

Hatem Abd El-Kader

Faculty of Computers and Information Minufiya University
Minufiya, Egypt
Hatem6803@yahoo.com
*Corresponding author: Email: amirasashour@yahoo.com

Abstract—The position and number of the on-body wearable
sensors affects significantly the acquired signal, which
sequentially has a direct influence on the patient’s diagnosis. The
patients of Parkinson's disease (PD) suffer from freezing of the
gait (FOG) in the form of episodes. In this paper, the choice of
the acceleration sensors’ location, which measures the patient’s
movement for monitoring the PD patient, was introduced using
several episodes to develop a patient-dependent model for FOG
detection. The proposed classification using the linear support
vector machine (SVM) based FOG detection was applied to the
ranked features using infinite feature selection (IFS) method to
distinguish between the freezing and no-freezing events. A
comparative study between the proposed IFS based detection
model and the use of Eigenvector feature selection was conducted
showing the same features ranking performance of the extracted
features from all acceleration signals from the multi-sensors.
However, the results established the superiority of the proposed
patient-dependent model using IFS ranked features for FOG
detection, which can be used to improve the PD monitoring
systems accuracy.
Keywords—Parkinson’s disease, wearable sensors,
classification, feature ranking.
I. INTRODUCTION
Parkinson’s disease is a neurological disease of several
symptoms affecting the motor system, such as Freezing of Gait
(FOG) [1, 2]. The PD patients suffer from freezing in the form
of episodes, where different types of sensors can be used to
acquire the FOG episodes. Such sensors are wearable assistant,
including three accelerometer sensors placed on the ankle
(shank), above the knee on the thigh, and on the hip [3] to
monitor the PD patients. Typically, FOG detection’s methods
can be categorized into freezing index/ threshold algorithms [4,
5, 6], and machine learning based methods [7, 8]. Several
researchers were interested to develop FOG detection methods,
such as Mazilu et al. [7], who applied several feature extraction
approaches with decision tree classifier. Saad et al. [8] used a
multi-sensor for FOG detection based on Gaussian neural
networks as a classification tool. Furthermore, different
patient-independent methods were used for FOG detection [5,
9-12]. El-Attar et al. [13] designed a patient-independent
model for long term monitoring using Discrete Wavelet
Transform (DWT) to extract the main features inherent in the
motion vertical signal acquired from one accelerometer sensor,
which placed on the ankle. Afterward the extracted DWT
features were applied to the SVM and Artificial Neural
Network (ANN) for FOG detection. Furthermore, using the
same acquired signals in [13], El-Attar et al. [14] suggested
another patient-independent model by integrating two types of
the extracted features of Fast Fourier Transform (FFT) and
DWT, which applied to the ANN to detect FOG. However,
Rodríguez-Martín et al. [15] conducted a comparative study
between the personalized/patient-dependent model and
generic/patient-independent model. This study proved a
significant improvement in the accuracy using the personalized
model compared to the generic model. Moreover, many studies
were employed several sensors at specific locations, however,
some of these literatures used only one signal from a single
sensor, while others used all signals from all sensor. Bächlin et
al. [4] connected three sensors at ankle, knee, and on hip, but
used only the vertical signal from the sensor at the ankle.
Consequently, the current work proposed a machine
learning based approach using patient-dependent model for
FOG detection. A comparative study was conducted to
compare the FOG detection performance using all signals from
three sensors, and using the ranked features to select the best
features.
The remaining sections are organized as follows. Section 2
includes features extraction and detection of FOG, ranking
features using the infinite feature selection method to support
the proposed patient-dependent method. Section 3 describes the

XXX-X-XXXX-XXXX-X/XX/$XX.00 ©20XX IEEE

978-1-5386-8154-1/18/$31.00
2018
c IEEE
used dataset and explains the results of using patient-dependent arranges the weighted edges, and model feature distributions,
model and feature ranking. Finally, section 4 includes the where P represents an adjacency matrix A. The infinity
conclusion. concept is achieved by calculating a new type of a feature
score, which can be expressed as follows:
 
II. METHODOLOGY C (i )  C l (i )    R (i , j )
l
(2)
l 1 l j v
A. Feature extraction and hybridization where l is the length of the paths, i ≥1 , j  n as n is the
number of features, and R  i, j  is a standard matrix algebra
In the present work, nine types signal were acquired from
three on body sensors, where each sensor acquires three
signals, namely horizontal, vertical, and lateral. The containing all the paths of length l between i and j . The
acceleration signals from any sensor consisted of freezing and geometric series G of matrix A can be expressed as follows:
no-freezing episodes [16]. All these episodes were obtained 
separately from acceleration sensors from each patient as G  Al (3)
l 1
reported in the used dataset. Two types of transformation,

  
C (i )  C l (i )  ( A l )e   Ge 
namely DWT [17] and FFT are used for features extraction (4)
from the three sensors. Two sets of features are chosen, l 1  l 1 i i
including the variance, maximum amplitude, minimum where e indicates a one-dimensional (1D) array of ones.
amplitude, maximum energy, and minimum energy of both the
From different forms of generating functions [21], the
approximate and detail coefficients of the DWT as well as the
FFT. Accordingly, ten features are extracted using the DWT, generating function for the l th path can be defined as:
 
while five features are extracted using the FFT. Hence, in the
C (i)   r l Cl (i)    r R (i, j)
l
l
(5)
present work, the hybridization of DWT and FFT features is l 1 l 1 jv
employed to determine the feature vector, including fifteen
where r is a regularization factor, and rl is the weight for
features from the nine acceleration signals of the three on
body sensors give a total of 135 features from each signal per paths of length l . To ensure that the infinite sum is
patient. converged, an appropriate choices of r is selected. Using
All these features and the corresponding target are applied algebraic criteria, the convergence property of the geometric
to a machine learning classifier, namely linear SVM using a power series of the matrix C (i ) can be efficiently computed
linear kernel function, for training to distinguish between the [22]:
freezing and no-freezing events. A target value of 0 is assigned G  ( I  rA)1  I (6)
for freezing cases and 1 is assigned for no-freezing cases using
extracted statistical information [18]. By using the matrix G , all the energy information about a set
of features can be encoded. The final energy scores for each
feature determined by the following quantity:
B. Infinite feature selection based features ranking
Feature ranking techniques are used for features selection, C (i)  Ge 
(7)
i
which order the features by the value of some scoring function Ranking C (i ) energy scores in decreasing order guarantees
and rank these 135 extracted features from the three sensors
features ranking, where the number of features ranking m can
according to their scores/ relevance. Such techniques discard
be selected to ensure the highest classification score using the
the irrelevant, redundant, or noisy features from a feature
most significant features with discarding the noisy features.
vector [19]. Let the score C (f j ) is computed from the training Accordingly, the ranked features form all signals of the
dataset, measuring certain criteria of feature f j , where a high sensors and the target are applied as input and output to/from
score indicates a valuable feature. linear SVM using a linear kernel function to train the network
and classify the data. Therefore, the proposed system is
C (f j )  C (f j 1 ) (1)
capable of detecting the FOG of PD.
where j  1,, n  1 and n is the number of features.
C. Proposed FOG detection model
One of the efficient features ranking methods is the infinite
feature selection (IFS). The features selection using the IFS is The current work used signals from each of the eight
considered a path among feature distributions and puts these patients who suffer from FOG. All freezing and no-freezing
paths tend to an infinite number to investigate the relation and episodes features are extracted from the all acceleration
redundancy of a feature and rank the important features [20]. signals from all sensors. Afterwards feature ranking using
To illustrate the concept of the IFS method, assume a set of infinite feature selection method is applied to select the
significant ranked features and ignore the noisy features from
feature distributions F  { f 1 , ..., f  n } and x  R
these episodes. Then, the selected features are applied to the
representing a sample of the generic distribution f . Consider SVM classifier to evaluate the FOG detection accuracy. The
an in-directed fully-connected graph P =(V,E), where V is the proposed patient-dependent system is illustrated in Figure 1
set of vertices related to each feature distribution, while E for S patients.

Acquired signals from all sensors
Determine all freezing and no freezing episodes
for each patient
the extracted features from the signals of the three sensors with
and without selected ranking features using IFS for each
patient. In Figure 2, the x-axis refers to the patient’s number
and y-axis is the detection accuracy of FOG.

Hybrid DWT and FFT extracted features

from all sensors’ signals (135 features)

Feature ranking (IFS)

SVM classifier

Performance Evaluation
Fig.2. Performance of using all features and ranking features
Fig. 1. Proposed patient-dependent model
Figure 2 reveals the superiority of the proposed model using
Figure 1 illustrates the steps of the proposed patient- the selected, ranked features, which improved the performance
dependent model to build a robust PD detection model. of FOG detection compared to using all the extracted features
from all sensor signals without ranking. These results indicate
III. RESULTS AND DISCUSSION the existence of noisy features that affected the performance in
The patients’ data who wear three accelerometer sensors the case of using all extracted features without ranking. In
was recorded over 8 hrs and 20 minute period of time [16]. The addition, it is observed that there is specific efficient sensor for
3-dimensional accelerometers located above the knee on the each patient, which is related to some specific features and
thigh, on the ankle (shank), and on the hip. The dataset files patients when using IFS for ranking as reported in Table II.
reported the time of each sample, the horizontal (forward), These reported results established the efficient sensor and the
vertical, and horizontal (lateral) acceleration for each of the 3 number of ranked, extracted features from each sensor for each
sensors (ankle, thigh and hip), respectively. Additionally, the patient.
annotations of ‘0’ for not part of experiment, ‘1’ for no freeze TABLE II. NUMBER OF RANKING FEATURES EXTRACTED FROM EACH
event and ‘2’ for a freeze event are also included. SENSOR
Patient Ankle sensor Knee sensor Hip sensor Number of
In this section, the results obtained from the proposed H V L H V L H V L features/
model are reported. All signals from the three on body sensors Accuracy
located at the ankle, knee, and the hip were used and then P1 5 3 5 1 3 3 2 1 2 25 88.9%
features ranking using IFS method was applied to select the P2 4 4 3 2 3 1 3 7 3 30 94.4%
best features of 135 features extracted from all sensor signals. P7 2 3 2 3 3 2 3 4 3 25 93.8%
P8 2 3 3 3 3 2 - 3 1 20 82.1%
Table I presents the accuracy of SVM classifier after ranking
using the first 40, 35, 30, 25, and 20 ranked/ selected features Table II shows, for example, that collecting of 4, 4, and 3
for selected 4 patients. features from horizontal, vertical, lateral signal from ankle
sensor; respectively, also 2, 3, and 1 feature from horizontal,
TABLE I. PERFORMANCE OF SVM USING INFINITE FEATURE SELECTION
vertical, lateral signal from knee sensor; ; respectively, and 3,
Patient Rank-40 Rank- Rank- Rank- Rank- Accuracy Selected 7, and 3 features from horizontal, vertical, lateral signal from
35 30 25 20 feature hip sensor from patient 2 achieved the best accuracy 94.4%.
P1 88.9% 88.9% 88.9% 88.9% 86.1% 88.9% Rank-25
P2 88.9% 83.3% 94.4% 77.8% 72.2% 94.4% Rank-30 Moreover, features ranking using the eigenvector method
P7 90.6% 90.6% 90.6% 93.8% 90.6% 93.8% Rank-25 [23] is used in the comparative study on the same samples.
P8 78.6% 82.1% 78.6% 82.1% 82.1% 82.1% Rank-20
The performance of SVM using eigenvector feature selection
The best classification accuracy of these patients is depicted is reported in Table III.
in Table I. Accordingly, for patient 1 it is recommended to use
TABLE III PERFORMANCE OF SVM USING EIGENVECTOR FEATURE SELECTION
the first 25 selected features using the IFS method for FOG
detection with 88.9% accuracy for computational time saving. Patient Rank- Rank- Rank- Rank- Rank- Best Selected
The same procedure is followed with each patient. 40 35 30 25 20 Accuracy feature
P1 88.9% 86.1% 88.9% 77.8% 83.3% 88.9% Rank-30
Accordingly, the first 30 ranked features were the best for P2 94.4% 77.8% 77.8% 66.7% 77.8% 94.4% Rank-40
patient 2, which achieved 94.4% accuracy, the first 25 ranked P7 93.8% 90.6% 90.6% 87.5% 90.6% 93.8% Rank-40
features were the best for patient 7 with 93.8% accuracy, and P8 78.6% 82.1% 82.1% 71.4% 78.6% 82.1% Rank-30
the first 20 ranked features were the best for patient 8 with
82.1% accuracy. Figure 2 demonstrates the relation between
 Table III demonstrates the best accuracy of each patient
using eigenvector method, where for patient 1 it is
recommended to use the first 30 selected features for FOG
detection with 88.9% accuracy. The same procedure is
followed with each patient, accordingly the first 40 ranked
features are the best for patient 2, which achieved 94.4%
accuracy, the first 40 ranked features are the best for patient 7
with 93.8% accuracy, and the first 30 ranked features are the
best for patient 8 that achieved 82.1% accuracy. Therefore,
comparing the results of the two ranking method explained in
Table I and Table III show the same accuracies at different
numbers of selected features. However, the proposed IFS
based patient-dependent model is selected less number of
features, which reduces the computational time.
IV. CONCLUSION
This paper presented a system for freezing of gait
detection for PD patients. The proposed FOG detection system
used the signals obtained from the three accelerometer based
on patient-dependent evaluation and SVM classifier. Feature
ranking demonstrated that a combination of specific features
from specific sensors enables to acquire accurate information
on FOG. Additionally, the results demonstrated the proposed
IFS based patient-dependent model selected less number of
features compared to the selected number of features using the
eigenvector based patient-dependent model, even both ranking
methods provided the same accuracy values. Therefore, by
using IFS method the 30 ranked features extracted from the
nine signals from the three sensors placed on ankle, knee, and
on hip of patient 2, for example, achieved 94.4% accuracy of
FOG detection, which able to build a more robust
classification model used to test any other patient.
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