Amanda C. De C. Williams

Chongyang Wang, Yuan Gao, Akhil Mathur et al.

Protective behavior exhibited by people with chronic pain (CP) during physical activities is the key to understanding their physical and emotional states. Existing automatic protective behavior detection (PBD) methods rely on pre-segmentation of activities predefined by users. However, in real life, people perform activities casually. Therefore, where those activities present difficulties for people with chronic pain, technology-enabled support should be delivered continuously and automatically adapted to activity type and occurrence of protective behavior. Hence, to facilitate ubiquitous CP management, it becomes critical to enable accurate PBD over continuous data. In this paper, we propose to integrate human activity recognition (HAR) with PBD via a novel hierarchical HAR-PBD architecture comprising graph-convolution and long short-term memory (GC-LSTM) networks, and alleviate class imbalances using a class-balanced focal categorical-cross-entropy (CFCC) loss. Through in-depth evaluation of the approach using a CP patients' dataset, we show that the leveraging of HAR, GC-LSTM networks, and CFCC loss leads to clear increase in PBD performance against the baseline (macro F1 score of 0.81 vs. 0.66 and precision-recall area-under-the-curve (PR-AUC) of 0.60 vs. 0.44). We conclude by discussing possible use cases of the hierarchical architecture in CP management and beyond. We also discuss current limitations and ways forward.

Chongyang Wang, Min Peng, Temitayo A. Olugbade et al.

For people with chronic pain, the assessment of protective behavior during physical functioning is essential to understand their subjective pain-related experiences (e.g., fear and anxiety toward pain and injury) and how they deal with such experiences (avoidance or reliance on specific body joints), with the ultimate goal of guiding intervention. Advances in deep learning (DL) can enable the development of such intervention. Using the EmoPain MoCap dataset, we investigate how attention-based DL architectures can be used to improve the detection of protective behavior by capturing the most informative temporal and body configurational cues characterizing specific movements and the strategies used to perform them. We propose an end-to-end deep learning architecture named BodyAttentionNet (BANet). BANet is designed to learn temporal and bodily parts that are more informative to the detection of protective behavior. The approach addresses the variety of ways people execute a movement (including healthy people) independently of the type of movement analyzed. Through extensive comparison experiments with other state-of-the-art machine learning techniques used with motion capture data, we show statistically significant improvements achieved by using these attention mechanisms. In addition, the BANet architecture requires a much lower number of parameters than the state of the art for comparable if not higher performances.

Chongyang Wang, Temitayo A. Olugbade, Akhil Mathur et al.

In chronic pain rehabilitation, physiotherapists adapt physical activity to patients' performance based on their expression of protective behavior, gradually exposing them to feared but harmless and essential everyday activities. As rehabilitation moves outside the clinic, technology should automatically detect such behavior to provide similar support. Previous works have shown the feasibility of automatic protective behavior detection (PBD) within a specific activity. In this paper, we investigate the use of deep learning for PBD across activity types, using wearable motion capture and surface electromyography data collected from healthy participants and people with chronic pain. We approach the problem by continuously detecting protective behavior within an activity rather than estimating its overall presence. The best performance reaches mean F1 score of 0.82 with leave-one-subject-out cross validation. When protective behavior is modelled per activity type, performance is mean F1 score of 0.77 for bend-down, 0.81 for one-leg-stand, 0.72 for sit-to-stand, 0.83 for stand-to-sit, and 0.67 for reach-forward. This performance reaches excellent level of agreement with the average experts' rating performance suggesting potential for personalized chronic pain management at home. We analyze various parameters characterizing our approach to understand how the results could generalize to other PBD datasets and different levels of ground truth granularity.