Cited by 126Balance, Gait, and Falls PreventionContext-Aware Activity Recognition SystemsGait Recognition and Analysis

Deep Learning Approaches for Detecting Freezing of Gait in Parkinson’s Disease Patients through On-Body Acceleration Sensors

Open access
Sigcha, Luis, Costa, Nélson, Pavón, Ignacio, Costa, Susana, Arezes, Pedro, López, Juan Manuel, De Arcas, Guillermo·2020·Sensors

Abstract

Freezing of gait (FOG) is one of the most incapacitating motor symptoms in Parkinson’s disease (PD). The occurrence of FOG reduces the patients’ quality of live and leads to falls. FOG assessment has usually been made through questionnaires, however, this method can be subjective and could not provide an accurate representation of the severity of this symptom. The use of sensor-based systems can provide accurate and objective information to track the symptoms’ evolution to optimize PD management and treatments. Several authors have proposed specific methods based on wearables and the analysis of inertial signals to detect FOG in laboratory conditions, however, its performance is usually lower when being used at patients’ homes. This study presents a new approach based on a recurrent neural network (RNN) and a single waist-worn triaxial accelerometer to enhance the FOG detection performance to be used in real home-environments. Also, several machine and deep learning approaches for FOG detection are evaluated using a leave-one-subject-out (LOSO) cross-validation. Results show that modeling spectral information of adjacent windows through an RNN can bring a significant improvement in the performance of FOG detection without increasing the length of the analysis window (required to using it as a cue-system).

AI snapshot

Written from the paper’s full text.

TL;DR

This study evaluates machine and deep learning classifiers for detecting freezing of gait (FOG) in Parkinson’s disease using a single waist-worn triaxial accelerometer in home environments. A CNN-LSTM model using FFT spectral features from the current and three previous 3.2-s windows achieved the best reported LOSO AUC of 0.939, improving on a Mazilu-feature Random Forest baseline (AUC 0.904).

Key findings

  • The best model was a CNN-LSTM using 64-bin FFT features with the current and three previous spectral windows and 75% overlap, evaluated with LOSO: AUC 0.939, EER 12.9%, and sensitivity/specificity 87.1% (Section 5.5 also reports AUC 0.936 and EER 12.7% for this comparison).
  • The reproduced baseline using Mazilu features and Random Forest under LOSO achieved sensitivity 0.826, specificity 0.825, GM 82.5%, and AUC 0.904; the CNN-LSTM improved AUC and reduced EER.
  • Supervised methods outperformed novelty detection; CNN-LSTM was best, while Random Forest and CNN-MLP had similar AUCs (0.921 and 0.920), and SVM was weakest (AUC 0.876).
  • Data came from 21 PD patients (3 women, 18 men; mean age 69) at home, with a FOG-to-non-FOG ratio of about 10:1 (10.5% FOG windows).

Methods

  • Used the Rodríguez-Martín et al. dataset: single waist-worn IMU, home ADL recordings, 200 Hz signals resampled to 40 Hz, filtered, and windowed into 128-sample (3.2 s) windows with 75% overlap; a window was labeled FOG only if >50% of its samples were FOG.
  • Compared data representations including Mazilu features, MFCCs adapted to inertial signals, 64-bin FFT, and contextual FFT stacking up to three previous windows; classifiers included OC-SVM, denoiser autoencoder, Random Forest, AdaBoost, SVM, CNN, and CNN-LSTM.
  • Main evaluation used leave-one-subject-out (LOSO) cross-validation repeated six times over 21 patients, with sensitivity, specificity, AUC, GM, and EER as metrics.

Limitations

  • Stated: deep recurrent models require large computational resources and large accurately labeled datasets; using more than three previous windows can be impractical for real-time applications; comparison with related work is difficult due to diverse approaches and validation methods; imbalanced FOG data present an additional challenge.
  • Stated: some patients (2, 4, and 20) showed different FOG patterns that reduced LOSO performance, and patient 1 had sensitivity/specificity below 0.804.
  • Evident from the text: the study relies on a single 21-patient home-monitoring dataset without external validation, and the reported best AUC/EER differ slightly across sections (0.939/12.9% vs. 0.936/12.7%).

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.3390/s20071895

Cites

85 of 85 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 40 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Modeling spectral information of adjacent windows through an RNN can bring a significant improvement in the performance of FOG detection without increasing the length of the analysis window.

    “Results show that modeling spectral information of adjacent windows through an RNN can bring a significant improvement in the performance of FOG detection without increasing the length of the analysis window (required to using it as a cue-system).”
    Quote in the paperSubstantial claim
  • Findingnone given

    The best result achieved an improvement from 0.904 to 0.939 of the area under the curve (AUC) with a LOSO evaluation.

    “The best result achieved shows an improvement from 0.904 to 0.939 of the area under the curve (AUC) with a LOSO evaluation.”
    Quote in the paperSubstantial claim
  • Findingown data

    The shallow models present lower performances than the deep learning classifiers.

    “In this experiment, the shallow models present lower performances than the deep learning classifiers.”
    Quote in the paperSubstantial claim
  • Findingown data

    When using previous windows through the CNN-LSTM model, there is a progressive increase in performance when adding more previous spectral windows.

    “According to the results shown in Table 7, when using previous windows through the CNN-LSTM model, there is a progressive increase in the performance when adding more previous spectral windows.”
    Quote in the paperSubstantial claim
  • Findingown data

    AUC increased from 0.923 without previous windows to 0.939 with three previous windows.

    “The results are improved with a reduction in the EER from 15.1% (with no previous windows) to 12.99% with tree previous windows, while the AUC is increased from 0.923 (without previous windows) to 0.939 with three previous windows.”
    Quote in the paperSubstantial claim
  • May combine two claims. 26
  • The quote only partly states this claim. 1
  • Classified as probably not a substantial claim. 22
  • May combine two claims.

    Findingown data

    The ratio between FOG and normal ADL movement is 10 to 1, where 89.5% corresponds to the absence of FOG symptoms and 10.5% correspond to FOG events.

    “The ratio between FOG and normal ADL movement is 10 to 1, where the 89.5% corresponds to the absence of FOG symptoms and the remaining 10.5% correspond to FOG events.”
    Quote in the paperSubstantial claim
  • May combine two claims. The quote only partly states this claim.

    Findingown data

    The AUC reaches a maximum value of 0.939 while the equal error rate is reduced to 12.9% for the CNN-LSTM with three previous windows.

    “The AUC reaches a maximum value of 0.939 while the equal error rate is reduced to 12.9%.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The best data representation for a personalized model (R10fold) was Mazilu, however, MFCCS and FFT representations present similar performances for sensitivity and specificity.

    “The three data representations tested in the first experiment (Section 4.2) show that the best data representation for a personalized model (R10fold evaluation) was Mazilu [44], however, the MFCCS and FFT representations present similar performances for sensitivity and specificity.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [44] Mazilu, S., Hardegger, M., Zhu, Z., Roggen, D., Tröster, G., Plotnik, M., and Hausdorff, J. (2012, January 21–24). Online Detection of Freezing of Gait with Smartphones and Machine Learning Techniques. Proceedings of the 6th International Conference on Pervasive Computing Technologies for Healthcare, San Diego, CA, USA. source

      Not checked in the free run.

  • May combine two claims.

    Findingreasoning

    Progressive improvement is presented in the LOSO evaluation, while in R10fold a significant improvement is presented when using higher overlap values, because of the random data sharing between the train and test subsets.

    “Progressive improvement is presented in the LOSO evaluation, while in R10fold a significant improvement is presented when using higher overlap values, because of the random data sharing between the train and test subsets.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    For a generic model with LOSO evaluation, the best results were achieved with the 64-bin FFT data representation extracted from 128 samples window, while MFCCs features show a significant improvement for generic models over the Mazilu features when using overlapped windows.

    “For a generic model with LOSO evaluation, the best results were achieved with the 64-bin FFT data representation extracted from 128 samples window, while MFCCs features show a significant improvement for generic models over the Mazuli features when using overlapped windows.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    The best model proposed in this study achieved an AUC of 0.939 and an ERR of 12.9%.

    “In the best model proposed in this study, an AUC of 0.939 and an ERR of 12.9% were achieved.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    In most patients, the AUC value reaches 0.915 except for patients 2 and 20, while the EER remains below 15% except in patients 2, 4, and 20.

    “In most patients, the AUC value reaches 0.915 except for the patients 2 and 20, while the EER remains below 15% except in patients 2, 4, and 20.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Random forest presented an improvement in sensitivity and specificity, as well as a lower EER.

    “Notwithstanding, the Random forest presents an improvement in sensitivity and specificity, as well as a lower EER.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    CNN-LSTM with 64-bin FFT and three previous windows decreased EER by 4.8%, from 17.5% to 12.7%, compared to the baseline.

    “a 4.8% decrease in EER (from 17.5% to 12.7%)”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Patients were included if they scored greater than 2 in the OFF state according to the Hoehn and Yahr scale.

    “Criteria for the inclusion of patients were: a score higher than 6 on the FOG Questionnaire (FoG-Q) [23], a score greater than 2 in the OFF state according to the Hoehn and Yahr scale [72].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [72] Hoehn, 1967, Parkinsonism: Onset, Progression and Mortality, Neurology source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    All data collection was carried out at the patients' homes.

    “All data collection was carried out at the patients’ homes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [59] Rodríguez-Martín, D., Samà, A., Pérez-López, C., Català, A., Moreno Arostegui, J.M., Cabestany, J., Bayés, À., Alcaine, S., Mestre, B., and Prats, A. (2017). Home detection of freezing of gait using support vector machines through a single waist-worn triaxial accelerometer. PLoS ONE, 12. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    With this approach of free-living, an increase in the time and frequency of the FOG episodes is expected.

    “With this approach of free-living, an increase in the time and frequency of the FOG episodes is expected [25,71].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [25] Nieuwboer, 1998, A frequency and correlation analysis of motor deficits in Parkinson patients, Disabil. Rehabil. source

      Not checked in the free run.

    • cites [71] Cabestany, 1992, Assessing Motor Fluctuations in Parkinson’s Disease Patients Based on a Single Inertial Sensor; Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinico-pathological study of 100 cases, J. Neurol. Neurosurg Psychiatry

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Patients were included if they scored higher than 6 on the FOG Questionnaire (FoG-Q).

    “Criteria for the inclusion of patients were: a score higher than 6 on the FOG Questionnaire (FoG-Q) [23], a score greater than 2 in the OFF state according to the Hoehn and Yahr scale [72].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [23] Giladi, 2009, Validation of the freezing of gait questionnaire in patients with Parkinson’s disease, Mov. Disord. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    The best method is able to outperform the state-of-the-art on FOG detection by using a single triaxial accelerometer and without adding delay or increasing the size of the temporal analysis window.

    “The results show that the best method is able to outperform the state-of-the-art on FOG detection by using a single triaxial accelerometer and without adding delay or increasing the size of the temporal analysis window.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    The data were collected through a wearable IMU located at the waist, in both ON and OFF states.

    “The data were collected through a wearable IMU located at the waist, in both ON and OFF states.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [59] Rodríguez-Martín, D., Samà, A., Pérez-López, C., Català, A., Moreno Arostegui, J.M., Cabestany, J., Bayés, À., Alcaine, S., Mestre, B., and Prats, A. (2017). Home detection of freezing of gait using support vector machines through a single waist-worn triaxial accelerometer. PLoS ONE, 12. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The data were labeled by an experienced clinician using video recordings of the tests.

    “The data were labeled by an experienced clinician using video recordings of the tests.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The mean Hoehn and Yahr scoring in OFF state was 3.07 (standard deviation: 0.426).

    “While the mean Hoehn and Yahr scoring in OFF state was 3.07 (standard deviation: 0.426).”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The data used for testing the proposed methods in FOG detection were collected for the article [59].

    “The data used for testing the proposed methods in FOG detection were collected for the article [59].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [59] Rodríguez-Martín, D., Samà, A., Pérez-López, C., Català, A., Moreno Arostegui, J.M., Cabestany, J., Bayés, À., Alcaine, S., Mestre, B., and Prats, A. (2017). Home detection of freezing of gait using support vector machines through a single waist-worn triaxial accelerometer. PLoS ONE, 12. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Windows containing FOG samples with less than 50% were discarded.

    “Windows containing FOG samples with less than 50% were discarded.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    The LOSO methodology shows more rigorous and accurate results when working with overlapped windows, avoiding data sharing between the train and test subsets.

    “The results achieved with the LOSO evaluation show a decrease in the performance over the R10Fold, however, the LOSO methodology shows more rigorous and accurate results when working with overlapped windows, avoiding data sharing between the train and test subsets.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisereasoning

    A more precise evaluation can be made by using a LOSO cross-validation.

    “In order to improve the evaluation of R10fold evaluation with overlapped windows, a more precise evaluation can be made by using a LOSO cross-validation.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The addition of new data to train personalized models can be difficult, because of the inherent time and resource consumption to collect and label new data.

    “The addition of new data to train personalized models can be difficult, because of the inherent time and resource consumption to collect and label new data.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    Keeping a reduced batch size can help to achieve better performance on generic models.

    “Therefore, keeping a reduced batch size can help to achieve better performance on generic models.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Most of the experiments in this study were carried out with a LOSO cross-validation.

    “Most of the experiments in this study were carried out with a LOSO cross-validation.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    All the experiments made in this subsection were evaluated through LOSO evaluation.

    “All the experiments made in this subsection were evaluated through LOSO evaluation.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductnone given

    The LOSO evaluation was made for each of the 21 patients, then the entire process has been repeated six times to verify the variability.

    “For this work, the LOSO evaluation was made for each of the 21 patients, then the entire process has been repeated six times to verify the variability.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim.

    Study design and conductcitation

    A window was labeled as a FOG only if more than 50% of its samples were labeled as FOG.

    “To address the reduced amount of FOG events in the data and to achieve a windowing strategy similar to that reported in the literature [65,67] a window was labeled as a FOG only if more than 50% of its samples were labeled as FOG.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [65] Camps, 2018, Deep learning for freezing of gait detection in Parkinson’s disease patients in their homes using a waist-worn inertial measurement unit, Knowl. Based Syst. source

      Not checked in the free run.

    • cites [67] San-Segundo, R., Torres-Sánchez, R., Hodgins, J., and Fernando De La, T. (2019). Increasing Robustness in the Detection of Freezing of Gait in Parkinson’s Disease. Electronics, 8. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    R10Fold evaluation could show overly optimistic performance when using overlapped windows, because there is a high probability that the training and test subsets share some of the same data, because of the random splitting process.

    “Despite being a widely used methodology, the R10Fold evaluation could show overly optimistic performance when using overlapped windows, because there is a high probability that the training and test subsets share some of the same data, because of the random splitting process [67].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [67] San-Segundo, R., Torres-Sánchez, R., Hodgins, J., and Fernando De La, T. (2019). Increasing Robustness in the Detection of Freezing of Gait in Parkinson’s Disease. Electronics, 8. source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    To consider a window as a non-FOG window, all samples must be labeled as not FOG.

    “Whereas to considered it as a non-FOG window, all samples must be labeled as not FOG.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationcitation

    Novelty detection is a reliable method for FOG detection and abnormal gait detection with a low computational burden and without the need for labeled data.

    “Despite these results, the use of novelty detection presents a reliable method for FOG detection and abnormal gait detection with a low computational burden, without the need for labeled data [66].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [66] Mohammadian Rad, N., van Laarhoven, T., Furlanello, C., and Marchiori, E. (2018). Novelty Detection using Deep Normative Modeling for IMU-Based Abnormal Movement Monitoring in Parkinson’s Disease and Autism Spectrum Disorders. Sensors, 18. source

      Not checked in the free run.

    • The authors state this as an assumption: FOG events occur, but may not necessarily, as a deviation from a normal pattern.
  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The CNN-LSTM model allows analyzing sequential data by using previous windows in order to take advantage of temporal behavior found in FOG events.

    “The CNN-LSTM model allows analyzing sequential data by using previous windows in order to take advantage of temporal behavior found in FOG events.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The partial results of patients 2 and 20 tend to reduce the global results and this may be explained by the fact that some patients present different freezing patterns when they are at their homes or in different scenarios.

    “The partial results of the patients 2 and 20 tend to reduce the global results and this may be explained by the fact that some patients present different freezing patterns when they are at their homes or in different scenarios.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Using 3-second windows or window between 2 and 4 seconds may enable the achievement of similar performances to longer windows.

    “Mazilu [44] and Zach [63] have reported that using 3-second windows or window between 2 and 4 seconds may enable the achievement of similar performances that to longer windows.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [44] Mazilu, S., Hardegger, M., Zhu, Z., Roggen, D., Tröster, G., Plotnik, M., and Hausdorff, J. (2012, January 21–24). Online Detection of Freezing of Gait with Smartphones and Machine Learning Techniques. Proceedings of the 6th International Conference on Pervasive Computing Technologies for Healthcare, San Diego, CA, USA. source

      Not checked in the free run.

    • cites [63] Zach, 2015, Identifying freezing of gait in Parkinson’s disease during freezing provoking tasks using waist-mounted accelerometry, Parkinsonism Relat Disord source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The use of longer temporal windows has shown an improvement performance in FOG detection, while increasing the latency time.

    “In the literature, the use of longer temporal windows has shown an improvement performance in FOG detection, while increasing the latency time.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [65] Camps, 2018, Deep learning for freezing of gait detection in Parkinson’s disease patients in their homes using a waist-worn inertial measurement unit, Knowl. Based Syst. source

      Not checked in the free run.

    • cites [67] San-Segundo, R., Torres-Sánchez, R., Hodgins, J., and Fernando De La, T. (2019). Increasing Robustness in the Detection of Freezing of Gait in Parkinson’s Disease. Electronics, 8. source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The use of larger batch sizes has shown a reduction in the ability of the model to generalize solutions and require a higher amount of memory to process the data.

    “In practice, the use of larger batch sizes has shown a reduction in the ability of the model to generalize solutions and require a higher amount of memory to process the data [80].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [80] Keskar, N.S., Mudigere, D., Nocedal, J., Smelyanskiy, M., and Tang, P.T.P. (2016). On Large-Batch Training for Deep Learning: Generalization Gap and Sharp Minima. arXiv.

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The addition of data from previous windows has shown an improvement in FOG detection, without the need of increasing the window size and avoiding increasing latency.

    “The addition of data from previous windows has shown an improvement in FOG detection, without the need of increasing the window size and avoiding increasing latency [65,67].”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [65] Camps, 2018, Deep learning for freezing of gait detection in Parkinson’s disease patients in their homes using a waist-worn inertial measurement unit, Knowl. Based Syst. source

      Not checked in the free run.

    • cites [67] San-Segundo, R., Torres-Sánchez, R., Hodgins, J., and Fernando De La, T. (2019). Increasing Robustness in the Detection of Freezing of Gait in Parkinson’s Disease. Electronics, 8. source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Spectral representations can achieve high performances with generic models, while hand-crafted FOG specific features (e.g., Mazilu features) show an improvement in the performance of personalized models.

    “These results suggest that spectral representations can achieve high performances with generic models, while the use of hand-crafted FOG specific features (e.g., Mazilu features) show an improvement in the performance of personalized models.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Deep neural networks are hard to train because of a large number of parameters that need to be adjusted in each layer.

    “Deep neural networks are hard to train because of a large number of parameters that need to be adjusted in each layer [79].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [79] Glorot, 2010, Understanding the difficulty of training deep feedforward neural networks, J. Mach. Learn. Res.

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Patients 2, 4, and 20 show a different pattern, making it difficult to identify FOG events through LOSO.

    “These patients show a different pattern, making it difficult to identify FOG events though LOSO.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Imbalanced data in FOG detection present an additional challenge to make accurate and reliable systems.

    “Also, imbalanced data in FOG detection present an additional challenge to make accurate and reliable systems.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    In the proposed model, CNN layers work as a feature extractor, while LSTM increases classification capabilities by modeling the temporal phases of FOG events.

    “In the proposed model the CNN layers work as a feature extractor, while the LSTM increases the classification capabilities by modeling the temporal phases of the FOG events.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    Using more than three previous windows can be impractical for real-time applications due to computational burden, and the improvement tends to be more reduced at each additional time step.

    “However, the use of more than three previous windows can be impractical for real-time applications, to avoid the computational burden, also the improvement tends to be more reduced at each additional time step.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    The use of previous windows shows a progressive improvement in FOG detection without increasing latency for use as an external cue.

    “The use of previous windows shows a progressive improvement in FOG detection without increasing the latency in order to use the system as an external cue.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    The best results reported in similar studies using a single sensor in a free-living environment with LOSO evaluation are 79.03% and 74.67% [59] and 84.49% sensitivity and 85.83 specificity [64].

    “The best results reported in similar studies using a single sensor on a free-living environment with LOSO evaluation are 79.03% and 74.67% [59] and 84.49% on sensitivity and 85.83 on specificity [64].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [59] Rodríguez-Martín, D., Samà, A., Pérez-López, C., Català, A., Moreno Arostegui, J.M., Cabestany, J., Bayés, À., Alcaine, S., Mestre, B., and Prats, A. (2017). Home detection of freezing of gait using support vector machines through a single waist-worn triaxial accelerometer. PLoS ONE, 12. source

      Not checked in the free run.

    • cites [64] Alcaine, 2018, Determining the optimal features in freezing of gait detection through a single waist accelerometer in home environments, Pattern Recog. Lett. source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisereasoning

    The comparison of the results with most related literature work is difficult because of the diversity of approaches and validation methodologies.

    “The comparison of the results with most of the related literature work is difficult, because of the diversity of approaches and validation methodologies.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    The best results with deep learning are achieved only when using a great amount of accurately labelled data, which is a time-consuming process.

    “Moreover, the best results with DL are achieved only when using a great amount of data (accurately labelled) which is a time-consuming process.”
    Quote in the paperNot a substantial claim
46 of 46
  • The paper relies on this without support.

    FOG assessment through questionnaires can be subjective and may not provide an accurate representation of the severity of the symptom.

    “FOG assessment has usually been made through questionnaires, however, this method can be subjective and could not provide an accurate representation of the severity of this symptom.”
  • The paper relies on this without support.

    Sensor-based systems can provide accurate and objective information to track the symptoms’ evolution to optimize PD management and treatments.

    “The use of sensor-based systems can provide accurate and objective information to track the symptoms’ evolution to optimize PD management and treatments.”
  • The paper relies on this without support.

    The performance of existing wearable methods for FOG detection is usually lower when used at patients’ homes than in laboratory conditions.

    “Several authors have proposed specific methods based on wearables and the analysis of inertial signals to detect FOG in laboratory conditions, however, its performance is usually lower when being used at patients’ homes.”
  • The authors state this as an assumption.

    In prediction, patterns with abnormal movement (with significant statistical differences from normal patterns) are FOG events.

    “In prediction, it is assumed that patterns with abnormal movement (with significant statistical differences from normal patterns) are FOG events.”
  • The authors state this as an assumption.

    FOG events occur, but may not necessarily, as a deviation from a normal pattern.

    “it is assumed that FOG events occur (but may not necessarily) as a deviation from a normal pattern.”
  • The paper relies on this without support.

    Training deep models with recurrent layers requires a large number of computational resources.

    “Despite the high performance of the DL approaches in FOG detection, it is important to consider that training deep models with recurrent layers requires a large number of computational resources.”
6 of 6

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Denoiser optimizer is reported as both RMSprop and Adam

    Major

    The denoiser autoencoder's architecture section specifies RMSprop, while the general training section says the DL models were trained with Adam.

  • Best model's AUC changes from 0.939 to 0.936

    Minor

    The baseline comparison gives the best CNN-LSTM model an AUC of 0.936, whereas the results and conclusion give it 0.939.

  • Reported FOG-Q range includes an excluded score

    Minor

    The stated inclusion criterion requires a score higher than 6, but the reported range starts at 6.

  • Patient 4 is inconsistently listed as an AUC exception

    Minor

    One per-patient summary lists only patients 2 and 20 as exceptions to the 0.915 AUC threshold; another also lists patient 4.

  • Reported class ratio does not match the percentages

    Minor

    The percentages imply an absence-of-FOG to FOG ratio of about 8.52 to 1, not 10 to 1. Read in the stated FOG-to-normal order, the ratio is reversed as well.

    Reported 10 · recomputed 8.52381

5 of 5

Cites

Flagged first, then by citations

2 of the 87 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Cabestany, 1992, Assessing Motor Fluctuations in Parkinson’s Disease Patients Based on a Single Inertial Sensor; Accuracy of clinical diagnosis of idiopathic Parkinson’s disease: A clinico-pathological study of 100 cases, J. Neurol. Neurosurg Psychiatry, 16, 181
  2. Kingma, D.P., and Ba, L.J. (2014). Adam: A Method for Stochastic Optimization. arXiv.
  3. Keskar, N.S., Mudigere, D., Nocedal, J., Smelyanskiy, M., and Tang, P.T.P. (2016). On Large-Batch Training for Deep Learning: Generalization Gap and Sharp Minima. arXiv.

Cited by

Sorted by citations

Authors
Sigcha, L., Costa, N., Pavón, I., Costa, S., Arezes, P., López, J. M., & De Arcas, G.
Affiliations
  • Universidad Politécnica de Madrid (ES)
  • University of Minho (PT)
  • Grupo de Investigación en Instrumentación y Acústica Aplicada (I2A2), ETSI Industriales, Universidad Politécnica de Madrid, Campus Sur UPM, Ctra. Valencia, Km 7., 28031 Madrid, Spain
Corresponding author
Pavón, Ignacio
Venue
Sensors
Publisher
MDPI AG
Published
2020-03-29
Volume
20
Issue
7
Pages
1895
ISSN
1424-8220 (ISSN-L)
OpenAlex
W3013838736
Cited by
126
References
87
Citations by year
2026: 13 · 2025: 26 · 2024: 20 · 2023: 19 · 2022: 28 · 2021: 16 · 2020: 4
FWCI
30.44
Type
journal article
Language
en
Open access
Locations
  • Sensors (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, cc-by)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
Funders
  • Centro Internacional sobre el envejecimiento, CENIE (0348_CIE_6_E)
  • Secretaría de Educación Superior, Ciencia, Tecnología e Innovación (Becas internacionales de posgrado 2019)
Topics
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
  • Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Context-Aware Activity Recognition Systems
  • Physical Sciences › Engineering › Biomedical Engineering › Gait Recognition and Analysis
Keywords
freezing of gait, Parkinson's disease, fog detection, recurrent neural networks, wearable sensors, home monitoring, spectral analysis, gait analysis, leave-one-subject-out cross-validation
MeSH terms
Wearable Electronic Devices, Deep Learning, Aged, Aged, 80 and over, Female, Gait, Humans, Male, Monitoring, Physiologic, Parkinson Disease, Signal Processing, Computer-Assisted, Biosensing Techniques, Accelerometry

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-07.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-07.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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