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eISSN 2287-982X

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Phys. Ther. Korea 2023; 30(2): 102-109

Published online May 20, 2023

https://doi.org/10.12674/ptk.2023.30.2.102

© Korean Research Society of Physical Therapy

Application of Decision Tree to Classify Fall Risk Using Inertial Measurement Unit Sensor Data and Clinical Measurements

Junwoo Park , PT, BPT, Jongwon Choi , PT, BPT, Seyoung Lee , PT, BPT, Kitaek Lim , PT, PhD, Woochol Joseph Choi , PT, PhD

Injury Prevention and Biomechanics Laboratory, Department of Physical Therapy, Yonsei University, Wonju, Korea

Correspondence to: Woochol Joseph Choi
E-mail: wcjchoi@yonsei.ac.kr
https://orcid.org/0000-0002-6623-3806

Received: May 5, 2023; Revised: May 8, 2023; Accepted: May 8, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: While efforts have been made to differentiate fall risk in older adults using wearable devices and clinical methodologies, technologies are still infancy. We applied a decision tree (DT) algorithm using inertial measurement unit (IMU) sensor data and clinical measurements to generate high performance classification models of fall risk of older adults. Objects: This study aims to develop a classification model of fall risk using IMU data and clinical measurements in older adults.
Methods: Twenty-six older adults were assessed and categorized into high and low fall risk groups. IMU sensor data were obtained while walking from each group, and features were extracted to be used for a DT algorithm with the Gini index (DT1) and the Entropy index (DT2), which generated classification models to differentiate high and low fall risk groups. Model’s performance was compared and presented with accuracy, sensitivity, and specificity.
Results: Accuracy, sensitivity and specificity were 77.8%, 80.0%, and 66.7%, respectively, for DT1; and 72.2%, 91.7%, and 33.3%, respectively, for DT2.
Conclusion: Our results suggest that the fall risk classification using IMU sensor data obtained during gait has potentials to be developed for practical use. Different machine learning techniques involving larger data set should be warranted for future research and development.

Keywords: Classification, Decision tree, Fall risk, Gait, Inertial measurement unit sensor

Article

Original Article

Phys. Ther. Korea 2023; 30(2): 102-109

Published online May 20, 2023 https://doi.org/10.12674/ptk.2023.30.2.102

Copyright © Korean Research Society of Physical Therapy.

Application of Decision Tree to Classify Fall Risk Using Inertial Measurement Unit Sensor Data and Clinical Measurements

Junwoo Park , PT, BPT, Jongwon Choi , PT, BPT, Seyoung Lee , PT, BPT, Kitaek Lim , PT, PhD, Woochol Joseph Choi , PT, PhD

Injury Prevention and Biomechanics Laboratory, Department of Physical Therapy, Yonsei University, Wonju, Korea

Correspondence to:Woochol Joseph Choi
E-mail: wcjchoi@yonsei.ac.kr
https://orcid.org/0000-0002-6623-3806

Received: May 5, 2023; Revised: May 8, 2023; Accepted: May 8, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: While efforts have been made to differentiate fall risk in older adults using wearable devices and clinical methodologies, technologies are still infancy. We applied a decision tree (DT) algorithm using inertial measurement unit (IMU) sensor data and clinical measurements to generate high performance classification models of fall risk of older adults. Objects: This study aims to develop a classification model of fall risk using IMU data and clinical measurements in older adults.
Methods: Twenty-six older adults were assessed and categorized into high and low fall risk groups. IMU sensor data were obtained while walking from each group, and features were extracted to be used for a DT algorithm with the Gini index (DT1) and the Entropy index (DT2), which generated classification models to differentiate high and low fall risk groups. Model’s performance was compared and presented with accuracy, sensitivity, and specificity.
Results: Accuracy, sensitivity and specificity were 77.8%, 80.0%, and 66.7%, respectively, for DT1; and 72.2%, 91.7%, and 33.3%, respectively, for DT2.
Conclusion: Our results suggest that the fall risk classification using IMU sensor data obtained during gait has potentials to be developed for practical use. Different machine learning techniques involving larger data set should be warranted for future research and development.

Keywords: Classification, Decision tree, Fall risk, Gait, Inertial measurement unit sensor

Fig 1.

Figure 1.Example data (red cross point) in each group. The white range in this figure is the average normal population fall-risk score for each age group. Subjects with S-PPA scores outside this white range were classified into the high fall-risk group.
Physical Therapy Korea 2023; 30: 102-109https://doi.org/10.12674/ptk.2023.30.2.102

Fig 2.

Figure 2.Definition method from angular velocity in Y-axis data using shin inertial measurement unit sensor data.
Physical Therapy Korea 2023; 30: 102-109https://doi.org/10.12674/ptk.2023.30.2.102

Fig 3.

Figure 3.Figure of DT1. Mean_Acc_Y_8, mean of accelerations in the Y-axis data from the right shin inertial measurement unit sensor; DT1, Gini index.
Physical Therapy Korea 2023; 30: 102-109https://doi.org/10.12674/ptk.2023.30.2.102

Fig 4.

Figure 4.Figure of DT2. Mean_Acc_X_6, mean of accelerations in X-axis data from the left shin inertial measurement unit sensor; DT2, Entropy index.
Physical Therapy Korea 2023; 30: 102-109https://doi.org/10.12674/ptk.2023.30.2.102

Table 1 . Clinical measurements of each group.

VariableHigh fall riskLow fall risk
Height (cm)156.1 ± 7.3152.3 ± 4.6
Weight (kg)58.4 ± 7.256.7 ± 8.0
Age (y)79.1 ± 5.180.9 ± 8.1
S-PPA4.2 ± 1.72.6 ± 1.9
Muscle mass (kg)21.0 ± 3.219.5 ± 2.4
Left hand grip strength (kg)19.2 ± 4.120.5 ± 4.2
Right hand grip strength (kg)19.5 ± 6.021.2 ± 4.9
BBS50.3 ± 4.151.0 ± 3.8
TUG (s)13.1 ± 3.710.8 ± 2.6
5STS (s)10.6 ± 3.311.4 ± 2.6
FES-I23.3 ± 9.720.8 ± 3.9
Fear of fall2.4 ± 1.32.9 ± 1.6

Values are presented as mean ± standard deviation. S-PPA, Short-form Physiological Profile Assessment; BBS, Berg Balance Scale; TUG, Timed Up and Go; 5STS, five times sit to stand; FES-I, Fall Efficacy Scale-International..


Table 2 . Classification performance of decision tree using DT1 and DT2.

VariableDT1DT2
Accuracy (%)77.872.2
Sensitivity (%)80.091.7
Specificity (%)66.733.3

DT1, Gini index; DT2, Entropy index..