Innovative Visualization Approach for Biomechanical Time Series in Stroke Diagnosis Using Explainable Machine Learning Methods: A Proof-of-Concept Study

Author:

Apostolidis Kyriakos1,Kokkotis Christos1,Karakasis Evangelos1,Karampina Evangeli1,Moustakidis Serafeim1ORCID,Menychtas Dimitrios1ORCID,Giarmatzis Georgios1ORCID,Tsiptsios Dimitrios2ORCID,Vadikolias Konstantinos2ORCID,Aggelousis Nikolaos1ORCID

Affiliation:

1. Department of Physical Education and Sport Science, Democritus University of Thrace, 69100 Komotini, Greece

2. Department of Neurology, School of Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece

Abstract

Stroke remains a predominant cause of mortality and disability worldwide. The endeavor to diagnose stroke through biomechanical time-series data coupled with Artificial Intelligence (AI) poses a formidable challenge, especially amidst constrained participant numbers. The challenge escalates when dealing with small datasets, a common scenario in preliminary medical research. While recent advances have ushered in few-shot learning algorithms adept at handling sparse data, this paper pioneers a distinctive methodology involving a visualization-centric approach to navigating the small-data challenge in diagnosing stroke survivors based on gait-analysis-derived biomechanical data. Employing Siamese neural networks (SNNs), our method transforms a biomechanical time series into visually intuitive images, facilitating a unique analytical lens. The kinematic data encapsulated comprise a spectrum of gait metrics, including movements of the ankle, knee, hip, and center of mass in three dimensions for both paretic and non-paretic legs. Following the visual transformation, the SNN serves as a potent feature extractor, mapping the data into a high-dimensional feature space conducive to classification. The extracted features are subsequently fed into various machine learning (ML) models like support vector machines (SVMs), Random Forest (RF), or neural networks (NN) for classification. In pursuit of heightened interpretability, a cornerstone in medical AI applications, we employ the Grad-CAM (Class Activation Map) tool to visually highlight the critical regions influencing the model’s decision. Our methodology, though exploratory, showcases a promising avenue for leveraging visualized biomechanical data in stroke diagnosis, achieving a perfect classification rate in our preliminary dataset. The visual inspection of generated images elucidates a clear separation of classes (100%), underscoring the potential of this visualization-driven approach in the realm of small data. This proof-of-concept study accentuates the novelty of visual data transformation in enhancing both interpretability and performance in stroke diagnosis using limited data, laying a robust foundation for future research in larger-scale evaluations.

Funder

Greek and European funds

Publisher

MDPI AG

Subject

Information Systems

Reference33 articles.

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3. (2023, August 31). Quantitative Analysis of Stroke Patients with Foot Drop—ProQuest. Available online: https://www.proquest.com/openview/f15d4e659e9e189283c67662abf8ee9b/1?pq-origsite=gscholar&cbl=18750.

4. Spasticity after Stroke: Physiology, Assessment and Treatment;Thibaut;Brain Inj.,2013

5. Gait Disturbances in Patients With Stroke;Balaban;PM&R,2014

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