Classification of Stroke Severity Using Clinically Relevant Symmetric Gait Features Based on Recursive Feature Elimination With Cross-Validation

Abstract

Stroke is a leading cause of disability among elderly individuals, and gait impairment is a typical characteristic related to the stroke severity experienced by patients. The aim of this study is to propose a novel stroke severity classification method using symmetric gait features with recursive feature elimination with cross-validation (RFECV). An experiment was conducted on data acquired from thirteen chronic stroke patients and eighteen elderly participants. They walked on a treadmill at four different speeds based on their preferred speed. Symmetric gait features representing the ratio between the left- and right-side values were used as inputs along with the general gait features that did not completely contain the patients' gait characteristics. We used four different machine learning (ML) techniques to determine the optimal subset for differentiating between the elderly and stroke groups according to severity based on RFECV. In addition, to verify the performance of RFECV and the symmetric gait features, four different feature sets were used: 1) all forty-five general features, 2) all twenty-one symmetric features, 3) the optimal general feature subset obtained by using RFECV, and 4) the optimal symmetric feature subset obtained by using RFECV. The best classification result was obtained by RF-RFECV with an RF classifier derived from the symmetric features (accuracy: 96.01%). The result proved that the stroke severity classification performance increased when symmetric gait data and the RFECV technique were applied. The findings of this study can help clinicians diagnose the stroke severity experienced by patients based on information obtained using ML technology.