Subtask Segmentation of Timed Up and Go Test for Mobility Assessment of Perioperative Total Knee Arthroplasty

Total knee arthroplasty (TKA) is one of the most common treatments for people with severe knee osteoarthritis (OA). The accuracy of outcome measurements and quantitative assessments for perioperative TKA is an important issue in clinical practice. Timed up and go (TUG) tests have been validated to measure basic mobility and balance capabilities. A TUG test contains a series of subtasks, including sit-to-stand, walking-out, turning, walking-in, turning around, and stand-to-sit tasks. Detailed information about subtasks is essential to aid clinical professionals and physiotherapists in making assessment decisions. The main objective of this study is to design and develop a subtask segmentation approach using machine-learning models and knowledge-based postprocessing during the TUG test for perioperative TKA. The experiment recruited 26 patients with severe knee OA (11 patients with bilateral TKA planned and 15 patients with unilateral TKA planned). A series of signal-processing mechanisms and pattern recognition approaches involving machine learning-based multi-classifiers, fragmentation modification and subtask inference are designed and developed to tackle technical challenges in typical classification algorithms, including motion variability, fragmentation and ambiguity. The experimental results reveal that the accuracy of the proposed subtask segmentation approach using the AdaBoost technique with a window size of 128 samples is 92%, which is an improvement of at least 15% compared to that of the typical subtask segmentation approach using machine-learning models only.