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Updated: Feb 9, 2026

The Lower Body Positive Pressure Treadmill for Knee Osteoarthritis Rehabilitation
Published on: July 22, 2019
An improved activation function for the recognition of knee osteoarthritis severity
Shuaishuai Chang1, Hongliang Duan1, QingE Wu2
1College of Pharmaceutical Sciences, Zhejiang University of Technology, Hangzhou, PR China.
Background:
Existing knee osteoarthritis (KOA) severity classification methods typically rely on a combination of object detection algorithms and classification algorithms. However, this approach not only increases the computational burden and time costs but also reduces the efficiency of real-time diagnosis, which makes it difficult to meet the needs of practical applications. To address the performance limitations of KOA severity recognition models that operate without target detection algorithms, a deep transfer learning approach incorporating a novel activation function (AvRELU) was proposed. The goal was to improve classification performance, particularly for small sample datasets, while optimizing computational resources.
Methods:
A dataset consisting of 3300 digital X-ray images of KOA patients was utilized. During model training and evaluation, five-fold cross-validation was used to assess robustness, and the dataset was divided into training, validation, and testing sets through a stratified sampling method at an 8:1:1 ratio. A transfer learning approach utilizing a pretrained Inception-v3 backbone was proposed, where Bayesian optimization automated both the fine-tuning process and downstream classifier construction. To improve the model performance, the activation function AvRELU was introduced in the network layer of the downstream model. Moreover, Kendall's tau-b correlation analysis was employed to evaluate the statistical significance of differences in the predicted Kellgren-Lawrence grades among the different methods.
Results:
Using five-fold cross-validation, the proposed method achieved an average test set performance of 95% accuracy, 95% F1-score, and 93% kappa. These results demonstrated the superior performance of the method in KOA severity recognition.
Conclusions:
The method proposed here not only significantly improves model performance on small-sample datasets but also maintains the model's lightweight and low-resource characteristics. Moreover, it achieves better performance in KOA severity recognition than most existing methods.
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