Support vector machines and other pattern recognition approaches to the diagnosis of cerebral palsy gait

Accurate identification of cerebral palsy (CP) gait is important for diagnosis as well as for proper evaluation of the treatment outcomes. This paper explores the use of support vector machines (SVM) for automated detection and classification of children with CP using two basic temporal-spatial gait parameters (stride length and cadence) as input features. Application of the SVM method to a children's dataset (68 normal healthy and 88 with spastic diplegia form of CP) and testing on tenfold cross-validation scheme demonstrated that an SVM classifier was able to classify the children groups with an overall accuracy of 83.33% [sensitivity 82.95%, specificity 83.82%, area under the receiver operating curve (AUC-ROC = 0.88)]. Classification accuracy improved significantly when the gait parameters were normalized by the individual leg length and age, leading to an overall accuracy of 96.80% (sensitivity 94.32%, specificity 100%, AUC-ROC area = 0.9924). This accuracy result was, respectively, 3.21% and 1.93% higher when compared to an linear discriminant analysis and an multilayer-perceptron-based classifier. SVM classifier also attains considerably higher ROC area than the other two classifiers. Among the four SVM kernel functions (linear, polynomial, radial basis, and analysis of variance spline) studied, the polynomial and radial basis kernel performed comparably and outperformed the others. Classifier's performance as functions of regularization and kernel parameters was also investigated. The enhanced classification accuracy of the SVM using only two easily obtainable basic gait parameters makes it attractive for identifying CP children as well as for evaluating the effectiveness of various treatment methods and rehabilitation techniques.