Freezing of Gait Prediction using Proactive Agent that Learns from Selected Experience and DDQN Algorithm

Objective assessment of Freezing of Gait (FoG) in Parkinson's disease (PD) relies predominantly on wearable Inertial Measurement Units (IMUs). While IMUs provide optimal kinematic precision, mandatory sensor attachment restricts continuous clinical deployment. Conversely, unobtrusive vision-based alternatives suffer substantial classification errors during turning-in-place tasks, where geometric self-occlusion degrades deterministic skeletal coordinates and obscures the high-frequency precursors required for FoG detection. To resolve these physical observation limits, we propose a supervised cross-modal subspace distillation framework. During optimisation, pre-trained kinematic data from IMU sensors and contextual clinical metadata act as oracles to guide a deployable visual architecture. By incorporating joint velocity and acceleration derivatives, utilising a confidence-based gating mechanism, the visual model mitigates some of the tracking errors during occlusion events. Empirical evaluations confirm this latent alignment transfers the predictive fidelity of hardware sensors directly into the visual representation, yielding $85.5\%$ accuracy, and $82.4\%$ balanced accuracy. All the while maintaining a vision only model at inference.

Accurate gait analysis in Parkinson's disease (PD) typically relies on laboratory-based systems to capture biomechanical data, such as ground reaction forces (GRFs). Estimating GRFs using inertial measurement units (IMUs) provides a feasible alternative. However, this approach remains challenging in pathological gait like PD due to its high variability and complexity. Moreover, existing monitoring approaches often require multiple body-mounted sensors, which limit practicality and reduce patient compliance. To date, no study has investigated the application of deep learning approaches to address this challenge. This study proposes, for the first time, a deep learning framework to estimate bilateral vertical GRFs (vGRFs) in PD using an optimized set of wearable IMUs. A hybrid CNN-BiLSTM model was trained separately on data from 61 PD patients and 65 healthy controls (HC) using 13 IMUs. The model achieved high intra-subject accuracy ($R^2$ = 0.98) and strong inter-subject generalization ($R^2$ = 0.93 for HC, $R^2$ = 0.91 for PD). Sensor configuration was found to significantly influence estimation accuracy, with optimal sensor placement varying between PD patients and HC. For PD patients, estimation accuracy dropped markedly when reducing to a single IMU. The optimal configuration for PD used four IMUs. We identified a minimal setup with only two IMUs still enabled robust estimation. This compact setup offers a practical and scalable solution. Overall, the proposed approach supports the development of wearable vGRF-based gait analysis systems for Parkinsonian gait and potentially other pathological conditions, enabling accessible clinical assessments, remote monitoring, and personalized rehabilitation.

Understanding motion in daily living requires context beyond kinematics, because similar inertial patterns during activities of daily living (ADLs) can reflect intentional stopping, object interaction, or pathological movement impairment. Egocentric vision provides task-related context that may help disambiguate these cases. We investigate this challenge through freezing of gait (FOG) detection in Parkinson's disease (PD), a symptom strongly influenced by contextual factors during ADLs. Using synchronized egocentric video, wearable IMUs, and expert-annotated FOG labels collected from 13 PD participants in their homes, we evaluate frozen representations from pretrained ego-video and time-series foundation models, alongside an IMU-based TCN trained from scratch, under leave-one-subject-out evaluation. The IMU-based TCN achieved the strongest event-detection performance, reaching 42.3 F1 and 83.0 AUROC, compared with 32.6 F1 and 77.2 AUROC for V-JEPA2 ego-video features. Although ego-video alone did not outperform IMU-based sensing, it showed above-chance discrimination, and qualitative analyses suggest that egocentric vision may capture FOG-relevant information independent of IMUs. Together, these results support the use of pretrained ego-video representations to add contextual information to wearable-sensor-based clinical motion understanding in daily living.