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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>An Interpretable Machine Vision Approach to Human Activity Recognition using Photoplethysmograph Sensor Data</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>Eoin Brophy[</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jose Juan Dominguez V</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>Insight Centre for Data Analytics, Dublin City University</institution>
          ,
          <addr-line>Glasnevin, Dublin</addr-line>
          ,
          <country country="IE">Ireland</country>
        </aff>
      </contrib-group>
      <abstract>
        <p>The current gold standard for human activity recognition (HAR) is based on the use of cameras. However, the poor scalability of camera systems renders them impractical in pursuit of the goal of wider adoption of HAR in mobile computing contexts. Consequently, researchers instead rely on wearable sensors and in particular inertial sensors. A particularly prevalent wearable is the smart watch which due to its integrated inertial and optical sensing capabilities holds great potential for realising better HAR in a non-obtrusive way. This paper seeks to simplify the wearable approach to HAR through determining if the wrist-mounted optical sensor alone typically found in a smartwatch or similar device can be used as a useful source of data for activity recognition. The approach has the potential to eliminate the need for the inertial sensing element which would in turn reduce the cost of and complexity of smartwatches and tness trackers. This could potentially commoditise the hardware requirements for HAR while retaining the functionality of both heart rate monitoring and activity capture all from a single optical sensor. Our approach relies on the adoption of machine vision for activity recognition based on suitably scaled plots of the optical signals. We take this approach so as to produce classi cations that are easily explainable and interpretable by non-technical users. More speci cally, images of photoplethysmography signal time series are used to retrain the penultimate layer of a convolutional neural network which has initially been trained on the ImageNet database. We then use the 2048 dimensional features from the penultimate layer as input to a support vector machine. Results from the experiment yielded an average classi cation accuracy of 92.3%. This result outperforms that of an optical and inertial sensor combined (78%) and illustrates the capability of HAR systems using standalone optical sensing elements which also allows for both HAR and heart rate monitoring. Finally, we demonstrate through the use of tools from research in explainable AI how this machine vision approach lends itself to more interpretable machine learning output.</p>
      </abstract>
      <kwd-group>
        <kwd>deep learning activity recognition explainable arti cial intelligence</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>-</title>
      <p>1</p>
    </sec>
    <sec id="sec-2">
      <title>Introduction</title>
      <p>
        Due to the ubiquitous nature of inertial and physiological sensors in phones
and tness trackers, human activity recognition (HAR) studies have become
more widespread [
        <xref ref-type="bibr" rid="ref13">13</xref>
        ]. The bene ts of HAR include rehabilitation for recovering
patients, activity monitoring of the elderly and vulnerable people, and
advancements in human-centric applications [
        <xref ref-type="bibr" rid="ref19">19</xref>
        ].
      </p>
      <p>Photoplethysmography (PPG) is an optical technique used to measure
volume changes of blood in the microvascular tissue. PPG is capable of measuring
heart rate by detecting the amount of light re ected/absorbed in red blood
cells as this varies with the cardiac cycle. Re ected light is read by an
ambient light sensor which then has its output conditioned, so a pulse rate can be
determined. The pulse rate is obtained from analysis of the small alternating
component (which arises from the pulsatile nature of blood ow) superimposed
on the larger base signal caused by the constant absorption of light.</p>
      <p>
        For usability reasons the wrist is a common site for wearables used in health
and tness contexts [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ]. Most smartwatches are equipped with a PPG sensor
capable of measuring pulse rate. Di culties arising in obtaining a robust
physiologically useful signal via PPG can be caused by motion artefacts due to the
changes in optical path length associated with disturbance of the source-detector
con guration. This disturbance is introduced by haemodynamic e ects and gross
motor movements of the limbs [
        <xref ref-type="bibr" rid="ref20">20</xref>
        ]. This can lead to an incorrect estimation of
the pulse rate. Reduction in motion artefacts can be achieved using a range of
techniques, for example, through the choice of physical attachment technique or
through adaptive signal ltering methods based on an estimation of the artefact
source from accelerometer-derived signals [
        <xref ref-type="bibr" rid="ref2">2</xref>
        ].
      </p>
      <p>
        In this study we sought to exploit the motion artefact to infer human activity
type from the PPG signals collected at the wrist. Our hypothesis was that there
is su cient information in the disturbance induced in the source-detector path
to distinguish di erent activities through the use of a machine learning approach.
In recent years, capabilities of machine learning methods in the eld of image
recognition has increased dramatically [
        <xref ref-type="bibr" rid="ref12">12</xref>
        ]. Building on these advancements in
image recognition would allow for simpli cation of wearables involved in HAR.
We chose an image-based approach to the machine learning challenge as this
work is part of a larger scope e ort to develop easily deployed AI (arti cial
intelligence) which can be used and interpreted by end users who do not have
signal processing expertise.
      </p>
      <p>
        This paper extends previous work completed in [
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. The additional
contributions of this paper are improved classi cation through the use of a hybrid
classi er approach and more signi cantly to demonstrate through the use of
tools from research in explainable arti cial intelligence (XAI) how this machine
vision approach lends itself to more interpretable machine learning output.
2
      </p>
    </sec>
    <sec id="sec-3">
      <title>Related Work</title>
      <p>
        Convolutional neural networks (CNNs) have been used since the 1990s and were
designed to mimic how the visual cortex of the human brain processes and
recognises images [
        <xref ref-type="bibr" rid="ref18">18</xref>
        ]. CNNs extract salient features from images at various layers of
the network. They allow implementation of high-accuracy image classi ers given
the correct training without the need for in-depth feature extraction knowledge.
      </p>
      <p>
        The current state of the art in activity recognition is based on the use of
cameras. Cameras allow direct and easy capture of motion but this output requires
signi cant processing for recognition of speci c activities. Inertial sensing is
another popular method used in HAR. To achieve the high accuracy of the inertial
sensing systems shown in [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ], a system consisting of multiple sensors is required,
compromising functionality and scalability. The associated signal processing is
not trivial and singular value decomposition (SVD), truncated Karhunen-Loeve
transform (KLT), Random Forest (RF) and Support Vector Machines (SVM)
are examples of feature extraction and machine learning methods that have
been applied to HAR.
      </p>
      <p>
        Inertial sensor data paired with PPG are amongst the most suitable sensors
for activity monitoring as they o er e ective tracking of movement actions as
well as relevant physiological parameters such as heart rate. They also have
the bene t of being easy to deploy. Mehrang et al. used RF and SVM machine
learning methods for a HAR classi er on combined accelerometer and PPG data
achieving an average recognition accuracy of 89.2% and 85.6% respectively [
        <xref ref-type="bibr" rid="ref16">16</xref>
        ].
      </p>
      <p>
        The average classi cation accuracy of the leading modern feature extraction
and machine learning methods for singular or multiple inertial sensors range
from 80% to 99% [
        <xref ref-type="bibr" rid="ref15">15</xref>
        ]. However, this can require up to 5 inertial measurement
units located at various positions on the body.
      </p>
      <p>
        Even with the success of deep learning, similar criticisms that plagued past
work on neural networks, mainly in terms of being uninterpretable, are recurring.
There is no unanimous de nition of interpretability, but works like Doshi-Velez
and Kim [
        <xref ref-type="bibr" rid="ref7">7</xref>
        ] try to de ne the term and provide a way of measuring how
interpretable a system is. Issues such as algorithmic fairness, accountability and
transparency are a source of current research. An example for the need of such
work is the European Unions right to explanation [
        <xref ref-type="bibr" rid="ref9">9</xref>
        ] in which users can demand
to be explained how an algorithmic decision that a ects them has been made.
The rami cations of these implicitly present issues with governance, policy and
privacy demonstrate a need for regulation of explainability in the near future.
In this paper the authors use the term interpretability in terms of transparency
and accountability.
3
3.1
      </p>
    </sec>
    <sec id="sec-4">
      <title>Methodology</title>
      <sec id="sec-4-1">
        <title>Data Collection</title>
        <p>
          We use a dataset collected by Deleram Jarchi and Alexander J. Casson and
is freely available from Physionet [
          <xref ref-type="bibr" rid="ref11">11</xref>
          ]. This dataset comprises PPG recordings
taken from 8 patients (5 female, 3 male) aged between 22-32 (mean age of 26.5),
during controlled exercises on a treadmill and an exercise bike. Data was recorded
using a wrist-worn PPG sensor attached to the Shimmer 3 GSR+ unit for an
average period of 4-6 minutes with a maximum duration of 10 minutes. A
frequency of 256 Hz was used to sample the physiological signal. Each individual
was allowed to set the intensity of their exercises as they saw t and every
exercise began from rest. The four exercises were broken down into walk on a
treadmill, run on a treadmill, low and high resistance exercise bike. For the walk
and run exercises the raw PPG signals required no ltering other than what
the Shimmer unit provides. The cycling recordings were low-pass ltered using
Matlab with a 15 Hz cut-o frequency to remove any high-frequency noise.
3.2
        </p>
      </sec>
      <sec id="sec-4-2">
        <title>Data Preparation</title>
        <p>
          The PPG data signal was downloaded using the PhysioBank ATM and plotted
in Python. Signals were segmented into smaller time series windows of 8-second
intervals chosen to match the time windows used in [
          <xref ref-type="bibr" rid="ref3">3</xref>
          ], which acts as a
benchmark for this study. A rectangular windowing function was used to step through
the data every 2 seconds, also conducted in [
          <xref ref-type="bibr" rid="ref3">3</xref>
          ]. It is worth re-emphasising that
a machine vision approach is being taken here, the input data to the classi er
is not time series vectors but images. These images correspond to simple plots
of the 8-second window produced in Python which plots and saves gures and
removes all axis labels, legends and grid ticks (removing non-salient features),
saving each gure as a 299x299 JPEG le. A total of 3321 images were created,
of which 80% (2657) were used for retraining, 10% (332) for validation and 10%
(332) for testing.
        </p>
        <p>The image les were stored in a directory hierarchy based on the movement
carried out. Four sub-directories of possible classi ers were created; run, walk,
high resistance bike and low resistance bike and contained within each were the
images of the plotted PPG signal. In Fig 1 an example of a plot for each activity
can be seen.
3.3</p>
      </sec>
      <sec id="sec-4-3">
        <title>The Network Infrastructure</title>
        <p>
          On completion of data preparation, the CNN could then be retrained. Building
a neural network from the ground up is not a trivial task, requiring a multilayer
implementation for even a simple perceptron [
          <xref ref-type="bibr" rid="ref18">18</xref>
          ] which needs optimization of
tens of thousands of parameters for even a trivial task such as handwritten digit
classi cation [
          <xref ref-type="bibr" rid="ref21">21</xref>
          ]. Also very large amounts of data is required for training. Here
we avoided both problems through use of Inception-v3 which can be implemented
with the TensorFlow framework and transfer learning.
        </p>
        <p>
          TensorFlow [
          <xref ref-type="bibr" rid="ref1">1</xref>
          ], a deep learning framework, was used for transfer learning
which is the concept of using a pretrained CNN and retraining the penultimate
layer that does classi cation before the output. This type of learning is ideal for
this study due to our relatively small dataset [
          <xref ref-type="bibr" rid="ref22">22</xref>
          ]. The results of the retraining
process can be viewed using the suite of visualisation tools on TensorBoard.
x104 High Bike
4
)(eVm 132
litdu -01
p -2
        </p>
        <p>
          Recognition of speci c objects from millions of images requires a model with
a large learning capacity. CNNs are particularly suitable for image classi cation
because convolution leverages three important properties that can help improve
a machine learning system: sparse interaction, parameter sharing and equivariant
representations [
          <xref ref-type="bibr" rid="ref8">8</xref>
          ]. These properties enable CNNs to detect small, meaningful
features from input images and reduce the storage requirements of the model
compared to traditional densely connected neural networks. CNNs are tuneable
in their depth and breadth meaning they can have much simpler architecture,
making them easier to train compared to other feedforward neural networks [
          <xref ref-type="bibr" rid="ref12">12</xref>
          ].
A pretrained CNN, Google's Inception-v3, was used which has been trained on
ImageNet, a database of over 14 million images and will soon be trained on up
to 50 million images [
          <xref ref-type="bibr" rid="ref16">16</xref>
          ]. To retrain a network, we use the approach taken by
Dominguez Veiga et. al [
          <xref ref-type="bibr" rid="ref6">6</xref>
          ]. The experiment was completed again using the
features from the retrained Inception-v3 penultimate layer. The 2048 dimensional
features were extracted from this layer and used as input into a radial basis
function SVM classi er as in [
          <xref ref-type="bibr" rid="ref16">16</xref>
          ], a nested cross-validation strategy was applied
here to prevent biasing the model evaluations.
        </p>
        <p>The retraining process can be ne-tuned through hyperparameters which
allows for optimisation of the training outcome. For the transfer learning approach
the default parameters were used except for the number of training steps which
were changed from the default of 4,000 steps to 10,000 steps. Selection of this
number of iterations allowed for the loss function (cross-entropy) to su ciently
converge, avoiding over- tting. For the CNN-SVM approach the
hyperparameters (kernel, gamma and C) were optimised by grid search1.
1 full classi er details: https://github.com/Brophy-E/PPG-Image-Classi er
4</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Results</title>
      <p>The average classi cation accuracy of the transfer learning approach was shown
to be 88.3% and as can be seen in Fig 2(b) the confusion matrix, demonstrates
the accuracy for correctly classifying the test set of PPG images.
The CNN-SVM achieved an average classi cation accuracy of 92.3%, see
Fig 2(a) for the confusion matrix associated with this method. The confusion
matrices for these deep learning approaches graphically demonstrates some of
the issues classifying the low-resistance bike exercise, where it was misclassi ed
as high-resistance 19.59% of the time. An increase 4.8% classi cation accuracy
was achieved using the CNN-SVM approach with nested cross-validation over
the transfer learning approach.</p>
      <p>
        Fig 4 shows two misclassi ed examples of each class. Based on the plots
shown in Fig 4, the errors may have been from a loose wrist strap or excessive
movement of the arms. In some circumstances, the signal can be seen to be cut
o which indicates gross movement of the limbs for those time instances [
        <xref ref-type="bibr" rid="ref20">20</xref>
        ].
      </p>
      <p>
        A study conducted by Biagetti et al. used feature extraction and reduction
with Bayesian classi cation on time series signals [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]. Their technique focused
on using singular value decomposition and truncated Karhunen-Loeve transform.
Their study used the same time series dataset and was designed to present an
e cient technique for HAR using PPG and accelerometer data. Below, in Fig 3
the confusion matrix for their results can be seen, using just the PPG signal for
feature extraction and classi cation.
      </p>
      <p>The feature extraction approach for determining HAR using just the PPG
yields an overall accuracy of 44.7%. This shows a reduced classi cation
performance versus the deep learning method employed in this paper. Although our
CNN-SVM achieved greater accuracy of over 47 percentage points (92.3% vs.
44.7%), Biagetti et al. in the same paper combined the PPG and
accelerometer data to bring their classi er accuracy rate to 78%. We are able to produce
High 14.60 84.40
0</p>
      <p>
        0
very competitive accuracy without the use of an accelerometer, i.e. through the
optical signal only.
Applying the CNN-SVM method to the PPG dataset leads to an accuracy of
92.3%. This result outperforms the combined PPG and accelerometer data for
HAR using SVD and KVL (92.3% vs. 78%) and of course is much more accurate
than the PPG only result (92.3% vs. 44.7%) [
        <xref ref-type="bibr" rid="ref3">3</xref>
        ]. This is a highly competitive
result and suggests that simpler wearables based on optical measurements only
could yield much of the functionality achievable with more sophisticated,
existing multi-modal devices. Of course, the addition of an inertial sensor will
always produce more information and therefore more nuanced activity
recognition. However, for the types of activity recognition commonly sought in clinical,
health and tness applications a surprisingly good performance can be extracted
from a very simple optical measurement.
5.1
      </p>
      <sec id="sec-5-1">
        <title>Limitiations</title>
        <p>Better understanding of the hyperparameters of the transfer learning prior to
the CNN-SVM may lead to higher average classi cation accuracy than the one
achieved in this paper (92.3%). The results generated in this paper are based on
data from a small sample size which contained a low number of individuals and
this may a ect the classi er if implemented of new, previously unseen data.
5.2</p>
      </sec>
      <sec id="sec-5-2">
        <title>Visualising the Network</title>
        <p>
          Due to the increase in the use of machine learning and neural networks in the last
number of years there has been a growing demand to make their working more
transparent and understandable by end users. Often, neural network models
are opaque and di cult to visualise. A lack of insight into the model results in
diminished trust on the part of the end user. People want to know why and when
the model succeeds and how to correct errors [
          <xref ref-type="bibr" rid="ref10">10</xref>
          ].
        </p>
        <p>CNNs can appear to operate as a black box. In our case, the input are
images, the layers process this and intermediate layers to do their work; extracting
patterns, edges and more abstract features. Then a decision is output to the
user foregoing any explanation as to why the particular decision was reached
e.g. \This image is a dog". Consequently there is emerging and growing
efforts to make such AI systems more explainable. For example, the US Defense
Advanced Research Projects Agency (DARPA) are currently working on an
explainable model with an explainable interface, i.e. \This is a dog because of
the snout, ears, body shape etc." This explainable interface can help end-users
better accept the decisions made by the AI system.</p>
        <p>
          A number of works have been able to produce high quality feature
visualisation techniques, with the goal of making CNNs more explainable. The work
done in [
          <xref ref-type="bibr" rid="ref17">17</xref>
          ] has the capability to demonstrate the function of the layers within
a CNN, how it builds up extracting edges, textures and patterns to extracting
parts of objects. The work done by Olah, et al., shows us what a CNN `sees' and
how it builds up its layers as we go deeper into the network.
        </p>
        <p>However, end users are still unable to intuitively determine why the input
caused the output. The information retaining to what feature in the input image
is a signi cant discriminating factor in the classi cation decision is unavailable.
The issue here is to be able to explain the decision making process rather than
visually representing what each layer extracts. A simple, visual representation of
the decision can be a very e ective method of explainable arti cial intelligence.</p>
        <p>
          Class activation maps (CAM) are one such visual method capable of aiding
in the explanation of the decision making process. CAMs indicate particularly
discriminate regions of an image that are used by a trained CNN to determine
the prediction of the image for a given layer [
          <xref ref-type="bibr" rid="ref23">23</xref>
          ], in other words what region in
the input image is relevant to the classi cation. The CAM for this paper uses
the global average pooling layer of the retrained Inception-v3 model.
        </p>
        <p>Fig 5 shows the CAM for the retrained network on all of the input classes;
high, low, run and walk respectively, they are representative of the average CAMs
for their class. Red areas indicate high activations while the dark blue areas
indicate little to no activation. Activations across all four classes demonstrate that
the model is correctly discriminating the plotted signal from the background of
the image. The location of the activations can be used to indicate the inter-class
variations. Each of the classes produces a distinct CAM from one another, the
di erence in these activations can be used to indicate how a class was classi ed.
For a human observer we can say the class is such due to it's amplitude or
frequency. The inter-class variation in the CAM across these plots may provide an
explainable interface into the decision making process taken by the CNN
regarding the image classi cation problem. \The activity was classi ed as a walk due
to the location of the content activations not present in other classes."</p>
        <p>
          Another XAI approach that can be adopted is the use of t-Distributed
Stochastic Neighbor Embedding (t-SNE) [
          <xref ref-type="bibr" rid="ref14">14</xref>
          ]. This dimensionality reduction
technique is well suited to the visualisation of high-dimensional datasets such
as the 2048 dimensional feature vector describing an image in the penultimate
layer of Inception-v3. Using t-SNE on Inception-v3 global average pooling layer
allows visualisation of the dimensionally reduced feature vectors for all classes.
Fig 6 demonstrates a clustering e ect of the data, close groupings of the same
class demonstrate the similarity between features available in that class. This
allows a user to see the where features for one class appears in relation to the
other classes in the trained model. t-SNE produces visualisations that are
interpretable by the user in relating the output to the input. One way to help the
user comprehend the visualisation of this technique is to place a decision
boundary over the output. A feature found within the decision boundary for one class
in particular would explain why the input generates the output. Conversely, it
might raise further questions if the feature appears outside the boundary. It is
also possible to graph one feature against another for a simple dataset (sepal
vs petal length [
          <xref ref-type="bibr" rid="ref5">5</xref>
          ]). However, this has not been investigated for this dataset yet
and this will form part of our future work.
        </p>
        <p>High
Low
Run</p>
        <p>
          Walk
The application of transfer learning in computer vision for human activity
recognition is a novel approach to extracting new useful information from wrist-worn
PPG sensors which are conventionally used for heart rate monitoring. We show
how CNN suitably con gured can create powerful classi ers for HAR
applications based on simple images of PPG time series plots [
          <xref ref-type="bibr" rid="ref12">12</xref>
          ].
        </p>
        <p>A great bene t of the deep learning approach adopted here is its performance
and relative simplicity. Users of this system need not possess a signal processing
background to understand the approach and this opens up the possibility that
non-experts can develop their own HAR classi cation applications more readily.
Pathways for HAR using deep learning are beginning to be explored on a larger
scale thanks to the simplicity of the transfer learning approach, signi cantly
reducing the development time of a suitable CNN. Furthermore this new approach
to HAR classi cation will allow for the easier testing of hypotheses relating to
HAR with wearable sensors. The development of AI applications and platforms
in the last number of years have led to signi cant progressions particularly in
the domain of image classi cation problems. These black box AI techniques have
a need for more explainable methods to reinforce the machines decision making
process. The activation maps (Fig 5) in conjunction with the t-SNE features
(Fig 6) have the potential to help with this explainable arti cial intelligence
issue. Inter-class variations in activations have the capability to provide an
explainable interface to the end user; \The exercise was classi ed as a run because
of the high amplitude, high frequency components present in your signal".</p>
        <p>The presented process allows activity classi cation models to be constructed
using PPG sensors only, potentially eliminating the need for an inertial sensor
set and simplifying the overall design of wearable devices.</p>
        <p>Acknowledgements This work was part-funded by Science Foundation Ireland
under grant number SFI/12/RC/2289 and by SAP SE.</p>
      </sec>
    </sec>
  </body>
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