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  <front>
    <journal-meta />
    <article-meta>
      <title-group>
        <article-title>MediaPipe-based LSTM-Autoencoder Sarcopenia Anomaly Detection and Requirements for Improving Detection Accuracy</article-title>
      </title-group>
      <contrib-group>
        <contrib contrib-type="author">
          <string-name>HyeRin Yoon</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Eunah Jo</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Seungjae Ryu</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jun-Il Yoo</string-name>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff1">1</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <contrib contrib-type="author">
          <string-name>Jin Hyun Kim</string-name>
          <email>jin.kim@gnu.ac.kr</email>
          <xref ref-type="aff" rid="aff0">0</xref>
          <xref ref-type="aff" rid="aff2">2</xref>
          <xref ref-type="aff" rid="aff3">3</xref>
        </contrib>
        <aff id="aff0">
          <label>0</label>
          <institution>1st International Workshop on Intelligent Software Engineering</institution>
          ,
          <addr-line>De-</addr-line>
        </aff>
        <aff id="aff1">
          <label>1</label>
          <institution>Gyeongsang National University Hospital</institution>
          ,
          <addr-line>52828</addr-line>
          ,
          <country country="KR">South Korea</country>
        </aff>
        <aff id="aff2">
          <label>2</label>
          <institution>Gyeongsang National University</institution>
          ,
          <addr-line>Jinju-si , 53828</addr-line>
          ,
          <country country="KR">South Korea</country>
        </aff>
        <aff id="aff3">
          <label>3</label>
          <institution>agement System) of DEEVO Co. Ltd with MediaPipe</institution>
        </aff>
      </contrib-group>
      <abstract>
        <p>MediaPipe is a leaning-based human pose detection technology that detects the position and movement of a person's body, face, fingers, etc., from videos. Nowadays, many orthopedic studies put eforts into finding a biomarker of orthopedic diseases from the correlation between gait and orthopedic, using MediaPipe. This paper presents the results of applying the LSTM(Long Short Term Memory)-Autoencoder-based anomaly detection technique for orthopedic diseases, e.g., sarcopenia disease and the capability of distinguishing the normal and abnormal gait. We compare the sensitivity of the anomaly detection based on 5 human body points in predicting sarcopenia so as to find the primary gait features of human body. In addition, we present four environmental factors afecting MediaPipe Recognition that can improve the accuracy of anomaly detection using MediaPipe. Our anomaly detection approach detects 92% (35) of sarcopenia patients from 38 patients.</p>
      </abstract>
      <kwd-group>
        <kwd>Detection</kwd>
      </kwd-group>
    </article-meta>
  </front>
  <body>
    <sec id="sec-1">
      <title>1. Introduction</title>
      <p>
        In recent years, AI(Artificial Intelligence) that can help
doctors’ decisions based on accumulated data is
positioned as a research flow in the medical area[
        <xref ref-type="bibr" rid="ref1">1</xref>
        ][
        <xref ref-type="bibr" rid="ref2">2</xref>
        ]. In
addition, AI is an efective diagnostic way because it can
provide immediate diagnosis and severity analysis for
patients at a low cost. Many orthopedic studies use gait
images or video to find the status of
musculoskeletalrelated diseases[
        <xref ref-type="bibr" rid="ref3">3</xref>
        ][
        <xref ref-type="bibr" rid="ref4">4</xref>
        ]. Chen et al. presented a hybrid
prediction model that combines an LSTM model and an
      </p>
      <sec id="sec-1-1">
        <title>SVM classifier to provide a functional description of the</title>
        <p>
          knee joint to patients with osteoarthritis, one of the
musculoskeletal diseases[
          <xref ref-type="bibr" rid="ref5">5</xref>
          ]. Mirelman et al. proposed the
RUSBoost(Random Under-Sampling Boosting)
classification algorithm to examine the correlation between gait
and the severity of Parkinson’s disease[
          <xref ref-type="bibr" rid="ref6">6</xref>
          ]. The problems
mentioned in such orthopedic papers are that the lack of
quantitative gait analysis systems leads to doctors’
subjective decisions or that the correlation between gait and
disease is unclear.
are mainly used as data acquisition methods for
develing the LSTM-Autoencoder model and anomaly detection
method and its results. In addition, this paper presents
four environmental factors afecting MediaPipe
recog
        </p>
        <p>
          Image tracking systems, such as marker-based VICON, resulting in abnormalities in physical function. In
addioping quantitative gait analysis systems[
          <xref ref-type="bibr" rid="ref7">7</xref>
          ][
          <xref ref-type="bibr" rid="ref8">8</xref>
          ]. However, symptoms appear is diferent among sarcopenia patients.
changes, one of the symptoms of Parkinson’s disease, the LSTM-Autoencoder model with normal gait data and
nition and their solutions: frame imbalance, headless, 2.2. Data Description and Pre-processing
clothing, and background that afect recognition error Process
when applying MediaPipe.
        </p>
        <p>In this paper is organized as follows: Section 2 explains This paper is ofered lateral gait video data of 78
the data pre-processing process and research method. sarcopenia patients and 29 normal persons from the
In Section 3, we propose the experimental results. In Gyeongsang National University Hospital Orthopedic.
Section 4, we describe environmental proposals for using After pre-processing, this paper uses lateral gait image
MediaPipe. Finally, we conclude this paper and present data from 38 sarcopenia patients and 21 normal persons.
future work in section 5. In the data pre-processing process, we remove parts of
videos that can cause recognition errors when applying
MediaPipe, such as parts that are not on the lateral of
2. METHODS pedestrians or that the camera frame covers the joints.</p>
        <p>And we apply MediaPipe to extract joint points and
cal</p>
        <p>This section describes the data extraction, preprocess- culate the angles of both knees, hips, and nose-shoulder
ing process, and the model used in the study. using the DMS of DEEVO Co. Ltd. And we exclude the
video data with spike values of the angle data caused
2.1. MediaPipe Description and Data by the MideaPipe’s recognition error that can afect the
Extraction model training. MediaPipe’s recognition errors refer to
these cases: recognizing the background as a pedestrian’s</p>
        <p>
          MediaPipe is an open-source gait analysis system sim- joint because of clothing in color similar to the
backilar to OpenPose developed by Google in June 2019[
          <xref ref-type="bibr" rid="ref10">10</xref>
          ]. ground, or the wrong joint when the pedestrian’s body
Like OpenPose, MediaPipe can extract joint points of a part is out of the camera frame, or an angled object as a
person’s face, hand, and body in real-time from a photo pedestrian’s joint. This paper constructs lateral gait video
or video. However, as shown in Table. 1, MediaPipe ex- data of 38 sarcopenia patients and 21 normal patients.
tracts more joint points than OpenPose and can express The LSTM-Autoencoder model trains using this angle
body joints and faces more delicately. data and predicts sarcopenia with anomaly detection.
        </p>
        <sec id="sec-1-1-1">
          <title>2.3. Sarcopenia Gait Detection using</title>
        </sec>
        <sec id="sec-1-1-2">
          <title>LSTM-Autoencoder</title>
        </sec>
      </sec>
      <sec id="sec-1-2">
        <title>LSTM is a deep learning neural network algorithm and</title>
        <p>
          is a model created to overcome the vanishing problem,
which is a drawback of RNN. An Autoencoder is a neural
network that compresses input data and restores the
compressed data to its original form. LSTM-Autoencoder
is a model that combines these two models. The
LSTMAutoencoder has a low loss value for the time series
data as learned and a relatively high loss value for the
untrained data[
          <xref ref-type="bibr" rid="ref11">11</xref>
          ]. Therefore, the LSTM-Autoencoder
in this paper trains the normal gait data and determines
the threshold for anomaly detection.
in Fig. 2(b). In the model structure of Fig. 2(a), (b), the
number of features in the encoder’s first layer and the
decoder’s last layer is diferent. Our model trains each body
part’s 18 normal gait data based on the hyper-parameters
in Table. 2. And we determine the threshold by averaging
each data’s most significant loss values.
        </p>
      </sec>
    </sec>
    <sec id="sec-2">
      <title>3. RESULTS</title>
      <p>than 30, and the nose-shoulder is 10. On the other hand,
the right and left hips show relatively low results with 7
and 5 sarcopenia patients, respectively.</p>
      <p>Fig. 3 shows a graph detecting outliers in the left knee Fig. 5 is a Confusion Matrix showing rates of
predictof sarcopenia patient who have video ID 29. The red line ing sarcopenia in other body parts when predicted in a
is the threshold obtained through training, and the red particular body part. For example, 0.29 in the first
coldots are outliers. umn and second row means the ratio of the number of</p>
      <p>Fig. 4 shows the number of sarcopenia patients de- predicted sarcopenia through the Right hip and Left hip
tected by each body part. The number of sarcopenia to the number of predicted sarcopenia through the Right
anomaly detected is 35 out of 38, showing an accuracy of hip. When both knees are predicted to be positive, the
about 92%. The number detected in both knees is more rate of other body parts also predicted to be positive is</p>
      <p>The most significant advantage of MediaPipe is that
gait analysis is possible with a smartphone without a
high-spec camera. It is easy to analyze for an
inexperienced expert. Also, as shown in Table. 1, MediaPipe
recognizes more joint points than OpenPose, enabling
accurate gait analysis. However, there are environmental
proposals when taking a video to increase the recognition
accuracy of MediaPipe.</p>
      <p>Therefore, this paper presents the four environmental
factors afecting MediaPipe recognition and their
solutions: frame imbalance, headless, clothing, and
background.
about 85% and about 28% for both hips and nose-shoulder. 1) Frame imbalance: It is a case where some body part
In other words, both knees have a higher anomaly detec- of a pedestrian is out of frame. In Fig. 6(1), there is a
tion ratio than both hips and nose-shoulder. And among recognition error because the pedestrian’s left foot is out
both knees, the anomaly detection rate of the right knee of the frame.
is higher. 2) Headless: It is a case in which only the body below
the neck is shown in the video. In Fig. 6(2), a recognition
error occurred because a video frame does not include
4. SUGGESTING the pedestrian’s head and shoulder.</p>
      <p>ENVIRONMENTS TO USE 3) Clothing: It is a case where pedestrians wear
clothMEDIAPIPE ing similar in color to the background, clothing too large
or too loose for their bodies. In Fig. 6(3), MediaPipe
recognized the knee as the angled hem of the large black
shorts.</p>
      <p>4) Background: It is a case where the video included
angular objects such as drawers and doors. In Fig. 6(4),
a recognition error is caused by a drawer behind the
pedestrian.</p>
      <sec id="sec-2-1">
        <title>4.1. 4 Environmental Factors Afecting</title>
      </sec>
      <sec id="sec-2-2">
        <title>MediaPipe Recognition</title>
      </sec>
      <sec id="sec-2-3">
        <title>4.2. Proposals to increase the recognition accuracy of MediaPipe</title>
        <sec id="sec-2-3-1">
          <title>In the pre-processing process of subsection 2.2, we</title>
          <p>analyze the angle data of the video is applying
MediaPipe. More than 50% of the total video data have a
MediaPipe recognition error, resulting in spike values
that can afect the model training. The recognition error
is caused by the four environmental factors MediaPipe
recognition described in subsection 4.1: frame imbalance,
headless, clothing, and background. Only video editing
cannot block all recognition errors for video data,
including any of the four environmental factors MediaPipe
recognition. Therefore, we present four environmental
proposals when taking a video.</p>
          <p>1) Frame: MediaPipe is a real-time gait analysis system
that recognizes pedestrians for each video frame.
However, the frame imbalance described in subsection 4.1 can
cause MediaPipe’s recognition errors in cases: where the
distance between the camera and the pedestrian is not
kept constant, that a body part is out of video frame due
to the diference between the camera’s moving speed and
the human’s gait speed. As a result of anomaly detection
using angle data of normal videos with recognition
errors and sarcopenia patients’ videos, they are all detected
as sarcopenia patients. We suppose this result to be the
efect of the spike values of the angle data caused by
the recognition error. Therefore, if we use a video with
frame imbalance, a normal person may be predicted as a
sarcopenia patient. Also, it may be dificult to determine
the severity of sarcopenia.</p>
          <p>In this paper, we propose an ideal frame and maximum
frame range that does not cause frame imbalance when
taking a video, using the coordinates of the bounding box
of the pedestrian center of the video through the YOLO
algorithm.
it shows the average of the top, bottom, left, and right
margins in total sarcopenia video data. Based on this,
this paper proposes an ideal and maximum frame range
that can recognize pedestrians.</p>
        </sec>
        <sec id="sec-2-3-2">
          <title>This paper uses the data from 38 sarcopenia patients</title>
          <p>
            in subsection 2.3 and the YOLO algorithm to determine Figure 8: Frame Range
the ideal and maximum frame range. YOLO(You Only
Look Once) is an algorithm that detects people or things Fig. 8 shows the ideal and the maximum frame range
through object detection in an image or video. For each for recognizing pedestrians. We calculated the frame
video frame with a pedestrian in the center of each video ranges using the average of the top, bottom and left, right
data, YOLO v3[
            <xref ref-type="bibr" rid="ref12">12</xref>
            ] draws a bounding box centered on the margins for the minimum and total averages in Table. 3.
pedestrian, as shown in Fig. 7. Also, YOLO v3 ofers the Fig. 8(a) shows the ideal frame range. The top and bottom
coordinates of the bounding box’s upper left and lower margins are 20%, and the left and right margins are 30%.
right. Based on the average of each coordinate value, Fig. 8(b) shows the maximum frame range. The top and
we get the top, bottom, left, and right margins of the bottom margins are 5%, and the left and right margins are
remainder of the video frame except for the bounding 16%. Therefore, we recommended taking a video within
box. And this paper obtains the top, bottom, left, and the ideal frame range of Fig. 8(a) to recognize pedestrians
right average margins of the 38 sarcopenia patients’ video when applying MediaPipe. However, if not, it is good to
data. maintain the maximum frame range in Fig. 8(b). When
          </p>
          <p>This paper classified each video data as long and short taking a video to apply MediaPipe, we can improve the
distance, using the bottom, left, and right margins. If it is recognition accuracy by following these proposals. Also,
larger than the average of each margin, it is classified as it can reduce the recognition error caused by 2) headless.
long distance, and if it is smaller, it is classified as short 3) Clothing: It is better to wear clothing that shows
distance. The reason for excluding the top margin is that body shape than clothing that covers joint points, such as
it could be afected by the height of the pedestrian. Then, skirts, shorts, and loose clothing. Also, clothing that
coneach video data is divided into long and short distances trasts colors with the background can reduce recognition
by the frequency of the previously classified distance. errors.</p>
          <p>Finally, we divide the video data into 13 long-distance 4) Background: MediaPipe tends to recognize angled
and 25 short-distance samples. objects as joints, so it is good to avoid angled objects
in the background if possible. We can remove or cover
Table 3 angled objects in a limited environment before taking a
Minimum and Total Average video. However, there is a problem that it cannot resolve
recognition errors caused by angle objects in
environ</p>
          <p>Margin Top Bottom Left Right ments where objects cannot be restricted, such as a street
Minimum(%) 2.2 8.2 16.4 15 or a house.</p>
          <p>Total Average(%)
17.1
18.5
33.5</p>
          <p>28.1</p>
        </sec>
        <sec id="sec-2-3-3">
          <title>TABLE. 3 shows the minimum of the top, bottom, left, and right margins in 38 sarcopenia video data. Also,</title>
        </sec>
      </sec>
    </sec>
    <sec id="sec-3">
      <title>5. CONCLUSION AND FUTURE</title>
    </sec>
    <sec id="sec-4">
      <title>WORK</title>
      <sec id="sec-4-1">
        <title>This paper proposes a sarcopenia detection technique</title>
        <p>using the LSTM-Autoencoder-based anomaly detection
method. And it presents four environmental factors
MediaPipe recognition and their solutions: frame imbalance,
headless, clothing, and background that afect
recognition error when applying MediaPipe.</p>
        <p>As a result of the technique, outliers are detected in 35
out of 38 sarcopenia patients with 92% accuracy. From
Fig. 5, both knees are the most sensitively detecting
body parts. Among both knees, the right knee has a
higher anomaly detection rate. We suppose that the low
anomaly detection rates in parts except for knees are due
to characteristics that distinguish between sarcopenia
and normal being uncertain. Therefore, this paper
expects a better performance of a model that can respond
sensitively to data in the future.</p>
        <p>This paper presents four environmental factors
MediaPipe recognition and their solutions: frame imbalance,
headless, clothing, and background that afect
recognition when applying MediaPipe. Frame imbalance is a case
where some body part of a pedestrian is out of frame. It
can reduce recognition error by maintaining the
previously proposed ideal frame range for pedestrian
recognition when taking a video or by retaining the maximum
frame range when impossible. This frame range can
also solve recognition errors due to the headless that
appears only on the body below the neck in the video. And
clothing that shows the pedestrian’s body shape well and
in color contrast with the background can make fewer
recognition errors. However, in the background case,
there is a problem in that the recognition error cannot
be entirely solved for the video taken in an environment
where angular objects cannot be restricted, such as a
street or a house.</p>
        <p>For future work, we intend to research how to improve
the accuracy of gait analysis by solving the background
problem among the four environmental factors afecting
MediaPipe recognition.</p>
      </sec>
    </sec>
    <sec id="sec-5">
      <title>Acknowledgements</title>
      <sec id="sec-5-1">
        <title>This work was supported by the National Research Foundation of Korea(NRF) grant funded by the Korea government(MSIT) (No. 2022R1A2C1014855).</title>
      </sec>
    </sec>
  </body>
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