{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:06:48Z","timestamp":1787029608161,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T00:00:00Z","timestamp":1654732800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"the Netherlands Organization for Health Research and Development","doi-asserted-by":"publisher","award":["104022005"],"award-info":[{"award-number":["104022005"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"the Netherlands Organization for Health Research and Development","doi-asserted-by":"publisher","award":["OpenSSI 2021"],"award-info":[{"award-number":["OpenSSI 2021"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"the Netherlands Organization for Health Research and Development","doi-asserted-by":"publisher","award":["SoE fellowship_12ZZW22N"],"award-info":[{"award-number":["SoE fellowship_12ZZW22N"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Moveshelf Labs B.V.","award":["104022005"],"award-info":[{"award-number":["104022005"]}]},{"name":"Moveshelf Labs B.V.","award":["OpenSSI 2021"],"award-info":[{"award-number":["OpenSSI 2021"]}]},{"name":"Moveshelf Labs B.V.","award":["SoE fellowship_12ZZW22N"],"award-info":[{"award-number":["SoE fellowship_12ZZW22N"]}]},{"name":"the Small-Scale Initiatives in Machine Learning of the Netherlands eScience Center","award":["104022005"],"award-info":[{"award-number":["104022005"]}]},{"name":"the Small-Scale Initiatives in Machine Learning of the Netherlands eScience Center","award":["OpenSSI 2021"],"award-info":[{"award-number":["OpenSSI 2021"]}]},{"name":"the Small-Scale Initiatives in Machine Learning of the Netherlands eScience Center","award":["SoE fellowship_12ZZW22N"],"award-info":[{"award-number":["SoE fellowship_12ZZW22N"]}]},{"name":"the Postdoctoral Fellow Marie Sk\u0142odowska-Curie Actions\u2014Seal of Excellence of the Research Foundation\u2014Flanders","award":["104022005"],"award-info":[{"award-number":["104022005"]}]},{"name":"the Postdoctoral Fellow Marie Sk\u0142odowska-Curie Actions\u2014Seal of Excellence of the Research Foundation\u2014Flanders","award":["OpenSSI 2021"],"award-info":[{"award-number":["OpenSSI 2021"]}]},{"name":"the Postdoctoral Fellow Marie Sk\u0142odowska-Curie Actions\u2014Seal of Excellence of the Research Foundation\u2014Flanders","award":["SoE fellowship_12ZZW22N"],"award-info":[{"award-number":["SoE fellowship_12ZZW22N"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>Accurate and reliable measurement of the severity of dystonia is essential for the indication, evaluation, monitoring and fine-tuning of treatments. Assessment of dystonia in children and adolescents with dyskinetic cerebral palsy (CP) is now commonly performed by visual evaluation either directly in the doctor\u2019s office or from video recordings using standardized scales. Both methods lack objectivity and require much time and effort of clinical experts. Only a snapshot of the severity of dyskinetic movements (i.e., choreoathetosis and dystonia) is captured, and they are known to fluctuate over time and can increase with fatigue, pain, stress or emotions, which likely happens in a clinical environment. The goal of this study was to investigate whether it is feasible to use home-based measurements to assess and evaluate the severity of dystonia using smartphone-coupled inertial sensors and machine learning. Video and sensor data during both active and rest situations from 12 patients were collected outside a clinical setting. Three clinicians analyzed the videos and clinically scored the dystonia of the extremities on a 0\u20134 scale, following the definition of amplitude of the Dyskinesia Impairment Scale. The clinical scores and the sensor data were coupled to train different machine learning models using cross-validation. The average F1 scores (0.67 \u00b1 0.19 for lower extremities and 0.68 \u00b1 0.14 for upper extremities) in independent test datasets indicate that it is possible to detected dystonia automatically using individually trained models. The predictions could complement standard dyskinetic CP measures by providing frequent, objective, real-world assessments that could enhance clinical care. A generalized model, trained with data from other subjects, shows lower F1 scores (0.45 for lower extremities and 0.34 for upper extremities), likely due to a lack of training data and dissimilarities between subjects. However, the generalized model is reasonably able to distinguish between high and lower scores. Future research should focus on gathering more high-quality data and study how the models perform over the whole day.<\/jats:p>","DOI":"10.3390\/s22124386","type":"journal-article","created":{"date-parts":[[2022,6,13]],"date-time":"2022-06-13T02:01:44Z","timestamp":1655085704000},"page":"4386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Home-Based Measurements of Dystonia in Cerebral Palsy Using Smartphone-Coupled Inertial Sensor Technology and Machine Learning: A Proof-of-Concept Study"],"prefix":"10.3390","volume":"22","author":[{"given":"Dylan","family":"den Hartog","sequence":"first","affiliation":[{"name":"Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9219-7183","authenticated-orcid":false,"given":"Marjolein M.","family":"van der Krogt","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation and Development, 1081 BT Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-6968","authenticated-orcid":false,"given":"Sven","family":"van der Burg","sequence":"additional","affiliation":[{"name":"Netherlands eScience Center, 1098 XH Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignazio","family":"Aleo","sequence":"additional","affiliation":[{"name":"Moveshelf Labs B.V., 3521 AL Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Gijsbers","sequence":"additional","affiliation":[{"name":"Moveshelf Labs B.V., 3521 AL Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Bonouvri\u00e9","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation and Development, 1081 BT Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2889-271X","authenticated-orcid":false,"given":"Jaap","family":"Harlaar","sequence":"additional","affiliation":[{"name":"Department Biomechanical Engineering, TU Delft, 2628 CD Delft, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5662-2843","authenticated-orcid":false,"given":"Annemieke I.","family":"Buizer","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation and Development, 1081 BT Amsterdam, The Netherlands"},{"name":"Emma Children\u2019s Hospital, Amsterdam UMC Location University of Amsterdam, 1105 AZ Amsterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9307-4102","authenticated-orcid":false,"given":"Helga","family":"Haberfehlner","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, 1081 HZ Amsterdam, The Netherlands"},{"name":"Amsterdam Movement Sciences, Rehabilitation and Development, 1081 BT Amsterdam, The Netherlands"},{"name":"Department of Rehabilitation Sciences, KU Leuven, Campus Bruges, 8200 Bruges, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"15082","DOI":"10.1038\/nrdp.2015.82","article-title":"Cerebral Palsy","volume":"2","author":"Graham","year":"2016","journal-title":"Nat. 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