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A Machine Learning Based Surface Electromyography Topography Evaluation

for Prognostic Prediction of Functional Restoration Rehabilitation in Chronic
Low Back Pain

Article in Spine · March 2017

DOI: 10.1097/BRS.0000000000002159

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 SPINE Volume 42, Number 21, pp 1635–1642
ß 2017 Wolters Kluwer Health, Inc. All rights reserved.

DIAGNOSTICS

A Machine Learning-based Surface

Electromyography Topography Evaluation for
Prognostic Prediction of Functional Restoration
Rehabilitation in Chronic Low Back Pain
Naifu Jiang, MSc,,y Keith Dip-Kei Luk, FRCSE, FRCSG, FRACS, MCh(Orth), FHKAM(Orth),
and Yong Hu, PhD ,y

were applied to the prediction based on the optimized features

Study Design. A retrospective study.
selected by the sequential floating forward selection (SFFS)
Objective. The aim of this study was to investigate the
algorithm.
feasibility and applicability of support vector machine (SVM)
Results. RMSD feature parameters following rehabilitation in
algorithm in classifying patients with LBP who would obtain
the ‘‘responding’’ group showed a significant difference
satisfactory or unsatisfactory progress after the functional restor-
(P < 0.05) with the one in the ‘‘nonresponding’’ group. The SVM
ation rehabilitation program.
classifier with Quadratic kernel based on SFFS-selected features
Summary of Background Data. Dynamic surface electro-
showed the best prediction performance (accuracy: 96.67%,
myography (SEMG) topography has demonstrated the potential
sensitivity: 100%, specificity: 93.75%, average area under curve
use in predicting the prognosis of functional restoration rehabili-
[AUC]: 0.8925) comparing with linear kernel (accuracy:
tation for patients with low back pain (LBP). However, proces-
80.00%, sensitivity: 85.71%, specificity: 75.00%, average AUC:
sing from raw SEMG topography to make prediction is not easy
0.7825), polynomial kernel (accuracy: 93.33%, sensitivity:
to clinicians.
Methods. A total of 30 patients with nonspecific LBP were 92.86%, specificity: 93.75%, average AUC: 0.9675), and radial
recruited and divided into ‘‘responding’’ and ‘‘non-responding’’ basis function (RBF) kernel (accuracy: 86.67%, sensitivity:
group according to the change of Visual analog pain rating scale 85.71%, specificity: 87.50%, average AUC: 0.7900).
Conclusion. The use of SVM-based classifier of SEMG topogra-
and Oswestry Disability Index. Each patient received a 12-week
phy can be applied to identify the patient responding to
functional restoration rehabilitation program. A normal database
functional restoration rehabilitation, which will help the health-
was calculated from a control group from 48 healthy partici-
care worker to improve the efficiency of LBP rehabilitation.
pants. Root-mean-square difference (RMSD) was extracted from
Key words: dynamic surface electromyography topography,
the recorded dynamic SEMG topography during symmetrical
functional restoration rehabilitation, low back pain, machine
and asymmetrical trunk-movement. SVM and cross-validation learning.
Level of Evidence: 3
Spine 2017;42:1635–1642
From the Department of Orthopaedics and Traumatology, Li Ka Shing
Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong;
and yDepartment of Orthopaedics and Traumatology, Shenzhen Key
Laboratory for Innovative Technology in Orthopaedic Trauma, The Uni-

versity of Hong Kong-Shenzhen Hospital, Shenzhen, 518053, China.
Acknowledgment date: October 17, 2016. First revision date: January 17,
2017. Second revision date: February 17, 2017. Acceptance date: February
24, 2017.
The device(s)/drug(s) is/are FDA-approved or approved by corresponding
national agency for this indication.
No relevant financial activities outside the submitted work.
Shenzhen Knowledge Innovation Program of Basic Research
(JCYJ20150331142757393) funds were received in support of this work.
Address correspondence and reprint requests to Dr. Yong Hu, PhD, Depart-
ment of Orthopaedics and Traumatology, The University of Hong Kong,
Address: 12 Sandy Bay Road, Pokfulam, Hong Kong; E-mail: yhud@hku.hk
DOI: 10.1097/BRS.0000000000002159
Spine
Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
L
ow back pain (LBP) is a common problem faced by a
vast population.1,2 It significantly affects people’s
daily life. To relieve the LBP, various treatments have
been proposed and applied.3–7
Functional restoration rehabilitation program has been
proved to be a common and effective treatment for non-
specific LBP patients.6,7 Nevertheless, not all nonspecific
LBP patients would have a good recovery result after reha-
bilitation program.8,9 Thus, the patient who would respond
to rehabilitation program needed to be triaged.
The current method of triaging LBP patient was to seek
the direct correlation between the outcome of rehabilitation
www.spinejournal.com 1635
 DIAGNOSTICS Prognostic Prediction of Functional Restoration Rehabilitation in Chronic LBP  Jiang et al
and clinical variables.10–15 However, those variables (e.g.,
age, pain intensity, days of sick leave, fear of physical
activity, and frequency of previous episodes) were quite
subjective and imprecise, resulting in lead inappropriate
therapies to some patients. It is very disappointing for a
patient to join a long-term rehabilitation without expected
outcome. If the patient is referred to a wrong type of treat-
ment, it will waste not only the patient’s rehabilitation time,
but also the valuable healthcare resources. Therefore, it is
crucial to accurately predict the prognosis of functional
restoration for each LBP patient before he/she attends this
program with an appropriate expectation.
Surface electromyography (SEMG) is a noninvasive
medical diagnosis technique to record the electrical activity
produced by skeletal muscles.16 Through visualizing the
lumbar muscle myoelectric activity, dynamic SEMG top-
ography was proposed to be a new objective tool to assess
the LBP and its rehabilitation progress.17–21 A recent report
proposed to use some feature parameters from SEMG top-
ography during symmetrical flexion-extension trunk-move-
ment to predict the prognosis of functional restoration
rehabilitation for chronic LBP.17 The root-mean-square
difference (RMSD) of relative area (RA) and relative width
(RW) within both flexion and extension phases showed
potential to predict the LBP patient who would respond
to the conservative care program.17
However, there was a lack of an optimization for the
prediction technique on SEMG topography in the previous
study for two reasons.17 First, the information of lumbar
neuromuscular function for LBP rehabilitation assessment
was not comprehensive because it only included SEMG
topography during symmetrical flexion-extension trunk-
movement without asymmetrical movement. Second, the
previous prediction was often based on threshold decision
method, which had clinicians to make classification with the
complicated SEMG topography. During the prediction pro-
cedure, the feature parameters were analyzed as separate
parameters while they were actually inter-related and there-
fore should have been analyzed in an integrated approach.
Comparatively, support vector machine (SVM)—a common
machine learning algorithm—could provide a more accurate
prediction as it integrates feature parameters from SEMG
topography. SVM’s fundamental principle is to find the
maximum-margin hyperplane, which could best classify
the data.22
Therefore, this study is to apply a SVM classification
method to automatically predict and identify the LBP
patients who respond to the functional restoration rehabil-
itation program. The method uses time-varying dynamic
SEMG topography during both symmetrical and asymmet-
rical trunk-movement.
MATERIALS AND METHODS
Subjects
A total of 30 patients with nonspecific LBP (mean age
43.8  9.3 years, 19 males and 11 females) were recruited.
1636 www.spinejournal.com
Copyright © 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
All LBP patients have no spinal deficits, or any other back
surgeries. The duration of the LBP for each patient is over 3
months without related organic findings warranted for
surgical intervention. All LBP patients were asked to com-
plete a standard questionnaire including the age, sex,
medical history, and nature of their pain symptoms (i.e.,
location, frequency and duration of the pain, visual analog
scale [VAS]). The Oswestry Disability Index (ODI) of each
patient was calculated from results of the Oswestry Low
Back Pain Questionnaire. Those patients with a high level of
pain-related disability (ODI >60) or a disability in perform-
ing lumbar flexion-extension and lateral-bending/turning
were excluded. To avoid the effect of the ‘‘fear of re-injury’’
and kinesiophobia,23,24 those subjects not willing to per-
form trunk-movement were excluded. To establish the nor-
mal value of SEMG topography, a control group with 48
healthy subjects (mean age 36  7.3 years, 33 males and 15
females) was recruited. Before testing, all subjects and
healthy volunteers signed written informed consent forms
approved by the ethics committee.
A 12-week functional restoration rehabilitation program
was applied to all LBP patients. It consisted of physical
conditioning (5 weeks), working conditioning (4 weeks),
and work readiness (3 weeks).6,7 To avoid potential bias, a
senior orthopedic surgeon recruited the patient based on his
clinical assessment (interrogation, physical examination,
and radiographic assessment), and referred to a standard
exercise rehabilitation program conducted by a
senior physiotherapist.
Clinical Assessment
Before and after rehabilitation program, patients were
required to accomplish an 11-point VAS and an ODI ques-
tionnaire for LBP.17,25 The patients with good progress
(VAS decreased by two-points and/or ODI decreased by
10-points) were classified as ‘‘responding’’ group, whereas
the others were ‘‘nonresponding’’ group.26,27
Data Collection
An array of 3X7 surface Ag/AgCl electrodes with three rows
and seven columns was attached evenly to the region of
lumbar muscles from the spinal level of L2 to L5
(Figure 1).17,19 The diameter of each electrode is 1.5 cm.
Before electrodes were attached, the skin had been cleaned
with alcohol, whereas the impedance was tested under
10 kV. The SEMG signal was acquired at a sample rate
of 2000 Hz and filtered between 15 and 950 Hz (YRKJ-
A2004, Zhuhai Yiruikeji Co, Ltd, China).
To comprehensively assess the lumbar muscle’s behav-
iors, the subjects were asked to accomplish several sym-
metrical and asymmetrical trunk-movements. SEMG data
were acquired during these movements. The types of trunk-
movements included flexion-extension trunk-movement,
left-/right- lateral-bending trunk-movement, and left-/right-
turning trunk-movement shown in the Figure 2. The detailed
procedure was at first they were required to straightly stand
on the ground. Then they spent about 1 second to forward-
November 2017
 DIAGNOSTICS Prognostic Prediction of Functional Restoration Rehabilitation in Chronic LBP  Jiang et al

Figure 1. Placement of 3X7 electrodes and a typical surface electromyography topography during flexion-extension trunk-movement with the
definition of the quantitative feature parameters. REF indicates reference electrode; GND, ground electrode; 1-16, 16 channels of target
surface electromyography electrode.

bend (308), lateral-bend (458), or turn (608) their trunk (the
degree was measured by protractor). Subsequently, they
maintained this posture for about 2 seconds. Finally, they
extended or turned back their trunk and returned to the
original standing posture within 2 seconds. All subjects were
asked to perform each movement twice and had a rest for
about 2 minutes between each performance. More rest was
allowed if the subject required. All SEMG measurements
were carried out in one room with a constant temperature.
Feature Extraction
After selecting three channels of SEMG signal as the reference
and two channels as the ground from 3X7 array of surface
electrodes, the remaining 60 channels of SEMG signals were
recorded and amplified by 2000 times (Figure 1). Through
calculating the root mean square (RMS) value of the ampli-
fied data and the linear cubic spline interpolation value of the
RMS among electrodes with a 400 ms of moving window, the
dynamic time-varying SEMG topography was formed.17–19
RMS parameters including RA, RH, and relative width (RW),
which appeared in previous study, could reflect SEMG top-
ography.18,19 The Figure 1 showed the method to calculate
RMS parameter during flexion-extension trunk-movement,
which was same with trunk-lateral-bending movement and
trunk-turning movement.
Based on RMS parameter, we used RMSD for further
prediction. The RMSD was a feature parameter to calculate
the difference of RMS parameter between the normal and
the LBP patient. It had been defined in previous study17 and
expressed in Appendix A, http://links.lww.com/BRS/B267.
In this study, above RMS parameters were applied to
measure the features of the highest 60% RMS value region
in SEMG topography. To predict the ‘‘responding’’ and
‘‘nonresponding’’ groups, RMSD parameters within the
flexion/turning phase and extension/returning phase were
selected and compared between the ‘‘responding’’ and
‘‘nonresponding’’ groups.

Feature Selection
In previous study, researchers found the performance of the
machine learning model was often not perfect owing to the
redundant features.28 Thus, in this study, it was necessary to
test whether the features were redundant and then to opti-
Figure 2. View of the defined trunk-movement for subject. mize the prediction result based on the selected optimal
Spine www.spinejournal.com 1637
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 DIAGNOSTICS Prognostic Prediction of Functional Restoration Rehabilitation in Chronic LBP  Jiang et al
Figure 3. Flow chart of SVM-based prediction procedure. SVM
indicates support vector machine.
features. Sequential floating forward selection (SFFS), a
feature selection algorithm, was applied in this study.29–32
Its basic principle is to perform an iterative process: to
calculate the best performance of model by adding the feature
one by one from one feature to all features and simultaneously
recalculate it by removing the feature one by one till the
performance does not turn worse. It is guaranteed to obtain
the optimal features and corresponding feature’s number.
Appendix B, http://links.lww.com/BRS/B267 describes SFFS
in detail.
Support Vector Machine Model and Evaluation of
Model Performance
After extracting and selecting the optimal features from
SEMG topography, it is significant to form a proper pre-
diction/classification model and evaluate its generalized
performance.
In this study, SVM was used to form the model and cross-
validation method was applied to evaluate the performance
of the model.22 The procedure was shown in Figure 3. The
original dataset of SEMG topography was firstly divided
into two parts: training dataset and testing dataset. Then the
features (RMSD parameters) were respectively extracted
and selected from these two datasets. Applying SVM
method to the feature data from the training dataset, the
prediction/classification model could be obtained. Finally,
the performance of the model was evaluated by the feature
data extracted from the testing dataset.
The SVM algorithm shown in Figure 3 is a supervised
machine learning algorithm.33,34 The performance of SVM
model is strongly dependent on the type of kernel function of
SVM.33 Thus, in this study, we used and compared the SVM
model in different kernels such as linear, quadratic, poly-
nomial and radial basis function (RBF) to identify the
‘‘responding’’ and ‘‘nonresponding’’ group.
TABLE 1. Demographic of Patients With Low Back Pain and Healthy Subjects
Responding Group (n ¼ 14) Nonresponding Group (n ¼ 16)
n Percent (%)
Age, y
20–40 4 28.6
41–60 10 71.4
Sex
Male 10 71.4
Female 4 28.6
1638 www.spinejournal.com
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In Figure 3, the original dataset was divided using cross-
validation method. The cross-validation method evaluates
the performance of SVM model by dividing the original
dataset into different groups of training dataset and testing
dataset and calculating the average performance from test-
ing datasets.33,34 In this study, because of the small sample
size, the leave-one-out cross-validation (LOOCV) was
applied to calculate the average accuracy, sensitivity, and
specificity of the SVM model, whereas the 10-fold cross-
validation (10 times) was applied to obtain the average area-
under-curve (AUC) from receiver-operating-characteristic
(ROC) curves.22,33–36
Statistical Analysis
All presented data were analyzed using MATLAB 7.14.0
(Mathworks, Natick, MA). RMSD parameters from SEMG
topography between the ‘‘responding’’ and ‘‘nonrespond-
ing’’ group were compared by one-way analysis of variance
(ANOVA). P value <0.05 was considered as statistically
significant and <0.01 was statistically highly significant.
RESULTS
Classification of LBP Patients by Clinical Assessment
The demographic data of healthy subjects and LBP patients
were summarized in Table 1. In this study, there were
14 patients in ‘‘responding’’ group and 16 patients in ‘‘non-
responding’’ group. After rehabilitation program, changes
of pain intensity (VAS/ODI) of 30 LBP patients were
listed in Table 2. In the ‘‘responding’’ group, the VAS
decreased from 3.46  1.37 to 1.92  1.32, whereas the
ODI decreased from 46.21  7.49 to 34.79  8.95. In the
‘‘nonresponding’’ group, the VAS changed from 3.98  1.69
to 3.96  1.56 and the ODI changed from 47.13  10.24 to
45.50  10.19.
Comparison of RMSD Parameters Between the
Responding and Nonresponding Groups
The RMSD RA and RMSD RW during asymmetrical trunk-
movement in the ‘‘responding’’ group were consistently
lower than the one in the ‘‘nonresponding’’ group
(Figure 4A-D). Especially during left lateral-bending move-
ment, there was significant difference (P < 0.05) or even
highly significant difference (P < 0.01) between these two
groups (Figure 4A).
Healthy Subjects (n ¼ 48)
n Percent (%) N Percent (%)
6 37.5 32 66.7
10 62.5 16 33.3
9 56.2 33 68.8
7 43.8 15 31.2
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 DIAGNOSTICS Prognostic Prediction of Functional Restoration Rehabilitation in Chronic LBP  Jiang et al

TABLE 2. Pain Intensity Result of Patients With Low Back Pain

Responding Group (n ¼ 14) VAS/ODI Nonresponding Group (n ¼ 16) VAS/ODI
Case No. Before Rehabilitation After Rehabilitation Before Rehabilitation After Rehabilitation
1 4/48 2/48 2.5/36 1.8/34
2 4.6/48 0.9/38 5/36 5 /31
3 3/46 4/30 3.2/44 3.1/38
4 3/48 2/33 4/54 3/52
5 3.5/50 1.5/46 2.4/48 3.3/42
6 5.2/52 5.2/42 3/38 3.9/44
7 5.5/30 0.9/34 2.1/56 2.1/54
8 2.1/57 1.4/47 5/52 5/56
9 4.7/38 2.1/28 7/60 6/56
10 2.4/42 1/26 1.2/28 1.2/30
11 5/40 3/37 4/42 4/49
12 1/38 0/22 2.4/60 3.3/58
13 3/56 2/38 3.8/42 3.7/38
14 1.5/54 0.9/18 5/40 5/32
15 6/60 6/58
16 7/58 7/56
ODI indicates Oswestry Disability Index; VAS, Visual Analog Pain Rating Scale.

Comparison Among Model Performance in Different
SVM Models
Although the 20 RMSD feature parameters including
RMSD RA and RMSD RW during symmetrical flexion-
extension trunk-movement had been extracted, it did not
mean the performance of SVM model based on all 20
features was optimal. Some features might be redundant.
Therefore, the SFFS algorithm and LOOCV algorithm were
applied to select the optimal feature parameters.
Owing to different kernels in SVM model, we needed to
compare the model performance in different kernels. The
changing curves of accuracy with varying number of SFFS-
selected features in different kernel’s SVM model were
shown in Figure 5. The highest prediction accuracy and
the corresponding sensitivity/specificity in different kernels
were shown in Table 3.
From Figure 5, it was obvious that the optimal number
of features in Quadratic kernel was 8 with the highest

Figure 4. Comparison of root-mean-square differ-

ence parameter among the ‘‘responding’’ and
‘‘nonresponding’’ groups during different asym-
metrical trunk-movements (P < 0.05, P < 0.01).
Spine www.spinejournal.com 1639
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 DIAGNOSTICS Prognostic Prediction of Functional Restoration Rehabilitation in Chronic LBP  Jiang et al
Figure 5. Prediction performance of SVM model with different ker-
nels using different numbers of SFFS-selected suboptimal features.
Linear indicates linear kernel; Quadratic, quadratic kernel; Poly-
nomial, polynomial kernel (order of the polynomial kernel is 3); Rbf,
RBF kernel (the scaling factor, sigma, in the RBF kernel is 1).
prediction accuracy (accuracy: 96.67%) and the smallest
number of features. Meanwhile, the corresponding sensi-
tivity and specificity were, respectively, 100.00% and
93.75%, as shown in Table 3. The eight optimal feature
parameters were RMSD RA (flexion) during symmetrical
flexion-extension trunk-movement, RMSD RW (extension)
during left lateral-bending, RMSD RA (extension)/RMSD
RW (flexion) during right lateral-bending, RMSD RA (turn-
ing)/RMSD RW (returning) during left turning and RMSD
RW (turning/returning) during right turning. Therefore, the
SVM model in Quadratic kernel with eight optimal features
showed the best prediction performance.
Meanwhile, the average AUC from ROC curves in differ-
ent SVM models based on these optimal features could be
obtained. Owing to the small sample size, we applied the 10-
fold cross-validation (10 times) to form the ROC curves.
The result was shown in the Table 4.
DISCUSSION
This study proposed SVM method to identify patients who
would respond to the 12-week rehabilitation program via
dynamic SEMG topography. The classification of features
was from the dynamic SEMG topography during both
symmetrical and asymmetrical trunk-movements. Through
SFFS and cross-validation, the number of features was
optimized and the Quadratic kernel was confirmed as the
best kernel of SVM with the highest prediction accuracy.
Thus, this study is helpful for therapists/doctors to recom-
mend the appropriate treatment for each LBP patient.
TABLE 3. Model Performances (Highest Accuracy and the Corresponding Sensitivity/Specificity)
Based on LOOCV
SVM Kernel Highest Accuracy (%)
Linear 80.00
Quadratic 96.67
Polynomial (order is 3) 93.33
RBF (sigma is 1) 86.67
LOOCV indicates leave-one-out cross-validation; RBF, radial basis function; SVM, support vector machine.
1640 www.spinejournal.com
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In previous studies, the association between standardized
sociodemographic, physical or psychological variables,
and treatment response status was often investi-
gated.10,12,14,15,37,38 Generally, it was found that some
variables (e.g., age, straight-leg raise, prone instability test,
aberrant motions, lumbar hypermobility, early pain inten-
sity, fear-avoidance beliefs, and kinesiophobia) had corre-
lation with the change of treatment response status.
However, no consistent evidence proved that some psycho-
logical variables (e.g., somatization, hypochondriasis,
anxiety, and depression) assessed by Middlesex Hospital
Questionnaire (MHQ)39 and Multiphasic Personality Inven-
tory (MMPI and MMPI-2) scale40 are correlated with the
treatment outcome.37,38,41,42 To obtain the prediction per-
formance, the ROC analysis and/or regression analysis was
often applied.14,15 Hicks et al14 showed the cutoff score
(sensitivity/specificity) of the prediction model from ROC
curve, but unfortunately the values of sensitivity and speci-
ficity were often not simultaneously high. Berglund et al15
showed the adjusted R2 as a measurement of the correlation,
but the value was often even <0.5. This study showed high
prediction accuracy (96.67%) with high corresponding sen-
sitivity (100%) and specificity (93.75%).Thus, the variables
from dynamic SEMG topography based on SVM algorithm
provided a better prediction with higher accuracy as shown
in this study.
In our previous study, the features from SEMG topog-
raphy during symmetrical trunk-movement had been pre-
liminarily investigated for prediction.17 The prediction
performance was obtained from the ROC analysis and
the largest AUC was 0.747. In addition to SEMG topog-
raphy in symmetrical trunk-movement, the SEMG features
from asymmetrical trunk-movement were included into
SVM algorithm to increase the prediction accuracy. Then,
we obtained the average AUC of >0.8 with a prediction
accuracy of >90%. Therefore, this study showed a better
choice to identify ‘‘responding’’ and ‘‘nonresponding’’
group.
Another issue was the feature selection. SFFS was used to
reduce the number of features and optimize the prediction
performance. As a method to select optimal features, SFFS
was successfully used in other medical application.31,43 Tan
et al31 used SFFS and SVM to improve radiologists’ per-
formance in classification between malignant and benign
breast lesions. Lin et al43 developed a two-stage model for
the detection and diagnosis of injury of the supraspinatus
Sensitivity (%) Specificity (%)
85.71 75.00
100.00 93.75
92.86 93.75
85.71 87.50
November 2017
 DIAGNOSTICS
TABLE 4. Model performances (average AUC)
with SFFS-selected optimal features
based on 10-fold cross-validation (10
times)
SVM Kernel Average AUC
Linear 0.7825
Quadratic 0.8925
Polynomial (order is 3) 0.9675
RBF (sigma is 1) 0.7900
AUC indicates area under the curve; RBF, radial basis function; SFFS,
sequential floating forward selection; SVM, support vector machine.
tendon by SFFS-selected features. The classifier’s perform-
ance constructed by SFFS-selected features was often
superior to those using all features in above two appli-
cations. Meanwhile, compared with other feature selection
methods such as Branch and Bound (BB), Sequential Feature
Selection (SFS), the computational time, and optimized
performance were better.44–46 In this study, the result based
on SFFS showed the best prediction performance when the
number of features was about half. Therefore, it coincided
with previous study.
There are still some limitations in this study. The average
age of the healthy subjects was younger than the LBP
patients because it was difficult to recruit patients older
than 45 years. Besides, the sample size of the LBP patient
was a bit small. More patients need to be recruited to form a
large scale of sample in the future. Finally, it needs further
development of a user-friendly prediction tool for clinical
application.
CONCLUSION
This study provides a new tool with high accuracy to predict
the prognosis of functional restoration rehabilitation in LBP
patients, by using the topography’s feature parameters in
both symmetrical and asymmetrical trunk-movement. It can
help clinicians to recommend the appropriate person with
LBP to receive 12-week rehabilitation program.
Key Points
SVM algorithm can be used to predict the
prognosis of functional restoration rehabilitation
in LBP patients.
Through dealing with the dynamic SEMG
topography, SVM algorithm can be used to
predict the prognosis of functional restoration
rehabilitation in LBP patients.
Through dealing with the dynamic SEMG
topography during symmetrical and
asymmetrical trunk-movement, SVM algorithm
can be used to predict the prognosis of
functional restoration rehabilitation in LBP
patients.
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Prognostic Prediction of Functional Restoration Rehabilitation in Chronic LBP  Jiang et al
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Direct URL citations appearing in the printed text are
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the journal’s Web site (www.spinejournal.com).
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