D4.13.

1 3DRSBA Experiment Problem Statement and Requirements

2014-02-10

Bertram Mller

This deliverable provides a detailed overview of the 3DRSBA experiment problem statement and requirements.

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Project acronym EXPERIMEDIA Full title Experiments in live social and networked media experiences Grant agreement number 287966 Funding scheme Large-scale Integrating Project (IP) Work programme topic Objective ICT-2011.1.6 Future Internet Research and Experimentation (FIRE) Project start date 2011-10-01 Project duration 36 months Activity 4 Experimentation Workpackage 4.13 EX13 - 3DRSBA 3D Remote Sports Biomechanics Analysis Deliverable lead organisation Qualisys Authors Bertram Mller (Scientific Advisor) Fredrik Mller (Qualisys) Reviewers Stephen C. Phillips (IT Innovation) Version 1.0 Status Final Dissemination level PU: Public Due date PM27 (2013-12-31) Delivery date 2014-02-10

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Table of Contents
1. 2. 3. Executive Summary............................................................................................................................ 3 Introduction ........................................................................................................................................ 4 Experiment Description .................................................................................................................... 6 3.1. 3.2. 3.3. Learning Objectives .................................................................................................................. 7 Experiment Procedure ............................................................................................................. 8 Background ................................................................................................................................ 8

3.3.1. Technical ................................................................................................................................ 8 3.3.2. Scientific ............................................................................................................................... 10 3.4. 3.5. 3.6. 4. 4.1. 4.2. 4.3. 4.4. 4.5. 4.6. 5. 5.1. 5.2. 5.3. 6. 7. Assumptions and Preconditions ........................................................................................... 11 Parameters ................................................................................................................................ 11 Constraints ............................................................................................................................... 12 Ethical Considerations ........................................................................................................... 13 Health Risks ............................................................................................................................. 13 Data Management ................................................................................................................... 13 Data Storage............................................................................................................................. 14 Data Transfer ........................................................................................................................... 15 Consent ..................................................................................................................................... 15 Requirements ........................................................................................................................... 17 System Architecture ................................................................................................................ 17 Content Lifecycle .................................................................................................................... 18

3.5.1. Metrics .................................................................................................................................. 11 Ethics and Privacy ............................................................................................................................ 13

Experiment Design .......................................................................................................................... 16

Plan for Implementation ................................................................................................................. 20 Conclusion ......................................................................................................................................... 21

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1. Executive Summary
This deliverable reports on the problem statement, design and requirements of the 3D Remote Sports Biomechanic Analysis (3DRSBA), which aims to combine the power of 3D motion capture in biomechanical laboratories (CAR) with the necessities in sports analysis to provide reality-close surroundings in measuring (training sites at CAR). Section 2 of this document explains the motivation for preparing the experiment. Section 3 contains the experiment problem statement with its objectives, constraints and relevant background information. In section 4, the ethical and privacy related issues are discussed. Section 5 discusses the experimental set-up and section 6 discusses the implementation. The document ends with a short concluding section.

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2. Introduction
3DRSBA stands for 3D Remote Sports Biomechanics Analysis, an experiment with the goal to bring biomechanical analysis to the athlete in order to facilitate screening for possible risk of lesions. The structured analysis of motion has become a very important tool in sports analysis. Using new video technology, tactics and performance studies in team sports increases the performance and general success. Besides the general motion studies, biomechanics intends to measure the motion and relates it to the underlying musculoskeletal function. This provides information for the performance of a single athlete, but can also provide information about the health status of the individual regarding the musculoskeletal system. A very wide range of technologies for motion capture are available, hence the outcome differs significantly with each system. Additionally, the technique and analysis differs widely, depending on the methodology used. For example, animation needs a continuously and steady signal, but does not need a physiological precision of the individual. The latter would be essential for clinical science, where motion capture needs to be complemented with other systems, such as force measurements and electromyography. This is needed in order to not just measure motion, but to analyse and comprehend the reason for the motion. This complexity is not just related to the technology applied, but also to the methodology behind the analytics. This is known as the biomechanical model. Whilst general motion analysis is used in the field, clinical motion analysis is more restricted to specialised laboratories, which consist of complex technology and specialised professionals to handle it. Currently, the professional education of such professionals is extensive and requires many years of experience; hence the availability of such experts is limited. This results in one of the main obstacles: the limited availability of biomechanically literate technical staff in addition to trainers; more so during busy periods of multiple training sessions in different locations at CAR. Whilst the laboratory approach delivers results of high technical quality, with carefully controlled parameters, it comes with some disadvantages. A full analysis session in the laboratory is an interruptive event in the already tight schedule of an elite athlete with a professional training plan and living and other educational requirements. The proposed experiment will focus on bringing biomechanical screening techniques directly to the training site of the athlete at CAR. The high number of athletes at CAR does not allow monitoring and testing all of them and general biomedical services are limited. Notwithstanding these concerns, the screening of musculo-skeletal performance has been widely suggested in sports science and yet, other than in a few exceptional cases, there is no widespread provision. By bringing together these powerful technologies the motion tracker by Qualisys, control remote technologies as well as the communication interface established at CAR under the auspices of the EXPERIMEDIA project, one can expect a direct payoff in the Quality of Service (QoS) provided by the institution, as well as Quality of Experience (QoE) for the athlete. The experiment itself consists in three general components:
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A. The feasibility to use remote control techniques in biomechanical analysis; B. The clinical viability of this approach, including clients satisfaction; C. The easier presentation of such complex biomechanical data to non-experts. Point one and three are related to the hard- and software of the whole set-up and to be tested accordingly. Point two relates to the scientific part of the project related to the best biomechanical modelling approach.

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3. Experiment Description
The experiment consists of testing the possibility in setting up 3D motion capture systems outside the normal laboratory surrounding, bringing laboratory tools to the athlete. This would allow establishing a screening procedure in injury risk detection. This includes three core investigations: 1) The possibility to remotely control a 3D capture system from the laboratory using a minimalistic approach, including the possibility to get additional support from external experts; 2) The viability of a screening mechanism with reduced equipment, but with similar precision when arriving to clinical conclusion; 3) Present the data in a user friendly way for professionals non-expert in the biomechanical field.

Figure 1. Screening setup using the biomechanical model to be established in Collaboration with CAR.

The first point includes the technical aspects such as the possibility to adjust and use a complex 3D motion system remotely and the viability of external experts to participate in quick decision making. The screening mechanism is more science related, as a compromise has to be found between minimal instrumentation (set-up time) and clinical validity. Laboratory testing usually includes not just 3D information (kinematics), but also how this motion is produced (kinetics) or even which muscle group is active (electromyography). The experimental system for the screening include motion only, but should still be able to detect risk factors, even if a laboratory test might be performed posteriorly in order to establish the clinical reason. Such a test could accept "false positive" data, where a risk might be detected, but not confirmed in a later stage. However, "false
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negative" information is not desired. The detection of the latter would not be able to detect easily though. The screening scheme can be seen in Figure 1. The last point is more technical in the sense of available methods to facilitate easier understanding of complex data and the acceptance of such data presentation. Besides experimenting with the technical aspect of the experiment, the user acceptance is very important if such a set-up will be used in different locations. Therefore the ECC component will gather time data related to the conduction of the tests and ask some feedback question from the athletes as well as the trainers. The timing will provide some comparison values with laboratory test including the quantity of tests performed and the duration. The end product would include an automated data processing structure, such as seen in Figure 2. Data storage would be in a server-kind structure, where data are hosted and managed centrally, contrary to common situation, where data are hosted centrally, but managed from the client side. The 3D data are stored together with final report and streamed to the user as requested and allowed by user rights.

Figure 2: Automated data processing structure within the Project Automation Framework (PAF).

3.1.

Learning Objectives

Each of the three blocks has experimental questions to be answered: The technical feasibility of the project, especially the remote control function: Can the system be controlled remotely, including the set-up of the cameras and calibration of the system? Is this possible with the biomechanical expert not on side? How do interruptions to the internet connection affect the service? Is set-up time and test time acceptable for athletes and trainers?

The viability of the biomechanical approach: Which are the determining factors in risk assessment? What it the detection rate of this approach? How are such data validated in a laboratory session later? Establishing automated data processing methods for fast analysis.

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The acceptance to athletes and trainers as a viable tool in improving the services provided at CAR: Is this approach beneficial for the athlete, or is there a preference to differentiate between training and clinical testing?

Visualisation of complex data: Up to which point can complex motion data be simplified without losing content? Which would be the best visualisation technique for such data? Storage and streaming structure. Who needs to see the data and how is the data to be presented for the best understanding?

3.2.

Experiment Procedure

Remote control: 1) Familiarisation with the 3D system and the biomechanical software packages necessary to treat the data. 2) Testing the remote control protocol relating to the amount of data transmitted and the effects of transmission delays on the experiment. 3) Setting up single and multiple sites to test the effect of such approach on the biomechanical expert. Biomechanical Model: 1) 2) 3) 4) 5) 6) 7) Evaluation of current screening methods available. Evaluation of existing protocols for the use in the screening process. Initial test with hardware. Developing the screening routine. Establish a baseline with existing clinical data. In-laboratory tests with the routine. On-site evaluation.

Visualisation: 8) Once the model (including marker placement is fixed), a visualisation protocol will be established. This includes the visualisation details for the avatar, the amount and type of additional data and presentation. 9) Establishing initial design. 10) Developing system and testing.

3.3.

Background

3.3.1. Technical

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The technology use for technical aspects is based on the 3D motion capture system seen in Figure 3.

Figure 3: A set of IR cameras (upper right) are capturing markers (upper left). The control programme is transferring the 3D data of a single marker included in a biomechanical model to 3D motion information as seen at the bottom.

Figure 4: Shows the full 3D workflow processing the 3D data from image to analysis.

This system provides the spatial position of markers in a 3D space. When such markers are placed on defined position of the human body, a general reference frame to the underlying anatomy is established (Figure 4). When anthropometric data are introduced into this frame, personalised information about the motion can be obtained. The methodology of the process from capturing single marker data to anatomical motion is called biomechanical model. As this is a very complex process, no single model can express all possible aspects of motion capture.
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Therefore, a clear relationship needs to be established. Once such model is established and the quality of the information is confirmed the captured data needs interpretation. This analysis needs to be performed by highly trained experts with backgrounds in technology as well as sports and/or health. For the processing of the model, a software package called Visual 3D (C-Motion Inc.) will be used, as it is well integrated and allows for perfect adaptation of biomechanical models (Figure 5).

Figure 5: Model building with Visual 3D (C-Motion Inc.)

In relation to the remote control, the first choice is the use of the Software package from Teamviewer (Teamviewer GmbH), as it is tested as providing high encryption with fast communication.

3.3.2. Scientific
In sports classification injuries are often divided by the process, either by contact with another person or by a non-contact moment. The latter might be based on a muscle imbalance or by the inability of the musculoskeletal system to adapt to an unusual position or high performance. In order to prevent this kind of injury, biomechanical tests have been established are continuing to surface for functional analysis of the human body. This kind of test is usually performed in highly specialised laboratories with a multidisciplinary expert team at hand. Together with the necessary technology for such types of testing, not many locations are found to perform those tests. Additionally, tests take quite some time to be conducted, reducing laboratory throughput to around 2 to 4 people per day. Thus, such testing is quite costly and not widespread, even with the usefulness established. Considering the effectiveness of such tests and the availability, the project aims to develop a reduced set-up. Whilst not allowing the full set of information, it should detect risk factors and pre-select athletes with a need to full functional testing. The experiment will focus on knee injuries, especially the prevention of ruptures of the anterior cruciate ligament (ACL), as the negative effects are drastic to athletes as for treatment and recovery time and the implication to the performance loss due to the injury. Studies have also shown an increased rate of incidents of females over males and effectiveness of specialised training in the prevention of such lesions. Therefore, an early detection of such risk factors and consecutive adaptation of training programmes would help to avoid such injuries. In order to make it available to a wider public, a

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two-stage programme would allow screening many athletes at their training side and referring to closer check-up in a motion laboratory, if necessary.

3.4.

Assumptions and Preconditions

The general assumption is that by bringing biomechanical test to the field, athletes and trainers would evaluate positively such a service, and not as a shortening in training time or any other objection. As such evaluation not just depends on the general idea of such a service, a simple survey would not be enough to determine the result. Therefore, the parameters in Section 3.5.1 are measured for testing this assumption as well as the real time saving in performing the tests on side. It is also assumed that a remote access to the side, especially from the biomechanics laboratory provides enough information to overlook the situation, as in common situations the visual information are more extensive, such as observation of preparation area, spatial camera setup, etc. The scientific assumption is the aim of a very reduces setup to provide viable clinical information. As there is existing literature on 2D screening as well as experience in the field at CAR in screening processes, using 3D capture including more complex motion of the athlete should assure the feasibility.

3.5.

Parameters

Scientific parameter will include different biomechanical models and their relation to the clinical and technical question of the experiment. A list of possible models is seen in Figure 6.

Figure 6: Common biomechanical models for lower limb motion capture.

Other parameters relates to the remote control set-up.

3.5.1. Metrics
In order to determine the usability of the setup, timing values as well as number of test are of interest. This includes: Time to set up the system; Preparation time of athletes;
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Capture times; Capture quantity; Time for processing; Amount of external consultation; Number of coaches involved and their coaching time in the specific sport. Demographic data about the user (age, sex, type of sport); User experience.

Some of the metrics will be gathered automatically, whilst the user experience metrics (QoE) will be captured through a web-based (LimeSurvey) questionnaire that can be run on a tablet device for easy access during experiment execution. The precise connection between Qualisys software and the Experiment Content Component (ECC) is intended to work as follows: a measurement session consists of several consecutive motion capture trials, when a trial has been completed the metrics date/time, length of measurement and a quality measure will be sent from the QTM computer (see Figure 8 below in Section 5.2) to the ECC server via the C#- API.

3.6.

Constraints

The complex relation between technology, biomechanical model and scientific question generates the need of a parallel development of all part prior to the experiment testing. Some parts of the development are therefore limited to a detailed specification at an early stage. As for the scientific part we believe to detect a high percentage of risk factors, but false information (either risk, where is none, or vice versa) is hard to detect, as lesions are multifactorial and no direct relation to the screening function might be possible to establish.

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4. Ethics and Privacy

4.1. Ethical Considerations
The project aims to increase access to a service already installed at CAR, which is the biomechanical laboratory, related to the health and science service provided. This service has been established using the guidance of ethical committees and regulated by Spanish and European law. Ethical concerns might be raised by the intention to move outside the laboratory to the training field, as this might increase exposure of individual health data to other professionals in the vicinity and a health screening mechanism is performed at the training side. This includes the amount of clinical data necessary for the test itself and the general data management. Therefore, even as the project aims to provide an additional and improved service to the individual, each athlete will be asked for agreement to participate in this study, without any kind of further implication to the rest of services provided by CAR. This includes the opt-out possibility at any stage for the athlete.

4.2.

Health Risks

The possibility of an increased health risk to the athlete is considered. The experimental design will include scientifically-established biomedical models. Those tests are evaluated and accepted at CAR. The methods intended for the experiment are running at sub-maximal performance level of the athletes, therefore should not reach any critical point. As in all exercises performed, there is always the possibility of non-contact lesions. In order to minimise this effect, only athletes having performed a prior warm-up will be tested.

4.3.

Data Management
Biomechanical data measured with the systems used in the project, referred to as Type-A data. As 3D motion data often includes video data, this type is further divided into A1 for including video data and A2 for motion data, where the origin of the data cannot be detected. Clinical data necessary for the study includes anthropometric data of each participant as well as data coming from physical exploration, consisting in data related to Range of motion for joint, muscle force and contraction test and structural data, such as joint positions and rotations. This is further referred as Type-B data. For the best clinical analysis, information about former injuries and issues related to musculoskeletal system needs to be included. This is referred as Type-C data.

There are three personal data types involved in this study:

The first three types consists in personal data with type-C as the most sensitive information. Additionally, further data types are used for separating between different usage forms, such as: Type-D stands for information transmitted in a remote form from the field location to the expert location. Expert location includes clinical, performance and scientific experts.
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Type-E data consists in the QoS/QoE measurements within the EXPERIMEDIA project. Those data are for statistical analysis of the project without any link to personal information. Type-F is related to the data which might be used for dissemination of the project by any participant.

Participants in this study are: PA: The athletes of CAR as the primary participant related to the analysis of the project. PB: Personal of the biomechanics laboratory at CAR as investigator/participant in the project. PC: Professional staff at CAR. PD: Qualisys as co-ordinator of this project. PE: Bertram Mller, Consultant and Clinical Scientist, as investigator. PF: All other partners in the EXPERIMEDIA project.

The schematics of the access of participants to the data is presented in table 1: A A1 PA PB PC PD PE PF X X X -1 X -above1 A2 X X X ? X ? B X X X ? C X X X X D X X X X X X X X X X E F X X X X X

Table 1: Relation to participants and data access. [X] Access to the data; [-] no access; [?] to be determined with participants and only with special agreement for special data sets.

4.4.

Data Storage

All data is stored at CAR, which is subject to current legislation stated in BOE 15/1999 of 13 December and registered with the Spanish Data Protection Agency (DPA). This is agreed and consented by athletes when entering the service of CAR. This includes PA to PC. Special conditions apply to opt-out situations for training data from athletes, as they are used for general improvements in service at CAR. CAR and PE will sign an agreement for confidentiality prepared within the legal frame of EXPERIMEDIA. Data at PE is protected against 3rd parties by using encryption (AES-256; Based on TrueCrypt, freely available at http://www.truecrypt.org/; System hardware protected by BIOS and Hardware encryption). Data will be used for scientific reasons, only. Additional use of the data for dissemination about the project, methodology developed and results, data will be stored further than the duration of the experiments. Consent will be asked specifically from the participants, including the
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information about details where and how data are stored and how to rectify in any stage. There will also be the possibility to contact PE for any question regarding the project, including clinical opinion. For this reason, PGP can be used for any communication, securing total privacy if so desired. In order to establish the gain in quality of this project, EXPERIMEDIA is storing data gathered using the ECC (QoE/QoS). Those data are used for statistical analysis and are totally anonymized. EXPERIMEDIA also stores data regarding the project details, as previously accepted by the European Commission. Data stored for dissemination and presentation of the project might be stored at any of the partners of the project. Explicit consent will be asked to all participants for this use of data.

4.5.

Data Transfer

As the project aims to investigate remote data gathering as well as the fact that there are many participants in the experiment, the way data is transferred needs to be examined. For the remote control of the system the initial option includes established commercial software (Teamviewer which has security acceptance for the German banking system), as the encryption methods are more than sufficient. Data connection can be logged at both ends for data conformity. Access to the host computer at the field is password protected, allowing the control by authorised personal only. Additional access can be given for other personal/experts, without the need to distribute the control password. The transmission of the control software includes only the direct Screen data, whilst the captured data are stored on side and within the CAR data cloud. Experimental data transferred between CAR and PE is either directly at CAR or using secured data transmission. Again, this is logged at both sides for additional security. Data between EXPERIMEDIA partners is transferred using the already established procedures agreed in earlier stages of the project. Communication outside CAR and to PE as related to personal information is enabled for encryption using PGP; therefore no raw text is sent via internet if not desired.

4.6.

Consent

As mentioned before, the general consent between CAR and athletes is well established and regulated. CAR is acting as data controller and Qualisys as data processor. Controller processor agreement will be signed between CAR, Qualisys and Bertram Mueller who is a scientific consultant for Qualisys. This process will be guided by KU Leuven.

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5. Experiment Design
The experiment design is as follows: A 3D-motion capture system is used to capture an athlete's movement pattern. Specific biomechanical parameters (kinematics) are automatically calculated from the movement pattern. A professional (coach or expert) gives advice to the athlete based upon the generated biomechanical parameters and his or hers experience and expertise (this can be done locally or remote). The advice can be in respect to performance optimization or injury prevention. The advice will be a set of suggestions how to change the specific movement pattern. This can be done by either telling the athlete to think about how he or she executes certain movements or specific training exercises. Since it takes some time for an athlete to adapt/change a movement pattern follow up sessions with the same athlete needs to be done after a period of time. Several consecutive sessions can be needed in order to monitor the development.

The different components needed to achieve the above experiment sequence are: A 3D-motion capture system (in this case from Qualisys AB) consisting of 8 special motion-capture cameras and 3D-tracking software) A biomechanical analysis software with specific biomechanical models that is driven by the motion capture data. Also needed is a report tool that provides an aggregated view of the calculated biomechanical parameters in a clean and easy understandable way. Coach and/or experts that can interpret and provide advice to athlete in the specific sport. Requires structured storage of the different data capture sessions.

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Figure 7: General structure of the experimental setup.

5.1.

Requirements

Part D in the description of the experiment design above requires a structured storage of the analysis result of the motion capture sessions and requires configuration and setup of the CAR Cloud storage environment. Also in conjunction with this Cloud storage a record of QoS- and QoE-data should be saved into the ECC environment. This will require support regarding the ECC-integration/interfacing. It would also be interesting to explore integration with the 3DCC module possibly enabling avatar creation and visualisation. When the correct biomechanical marker set has been fully established a couple of test can be performed to evaluate the quality and usefulness of such avatars. A concern is that typically markers sets for visualisation (avatar creation) differs from marker sets for biomechanical calculations.

5.2.

System Architecture

Overall system architecture could be described according to this:

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Figure 8: Integration of Experiment setup with EXPERIMEDIA core components.

QTM is the 3D-reconstruction/tracking software provided by Qualisys. Visual3D is the biomechanical modelling and analysis tool provided through Qualisys. PAF is the report generator and motion capture session project handling software provided by Qualisys. Qualisys Data Server would be a web server provided by Qualisys hosting/building web reports. Data storage would be the CAR server Cloud environment. The arrows depict the actual flow of data through the system.

5.3.

Content Lifecycle

Material developed for the technical part will be used for dissemination by Qualisys and CAR until out of date. Scientifically content will be used by CAR and Qualisys (for promotional activities anonymised data). System performance content parameters as exported to the ECC environment (statistical data for QoE/QoS) will and can be used by all EXPERIMEDIA partners (including CAR). The data coming from motion capture will be used at CAR in order to improve the biomechanical service for screening. Such data are regulated by the directives already established
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and under control of CAR. Some of such data will be used for dissemination. The specifics will be under total guidance of CAR and its regulations. The data coming from motion capture sessions will be provided in its final stage as a web report hosted by a webserver located on the CAR server (see 5.2 above). The web report could look like this:

Figure 9: Possible format of the presentation of data from the web server. Additionally, the 3D integration should be included.

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6. Plan for Implementation

The Gantt chart shows the general outline of the project. However, preparation for later staged will be prepared parallel to running tasks, as some crossover relations has to be met.
Project Month

10/2013

11/2013

12/2013

01/2014

02/2014

03/2014

04/2014

05/2014

06/2014

07/2014

08/2014

WP 4.13.1 T 4.13.1.1 T 4.13.1.2 T 4.13.1.3 WP 4.13.2 T 4.13.2.1 T 4.13.2.2 WP 4.13.3 T 4.13.3.1 T 4.13.3.2 T 4.13.3.3 WP 4.13.4 T 4.13.4.1 T 4.13.4.2 WP 4.13.5 T 4.13.5.1 T 4.13.5.2 T 4. 13.5.3

Definition of Experiment Design Hardware and Software Definition Definition of integration parameters Establishing validation criteria Integration of system at CAR Data management in the cloud User rights management Performance testing and tuning Performance in the motion laboratory Performance at training sites at CAR Performance outside CAR Evaluation of biomechanical models Establishing model criteria Comparison of models Training, Evaluation and Dissemination Training of initial participants Evaluation of system and set-up Presentation to all staff

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09/2014

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7. Conclusion
The information obtained in this project will be important for different aspects. On one side it will determine the efficiency of the technology used for remote access and data dissemination. This has a commercial aspect about the products used, as well as in optimising the workflow of such applications. On the other hand it will provide scientific information about the feasibility and outcome of using 3D capture as a screening tool in sport health application. Following the experiments, it is aimed to be used in different centres as well as for a wider population than just elite athletes.

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