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Prediction of muscular paralysis disease based on hybrid feature extraction with machine learning technique for COVID-19 and post-COVID-19 patients

Many Coronavirus disease 2019 (COVID-19) and post-COVID-19 patients experience muscle fatigues. Early detection of muscle fatigue and muscular paralysis helps in the diagnosis, prediction, and prevention of COVID-19 and post-COVID-19 patients. Nowadays, the biomedical and clinical domains widely used the electromyography (EMG) signal due to its ability to differentiate various neuromuscular diseases. In general, nerves or muscles and the spinal cord influence numerous neuromuscular disorders. The clinical examination plays a major role in early finding and diagnosis of these diseases; this research study focused on the prediction of muscular paralysis using EMG signals. Machine learning–based diagnosis of the diseases has been widely used due to its efficiency and the hybrid feature extraction (FE) methods with deep learning classifier are used for the muscular paralysis disease prediction. The discrete wavelet transform (DWT) method is applied to decompose the EMG signal and reduce feature degradation. The proposed hybrid FE method consists of Yule-Walker, Burg’s method, Renyi entropy, mean absolute value, min-max voltage FE, and other 17 conventional features for prediction of muscular paralysis disease. The hybrid FE method has the advantage of extract the relevant features from the signals and the Relief-F feature selection (FS) method is applied to select the optimal relevant feature for the deep learning classifier. The University of California, Irvine (UCI), EMG-Lower Limb Dataset is used to determine the performance of the proposed classifier. The evaluation shows that the proposed hybrid FE method achieved 88% of precision, while the existing neural network (NN) achieved 65% of precision and the support vector machine (SVM) achieved 35% of precision on whole EMG signal.


Introduction
In worldwide, around 57 million people have been affected by Coronavirus disease 2019  and about 1.4 million have died from COVID-19. Many researches have been carried out on detection, early prediction, diagnosis, and prevention of COVID-19 [1]. Common symptoms include fever, cough, shortness of breath, myalgia, frailty, and fatigue. Electromyography (EMG) signal is used to diagnosis patients with severe patients [2,3]. Many patients who recovered from COVID-19 experience severe acute respiratory syndrome and fatigue. Fatigue is a nontransient feeling of physical and mental tiredness by muscle weakness, lack of energy, and drowsiness [4]. Detection of muscle fatigue and muscle paralysis helps in the diagnosis and treatment of COVID-19 and post-COVID-19 patients. EMG is a medical test used to measure the function of the muscles and nerves of the human body. The EMG signals are studied to diagnose the diseases such as muscular dystrophies and neuropathies. Neuromuscular disorders are a group of diseases that include motor nuclei in the brain, spinal cord cells, nerve roots, and spinal nerves that cause muscle weakness. The damage of the peripheral nervous system is illustrated by neuropathies, which carries information from the brain and spinal cord to all other parts of the body. The patient with muscular disease may experience temporary numbness, tingling, sensations of pricking, allergic reactions, or muscle weakness, and some other symptoms include burning pain, muscle paralysis, or dysfunction of the limbs. Early diagnosis of muscular disease can treat these diseases, and therefore, the signal of EMG analysis is performed for early diagnosis of the disease [5]. Machine learning methods have been widely used to diagnose diseases due to their effective performance in analyzing the features [6][7][8]. In this research study, prediction of muscular paralysis is carried out, because adults and children are affected by this paralysis disease [9]. Regardless, the spinal cord injury (SCI) and other clinical signs cause muscle weakness and it is very important to determine how a spinal injury affects the survival and function of the motor unit [10]. The classification of paralyzed muscles has been enhanced by the dissemination of knowledge, and various methods have been proposed considering the age of origin, body composition, and etiology as the main distinguishing features. A team of experts in leading muscular paralysis has proposed a revised definition and new classification of muscular-skeletal disorders [11]. EMG recording showed an unusual long-term rupture of EMG function, joint contraction of antagonist muscles, and excessive strain of nonfunctional muscles [12].
Various researchers validate the prediction model based on the measure to assess performance and learning capacity of models. The measures include the couple kinematic parameters, which describe the movement of the lower limb and EMG activity associated with the kinematics produced [13,14]. The muscle activity indicator is calculated by measuring the average EMG value for all types of activity [15]. The electronic EMG sign shows the results of daily activities, especially in lower knee exercises. Many artifacts contaminate the signals of EMG and time-series data is not suitable for demonstration purposes. The traditional methods used the frequency-and time-dependent properties to identify the EMG features under various patterns of knee exercise [16,17]. The existing methods have the limitation of irrelevant feature selection and lower classification performance in muscular paralysis disease prediction. In this research, the hybrid FE method is proposed for the muscular paralysis disease prediction, and DWT is used to reduce the feature degradation. The Relief-F feature selection selects the optimal relevant features for the classification and CNN method effectively analysis the feature relation for the classification. The UCI EMG-Lower Limb Dataset is used to validate the results of the proposed CNN method along with existing techniques in terms of important parameters F-measure, accuracy, precision, recall, and error rate.
The organization of the paper is given as follows: Section 2 illustrates the study of existing techniques that are used to predict muscular paralysis. In order to solve the issues of existing technique, the proposed deep learning classifier called Convolutional Neural Network (CNN) is briefly explained in Section 3. The validation of proposed CNN with other classifiers on UCI EMG signals in terms of various parameters is given in Section 4. Finally, the conclusion of the research study along with its future work is described in Section 5.

Literature review
The EMG signals are used to analyze the skeletal-related muscular information for disease detection. Some machine learning methods have been applied in the detection of activities muscular paralysis disease.
Gautam et al. [18] developed a transfer learning-based long-term recurrent convolution network named as MyoNet. The method involves three processes namely FE, prediction of joint angle, and classification of movement. The model was trained end-to-end for knee joint prediction angle by transfer learning for memory and computational efficiency. The UCI dataset was used to analyze the performance of the developed method in the prediction. The analysis showed that the MyoNet has better accuracy on various positions of subjects compared to existing methods. The developed model has overfitting problem that affects the performance of the model.
Ertugrul et al. [19] proposed an adaptive local binary pattern (aLBP) method for the EMG analysis. The downsampling and smoothing coefficient method was used to assign the adaptive neighbor value for analysis. The UCI EMG dataset was used in the simulation process and the results proved that aLBP has higher performance in the analysis. The computational cost and memory requirement of the method were low for the EMG analysis. The relevant features were needed to select the effective performance of the developed method in EMG analysis.
Huang et al. [20] proposed association rule-based FS method and random equilibrium sampling-based integrated classification algorithm. The stochastic equalization method was used for the multi-disease classification. The various UCI medical data were used for the experimental process and showed that rule-based FS has the capacity to handle imbalanced dataset. The relevant features were required for the effective performance of the developed method.
Miljkovic et al. [21] applied fractional-order calculus with linear and non-linear moving window filters for artifacts removal from EMG signals. The developed method effectively removed artifacts in the EMG signals. The simulation results validated that the developed method has the better classification accuracy compared to existing methods. The effective classification model is required to increase the effectiveness of signal detection.
Spanias et al. [22] established the log-likelihood method to remove the disturbance in the EMG signal. The single threshold acquired from the training data was used to remove the disturbance in the EMG signal. The linear discriminant analysis (LDA) classifier based on log-likelihood was used for the classification of signal. The EMG signal dataset was used to analyze the performance of the LDA method that has a lower prediction error and low false-positive value in the threshold. The relevant features need to be selected from the signal for effective classification.
Kamali et al. [23] classified the muscles as normal, neurogenic, or myopathic by developing a transparent semisupervised EMG muscle classification system. According to the motor unit potentials (MUPs), the predictions were carried out by using multiple instance learning (MIL) based classifiers. The main aim of this study was to develop a fuzzy-based MIL that improves the quantitative EMG techniques' usage. The different groups of muscles included proximal and distal of both hand and leg muscles were used to validate the performance of fuzzy-based MIL by implementing the existing SVM and Random Forest in terms of accuracy, sensitivity, and specificity. In general, fuzzy model has three categories namely Takagi-Sugeno-Kang (TSK) models, Mamdani-Larsen models, and generalized fuzzy models; however, only TSK was considered due to less time consumption for defuzzification. The classifier performance is required to be improved for effective performance of the signal classification.
Chen et al. [24] developed a regression model using the collected surface EMG signals of human lower limbs. In order to extract the time-series EMG signals, the model calculated the joint angles of knee, hip, and ankle accurately. After this calculation, deep belief network (DBN) was developed, which contained restricted Boltzmann machines. The optimal features were extracted by encoding the multi-channel surface EMG in a low dimensional space. Finally, the optimal surface EMG features were mapped with the flexion/extension joint angles by developing a back propagation neural network. The results proved that the DBN achieved better performance than principal components analysis (PCA). However, the performance of this method was verified with six healthy patients and collected the data from normal gait datasets, where abnormal gait data were required to verify the developed method's performance. The performance of the developed method needs to evaluate in standard dataset.
Gupta and Agarwal [25] developed a singlechannel EMG signal of terrain identification (TI) method, where effective information to the classifier was provided by implementing an iterative FS technique. The data were collected from the 15 patients of three daily life terrains and 10 patients of five daily life terrains. While comparing with the PCA, the accuracy of the developed FS algorithm was improved by ANOVA test. The computational burden of the processor was minimized and control system's performance was enhanced by the developed terrain identification method. However, these developed methods worked only on the off-line process, which was the major limitation.
Gregory and Ren [26] developed multi-class classifiers to predict continuous multi-axial user motion using surface EMG signals. The method collected the data based on gait experiments and applied the various FS techniques for predicting the motion of the patient along with the frontal plane and sagittal plane. Even though FS techniques were applied in this study, the results proved that multi-class classifiers achieved only 77.2% of predicted accuracy. The developed method finds difficulty in identifying the multi-axial ankle motion in the limited number of EMG data.
Zhang et al. [27] collected the EMG signals from 14 patients by doing three knee exercises such as walking, sitting, and standing. In order to classify the types of exercises, the study implemented a single-class classifier called SVM, where the EMG signals were decomposed by wavelet transform according to singular value decomposition (SVD). The EMG features from both time-domain and frequency-domain were used to improve the performance of the SVM. The robust accuracy was achieved by performing the fivefold crossvalidation process up to fifty iterations. However, the study achieved poor predicted accuracy by using all feature vectors with wavelet components, which proved that FS techniques were required to achieve better performance.
From the study of existing techniques, it is clearly proved that optimal features are required to use appropriate FS to achieve better performance for muscular paralysis prediction. Therefore, this research study uses the Relief-F FS algorithm for optimal solution along with CNN that will be described in the following section.
In the organ of the human body, muscle plays a major role in movements and various researches have been carried out for muscular disease prediction. In this research, the hybrid FE method is proposed with CNN classifier for the muscular paralysis disease prediction. The UCI dataset is used to evaluate the performance due to the less number data is present to analyze the COVID-19 and post-COVID-19 patients. The DWT method decomposes the input signal and reduces the feature degradation. The hybrid FE methods consist of Yule-Walker, Burg's method, Renyi entropy, peak-magnitude to root mean square ratio (PMRS), min-max voltage FE, and 17 other conventional features. The proposed hybrid FE method extracts the relevant features from the signal that are used for disease prediction. More number of features leads to poor performance on final classification; therefore, the Relief-F method is applied to select the most relevant features for classification. The CNN classifier is an instance-based classifier and adaptively learns the data for the classification method. The block diagram of the proposed hybrid FE method with CNN classifier is presented in Fig. 1.

Pre-processing
Initially, the input signals are collected from the UCI repository and a brief explanation of dataset is given in the results and discussion section. Pre-processing is very important in medical data analysis as the raw input signal data affects the quality of diagnosis. In this research study, normalization method is applied in the EMG signal to reduce the redundancy in the signal. The artifacts of the input EMG signals are removed using the normalization method that sets the maximum amplitude as either +1 or −1 and considers the baseline as 0. Some samples are moved by applying the windowing method to the primary (R) peak.

Discrete wavelet transform
The DWT is applied to the pre-processed EMG signals for the transformation process. The reason for choosing DWT is that it provides better frequency and time resolution in the input signals due to its localization ability. In addition, feature degradation is minimized, and the local characteristics of the input signals are revealed by DWT. DWT is used in this research due to its ability to preserve the edge of the signal as well as short time windows are used to achieve the improved low-and high-frequency information. Therefore, to investigate the non-stationary signals, the researchers widely used the DWT. The following mathematical equation in Eq. (1) shows the formula for general DWT.
where the function of wavelet is illustrated as μ, the actual value of wavelet is represented as x(N), and the parameters of scaling shifting are given as 2 j and 2 j K.

Description of hybrid feature extraction
The 22 features are extracted from the pre-processed signal and then, optimal features are selected using Relief-F method for the prediction of disease. The explanation of the FE method is given in this section.

Yule-Walker method
The autocorrelation data function's result biased coefficient is used in this method to identify the parameters of autoregressive [28]. The error calculation of forward prediction of least squares' minimization is estimated by Fig. 1 Working flow of proposed method autoregressive coefficients, which is mathematically given in Eq. (2).
where r xx is defined using Eq. (3).
The set of above linear equations (p + 1) must be calculated to achieve a coefficient of autoregressive that is given in Eq. (4): while approximation of lowest mean square error of predictor is given by σ̂wp that is shown in Eq. (5).

Burg's method
Without the requirement of the autocorrelation function, coefficient of reflection is directly measured by this method. The data records of power spectral density (PSD) are identified by this method, which exactly reflects like original data value. In input EMG signals, the intimately packed sinusoids are achieved, once the less amount of noises are presented in the signals. The major difference between Burg's and Yule-Waker method is the estimation of the PSD [29], where Eq. (6) shows the formula for the calculation of PSD using Burg's method.
where a p represents the prediction coefficient and the standard methods, such as regressive reduce visual leakage problems and provide a better repetition solution. The main advantages of the Burg method are the resolution of very distant sinusoids of low noise signals and the size of short data records, which comes with the estimation of the power spectral potential very close to the true value. In addition, the Burg method provides a consistent and stable regressive model.

Renyi entropy
This entropy estimates the randomness and diversity of the signal of discrete distribution, and also, it is used to calculate the discrete signals' uncertainty. Equation (7) shows the formula for measuring the generalized entropy function.
where discrete signals' probability is given as p i . Alpha is considered as order of entropy, where it has the value lies between α > 0 and α ≠ 1. The equal bins width is achieved by categorizing the variable in the probability density function. According to the range of X, the width of bins is calculated using h = (x max − xmin)/k . The following equation in Eq. (8) is used to determine Renyi entropy.
Here, v j is used, when the points of data are dropped, number of bins is represented by k.

PMRS and min-max voltage FE
The pulse or transition waveform's negative and positive peak value is estimated using PMRS. The first/low state level is described as minimum peak value, where the second/high state level is illustrated as maximum peak value. Equation (9) explains the formula for PMRS: where input vector of either complex or real value is represented as X, wavelet of real value is given as N and total number of input samples is given as n. The algorithm is suitable for analyzing the structure of waves with levels of negligence or short-term. In addition, the EMG signal produces the highest and lowest electrical signals. According to voltages, a vast amount of information is obtained by EMG signals, where various voltages provide different types of knee flexion.

Mean absolute value
The most popular EMG features are described as mean absolute value (MAV), which shows the average value of signal's absolute summation [30]. The mathematical equation (Eq. (10)) gives the formula for MAV.
where coefficient of wavelet is illustrated as x and coefficient's length is given as L.

Waveform length
The waveform summation's cumulative length is simplified by determining waveform length (WL), which is represented in Eq. (11).

Enhanced mean absolute value and enhanced wavelength
The vast amount of information is obtained in the mid-portion of EMG signals. On the other hand, the signals obtained at the initial and final stages contain less information due to the gradual reaction of the subject in the experiment. To solve the aforementioned problems, the researchers implement features of enhanced mean absolute value (EMAV) and enhanced wavelength (EWL). Equations (12) and (13) gives the formula for the developed features: where p ¼ 0:75; if i≥ 0:2Li ≤ 0:8L f 0:50; otherwise } The influence of the samples is determined by parameter p, which is seen in Eqs. (12) and (13).

Slope sign change
This slope sign change (SSC) feature is used to determine how many times the waveform changes its sign, where the following expression (Eq. (14)) shows the formula for SSC. where

Zero crossing
The information about frequency is calculated by the zero crossing (ZC), which is the EMG feature, and Eq. (15) gives the formula.
j≥ T 0; otherwiseg where the value of the threshold is given as T.

Root mean square and average amplitude change
The information of muscles is given using root mean square (RMS), where Eq. (16) is used to determine the RMS. Equations (17) and (18) give the formula for average amplitude change (AAC) and difference absolute standard deviation value (DASDV), which are considered as one of the most popular features in EMG signals.

Log detector
The exerted force is identified by this log detector (LD) feature, which is given in Eq. (19):

Modified mean absolute value (MMAV)
The MAV features are extended by conveying the function of weight window called modified mean absolute value (MMAV). Equation (20) is used to identify the MMAV.
The function of the continuous weight window is assigned and therefore, the extension of MAV is achieved, i.e., MMAV2 feature and the following formula (21) is used to determine the MMAV2. where

Myopulse percentage rate
The pre-defined threshold value is exceeded by using the absolute value of EMG signal; i.e., mean of myopulse is achieved and it is called myopulse (MYOP). The formula for this feature is given in Eq. (22). where

Simple square integral
The square value of amplitude's EMG signal is defined as simple square integral (SSI) and it is mathematically expressed in Eq. (23).

Variance of EMG
Equation (24) shows the formula of variance of EMG (VAR), which is the best EMG feature to validate the power of the signal.

Willison amplitude
The Willison amplitude (WA) behaves as an indicator, where Eq. (25) is used to identify the WA and calculates the potential of motor unit.

Maximum fractal length
The low-level muscle contraction's activation is measured by maximum fractal length (MFL) [31], which is one of the most important EMG signal feature. Equation (26) is described the formula for MFL feature.
MFL ¼ log 10 ffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi ffi After the FE, the extracted features are applied in the selection technique of Relief-F to obtain the optimal feature for classification stage.

Relief-F feature selection method
In order to remove the irrelevant features, the feature score of all attributes is calculated and arranged accordingly to their feature score using a Relief-F algorithm [32]. The downstream model is constructed using the feature weights, i.e., scores obtained by proposed FS technique. In the system model, weights are initialized to select the features. The following Eq. (27) is used to initialize the weight: For each and every iteration, the Relief-F algorithm contains a feature vector (x) associated with one sample, and the samples that are close to x are calculated by the Euclidean distance for each class. The near-hit is defined as the samples that have a shorter distance from the same class, where nearmiss is represented as closer sample from another class. The feature vector (x) contains the features as shown in Eq. (28). The threshold value of nearHit i and nearMiss i is set as the mean values. In random instances, Relief-F is used to analyze the miss and hits of every class, as shown in Eq. (29).
x ¼ DWT j; k ð Þ; P BU xx ; P BU xx f ð Þ; H α X ð Þ; PMRS; MAV; WL; EMAV; EWL; Finally, the Relief-F selected features are applied in the CNN classifier to predict the disease.

Convolutional neural network
After the selection of optimal features, the extracted features of EMG signal data are used for final classification. The process of classification is defined as the boundary between classes for classifying classes based on the characteristics they measure. This study uses the CNN classifier to distinguish between normal and abnormal knee movements. The purpose of CNN's classification is used to predict paralysis diseases and the CNN classifier does not require prior knowledge of the data distribution. The CNN structure has nine layers as shown in Fig. 2, where the layers include batch normalization (BN)-3, convolution layers-3, and pool layers-3.
The layers C1, C2, and C3 are convolution layers and consist of 30, 60, and 80 feature maps that extract and combine those features, respectively. Growing neuron in each feature map is connected to a local receptive field 5×5 into the previous layer in three convolution layers. Layers S1, S2, and S3 are layers of sub-sampling whose number of feature maps is equal to the number of maps of their previous layers of convolution. Growing neuron in each function map connects to a local receptive field in 2×2 to the previous layer in three subsampling layers. F1 is the first complete connecting layer with 512 neurons, each connecting to all of the S3 maps. The output layer is also a fully connected layer which connects each neuron to the first fully connected layer. The output layer must identify all the input signals based on the exact functions.
Convolutional layer The first-come, first-served approach in CNN architecture has been always on a complex level. CNN usually accepts the M×N×1 input level. Here is the 2D signal size with different M×N levels and the CNN uses filters with specific parameters which have the same depth as the input signal and are integrated with the filtered signals. The filter indicates the curve or shape at which the input signal is allowed. The selected feature based on Relief-F algorithm is given as C * i to CNN to evaluate the performance. The contrast of the curved shape represented by the filter in the input signal ends with higher values. The convection process can be signified by Eq. (30).
Pooling layer This layer carried out to lessen the size of the data, where it also performs grouping matrix data into multiple sections, swapping the entire segment with a single value, and reducing the size of the metric data. Some famous pooling features are max pool and average pool, where the arrays in a bucket change to the extraordinary or ordinary of all values in the current bucket.
Fully connected layer These layers are reshaped to match the network-level architecture. A fully connected layer is a functional operation among a meter and an N, in which the parameters of each input and output are linked. This layer connects all activity from the earliest layer to the subsequent layer, which is similar to traditional artificial neural network.

Softmax layer
The softmax function translates the inputs of the previous levels into probabilities for the classes. Therefore, this level plays a decisive role in the output, since it is the predicted output class that has the highest probability inputs.

Experimental results
Disease prediction based on the EMG is important process in medical data analysis. In this research, hybrid FE with CNN method is proposed for the muscular paralysis disease prediction. The DWT method is applied to represent the local characteristics and reduce feature degradation. The 22 FE methods are used due to their simplicity and significant performance. The proposed hybrid FE with CNN method is executed on MATLAB 2020a and the system consists of an Intel i7 processor and 8GB RAM. The performance metrics such as accuracy, precision, recall, and error rate are used for the simulation process. The CNN epoch is set as 90, the momentum is set as 0.9, weight decay is set as 0.0005, and the learning rate is at 0.01.

Parameter evaluation
Accuracy can be calculated by using Eq. (31), and among the number of labeled positive class samples, precision is used to identify the number of accurately labeled samples, which is shown in Eq. (32). On the contrary, according to the positive Fig. 2 Structure of convolutional neural network class, recall is used to predict the number of accurate positive class labeled samples, which can be divided by the total sum of the samples. The mathematical expression for the recall is given in Eq. (33). Recall ErrorRate where TP is expressed as true positive, TN is expressed as true negative, FP is expressed as false positive and FN is expressed as false negative.
Dataset To evaluate the performance of the proposed hybrid FE with CNN method, the UCI EMG-Lower Limb Dataset is used. The following link is used to download the dataset https://archive.ics.uci.edu/ml/datasets/EMG+dataset+in+ Lower+Limb#. The resulting data consist of 22 subjects, of which 11 subjects are normal and the remaining 11 subjects are abnormal, i.e., knee pathology. Three different positions are given to each participant such as one walking, one standing, and one sitting.

Performance of proposed method for overall EMG signals
The existing techniques are validated by the dataset called proximal and distal muscles for both hand and leg [22], surface EMG signals [19,20], or collected EMG signals [21,22] for muscle paralysis prediction. In this research, the EMG signals in the Lower Limb Datasets with five attributes and 132 instances for validation. Therefore, the SVM [23,25] and NN [25] are implemented along with the proposed techniques by using input EMG signals of Lower Limb Datasets. The performance analysis of the proposed CNN, the existing NN and SVM with and without FS is given in Table 1.
The accuracy of the proposed hybrid FE with the CNN method is evaluated and compared with other classifiers as shown in Fig. 3.
From Table 1, it is proved that the proposed hybrid FE method achieved higher performance, when it is analyzed with existing NN and SVM classifiers. Without Relief-F FS technique, all the classifiers including the proposed CNN achieved lower accuracy. For instance, CNN achieved 80% of accuracy, NN achieved 70% of accuracy and SVM achieved only 78% of accuracy. Here, the decisions are taken by validating the samples on nearest neighbors in CNN, where the SVM and NN focused on training samples and consumed a high number of features for prediction of diseases. Therefore, Relief-F is used to select the optimal features. By incorporating the Relief-F, CNN achieved 88% of accuracy, SVM achieved only 80% of accuracy, and NN achieved 72% of accuracy. The analysis shows that the proposed hybrid FE with CNN method has higher accuracy compared to existing methods. The reason is that the DWT method reduces the feature degradation in this research study, where SVM and NN did not reduce those feature degradation. In addition, CNN method adaptively learns the data for the classification and the relevant feature is effectively selected by the proposed hybrid FS method. The precision value of the proposed hybrid FE with CNN method is analyzed and compared with NN and SVM, as shown in Fig. 4.
When compared with CNN and NN, SVM provides poor performance of the input signals for prediction; i.e., SVM achieved only 35% of precision that are not influenced by the FS technique. Even though SVM performed well on semi-structured and unstructured data, it provides poor performance when the target class are overlapping. The NN achieved 65% of precision without Relief-F algorithm for final prediction, where it increased its performance nearly 3% when it is incorporated with a Relief-F algorithm. The reason is that it requires vast amount of data, i.e., more than thousands of data for training. The research study uses only limited amount of data as input for muscular paralysis disease prediction; therefore, CNN is implemented and achieved 85% of precision by using hybrid FE techniques. The CNN method has the advantage of instance-based learning and this method adaptive learn the data for classification. However, more features lead to poor performance on final classification, which requires optimal features. Therefore, Relief-F is implemented with CNN and achieved 88% of precision. The recall value of the proposed hybrid FE with CNN method is analyzed, as shown in Fig. 5. The analysis shows that the proposed hybrid FE method has a higher recall value compared to the standard classifier. The NN achieved a lower recall value with and without FS than the other two techniques namely SVM and CNN; i.e., NN achieved nearly 75% to 77% of recall values. The SVM achieved 83% of recall values when FS technique is used for classification, where the same method degrades its performance to 2%, when the optimal features are not used for muscular paralysis prediction process. In this research study, the proposed hybrid FE method is used to extract the relevant features in the signal and achieved 81% recall value using CNN technique. However, more features lead to poor performance, and therefore, optimal features are selected by Relief-F algorithm and achieved 89% of recall value along with CNN technique. In addition, the CNN method has the advantage of adaptive learn the data for the classification. The error value of the proposed hybrid FE with CNN method is compared with NN and SVM, as shown in Figure 6.
The evaluation shows that the proposed hybrid FE method with CNN has lower error rate compared to NN and SVM. Among all other techniques, NN has a higher error rate value; i.e., it achieved 0.28 error rate without FS technique and it minimized 1% of error rate, while incorporated with Relief-F algorithm. This is due to NN requires vast amount of training data for classification; however, this research study uses a limited number of samples and this leads to having high error rate in NN. But the existing SVM has 0.18 to 0.19 error rate with and without FS technique and shows better performance than NN. The proposed CNN achieved a 0.19 error rate, when only the hybrid feature extraction technique is used. The reason for achieving less error rate is that the proposed FE method extracted only the relevant features in the signal.

Comparative Analysis of Proposed CNN classifier
In this section, the performance of CNN classifier is validated with existing techniques such as aLBP [19], SVM [23,25], Fig. 3 The accuracy of the proposed method Fig. 4 The precision of the proposed method   [25], and SVD+SVM [27] in terms of classification accuracy. Table 2 shows the validated results of CNN along with other classifiers and Fig. 7 shows the graphical results of the proposed CNN.
From Table 2, the simulation results proved that proposed CNN achieved better performance than other all existing techniques namely NN, SVM, and aLBP. Among the existing techniques, NN provides poor performance, i.e., 72% of accuracy; this is because most important features of EMG are not extracted by the NN. The input signals are decomposed by SVD and given as input to the SVM, which achieved 77.10% of accuracy. The SVD is used to compute the feature vector from the combination of five-level wavelet decomposition that leads computation complexity. The existing aLBP achieved nearly better performance, i.e., 84.85% of accuracy by extracting the important features of EMG signals. However, the irrelevant features are not eliminated in the aLBP technique that requires effective FS technique. In order to solve these issues, Relief-F FS algorithm is developed in this study with CNN for extracting the most valuable features. Therefore, the proposed CNN achieved 88% of accuracy on overall input EMG signals and proved that FS plays a vital role in muscular paralysis prediction.

Performance of proposed CNN on different positions of EMG signals
The input EMG signals have three positions namely walking as W, standing as ST, and sitting as SI on normal/healthy and knee pathology movements. In this section, the performance of the proposed CNN is tested with MyoNet [18] on both normal and abnormal knee movements for 11 subjects. Table 3 presents the validated results of both techniques on healthy 11 subjects based on three different positions. Table 3 shows the average of MyoNet and proposed CNN for healthy subjects with different positions. The proposed CNN achieved nearly 99% of classification accuracy on both walking and sitting positions, where MyoNet achieved nearly 98% of accuracy. The reason is that the overfitting issues occurred on the MyoNet that leads to only 97.7% of accuracy on standing position. The research study solved the overfitting issues by implementing ReLU and BN in the CNN; therefore, it achieved 98.93% of accuracy on standing positions. Table 4 presents the performance analysis of proposed CNN on abnormal subjects for all different positions.
The above simulation results proved that the proposed CNN achieved better performance in abnormal data subjects for three different positions. However, when compared with the healthy subjects, both techniques achieved less performance. For instance, MyoNet achieved nearly 98% on all positions, and proposed CNN achieved nearly 99% on all positions for healthy subjects. But the same MyoNet achieved only 92% of accuracy on all positions and proposed CNN achieved nearly 94% of accuracy for abnormal data signals with knee movements. In walking position, the MyoNet achieved 92.8% of accuracy, but the CNN achieved 95.11% of accuracy. The reason is that the features used in MyoNet are data-driven, but the CNN used the most important twenty features of EMG signals along with FS algorithm.

Comparative analysis of proposed CNN method
In this section, the proposed CNN is compared with MyoNet [18] on the basis of precision, recall, and F-Measure for both healthy and knee pathology data. Table 5 presents the comparative analysis of CNN and MyoNet on different subjects.
The knee pathology subjects have less performance on both MyoNet and proposed CNN, while compared to healthy subjects. For instance, MyoNet achieved nearly 92% of precision, recall, and F-measure, where CNN achieved 94 to 95% of precision, recall, and F-measure. For healthy subjects, the proposed CNN achieved nearly 99% on all parameters and MyoNet achieved only 98% on all parameters. The MyoNet uses the feature extracted from data-driven and no optimal solutions are used for prediction. But the proposed CNN uses the hybrid FEs of the most popular features on EMG signals and chooses only optimal features for final classification. The Relief-F method is applied to select the features in the training process, and in the testing process, the selected features were used to evaluate the model that reduces the computational complexity.
Therefore, CNN along with Relief-F achieved better performance for muscular paralysis prediction and also proves the importance of the FE and FS algorithm. When comparing with whole EMG input signals, the proposed CNN achieved better performance on three different positions of both subjects. The reason is that data distribution that affects the performance of CNN. Therefore, multi-scale deep learning techniques must be developed as future work for better performance on whole EMG signals.

Conclusion
Machine learning-based models have been used in the existing method for the diagnosis of diseases due to its efficiency. In this research, the hybrid FE method is proposed with CNN classifier for muscular paralysis disease prediction. The hybrid FE methods consist of Yule-Walker, Burg's method, Renyi entropy, PMRS, min-max voltage FE, and other 17 features. The proposed hybrid FE method has the advantage of selecting the relevant information in the signal. Relief-F is used to select the optimal features for better classification accuracy. Here, CNN is used as a classifier, which is an instancebased learning method, and adaptively learns the data for classification. The UCI EMG-Lower Limb Dataset is used to evaluate the performance of the proposed hybrid FE method. The analysis shows that the developed method has higher performance compared to other standard classifiers such as NN and SVM. The proposed CNN achieved 88% of accuracy, 89% of recall, and only 0.143 error rate, where NN achieved 72% of accuracy, 77% of recall, and 0.27 error rate when incorporated with the Relief-F FS technique. However, the same proposed CNN achieved only 80% of accuracy, 81% of recall, and 0.195 error rate, and the existing NN achieved 70% of accuracy, 75% of recall, and 0.28 error rate implemented with Relief-F algorithm. Therefore, the validated results proved that FS plays a major role in muscular paralysis disease prediction. The future work of the developed method involves applying the multi-scale deep learning technique for multi-disease prediction.

Declarations
Conflict of interest The authors declare no conflict of interest.