Efficient Pain Recognition via Respiration Signals: A Single Cross-Attention Transformer Multi-Window Fusion Pipeline

Pain is a complex condition affecting a large portion of the population. Accurate and consistent evaluation is essential for individuals experiencing pain, and it supports the development of effective and advanced management strategies. Automatic pain assessment systems provide continuous monitoring and support clinical decision-making, aiming to reduce distress and prevent functional decline. This study has been submitted to the \textit{Second Multimodal Sensing Grand Challenge for Next-Gen Pain Assessment (AI4PAIN)}. The proposed method introduces a pipeline that leverages respiration as the input signal and incorporates a highly efficient cross-attention transformer alongside a multi-windowing strategy. Extensive experiments demonstrate that respiration is a valuable physiological modality for pain assessment. Moreover, experiments revealed that compact and efficient models, when properly optimized, can achieve strong performance, often surpassing larger counterparts. The proposed multi-window approach effectively captures both short-term and long-term features, as well as global characteristics, thereby enhancing the model's representational capacity.