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Optimality of multisensory integration while compensating for uncertain visual target information with artificial vibrotactile cues during reach planning 用人工振动触觉线索补偿不确定的视觉目标信息的同时,优化多感官整合的到达规划
IF 5.1 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-09 DOI: 10.1186/s12984-024-01448-0
Lukas K. Amann, Virginia Casasnovas, Jannis Hainke, Alexander Gail
Planning and executing movements requires the integration of different sensory modalities, such as vision and proprioception. However, neurological diseases like stroke can lead to full or partial loss of proprioception, resulting in impaired movements. Recent advances focused on providing additional sensory feedback to patients to compensate for the sensory loss, proving vibrotactile stimulation to be a viable option as it is inexpensive and easy to implement. Here, we test how such vibrotactile information can be integrated with visual signals to estimate the spatial location of a reach target. We used a center-out reach paradigm with 31 healthy human participants to investigate how artificial vibrotactile stimulation can be integrated with visual-spatial cues indicating target location. Specifically, we provided multisite vibrotactile stimulation to the moving dominant arm using eccentric rotating mass (ERM) motors. As the integration of inputs across multiple sensory modalities becomes especially relevant when one of them is uncertain, we additionally modulated the reliability of visual cues. We then compared the weighing of vibrotactile and visual inputs as a function of visual uncertainty to predictions from the maximum likelihood estimation (MLE) framework to decide if participants achieve quasi-optimal integration. Our results show that participants could estimate target locations based on vibrotactile instructions. After short training, combined visual and vibrotactile cues led to higher hit rates and reduced reach errors when visual cues were uncertain. Additionally, we observed lower reaction times in trials with low visual uncertainty when vibrotactile stimulation was present. Using MLE predictions, we found that integration of vibrotactile and visual cues followed optimal integration when vibrotactile cues required the detection of one or two active motors. However, if estimating the location of a target required discriminating the intensities of two cues, integration violated MLE predictions. We conclude that participants can quickly learn to integrate visual and artificial vibrotactile information. Therefore, using additional vibrotactile stimulation may serve as a promising way to improve rehabilitation or the control of prosthetic devices by patients suffering loss of proprioception.
计划和执行动作需要整合不同的感觉模式,如视觉和本体感觉。然而,中风等神经系统疾病会导致本体感觉全部或部分丧失,从而导致运动障碍。最近的研究重点是为患者提供额外的感官反馈,以弥补患者的感官缺失,事实证明振动触觉刺激是一种可行的选择,因为它成本低廉且易于实施。在这里,我们测试了如何将这种振动触觉信息与视觉信号相结合,以估计伸手目标的空间位置。我们对 31 名健康的人类参与者采用了中心向外伸手范例,研究人工振动触觉刺激如何与指示目标位置的视觉空间线索相结合。具体来说,我们使用偏心旋转质量(ERM)电机为移动的优势臂提供多点振动触觉刺激。当其中一种感觉模式不确定时,整合多种感觉模式的输入就变得尤为重要,因此我们还额外调节了视觉线索的可靠性。然后,我们将作为视觉不确定性函数的振动触觉和视觉输入的权衡与最大似然估计(MLE)框架的预测进行了比较,以确定参与者是否实现了准最佳整合。我们的结果表明,参与者可以根据振动触觉指令估计目标位置。经过短期培训后,当视觉线索不确定时,结合视觉和振动触觉线索可提高命中率并减少到达错误。此外,我们还观察到,当存在振动触觉刺激时,在视觉不确定性较低的试验中反应时间较短。利用 MLE 预测,我们发现当振动触觉线索需要检测一个或两个活动电机时,振动触觉和视觉线索的整合遵循最佳整合。但是,如果估计目标的位置需要分辨两个线索的强度,整合就违反了 MLE 预测。我们的结论是,参与者可以很快学会整合视觉和人工振动触觉信息。因此,使用额外的振动触觉刺激可能是改善本体感觉缺失患者康复或控制假肢装置的一种有前途的方法。
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引用次数: 0
Effects of ankle joint degree of freedom of knee-ankle-foot orthoses on loading patterns and triceps surae muscle activity on the paretic side in individuals with subacute severe hemiplegia: a retrospective study. 膝踝足矫形器的踝关节自由度对亚急性重度偏瘫患者瘫侧负荷模式和肱三头肌活动的影响:一项回顾性研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-04 DOI: 10.1186/s12984-024-01432-8
Ayumu Ogura, Yuta Chujo, Naoto Mano, Kimihiko Mori, Takayuki Konishi, Takayuki Kuwabara, Masanori Wakida, Kimitaka Hase

Background: Individuals with subacute severe hemiplegia often undergo alternate gait training to overcome challenges in achieving walking independence. However, the ankle joint setting in a knee-ankle-foot orthosis (KAFO) depends on trunk function or paralysis stage for alternate gait training with a KAFO. The optimal degree of ankle joint freedom in a KAFO and the specific ankle joint conditions for effective rehabilitation remain unclear. Therefore, this study aimed to investigate the effects of different degrees of freedom of the ankle joint on center-of-pressure (CoP) parameters and muscle activity on the paretic side using a KAFO and to investigate the recommended setting of ankle joint angle in a KAFO depending on physical function.

Methods: This study included 14 participants with subacute stroke (67.4 ± 13.3 years). The CoP parameters and muscle activity of the gastrocnemius lateralis (GCL) and soleus muscles were compared using a linear mixed model (LMM) under two ankle joint conditions in the KAFO: fixed at 0° and free ankle dorsiflexion. We confirmed the relationship between changes in CoP parameters or muscle activity under different conditions and physical functional characteristics such as the Fugl-Meyer Assessment of Lower Extremity Synergy Score (FMAs) and Trunk Impairment Scale (TIS) using LMM.

Results: Anterior-posterior displacement of CoP (AP_CoP) (p = 0.011) and muscle activity of the GCL (p = 0.043) increased in the free condition of ankle dorsiflexion compared with that in the fixed condition. The FMAs (p = 0.004) and TIS (p = 0.008) demonstrated a positive relationship with AP_CoP. A positive relationship was also found between TIS and the percentage of medial forefoot loading time in the CoP (p < 0.001).

Conclusions: For individuals with severe subacute hemiplegia, the ankle dorsiflexion induction in the KAFO, which did not impede the forward tilt of the shank, promotes anterior movement in the CoP and muscle activity of the GCL. This study suggests that adjusting the dorsiflexion mobility of the ankle joint in the KAFO according to improvement in physical function promotes loading of the CoP to the medial forefoot.

背景:亚急性重度偏瘫患者通常会接受交替步态训练,以克服实现独立行走的挑战。然而,膝踝足矫形器(KAFO)中的踝关节设置取决于使用 KAFO 进行交替步态训练的躯干功能或瘫痪阶段。膝踝足矫形器中踝关节的最佳自由度以及有效康复所需的特定踝关节条件仍不清楚。因此,本研究旨在调查踝关节不同自由度对使用 KAFO 的瘫痪侧压力中心(CoP)参数和肌肉活动的影响,并根据身体功能调查 KAFO 中踝关节角度的推荐设置:本研究包括 14 名亚急性中风患者(67.4 ± 13.3 岁)。使用线性混合模型(LMM)比较了在 KAFO 中两种踝关节条件下的 CoP 参数以及腓肠肌外侧(GCL)和比目鱼肌的肌肉活动:固定在 0° 和踝关节自由外展。我们使用线性混合模型证实了不同条件下 CoP 参数或肌肉活动的变化与身体功能特征(如 Fugl-Meyer 下肢协同作用评估评分(FMAs)和躯干损伤量表(TIS))之间的关系:结果:与固定状态相比,在踝关节外翻的自由状态下,CoP 的前后位移(AP_CoP)(p = 0.011)和 GCL 的肌肉活动(p = 0.043)均有所增加。FMAs (p = 0.004) 和 TIS (p = 0.008) 与 AP_CoP 呈正相关。此外,还发现 TIS 与 CoP 中前脚掌内侧负重时间的百分比之间存在正相关关系(p 结论:TIS 与 CoP 中前脚掌内侧负重时间的百分比之间存在正相关关系:对于重度亚急性偏瘫患者,KAFO 中的踝关节外展诱导不会阻碍小腿的前倾,可促进 CoP 的前移和 GCL 的肌肉活动。这项研究表明,根据身体功能的改善情况调整 KAFO 中踝关节的背屈活动度可促进 CoP 向前脚内侧加载。
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引用次数: 0
A new modular neuroprosthesis suitable for hybrid FES-robot applications and tailored assistance. 一种新型模块化神经假体,适用于 FES-机器人混合应用和定制辅助。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-04 DOI: 10.1186/s12984-024-01450-6
Javier Gil-Castillo, Diana Herrera-Valenzuela, Diego Torricelli, Ángel Gil-Agudo, Eloy Opisso, Joan Vidal, Josep M Font-Llagunes, Antonio J Del-Ama, Juan C Moreno

Background: To overcome the application limitations of functional electrical stimulation (FES), such as fatigue or nonlinear muscle response, the combination of neuroprosthetic systems with robotic devices has been evaluated, resulting in hybrid systems that have promising potential. However, current technology shows a lack of flexibility to adapt to the needs of any application, context or individual. The main objective of this study is the development of a new modular neuroprosthetic system suitable for hybrid FES-robot applications to meet these needs.

Methods: In this study, we conducted an analysis of the requirements for developing hybrid FES-robot systems and reviewed existing literature on similar systems. Building upon these insights, we developed a novel modular neuroprosthetic system tailored for hybrid applications. The system was specifically adapted for gait assistance, and a technological personalization process based on clinical criteria was devised. This process was used to generate different system configurations adjusted to four individuals with spinal cord injury or stroke. The effect of each system configuration on gait kinematic metrics was analyzed by using repeated measures ANOVA or Friedman's test.

Results: A modular NP system has been developed that is distinguished by its flexibility, scalability and personalization capabilities. With excellent connection characteristics, it can be effectively integrated with robotic devices. Its 3D design facilitates fitting both as a stand-alone system and in combination with other robotic devices. In addition, it meets rigorous requirements for safe use by incorporating appropriate safety protocols, and features appropriate battery autonomy, weight and dimensions. Different technological configurations adapted to the needs of each patient were obtained, which demonstrated an impact on the kinematic gait pattern comparable to that of other devices reported in the literature.

Conclusions: The system met the identified technical requirements, showcasing advancements compared to systems reported in the literature. In addition, it demonstrated its versatility and capacity to be combined with robotic devices forming hybrids, adapting well to the gait application. Moreover, the personalization procedure proved to be useful in obtaining various system configurations tailored to the diverse needs of individuals.

背景:为了克服功能性电刺激(FES)在应用上的局限性,如疲劳或非线性肌肉反应,人们对神经假体系统与机器人设备的结合进行了评估,结果发现混合系统具有很大的潜力。然而,目前的技术缺乏灵活性,无法适应任何应用、环境或个人的需求。本研究的主要目的是开发一种适用于 FES 与机器人混合应用的新型模块化神经假体系统,以满足这些需求:在这项研究中,我们分析了开发混合 FES 机器人系统的要求,并查阅了有关类似系统的现有文献。在此基础上,我们开发了一种专为混合应用定制的新型模块化神经假体系统。该系统专门用于步态辅助,并根据临床标准设计了一套技术个性化流程。这一过程被用来生成不同的系统配置,以适应四名脊髓损伤或中风患者。使用重复测量方差分析或弗里德曼检验分析了每种系统配置对步态运动学指标的影响:开发出的模块化 NP 系统具有灵活性、可扩展性和个性化的特点。该系统具有出色的连接特性,可与机器人设备有效集成。其三维设计便于作为独立系统或与其他机器人设备组合使用。此外,它还采用了适当的安全协议,符合严格的安全使用要求,并具有适当的电池续航能力、重量和尺寸。根据每位患者的需求进行了不同的技术配置,对运动步态模式的影响与文献中报道的其他设备相当:结论:该系统满足了已确定的技术要求,与文献报道的系统相比取得了进步。此外,该系统还展示了其多功能性和与机器人设备结合形成混合体的能力,能很好地适应步态应用。此外,个性化程序被证明有助于获得适合个人不同需求的各种系统配置。
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引用次数: 0
Feasibility of a home-based home videogaming intervention with a family-centered approach for children with cerebral palsy: a randomized multiple baseline single-case experimental design. 以家庭为中心的脑瘫儿童家庭视频游戏干预的可行性:随机多基线单例实验设计。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-04 DOI: 10.1186/s12984-024-01446-2
Daniela Chan-Víquez, Heilyn Fernández-Huertas, Carles Montserrat-Gonzalez, Ajmal Khan, Darcy Fehlings, Sarah Munce, F Virginia Wright, Elaine Biddiss

Background: Worldwide, children with cerebral palsy (CP) living in underserved communities face barriers to accessing motor therapy services. This study assessed the implementation and effectiveness of an 8-week, upper limb (UL) home-based intervention with a movement-tracking videogame (Bootle Blast) in Costa Rican children with CP.

Methods: Children established a weekly playtime goal and two UL activities of daily living (ADLs) that they would like to improve on. A multiple-baseline, single-case experimental design, was used with the Performance Quality Rating Scale (PQRS) as the repeated measure to track changes in performance of the selected ADLs between the baseline (usual care) and intervention (Bootle Blast) phases. The Canadian Occupational Performance Measure (COPM), the Box and Blocks Test (BBT) and the Children's Hand-Use Experience Questionnaire (CHEQ) were collected before and after the intervention. Technical barriers were documented during weekly video calls with a monitoring therapist. Treatment effect size, slope changes and percentage of non-overlapping data were identified for the PQRS. Descriptive statistics summarized results for the BBT, CHEQ, videogame logs (e.g., playtime) and technical barriers.

Results: Fifteen children participated and 13 completed the intervention. Both participants who dropped out did so after completing baseline assessments, but before experiencing Bootle Blast. Children's mean active playtime (i.e., mini-games targeting the UL) across the 8-weeks was 377 min, while mean total time spent engaging with Bootle Blast (active + passive play time [e.g., time navigating menus, reviewing rewards]) was 728 min. In total, eight technical issues (from five children) were reported, and all but three were resolved within 48 h. Partial effectiveness was associated with the intervention. Specifically, 85% of participants improved on the PQRS and 69% achieved clinically important improvements ≥ 2 points in performance on the COPM. Children improved by 1.8 blocks on average on the BBT, while on the CHEQ, five children had a clinically important increase of 10% of the total number of UL activities performed with both hands.

Conclusion: Bootle Blast is a feasible and effective option to facilitate access and engage children with cerebral palsy in UL home rehabilitation. Trial registration Trial registration number: NCT05403567.

背景:在世界范围内,生活在服务不足社区的脑瘫(CP)儿童在获得运动治疗服务方面面临障碍。本研究评估了一项为期 8 周的上肢(UL)家庭干预措施的实施情况和效果,该干预措施在哥斯达黎加的 CP 儿童中使用了运动追踪电子游戏(Bootle Blast):方法:儿童确定了每周游戏时间目标和他们希望改善的两项 UL 日常生活活动 (ADL)。采用多基线、单病例实验设计,以表现质量评定量表(PQRS)作为重复测量方法,跟踪基线(常规护理)和干预(Bootle Blast)阶段之间所选 ADL 的表现变化。在干预前后,还收集了加拿大职业表现量表(COPM)、盒积木测试(BBT)和儿童手部使用体验问卷(CHEQ)。在每周与监测治疗师的视频通话中记录了技术障碍。确定了 PQRS 的治疗效果大小、斜率变化和非重叠数据的百分比。描述性统计汇总了BBT、CHEQ、视频游戏日志(如游戏时间)和技术障碍的结果:15 名儿童参加了干预活动,其中 13 人完成了干预活动。两名退出的参与者都是在完成基线评估后,但在体验 Bootle Blast 之前退出的。儿童在 8 周内的平均主动游戏时间(即针对 UL 的小游戏)为 377 分钟,而参与 Bootle Blast 的平均总时间(主动游戏时间+被动游戏时间[如浏览菜单、查看奖励])为 728 分钟。共报告了 8 个技术问题(来自 5 名儿童),除 3 个问题外,其他问题均在 48 小时内得到解决。具体来说,85% 的参与者在 PQRS 方面有所改善,69% 的参与者在 COPM 方面取得了临床重要改善,改善幅度≥ 2 分。儿童在BBT上平均提高了1.8个区块,而在CHEQ上,有5名儿童用双手完成UL活动的总次数提高了10%,具有重要的临床意义:结论:Bootle Blast 是促进脑瘫儿童参与 UL 家庭康复的可行且有效的选择。试验注册 试验注册号:NCT05403567:NCT05403567.
{"title":"Feasibility of a home-based home videogaming intervention with a family-centered approach for children with cerebral palsy: a randomized multiple baseline single-case experimental design.","authors":"Daniela Chan-Víquez, Heilyn Fernández-Huertas, Carles Montserrat-Gonzalez, Ajmal Khan, Darcy Fehlings, Sarah Munce, F Virginia Wright, Elaine Biddiss","doi":"10.1186/s12984-024-01446-2","DOIUrl":"10.1186/s12984-024-01446-2","url":null,"abstract":"<p><strong>Background: </strong>Worldwide, children with cerebral palsy (CP) living in underserved communities face barriers to accessing motor therapy services. This study assessed the implementation and effectiveness of an 8-week, upper limb (UL) home-based intervention with a movement-tracking videogame (Bootle Blast) in Costa Rican children with CP.</p><p><strong>Methods: </strong>Children established a weekly playtime goal and two UL activities of daily living (ADLs) that they would like to improve on. A multiple-baseline, single-case experimental design, was used with the Performance Quality Rating Scale (PQRS) as the repeated measure to track changes in performance of the selected ADLs between the baseline (usual care) and intervention (Bootle Blast) phases. The Canadian Occupational Performance Measure (COPM), the Box and Blocks Test (BBT) and the Children's Hand-Use Experience Questionnaire (CHEQ) were collected before and after the intervention. Technical barriers were documented during weekly video calls with a monitoring therapist. Treatment effect size, slope changes and percentage of non-overlapping data were identified for the PQRS. Descriptive statistics summarized results for the BBT, CHEQ, videogame logs (e.g., playtime) and technical barriers.</p><p><strong>Results: </strong>Fifteen children participated and 13 completed the intervention. Both participants who dropped out did so after completing baseline assessments, but before experiencing Bootle Blast. Children's mean active playtime (i.e., mini-games targeting the UL) across the 8-weeks was 377 min, while mean total time spent engaging with Bootle Blast (active + passive play time [e.g., time navigating menus, reviewing rewards]) was 728 min. In total, eight technical issues (from five children) were reported, and all but three were resolved within 48 h. Partial effectiveness was associated with the intervention. Specifically, 85% of participants improved on the PQRS and 69% achieved clinically important improvements ≥ 2 points in performance on the COPM. Children improved by 1.8 blocks on average on the BBT, while on the CHEQ, five children had a clinically important increase of 10% of the total number of UL activities performed with both hands.</p><p><strong>Conclusion: </strong>Bootle Blast is a feasible and effective option to facilitate access and engage children with cerebral palsy in UL home rehabilitation. Trial registration Trial registration number: NCT05403567.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"151"},"PeriodicalIF":5.2,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11373410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142126001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Shaping corticospinal pathways in virtual reality: effects of task complexity and sensory feedback during mirror therapy in neurologically intact individuals. 在虚拟现实中塑造皮质脊髓通路:任务复杂性和感官反馈对神经系统完好者镜像疗法的影响。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-04 DOI: 10.1186/s12984-024-01454-2
Trevor A Norris, Thomas E Augenstein, Kazandra M Rodriguez, Edward S Claflin, Chandramouli Krishnan

Background: Restoration of limb function for individuals with unilateral weakness typically requires volitional muscle control, which is often not present for individuals with severe impairment. Mirror therapy-interventions using a mirror box to reflect the less-impaired limb onto the more-impaired limb-can facilitate corticospinal excitability, leading to enhanced recovery in severely impaired clinical populations. However, the mirror box applies limitations on mirror therapy, namely that all movements appear bilateral and are confined to a small area, impeding integration of complex activities and multisensory feedback (e.g., visuo-tactile stimulation). These limitations can be addressed with virtual reality, but the resulting effect on corticospinal excitability is unclear.

Objective: Examine how virtual reality-based unilateral mirroring, complex activities during mirroring, and visuo-tactile stimulation prior to mirroring affect corticospinal excitability.

Materials and methods: Participants with no known neurological conditions (n = 17) donned a virtual reality system (NeuRRoVR) that displayed a first-person perspective of a virtual avatar that matched their motions. Transcranial magnetic stimulation-induced motor evoked potentials in the nondominant hand muscles were used to evaluate corticospinal excitability in four conditions: resting, mirroring, mirroring with prior visuo-tactile stimulation (mirroring + TACT), and control. During mirroring, the movements of each participant's dominant limb were reflected onto the nondominant limb of the virtual avatar, and the avatar's dominant limb was kept immobile (i.e., unilateral mirroring). The mirroring + TACT condition was the same as the mirroring condition, except that mirroring was preceded by visuo-tactile stimulation of the nondominant limb. During the control condition, unilateral mirroring was disabled. During all conditions, participants performed simple (flex/extend fingers) and complex (stack virtual blocks) activities.

Results: We found that unilateral mirroring increased corticospinal excitability compared to no mirroring (p < 0.001), complex activities increased excitability compared to simple activities during mirroring (p < 0.001), and visuo-tactile stimulation prior to mirroring decreased excitability (p = 0.032). We also found that these features did not interact with each other.

Discussions: The findings of this study shed light onto the neurological mechanisms of mirror therapy and demonstrate the unique ways in which virtual reality can augment mirror therapy. The findings have important implications for rehabilitation for design of virtual reality systems for clinical populations.

背景:单侧肢体无力者恢复肢体功能通常需要意志肌肉控制,而严重受损者往往不具备这种能力。镜像疗法--使用镜像箱将受损较轻的肢体反射到受损较重的肢体上,可促进皮质脊髓的兴奋性,从而提高严重受损临床人群的恢复能力。不过,镜箱对镜像疗法有一定的限制,即所有动作都是双侧的,而且仅限于一小块区域,妨碍了复杂活动和多感官反馈(如视觉触觉刺激)的整合。虚拟现实可以解决这些限制,但对皮质脊髓兴奋性的影响尚不清楚:研究基于虚拟现实的单侧镜像、镜像过程中的复杂活动以及镜像前的视觉触觉刺激如何影响皮质脊髓兴奋性:没有已知神经系统疾病的参与者(n = 17)戴上虚拟现实系统(NeuRRoVR),该系统会以第一人称视角显示与其动作相匹配的虚拟化身。经颅磁刺激诱导的非支配手部肌肉运动诱发电位用于评估皮质脊髓在四种情况下的兴奋性:静止、镜像、镜像前视觉触觉刺激(镜像 + TACT)和对照。在镜像过程中,每位受试者优势肢体的运动被反射到虚拟化身的非优势肢体上,而虚拟化身的优势肢体保持不动(即单侧镜像)。镜像 + TACT 条件与镜像条件相同,只是在镜像之前先对非优势肢体进行视觉触觉刺激。在对照组条件下,单侧镜像被禁用。在所有条件下,参与者进行简单(弯曲/伸展手指)和复杂(堆叠虚拟积木)的活动:结果:我们发现,与无镜像相比,单侧镜像增加了皮质脊髓兴奋性(p 讨论):本研究结果揭示了镜像疗法的神经机制,并展示了虚拟现实技术增强镜像疗法的独特方式。研究结果对临床人群的虚拟现实系统康复设计具有重要意义。
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引用次数: 0
Human-exoskeleton interaction portrait. 人机交互画像。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-09-04 DOI: 10.1186/s12984-024-01447-1
Mohammad Shushtari, Julia Foellmer, Arash Arami

Human-robot physical interaction contains crucial information for optimizing user experience, enhancing robot performance, and objectively assessing user adaptation. This study introduces a new method to evaluate human-robot interaction and co-adaptation in lower limb exoskeletons by analyzing muscle activity and interaction torque as a two-dimensional random variable. We introduce the interaction portrait (IP), which visualizes this variable's distribution in polar coordinates. We applied IP to compare a recently developed hybrid torque controller (HTC) based on kinematic state feedback and a novel adaptive model-based torque controller (AMTC) with online learning, proposed herein, against a time-based controller (TBC) during treadmill walking at varying speeds. Compared to TBC, both HTC and AMTC significantly lower users' normalized oxygen uptake, suggesting enhanced user-exoskeleton coordination. IP analysis reveals that this improvement stems from two distinct co-adaptation strategies, unidentifiable by traditional muscle activity or interaction torque analyses alone. HTC encourages users to yield control to the exoskeleton, decreasing overall muscular effort but increasing interaction torque, as the exoskeleton compensates for user dynamics. Conversely, AMTC promotes user engagement through increased muscular effort and reduces interaction torques, aligning it more closely with rehabilitation and gait training applications. IP phase evolution provides insight into each user's interaction strategy formation, showcasing IP analysis's potential in comparing and designing novel controllers to optimize human-robot interaction in wearable robots.

人机物理交互包含优化用户体验、提高机器人性能和客观评估用户适应性的关键信息。本研究引入了一种新方法,通过分析作为二维随机变量的肌肉活动和交互扭矩,评估下肢外骨骼中的人机交互和协同适应。我们引入了交互肖像(IP),它将这一变量在极坐标中的分布可视化。我们应用 IP 比较了最近开发的基于运动状态反馈的混合扭矩控制器(HTC)和本文提出的具有在线学习功能的新型基于模型的自适应扭矩控制器(AMTC)与基于时间的控制器(TBC)在不同速度下的跑步机行走过程。与TBC相比,HTC和AMTC都显著降低了用户的归一化摄氧量,表明用户与骨骼的协调性得到了增强。IP 分析表明,这种改善源于两种不同的共同适应策略,仅靠传统的肌肉活动或交互扭矩分析是无法识别的。HTC 鼓励用户将控制权交给外骨骼,从而减少了整体肌肉活动,但增加了交互扭矩,因为外骨骼会对用户的动态进行补偿。相反,AMTC 则通过增加肌肉运动来促进用户参与,并降低交互扭矩,使其更符合康复和步态训练应用。IP 阶段演化深入揭示了每个用户交互策略的形成,展示了 IP 分析在比较和设计新型控制器以优化可穿戴机器人的人机交互方面的潜力。
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引用次数: 0
Using eye tracking to assess learning of a multifunction prosthetic hand: an exploratory study from a rehabilitation perspective. 利用眼动跟踪评估多功能假手的学习情况:从康复角度进行的探索性研究。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-31 DOI: 10.1186/s12984-024-01445-3
Wendy Hill, Helen Lindner

Background: Eye tracking technology not only reveals the acquisition of visual information at fixation but also has the potential to unveil underlying cognitive processes involved in learning to use a multifunction prosthetic hand. It also reveals gaze behaviours observed during standardized tasks and self-chosen tasks. The aim of the study was to explore the use of eye tracking to track learning progress of multifunction hands at two different time points in prosthetic rehabilitation.

Methods: Three amputees received control training of a multifunction hand with new control strategy. Detailed description of control training was collected first. They wore Tobii Pro2 eye-tracking glasses and performed a set of standardized tasks (required to switch to different grips for each task) after one day of training and at one-year-follow-up (missing data for Subject 3 at the follow up due to socket problem). They also performed a self-chosen task (free to use any grip for any object) and were instructed to perform the task in a way how they would normally do at home. The gaze-overlaid videos were analysed using the Tobii Pro Lab and the following metrics were extracted: fixation duration, saccade amplitude, eye-hand latency, fixation count and time to first fixation.

Results: During control training, the subjects learned 3 to 4 grips. Some grips were easier, and others were more difficult because they forgot or were confused with the switching strategies. At the one-year-follow-up, a decrease in performance time, fixation duration, eye-hand latency, and fixation count was observed in Subject 1 and 2, indicating an improvement in the ability to control the multifunction hand and a reduction of cognitive load. An increase in saccade amplitude was observed in both subjects, suggesting a decrease in difficulty to control the prosthetic hand. During the standardized tasks, the first fixation of all three subjects were on the multifunction hand in all objects. During the self-chosen tasks, the first fixations were mostly on the objects first.

Conclusion: The qualitative data from control training and the quantitative eye tracking data from clinical standardized tasks provided a rich exploration of cognitive processing in learning to control a multifunction hand. Many prosthesis users prefer multifunction hands and with this study we have demonstrated that a targeted prosthetic training protocol with reliable assessment methods will help to lay the foundation for measuring functional benefits of multifunction hands.

背景:眼动跟踪技术不仅能揭示在固定点获取视觉信息的过程,还能揭示学习使用多功能假手的潜在认知过程。它还能揭示在标准化任务和自选任务中观察到的注视行为。本研究旨在探索在假肢康复的两个不同时间点使用眼动仪跟踪多功能假手的学习进度:方法:三名截肢者接受了新控制策略的多功能手控制训练。首先收集控制训练的详细描述。他们佩戴 Tobii Pro2 眼球跟踪眼镜,在一天的训练后和一年的随访中完成了一系列标准化任务(要求在每项任务中切换不同的手柄)(由于插座问题,随访中缺少受试者 3 的数据)。受试者还进行了一项自选任务(可自由使用任何手柄握住任何物体),并被要求以他们通常在家的方式完成任务。我们使用 Tobii Pro Lab 对凝视叠加视频进行了分析,并提取了以下指标:定点持续时间、囊状移动幅度、眼手延迟、定点计数和首次定点时间:结果:在控制训练中,受试者学会了 3 至 4 种手柄。结果:在对照组训练中,受试者学会了 3 到 4 种手势,其中一些手势比较简单,另一些手势则比较困难,因为他们忘记或混淆了切换策略。在为期一年的随访中,观察到受试者 1 和 2 的表现时间、定点持续时间、眼手潜伏期和定点计数均有所减少,表明控制多功能手的能力有所提高,认知负荷有所减轻。两名受试者的囊状回旋幅度均有所增加,表明控制假手的难度有所降低。在标准化任务中,三名受试者在所有物体上的第一个定点都是多功能手。在自选任务中,第一个定点大多首先在物体上:来自控制训练的定性数据和来自临床标准化任务的定量眼动数据为学习控制多功能手的认知过程提供了丰富的探索。通过这项研究,我们证明了有针对性的假肢训练方案和可靠的评估方法将有助于为测量多功能手的功能益处奠定基础。
{"title":"Using eye tracking to assess learning of a multifunction prosthetic hand: an exploratory study from a rehabilitation perspective.","authors":"Wendy Hill, Helen Lindner","doi":"10.1186/s12984-024-01445-3","DOIUrl":"10.1186/s12984-024-01445-3","url":null,"abstract":"<p><strong>Background: </strong>Eye tracking technology not only reveals the acquisition of visual information at fixation but also has the potential to unveil underlying cognitive processes involved in learning to use a multifunction prosthetic hand. It also reveals gaze behaviours observed during standardized tasks and self-chosen tasks. The aim of the study was to explore the use of eye tracking to track learning progress of multifunction hands at two different time points in prosthetic rehabilitation.</p><p><strong>Methods: </strong>Three amputees received control training of a multifunction hand with new control strategy. Detailed description of control training was collected first. They wore Tobii Pro2 eye-tracking glasses and performed a set of standardized tasks (required to switch to different grips for each task) after one day of training and at one-year-follow-up (missing data for Subject 3 at the follow up due to socket problem). They also performed a self-chosen task (free to use any grip for any object) and were instructed to perform the task in a way how they would normally do at home. The gaze-overlaid videos were analysed using the Tobii Pro Lab and the following metrics were extracted: fixation duration, saccade amplitude, eye-hand latency, fixation count and time to first fixation.</p><p><strong>Results: </strong>During control training, the subjects learned 3 to 4 grips. Some grips were easier, and others were more difficult because they forgot or were confused with the switching strategies. At the one-year-follow-up, a decrease in performance time, fixation duration, eye-hand latency, and fixation count was observed in Subject 1 and 2, indicating an improvement in the ability to control the multifunction hand and a reduction of cognitive load. An increase in saccade amplitude was observed in both subjects, suggesting a decrease in difficulty to control the prosthetic hand. During the standardized tasks, the first fixation of all three subjects were on the multifunction hand in all objects. During the self-chosen tasks, the first fixations were mostly on the objects first.</p><p><strong>Conclusion: </strong>The qualitative data from control training and the quantitative eye tracking data from clinical standardized tasks provided a rich exploration of cognitive processing in learning to control a multifunction hand. Many prosthesis users prefer multifunction hands and with this study we have demonstrated that a targeted prosthetic training protocol with reliable assessment methods will help to lay the foundation for measuring functional benefits of multifunction hands.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"148"},"PeriodicalIF":5.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Correction: Effects of a dual intervention (motor and virtual reality-based cognitive) on cognition in patients with mild cognitive impairment: a single-blind, randomized controlled trial. 更正:双重干预(运动和基于虚拟现实的认知)对轻度认知障碍患者认知能力的影响:单盲随机对照试验。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-31 DOI: 10.1186/s12984-024-01443-5
Jorge Buele, Fátima Avilés-Castillo, Carolina Del-Valle-Soto, José Varela-Aldás, Guillermo Palacios-Navarro
{"title":"Correction: Effects of a dual intervention (motor and virtual reality-based cognitive) on cognition in patients with mild cognitive impairment: a single-blind, randomized controlled trial.","authors":"Jorge Buele, Fátima Avilés-Castillo, Carolina Del-Valle-Soto, José Varela-Aldás, Guillermo Palacios-Navarro","doi":"10.1186/s12984-024-01443-5","DOIUrl":"10.1186/s12984-024-01443-5","url":null,"abstract":"","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"149"},"PeriodicalIF":5.2,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11365221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Soft pneumatic actuators for pushing fingers into extension. 用于推动手指伸展的软气动执行器。
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-30 DOI: 10.1186/s12984-024-01444-4
James V McCall, Gregory D Buckner, Derek G Kamper

Background: Compliant pneumatic actuators possess many characteristics that are desirable for wearable robotic systems. These actuators can be lightweight, integrated with clothing, and accommodate uncontrolled degrees of freedom. These attributes are especially desirable for hand exoskeletons, where the soft actuator can conform to the highly variable digit shape. In particular, locating the pneumatic actuator on the palmar side of the digit may have benefits for assisting finger extension and resisting unwanted finger flexion, but this configuration requires suppleness to allow digit flexion while retaining sufficient stiffness to assist extension.

Methods: To meet these needs, we designed an actuator consisting of a hollow chamber long enough to span the joints of each digit while sufficiently narrow not to inhibit finger adduction. We explored the geometrical design parameter space for this chamber in terms of shape, dimensions, and wall thickness. After fabricating an elastomer-based prototype for each actuator design, we measured active extension force and passive resistance to bending for each chamber using a mechanical jig. We also created a finite element model for each chamber to enable estimation of the impact of chamber deformation, caused by joint rotation, on airflow through the chamber. Finally, we created a prototype hand exoskeleton with the chamber parameters yielding the best outcomes.

Results: A rectangular cross-sectional area was preferable to a semi-obround shape for the chamber; wall thickness also impacted performance. Extension joint torque reached 0.33 N-m at a low chamber pressure of 48.3 kPa. The finite element model confirmed that airflow for the rectangular chamber remained high despite deformation resulting from joint rotation. The hand exoskeleton created with the rectangular chambers enabled rapid movement, with a cycle time of 1.1 s for voluntary flexion followed by actuated extension.

Conclusions: The developed soft actuators are feasible for use in promoting finger extension from the palmar side of the hand. This placement utilizes pushing rather than pulling for digit extension, which is more comfortable and safer. The small chamber volumes allow rapid filling and evacuation to facilitate relatively high frequency finger movements.

背景:顺应性气动执行器具有许多可穿戴机器人系统所需要的特性。这些致动器重量轻,可与服装集成,并能适应不受控制的自由度。对于手部外骨骼来说,这些特性尤为理想,因为在手部外骨骼中,柔软的致动器可以适应高度可变的数字形状。特别是,将气动致动器安装在手指的掌侧可能有利于帮助手指伸展并防止不必要的手指弯曲,但这种配置需要柔软度以允许手指弯曲,同时保留足够的硬度以帮助手指伸展:为了满足这些需求,我们设计了一种由空腔组成的致动器,空腔的长度足以跨越每个手指的关节,同时又足够狭窄,不会抑制手指的内收。我们从形状、尺寸和壁厚等方面探索了空腔的几何设计参数空间。在为每种致动器设计制作了基于弹性体的原型后,我们使用机械夹具测量了每个腔体的主动伸展力和被动抗弯强度。我们还为每个腔体创建了一个有限元模型,以便估算关节旋转造成的腔体变形对通过腔体的气流的影响。最后,我们创建了一个手部外骨骼原型,其腔室参数产生了最佳效果:结果:长方形横截面积比半圆形的腔室更可取;壁厚也会影响性能。在 48.3 kPa 的低腔室压力下,伸展关节扭矩达到 0.33 N-m。有限元模型证实,尽管关节旋转会导致变形,但矩形腔室的气流仍然很高。用矩形腔体制作的手部外骨骼能够快速运动,自主屈伸和驱动伸展的周期时间为 1.1 秒:结论:开发的软促动器可用于从手掌侧促进手指伸展。这种装置利用推力而不是拉力来实现手指伸展,更加舒适和安全。小腔容积允许快速填充和排空,以促进相对高频率的手指运动。
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引用次数: 0
Pilot study of using transcranial temporal interfering theta-burst stimulation for modulating motor excitability in rat. 利用经颅瞬时干扰θ-脉冲刺激调节大鼠运动兴奋性的试验性研究
IF 5.2 2区 医学 Q1 ENGINEERING, BIOMEDICAL Pub Date : 2024-08-30 DOI: 10.1186/s12984-024-01451-5
Chun-Wei Wu, Bor-Shing Lin, Zhao Zhang, Tsung-Hsun Hsieh, Jian-Chiun Liou, Wei-Lun Lo, Yu-Ting Li, Shao-Chu Chiu, Chih-Wei Peng

Transcranial temporal interference stimulation (tTIS) is a promising brain stimulation method that can target deep brain regions by delivering an interfering current from surface electrodes. Most instances of tTIS stimulate the brain with a single-frequency sinusoidal waveform generated by wave interference. Theta burst stimulation is an effective stimulation scheme that can modulate neuroplasticity by generating long-term potentiation- or depression-like effects. To broaden tTIS application, we developed a theta burst protocol using tTIS technique to modulate neuroplasticity in rats. Two cannula electrodes were unilaterally implanted into the intact skull over the primary motor cortex. Electrical field of temporal interference envelopes generated by tTIS through cannula electrodes were recorded from primary motor cortex. Theta burst schemes were characterized, and motor activation induced by the stimulation was also evaluated simultaneously by observing electromyographic signals from the corresponding brachioradialis muscle. After validating the stimulation scheme, we further tested the modulatory effects of theta burst stimulation delivered by tTIS and by conventional transcranial electrical stimulation on primary motor cortex excitability. Changes in the amplitude of motor evoked potentials, elicited when the primary motor cortex was activated by electrical pulses, were measured before and after theta burst stimulation by both techniques. Significant potentiation and suppression were found at 15 to 30 min after the intermittent and continuous theta burst stimulation delivered using tTIS, respectively. However, comparing to theta burst stimulations delivered using conventional form of transcranial electrical stimulation, using tTIS expressed no significant difference in modulating motor evoked potential amplitudes. Sham treatment from both methods had no effect on changing the motor evoked potential amplitude. The present study demonstrated the feasibility of using tTIS to achieve a theta burst stimulation scheme for motor cortical neuromodulation. These findings also indicated the future potential of using tTIS to carry out theta burst stimulation protocols in deep-brain networks for modulating neuroplasticity.

经颅颞部干扰刺激(tTIS)是一种很有前途的脑刺激方法,它可以通过从表面电极发出干扰电流来刺激大脑深部区域。大多数经颅颞部干扰刺激都是通过波干扰产生的单频正弦波来刺激大脑。Theta 突发性刺激是一种有效的刺激方案,可通过产生类似长期延时或抑制的效果来调节神经可塑性。为了扩大 tTIS 的应用范围,我们开发了一种使用 tTIS 技术调节大鼠神经可塑性的 Theta 脉冲串方案。我们将两个插管电极单侧植入完整头骨的初级运动皮层。通过插管电极从初级运动皮层记录 tTIS 产生的时间干扰包络电场。对θ猝发方案进行了表征,并通过观察相应肱肌的肌电信号同时评估了刺激引起的运动激活。在验证了刺激方案后,我们进一步测试了 tTIS 和传统经颅电刺激对初级运动皮层兴奋性的调节作用。通过这两种技术测量了θ脉冲刺激前后初级运动皮层被电脉冲激活时运动诱发电位振幅的变化。在使用 tTIS 进行间歇性和持续性θ脉冲串刺激后 15 至 30 分钟,分别发现了显著的增强和抑制作用。不过,与传统的经颅电刺激相比,tTIS 在调节运动诱发电位振幅方面没有显著差异。两种方法的假治疗对运动诱发电位振幅的改变均无影响。本研究证明了使用 tTIS 实现用于运动皮层神经调控的θ突发性刺激方案的可行性。这些研究结果还表明,使用 tTIS 在深脑网络中实施θ 脉冲串刺激方案以调节神经可塑性的未来潜力。
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引用次数: 0
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Journal of NeuroEngineering and Rehabilitation
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