[This corrects the article DOI: 10.1186/s42490-019-0015-y.].
[This corrects the article DOI: 10.1186/s42490-019-0015-y.].
Background: Arm support devices are available to support people with Duchenne muscular dystrophy (DMD), but active trunk support devices are lacking. An active trunk support device can potentially extend the reach of the arm and stabilize the unstable trunk of people with DMD. In a previous study, we showed that healthy people were able to control an active trunk support using four different control interfaces (based on joystick, force on feet, force on sternum and surface electromyography). All four control interfaces had different advantages and disadvantages. The aim of this study was to explore which of the four inputs is detectably used by people with DMD to control an active trunk support.
Results: The results were subject-dependent in both experiments. In the active experiment, the joystick was the most promising control interface. Regarding the static experiment, surface electromyography and force on feet worked for two out of the three subjects.
Conclusions: To our knowledge, this is the first time that people with DMD have engaged in a control task using signals other than those related to their arm muscles. According to our findings, the control interfaces have to be customised to every DMD subject.
Muscles contain contractile and (visco-) elastic passive components. At the latest since Hill's classic works in the 1930s, it has been known that these elastic components affect the length and rate of change in length of the contractile component, and thus the active force capability of dynamically working muscles. In an attempt to elucidate functional properties of these muscle elastic components, scientists have introduced the notion of "series" and "parallel" elasticity. Unfortunately, this has led to much confusion and erroneous interpretations of results when the mechanical definitions of parallel and series elasticity were violated. In this review, I will focus on muscle series elasticity, by first providing the mechanical definition for series elasticity, and then provide theoretical and experimental examples of the concept of series elasticity. Of particular importance is the treatment of aponeuroses. Aponeuroses are not in series with the tendon of a muscle nor the muscle's contractile elements. The implicit and explicit treatment of aponeuroses as series elastic elements in muscle has led to incorrect conclusions about aponeuroses stiffness and Young's modulus, and has contributed to vast overestimations of the storage and release of mechanical energy in cyclic muscle contractions. Series elasticity is a defined mechanical concept that needs to be treated carefully when applied to skeletal muscle mechanics. Measuring aponeuroses mechanical properties in a muscle, and its possible contribution to the storage and release of mechanical energy is not trivial, and to my best knowledge, has not been (correctly) done yet.
Background: Hybrid exoskeletons are a recent development which combine Functional Electrical Stimulation with actuators to improve both the mental and physical rehabilitation of stroke patients. Hybrid exoskeletons have been shown capable of reducing the weight of the actuator and improving movement precision compared to Functional Electrical Stimulation alone. However little attention has been given towards the ability of hybrid exoskeletons to reduce and manage Functional Electrical Stimulation induced fatigue or towards adapting to user ability. This work details the construction and testing of a novel assist-as-need upper-extremity hybrid exoskeleton which uses model-based Functional Electrical Stimulation control to delay Functional Electrical Stimulation induced muscle fatigue. The hybrid control is compared with Functional Electrical Stimulation only control on a healthy subject.
Results: The hybrid system produced 24° less average angle error and 13.2° less Root Mean Square Error, than Functional Electrical Stimulation on its own and showed a reduction in Functional Electrical Stimulation induced fatigue.
Conclusion: As far as the authors are aware, this is the study which provides evidence of the advantages of hybrid exoskeletons compared to use of Functional Electrical Stimulation on its own with regards to the delay of Functional Electrical Stimulation induced muscle fatigue.
Background: Triple tracer meal experiments used to investigate organ glucose-insulin dynamics, such as endogenous glucose production (EGP) of the liver are labor intensive and expensive. A procedure was developed to obtain individual liver related parameters to describe EGP dynamics without the need for tracers.
Results: The development used an existing formula describing the EGP dynamics comprising 4 parameters defined from glucose, insulin and C-peptide dynamics arising from triple meal studies. The method employs a set of partial differential equations in order to estimate the parameters for EGP dynamics. Tracer-derived and simulated data sets were used to develop and test the procedure. The predicted EGP dynamics showed an overall mean R 2 of 0.91.
Conclusions: In summary, a method was developed for predicting the hepatic EGP dynamics for healthy, pre-diabetic, and type 2 diabetic individuals without applying tracer experiments.
Background: Since nuclei segmentation in histopathology images can provide key information for identifying the presence or stage of a disease, the images need to be assessed carefully. However, color variation in histopathology images, and various structures of nuclei are two major obstacles in accurately segmenting and analyzing histopathology images. Several machine learning methods heavily rely on hand-crafted features which have limitations due to manual thresholding.
Results: To obtain robust results, deep learning based methods have been proposed. Deep convolutional neural networks (DCNN) used for automatically extracting features from raw image data have been proven to achieve great performance. Inspired by such achievements, we propose a nuclei segmentation method based on DCNNs. To normalize the color of histopathology images, we use a deep convolutional Gaussian mixture color normalization model which is able to cluster pixels while considering the structures of nuclei. To segment nuclei, we use Mask R-CNN which achieves state-of-the-art object segmentation performance in the field of computer vision. In addition, we perform multiple inference as a post-processing step to boost segmentation performance. We evaluate our segmentation method on two different datasets. The first dataset consists of histopathology images of various organ while the other consists histopathology images of the same organ. Performance of our segmentation method is measured in various experimental setups at the object-level and the pixel-level. In addition, we compare the performance of our method with that of existing state-of-the-art methods. The experimental results show that our nuclei segmentation method outperforms the existing methods.
Conclusions: We propose a nuclei segmentation method based on DCNNs for histopathology images. The proposed method which uses Mask R-CNN with color normalization and multiple inference post-processing provides robust nuclei segmentation results. Our method also can facilitate downstream nuclei morphological analyses as it provides high-quality features extracted from histopathology images.
Background: Leg-press devices are one of the most widely used training tools for musculoskeletal strengthening of the lower-limbs, and have demonstrated important cardiopulmonary benefits for healthy and patient populations. Further engineering development was done on a dynamic leg-press for work-rate estimation by integrating force and motion sensors, power calculation and a visual feedback system for volitional work-rate control. This study aimed to assess the feasibility of the enhanced dynamic leg press for cardiopulmonary exercise training in constant-load training and high-intensity interval training. Five healthy participants aged 31.0±3.9 years (mean ± standard deviation) performed two cardiopulmonary training sessions: constant-load training and high-intensity interval training. Participants carried out the training sessions at a work rate that corresponds to their first ventilatory threshold for constant-load training, and their second ventilatory threshold for high-intensity interval training.
Results: All participants tolerated both training protocols, and could complete the training sessions with no complications. Substantial cardiopulmonary responses were observed. The difference between mean oxygen uptake and target oxygen uptake was 0.07±0.34 L/min (103 ±17%) during constant-load training, and 0.35±0.66 L/min (113 ±27%) during high-intensity interval training. The difference between mean heart rate and target heart rate was -7±19 bpm (94 ±15%) during constant-load training, and 4.2±16 bpm (103 ±12%) during high-intensity interval training.
Conclusions: The enhanced dynamic leg press was found to be feasible for cardiopulmonary exercise training, and for exercise prescription for different training programmes based on the ventilatory thresholds.
Background: Accurate spasticity assessment provides an objective evaluation index for the rehabilitation treatment of patients with spasticity, and the key is detecting stretch reflex onset. The surface electromyogram of patients with spasticity is prone to false peaks, and its data length is unstable. These conditions decrease signal differences before and after stretch reflex onset. Therefore, a method for detecting stretch reflex onset based on empirical mode decomposition denoising and modified sample entropy recognition is proposed in this study.
Results: The empirical mode decomposition algorithm is better than the wavelet threshold algorithm in denoising surface electromyogram signal. Without adding Gaussian white noise to the electromyogram signal, the stretch reflex onset recognition rate of the electromyogram signal before and after empirical mode decomposition denoising was increased by 56%. In particular, the recognition rate of stretch reflex onset under the optimal parameter of the modified sample entropy can reach up to 100% and the average recognition rate is 93%.
Conclusions: The empirical mode decomposition algorithm can eliminate the baseline activity of the surface electromyogram signal before stretch reflex onset and effectively remove noise from the signal. The identification of stretch reflex onset using combined empirical mode decomposition and modified sample entropy is better than that via modified sample entropy alone, and stretch reflex onset can be accurately determined.
Many people suffer from movement disability due to amputation or neurological diseases. Fortunately, with modern neurotechnology now it is possible to intercept motor control signals at various points along the neural transduction pathway and use that to drive external devices for communication or control. Here we will review the latest developments in human motor decoding. We reviewed the various strategies to decode motor intention from human and their respective advantages and challenges. Neural control signals can be intercepted at various points in the neural signal transduction pathway, including the brain (electroencephalography, electrocorticography, intracortical recordings), the nerves (peripheral nerve recordings) and the muscles (electromyography). We systematically discussed the sites of signal acquisition, available neural features, signal processing techniques and decoding algorithms in each of these potential interception points. Examples of applications and the current state-of-the-art performance were also reviewed. Although great strides have been made in human motor decoding, we are still far away from achieving naturalistic and dexterous control like our native limbs. Concerted efforts from material scientists, electrical engineers, and healthcare professionals are needed to further advance the field and make the technology widely available in clinical use.
Background: In virtual reality (VR) applications such as games, virtual training, and interactive neurorehabilitation, one can employ either the first-person user perspective or the third-person perspective to perceive the virtual environment; however, applications rarely offer both perspectives for the same task. We used a targeted-reaching task in a large-scale virtual reality environment (N=30 healthy volunteers) to evaluate the effects of user perspective on the head and upper extremity movements, and on user performance. We further evaluated how different cognitive challenges would modulate these effects. Finally, we obtained the user-reported engagement level under the different perspectives.
Results: We found that first-person perspective resulted in larger head movements (3.52±1.3m) than the third-person perspective (2.41±0.7m). First-person perspective also resulted in more upper-extremity movement (30.08±7.28m compared to 26.66±4.86m) and longer completion times (61.3±16.4s compared to 53±10.4s) for more challenging tasks such as the "flipped mode", in which moving one arm causes the opposite virtual arm to move. We observed no significant effect of user perspective alone on the success rate. Subjects reported experiencing roughly the same level of engagement in both first-person and third-person perspectives (F(1.58)=0.9,P=.445).
Conclusion: User perspective and its interaction with higher-cognitive load tasks influences the extent of movement and user performance in a virtual theater environment, and may influence the choice of the interface type (first or third person) in immersive training depending on the user conditions and exercise requirements.