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Concurrent validity of inertial measurement units in range of motion measurements of upper extremity: A systematic review and meta-analysis. 惯性测量单元在上肢运动范围测量中的并发有效性:系统回顾与荟萃分析。
IF 3.4 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-10-04 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2024.6
Jinfeng Li, Fanji Qiu, Liaoyan Gan, Li-Shan Chou

Inertial measurement units (IMUs) have proven to be valuable tools in measuring the range of motion (RoM) of human upper limb joints. Although several studies have reported on the validity of IMUs compared to the gold standard (optical motion capture system, OMC), a quantitative summary of the accuracy of IMUs in measuring RoM of upper limb joints is still lacking. Thus, the primary objective of this systematic review and meta-analysis was to determine the concurrent validity of IMUs for measuring RoM of the upper extremity in adults. Fifty-one articles were included in the systematic review, and data from 16 were pooled for meta-analysis. Concurrent validity is excellent for shoulder flexion-extension (Pearson's r = 0.969 [0.935, 0.986], ICC = 0.935 [0.749, 0.984], mean difference = -3.19 (p = 0.55)), elbow flexion-extension (Pearson's r = 0.954 [0.929, 0.970], ICC = 0.929 [0.814, 0.974], mean difference = 10.61 (p = 0.36)), wrist flexion-extension (Pearson's r = 0.974 [0.945, 0.988], mean difference = -4.20 (p = 0.58)), good to excellent for shoulder abduction-adduction (Pearson's r = 0.919 [0.848, 0.957], ICC = 0.840 [0.430, 0.963], mean difference = -7.10 (p = 0.50)), and elbow pronation-supination (Pearson's r = 0.966 [0.939, 0.981], ICC = 0.821 [0.696, 0.900]). There are some inconsistent results for shoulder internal-external rotation (Pearson's r = 0.939 [0.894, 0.965], mean difference = -9.13 (p < 0.0001)). In conclusion, the results support IMU as a viable instrument for measuring RoM of upper extremity, but for some specific joint movements, such as shoulder rotation and wrist ulnar-radial deviation, IMU measurements need to be used with caution.

惯性测量单元(IMU)已被证明是测量人体上肢关节运动范围(RoM)的重要工具。尽管有多项研究报告了惯性测量单元与黄金标准(光学运动捕捉系统,OMC)相比的有效性,但仍缺乏对惯性测量单元测量上肢关节 RoM 的准确性的定量总结。因此,本系统综述和荟萃分析的主要目的是确定 IMU 测量成人上肢 RoM 的并发有效性。系统综述共收录了 51 篇文章,并汇总了 16 篇文章的数据进行荟萃分析。肩关节屈伸(Pearson's r = 0.969 [0.935, 0.986],ICC = 0.935 [0.749, 0.984],平均差 = -3.19 (p = 0.55))、肘关节屈伸(Pearson's r = 0.954 [0.929, 0.970],ICC = 0.929 [0.814, 0.974],平均差 = 10.61(P = 0.36))、腕关节屈伸(Pearson's r = 0.974 [0.945, 0.988],平均差 = -4.20 (p = 0.58)),肩关节外展-内收良好至优秀(Pearson's r = 0.919 [0.848, 0.957],ICC = 0.840 [0.430, 0.963],平均差 = -7.10 (p = 0.50))和肘关节前屈-上伸(Pearson's r = 0.966 [0.939, 0.981],ICC = 0.821 [0.696, 0.900])。肩关节内旋-外旋(Pearson's r = 0.939 [0.894, 0.965],平均差 = -9.13 (p
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引用次数: 0
GLULA: Linear attention-based model for efficient human activity recognition from wearable sensors GLULA:从可穿戴传感器高效识别人类活动的线性注意力模型
Q2 Medicine Pub Date : 2024-04-05 DOI: 10.1017/wtc.2024.5
Aldiyar Bolatov, A. Yessenbayeva, Adnan Yazici
Body-worn sensor data is used in monitoring patient activity during rehabilitation and also can be extended to controlling rehabilitation devices based on the activity of the person. The primary focus of research has been on effectively capturing the spatiotemporal dependencies in the data collected by these sensors and efficiently classifying human activities. With the increasing complexity and size of models, there is a growing emphasis on optimizing their efficiency in terms of memory usage and inference time for real-time usage and mobile computers. While hybrid models combining convolutional and recurrent neural networks have shown strong performance compared to traditional approaches, self-attention-based networks have demonstrated even superior results. However, instead of relying on the same transformer architecture, there is an opportunity to develop a novel framework that incorporates recent advancements to enhance speed and memory efficiency, specifically tailored for human activity recognition (HAR) tasks. In line with this approach, we present GLULA, a unique architecture for HAR. GLULA combines gated convolutional networks, branched convolutions, and linear self-attention to achieve efficient and powerful solutions. To enhance the performance of our proposed architecture, we employed manifold mixup as an augmentation variant which proved beneficial in limited data settings. Extensive experiments were conducted on five benchmark datasets: PAMAP2, SKODA, OPPORTUNITY, DAPHNET, and USC-HAD. Our findings demonstrate that GLULA outperforms recent models in the literature on the latter four datasets but also exhibits the lowest parameter count and close to the fastest inference time among state-of-the-art models.
体戴式传感器数据可用于监测康复过程中病人的活动,也可扩展到根据人的活动控制康复设备。研究的主要重点是有效捕捉这些传感器收集的数据中的时空相关性,并对人类活动进行有效分类。随着模型的复杂性和规模不断增加,人们越来越重视在内存使用和推理时间方面优化模型的效率,以满足实时使用和移动计算机的需求。与传统方法相比,结合了卷积和递归神经网络的混合模型表现出了强劲的性能,而基于自我注意的网络则表现出了更出色的效果。然而,与其依赖相同的变压器架构,我们有机会开发出一种新颖的框架,将最新的技术融入其中,提高速度和记忆效率,专门用于人类活动识别(HAR)任务。根据这种方法,我们提出了 GLULA,一种用于 HAR 的独特架构。GLULA 结合了门控卷积网络、分支卷积和线性自注意,以实现高效而强大的解决方案。为了提高我们提出的架构的性能,我们采用了流形混合作为增强变体,这在有限的数据设置中被证明是有益的。我们在五个基准数据集上进行了广泛的实验:PAMAP2、SKODA、OPPORTUNITY、DAPHNET 和 USC-HAD。我们的研究结果表明,在后四个数据集上,GLULA 的表现优于文献中的最新模型,而且在最先进的模型中,GLULA 的参数数量最少,推理时间接近最快。
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引用次数: 0
Acute suppression of lower limb spasm by sacral afferent stimulation for people with spinal cord injury: A pilot study 脊髓损伤患者通过骶骨传入神经刺激急性抑制下肢痉挛:试点研究
Q2 Medicine Pub Date : 2024-04-05 DOI: 10.1017/wtc.2024.4
Sarah Massey, Sean Doherty, Lynsey Duffell, Mike Craggs, Sarah L. Knight
Lower limb spasm and spasticity may develop following spinal cord injury (SCI), causing hyper-excitability and increased tone, which can impact function and quality of life. Pharmaceutical interventions for spasticity may cause unwanted side effects such as drowsiness and weakness. Invasive and non-invasive electrical stimulation has been shown to reduce spasticity without these side effects. The aim of this study was to investigate the effect of sacral afferent stimulation (SAS), through surface electrical stimulation of the dorsal genital nerve (N = 7), and through implanted electrodes on the sacral afferent nerve roots, on lower limb spasm and spasticity (N = 2). Provoked spasms were interrupted with conditional SAS, where stimulation commenced following a provoked spasm, or unconditional stimulation, which was applied continuously. Conditionally and unconditionally applied SAS was shown to suppress acute provoked spasms in people with SCI. There was a statistically significant reduction in area under the curve of quadriceps electromyography during acute spasm with SAS compared to a control spasm. These results show that SAS may provide a safe, low-cost method of reducing acute spasm and spasticity in people living with SCI. SAS through implanted electrodes may also provide an additional function to sacral nerve stimulation devices.
脊髓损伤(SCI)后可能会出现下肢痉挛和痉挛,导致过度兴奋和张力增加,从而影响功能和生活质量。针对痉挛的药物干预可能会产生不必要的副作用,如嗜睡和乏力。有创和无创电刺激已被证明可以减轻痉挛,且不会产生这些副作用。本研究旨在通过对生殖器背神经(7 例)进行表面电刺激,以及通过在骶骨传入神经根部植入电极,研究骶骨传入刺激(SAS)对下肢痉挛和痉挛(2 例)的影响。有条件的 SAS(在诱发痉挛后开始刺激)或无条件的 SAS(持续刺激)可中断诱发的痉挛。结果表明,有条件和无条件地应用 SAS 可抑制 SCI 患者的急性诱发痉挛。与对照痉挛相比,在使用 SAS 的急性痉挛期间,股四头肌肌电图曲线下面积的减少具有统计学意义。这些结果表明,SAS 可以提供一种安全、低成本的方法来减轻 SCI 患者的急性痉挛和痉挛。通过植入电极进行 SAS 治疗还可以为骶神经刺激装置提供额外的功能。
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引用次数: 0
Erratum: Validity of estimating center of pressure during walking and running with plantar load from a three-sensor wireless insole - ERRATUM. 勘误:利用三传感器无线鞋垫估算步行和跑步时足底压力中心的有效性 - ERRATUM。
Q2 Medicine Pub Date : 2024-03-21 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2023.22
Richard A Brindle, Chris M Bleakley, Jeffrey B Taylor, Robin M Queen, Kevin R Ford

[This corrects the article DOI: 10.1017/wtc.2022.5.].

[此处更正了文章 DOI:10.1017/wtc.2022.5]。
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引用次数: 0
A novel neck brace to characterize neck mobility impairments following neck dissection in head and neck cancer patients - ADDENDUM. 一种新型颈托,用于描述头颈部癌症患者颈部切除术后颈部活动障碍的特征 - 增补。
Q2 Medicine Pub Date : 2024-02-16 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2024.3
Biing-Chwen Chang, Haohan Zhang, Sallie Long, Adetokunbo Obayemi, Scott H Troob, Sunil K Agrawal
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引用次数: 0
Benchmarking commercially available soft and rigid passive back exoskeletons for an industrial workplace. 为工业工作场所的市售软质和硬质被动式背部外骨骼设定基准。
Q2 Medicine Pub Date : 2024-02-15 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2024.2
Mohamed I Mohamed Refai, Alejandro Moya-Esteban, Lynn van Zijl, Herman van der Kooij, Massimo Sartori

Low-back pain is a common occupational hazard for industrial workers. Several studies show the advantages of using rigid and soft back-support passive exoskeletons and exosuits (exos) to reduce the low-back loading and risk of injury. However, benefits of using these exos have been shown to be task-specific. Therefore, in this study, we developed a benchmarking approach to assess exos for an industrial workplace at Hankamp Gears B.V. We assessed two rigid (Laevo Flex, Paexo back) and two soft (Auxivo Liftsuit 1.0, and Darwing Hakobelude) exos for tasks resembling the workplace. We measured the assistive moment provided by each exo and their respective influence on muscle activity as well as the user's perception of comfort and exertion. Ten participants performed four lifting tasks (Static hold, Asymmetric, Squat, and Stoop), while their electromyography and subjective measures were collected. The two rigid exos provided the largest assistance during the Dynamic tasks. Reductions in erector spinae activity were seen to be task-specific, with larger reductions for the two rigid exos. Overall, Laevo Flex offered a good balance between assistive moments, reductions in muscle activity, as well as user comfort and reductions in perceived exertion. Thus, we recommend benchmarking exos for intended use in the industrial workplace. This will hopefully result in a better adoption of the back-support exoskeletons in the workplace and help reduce low-back pain.

腰痛是产业工人常见的职业危害。多项研究表明,使用硬质和软质背部支撑被动外骨骼和外骨骼防护服(exos)具有降低腰背负荷和受伤风险的优势。然而,使用这些外骨骼的好处已被证明是针对特定任务的。因此,在这项研究中,我们开发了一种基准方法,用于评估 Hankamp Gears B.V. 公司工业工作场所的外骨骼。我们评估了两款刚性(Laevo Flex、Paexo back)和两款软性(Auxivo Liftsuit 1.0 和 Darwing Hakobelude)外装在类似工作场所的任务中的使用情况。我们测量了每种外衣提供的辅助力矩、它们各自对肌肉活动的影响以及使用者对舒适度和用力的感知。十名参与者分别完成了四项移位任务(静态保持、不对称、下蹲和弯腰),同时收集了他们的肌电图和主观测量数据。在动态任务中,两个硬质外容器提供的帮助最大。竖脊肌活动的减少与具体任务有关,两种硬质外骨骼的减少幅度更大。总体而言,Laevo Flex 在辅助力矩、肌肉活动减少、用户舒适度和感知消耗减少之间实现了良好的平衡。因此,我们建议对工业工作场所中预期使用的外骨骼进行基准测试。这将有望使背部支撑外骨骼在工作场所得到更好的应用,并有助于减少腰背疼痛。
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引用次数: 0
Design of a wearable shoulder exoskeleton robot with dual-purpose gravity compensation and a compliant misalignment compensation mechanism. 设计具有两用重力补偿和顺应性错位补偿机制的可穿戴肩部外骨骼机器人。
IF 3.4 Q2 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-12 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2024.1
John Atkins, Dongjune Chang, Hyunglae Lee

This paper presents the design and validation of a wearable shoulder exoskeleton robot intended to serve as a platform for assistive controllers that can mitigate the risk of musculoskeletal disorders seen in workers. The design features a four-bar mechanism that moves the exoskeleton's center of mass from the upper shoulders to the user's torso, dual-purpose gravity compensation mechanism located inside the four-bar's linkages that supports the full gravitational loading from the exoskeleton with partial user's arm weight compensation, and a novel 6 degree-of-freedom (DoF) compliant misalignment compensation mechanism located between the end effector and the user's arm to allow shoulder translation while maintaining control of the arm's direction. Simulations show the four-bar design lowers the center of mass by  cm and the kinematic chain can follow the motion of common upper arm trajectories. Experimental tests show the gravity compensation mechanism compensates gravitational loading within  Nm over the range of shoulder motion and the misalignment compensation mechanism has the desired 6 DoF stiffness characteristics and range of motion to adjust for shoulder center translation. Finally, a workspace admittance controller was implemented and evaluated showing the system is capable of accurately reproducing simulated impedance behavior with transparent low-impedance human operation.

本文介绍了一种可穿戴肩部外骨骼机器人的设计和验证,该机器人旨在作为辅助控制器的平台,以降低工人患肌肉骨骼疾病的风险。该设计采用了四杆机制,将外骨骼的质心从肩部上部移至用户的躯干;位于四杆连杆内部的两用重力补偿机制可支持外骨骼的全部重力负荷,并对用户手臂的部分重量进行补偿;以及位于末端效应器和用户手臂之间的新型 6 自由度(DoF)顺应性错位补偿机制,允许肩部平移,同时保持对手臂方向的控制。模拟结果表明,四杆设计将质心降低了厘米,运动链可以跟随常见的上臂轨迹运动。实验测试表明,重力补偿机制可在肩部运动范围内补偿牛顿米以内的重力负荷,错位补偿机制具有所需的 6 DoF 刚度特性和运动范围,可调整肩部中心的平移。最后,对工作空间导纳控制器进行了实施和评估,结果表明该系统能够以透明的低阻抗人体操作准确再现模拟阻抗行为。
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引用次数: 0
Versatile and non-versatile occupational back-support exoskeletons: A comparison in laboratory and field studies - ADDENDUM. 多功能和非多功能职业性背部支撑外骨骼:实验室和实地研究比较 - 增补。
Q2 Medicine Pub Date : 2024-02-12 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2023.27
Tommaso Poliero, Matteo Sposito, Stefano Toxiri, Christian Di Natali, Matteo Iurato, Vittorio Sanguineti, Darwin G Caldwell, Jesús Ortiz
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引用次数: 0
The effect of transcutaneous spinal cord stimulation on the balance and neurophysiological characteristics of young healthy adults. 经皮脊髓刺激对年轻健康成年人的平衡和神经生理特征的影响。
Q2 Medicine Pub Date : 2024-02-08 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2023.24
Isirame Omofuma, Robert Carrera, Jayson King-Ori, Sunil K Agrawal

Transcutaneous spinal cord stimulation (TSCS) is gaining popularity as a noninvasive alternative to epidural stimulation. However, there is still much to learn about its effects and utility in assisting recovery of motor control. In this study, we applied TSCS to healthy subjects concurrently performing a functional training task to study its effects during a training intervention. We first carried out neurophysiological tests to characterize the H-reflex, H-reflex recovery, and posterior root muscle reflex thresholds, and then conducted balance tests, first without TSCS and then with TSCS. Balance tests included trunk perturbations in forward, backward, left, and right directions, and subjects' balance was characterized by their response to force perturbations. A balance training task involved the subjects playing a catch-and-throw game in virtual reality (VR) while receiving trunk perturbations and TSCS. Balance tests with and without TSCS were conducted after the VR training to measure subjects' post-training balance characteristics and then neurophysiological tests were carried out again. Statistical comparisons using t-tests between the balance and neurophysiological data collected before and after the VR training intervention found that the immediate effect of TSCS was to increase muscle activity during forward perturbations and to reduce balance performance in that direction. Muscle activity decreased after training and even more once TSCS was turned off. We thus observed an interaction of effects where TSCS increased muscle activity while the physical training decreased it.

经皮脊髓刺激(TSCS)作为硬膜外刺激的非侵入性替代疗法,越来越受到人们的欢迎。然而,关于经皮脊髓刺激在帮助恢复运动控制方面的效果和作用,我们还有很多需要了解的地方。在本研究中,我们将 TSCS 应用于同时进行功能训练任务的健康受试者,以研究其在训练干预期间的效果。我们首先进行了神经生理学测试,以确定 H 反射、H 反射恢复和后根肌肉反射阈值的特征,然后进行了平衡测试,首先是在不使用 TSCS 的情况下,然后是在使用 TSCS 的情况下。平衡测试包括向前、向后、向左和向右方向的躯干扰动,受试者对力扰动的反应表征了他们的平衡能力。平衡训练任务包括受试者在虚拟现实(VR)中玩接球投球游戏,同时接受躯干扰动和 TSCS。VR 训练结束后,受试者分别进行了有 TSCS 和无 TSCS 的平衡测试,以测量受试者训练后的平衡特性,然后再次进行神经电生理测试。使用 t 检验对 VR 训练干预前后收集的平衡和神经生理学数据进行统计比较后发现,TSCS 的直接效果是增加向前扰动时的肌肉活动,并降低该方向的平衡性能。肌肉活动在训练后会减少,一旦关闭 TSCS,减少的幅度更大。因此,我们观察到了一种相互作用的效应,即 TSCS 增加了肌肉活动,而物理训练则减少了肌肉活动。
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引用次数: 0
The efficacy of different torque profiles for weight compensation of the hand. 不同扭矩曲线对手部重量补偿的功效。
Q2 Medicine Pub Date : 2024-01-29 eCollection Date: 2024-01-01 DOI: 10.1017/wtc.2023.23
Bas J van der Burgh, Suzanne J Filius, Giuseppe Radaelli, Jaap Harlaar

Orthotic wrist supports will be beneficial for people with muscular weakness to keep their hand in a neutral rest position and prevent potential wrist contractures. Compensating the weight of the hands is complex since the level of support depends on both wrist and forearm orientations. To explore simplified approaches, two different weight compensation strategies (constant and linear) were compared to the theoretical ideal sinusoidal profile and no compensation in eight healthy subjects using a mechanical wrist support system. All three compensation strategies showed a significant reduction of 47-53% surface electromyography activity in the anti-gravity m. extensor carpi radialis. However, for the higher palmar flexion region, a significant increase of 44-61% in the m. flexor carpi radialis was found for all compensation strategies. No significant differences were observed between the various compensation strategies. Two conclusions can be drawn: (1) a simplified torque profile (e.g., constant or linear) for weight compensation can be considered as equally effective as the theoretically ideal sinusoidal profile and (2) even the theoretically ideal profile provides no perfect support as other factors than weight, such as passive joint impedance, most likely influence the required compensation torque for the wrist joint.

矫形腕托有利于肌肉无力者将手保持在中性休息位置,防止潜在的腕部挛缩。手部的重量补偿非常复杂,因为支撑水平取决于手腕和前臂的方向。为了探索简化的方法,我们使用机械腕部支撑系统,将两种不同的重量补偿策略(恒定和线性)与理论上的理想正弦曲线和无补偿进行了比较。所有三种补偿策略都显示,反重力腕伸肌的表面肌电活动明显减少了 47-53%。然而,在较高的掌屈区域,所有补偿策略都发现腕屈肌的表面肌电活动显著增加了 44-61%。各种补偿策略之间没有明显差异。可以得出两个结论:(1)用于体重补偿的简化扭矩曲线(如恒定或线性)与理论上理想的正弦曲线同样有效;(2)即使是理论上理想的曲线也不能提供完美的支持,因为除体重外的其他因素(如被动关节阻抗)很可能会影响腕关节所需的补偿扭矩。
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引用次数: 0
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Wearable technologies
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