Biosignal‐based human–machine interfaces for assistance and rehabilitation : a survey

As a definition, Human–Machine Interface (HMI) enables a person to interact with a device. Starting from elementary equipment, the recent development of novel techniques and unobtrusive devices for biosignals monitoring paved the way for a new class of HMIs, which take such biosignals as inputs to control various applications. The current survey aims to review the large literature of the last two decades regarding biosignal‐based HMIs for assistance and rehabilitation to outline state‐of‐the‐art and identify emerging technologies and potential future research trends. PubMed and other databases were surveyed by using specific keywords. The found studies were further screened in three levels (title, abstract, full‐text), and eventually, 144 journal papers and 37 conference papers were included. Four macrocategories were considered to classify the different biosignals used for HMI control: biopotential, muscle mechanical motion, body motion, and their combinations (hybrid systems). The HMIs were also classified according to their target application by considering six categories: prosthetic control, robotic control, virtual reality control, gesture recognition, communication, and smart environment control. An ever‐growing number of publications has been observed over the last years. Most of the studies (about 67%) pertain to the assistive field, while 20% relate to rehabilitation and 13% to assistance and rehabilitation. A moderate increase can be observed in studies focusing on robotic control, prosthetic control, and gesture recognition in the last decade. In contrast, studies on the other targets experienced only a small increase. Biopotentials are no longer the leading control signals, and the use of muscle mechanical motion signals has experienced a considerable rise, especially in prosthetic control. Hybrid technologies are promising, as they could lead to higher performances. However, they also increase HMIs’ complex-ity, so their usefulness should be carefully evaluated for the specific application

Empowering and assisting natural human mobility: The simbiosis walker

This paper presents the complete development of the Simbiosis Smart Walker. The device is equipped with a set of sensor subsystems to acquire user-machine interaction forces and the temporal evolution of user's feet during gait. The authors present an adaptive filtering technique used for the identification and separation of different components found on the human-machine interaction forces. This technique allowed isolating the components related with the navigational commands and developing a Fuzzy logic controller to guide the device. The Smart Walker was clinically validated at the Spinal Cord Injury Hospital of Toledo - Spain, presenting great acceptability by spinal chord injury patients and clinical staf

Brain-Computer Interfacing for Wheelchair Control by Detecting Voluntary Eye Blinks

The human brain is considered as one of the most powerful quantum computers and combining the human brain with technology can even outperform artificial intelligence. Using a Brain-Computer Interface (BCI) system, the brain signals can be analyzed and programmed for specific tasks. This research work employs BCI technology for a medical application that gives the unfortunate paralyzed individuals the capability to interact with their surroundings solely using voluntary eye blinks. This research contributes to the existing technology to be more feasible by introducing a modular design with three physically separated components: a headwear, a computer, and a wheelchair. As the signal-to-noise ratio (SNR) of the existing systems is too high to separate the eye blink artifacts from the regular EEG signal, a precise ThinkGear module is used which acquired the raw EEG signal through a single dry electrode. This chip offers an advanced filtering technology that has a high noise immunity along with an embedded Bluetooth module using which the acquired signal is transferred wirelessly to a computer. A MATLAB program captures voluntary eye blink artifacts from the brain waves and commands the movement of a miniature wheelchair via Bluetooth. To distinguish voluntary eye blinks from involuntary eye blinks, blink strength thresholds are determined. A Graphical User Interface (GUI) designed in MATLAB displays the EEG waves in real-time and enables the user to determine the movements of the wheelchair which is specially designed to take commands from the GUI.  The findings from the testing phase unveil the advantages of a modular design and the efficacy of using eye blink artifacts as the control element for brain-controlled wheelchairs. The work presented here gives a basic understanding of the functionality of a BCI system, and provides eye blink-controlled navigation of a wheelchair for patients suffering from severe paralysis

A wireless sEMG-based body-machine interface for assistive technology devices

Assistive technology (AT) tools and appliances are being more and more widely used and developed worldwide to improve the autonomy of people living with disabilities and ease the interaction with their environment. This paper describes an intuitive and wireless surface electromyography (sEMG) based body-machine interface for AT tools. Spinal cord injuries at C5-C8 levels affect patients' arms, forearms, hands, and fingers control. Thus, using classical AT control interfaces (keypads, joysticks, etc.) is often difficult or impossible. The proposed system reads the AT users' residual functional capacities through their sEMG activity, and converts them into appropriate commands using a threshold-based control algorithm. It has proven to be suitable as a control alternative for assistive devices and has been tested with the JACO arm, an articulated assistive device of which the vocation is to help people living with upper-body disabilities in their daily life activities. The wireless prototype, the architecture of which is based on a 3-channel sEMG measurement system and a 915-MHz wireless transceiver built around a low-power microcontroller, uses low-cost off-the-shelf commercial components. The embedded controller is compared with JACO's regular joystick-based interface, using combinations of forearm, pectoral, masseter, and trapeze muscles. The measured index of performance values is 0.88, 0.51, and 0.41 bits/s, respectively, for correlation coefficients with the Fitt's model of 0.75, 0.85, and 0.67. These results demonstrate that the proposed controller offers an attractive alternative to conventional interfaces, such as joystick devices, for upper-body disabled people using ATs such as JACO

Applications of Brain Computer Interface in Present Healthcare Setting

Brain-computer interface (BCI) is an innovative method of integrating technology for healthcare. Utilizing BCI technology allows for direct communication and/or control between the brain and an external device, thereby displacing conventional neuromuscular pathways. The primary goal of BCI in healthcare is to repair or reinstate useful function to people who have impairments caused by neuromuscular disorders (e.g., stroke, amyotrophic lateral sclerosis, spinal cord injury, or cerebral palsy). BCI brings with it technical and usability flaws in addition to its benefits. We present an overview of BCI in this chapter, followed by its applications in the medical sector in diagnosis, rehabilitation, and assistive technology. We also discuss BCI’s strengths and limitations, as well as its future direction

Upper-limb Kinematic Analysis and Artificial Intelligent Techniques for Neurorehabilitation and Assistive Environments

Stroke, one of the leading causes of death and disability around the world, usually affects the motor cortex causing weakness or paralysis in the limbs of one side of the body. Research efforts in neurorehabilitation technology have focused on the development of robotic devices to restore motor and cognitive function in impaired individuals, having the potential to deliver high-intensity and motivating therapy. End-effector-based devices have become an usual tool in the upper- limb neurorehabilitation due to the ease of adapting to patients. However, they are unable to measure the joint movements during the exercise. Thus, the first part of this thesis is focused on the development of a kinematic reconstruction algorithm that can be used in a real rehabilitation environment, without disturbing the normal patient-clinician interaction. On the basis of the algorithm found in the literature that presents some instabilities, a new algorithm is developed. The proposed algorithm is the first one able to online estimate not only the upper-limb joints, but also the trunk compensation using only two non-invasive wearable devices, placed onto the shoulder and upper arm of the patient. This new tool will allow the therapist to perform a comprehensive assessment combining the range of movement with clinical assessment scales. Knowing that the intensity of the therapy improves the outcomes of neurorehabilitation, a ‘self-managed’ rehabilitation system can allow the patients to continue the rehabilitation at home. This thesis proposes a system to online measure a set of upper-limb rehabilitation gestures, and intelligently evaluates the quality of the exercise performed by the patients. The assessment is performed through the study of the performed movement as a whole as well as evaluating each joint independently. The first results are promising and suggest that this system can became a a new tool to complement the clinical therapy at home and improve the rehabilitation outcomes. Finally, severe motor condition can remain after rehabilitation process. Thus, a technology solution for these patients and people with severe motor disabilities is proposed. An intelligent environmental control interface is developed with the ability to adapt its scan control to the residual capabilities of the user. Furthermore, the system estimates the intention of the user from the environmental information and the behavior of the user, helping in the navigation through the interface, improving its independence at home.El accidente cerebrovascular o ictus es una de las causas principales de muerte y discapacidad a nivel mundial. Normalmente afecta a la corteza motora causando debilidad o parálisis en las articulaciones del mismo lado del cuerpo. Los esfuerzos de investigación dentro de la tecnología de neurorehabilitación se han centrado en el desarrollo de dispositivos robóticos para restaurar las funciones motoras y cognitivas en las personas con esta discapacidad, teniendo un gran potencial para ofrecer una terapia de alta intensidad y motivadora. Los dispositivos basados en efector final se han convertido en una herramienta habitual en la neurorehabilitación de miembro superior ya que es muy sencillo adaptarlo a los pacientes. Sin embargo, éstos no son capaces de medir los movimientos articulares durante la realización del ejercicio. Por tanto, la primera parte de esta tesis se centra en el desarrollo de un algoritmo de reconstrucción cinemática que pueda ser usado en un entorno de rehabilitación real, sin perjudicar a la interacción normal entre el paciente y el clínico. Partiendo de la base que propone el algoritmo encontrado en la literatura, el cual presenta algunas inestabilidades, se ha desarrollado un nuevo algoritmo. El algoritmo propuesto es el primero capaz de estimar en tiempo real no sólo las articulaciones del miembro superior, sino también la compensación del tronco usando solamente dos dispositivos no invasivos y portátiles, colocados sobre el hombro y el brazo del paciente. Esta nueva herramienta permite al terapeuta realizar una valoración más exhaustiva combinando el rango de movimiento con las escalas de valoración clínicas. Sabiendo que la intensidad de la terapia mejora los resultados de la recuperación del ictus, un sistema de rehabilitación ‘auto-gestionado’ permite a los pacientes continuar con la rehabilitación en casa. Esta tesis propone un sistema para medir en tiempo real un conjunto de gestos de miembro superior y evaluar de manera inteligente la calidad del ejercicio realizado por el paciente. La valoración se hace a través del estudio del movimiento ejecutado en su conjunto, así como evaluando cada articulación independientemente. Los primeros resultados son prometedores y apuntan a que este sistema puede convertirse en una nueva herramienta para complementar la terapia clínica en casa y mejorar los resultados de la rehabilitación. Finalmente, después del proceso de rehabilitación pueden quedar secuelas motoras graves. Por este motivo, se propone una solución tecnológica para estas personas y para personas con discapacidades motoras severas. Así, se ha desarrollado una interfaz de control de entorno inteligente capaz de adaptar su control a las capacidades residuales del usuario. Además, el sistema estima la intención del usuario a partir de la información del entorno y el comportamiento del usuario, ayudando en la navegación a través de la interfaz, mejorando su independencia en el hogar

Development of a new robust hybrid automata algorithm based on surface electromyography (SEMG) signal for instrumented wheelchair control

Instrumented wheelchair operates based on surface electromyography (sEMG) is one of alternative to assist impairment person for mobility. SEMG is chosen due to good in accuracy and easier preparation to place the electrodes. Motor neuron transmit electrical potential to muscle fibre to perform isometric, concentric or eccentric contraction. These electrical changes that is called Motor Unit Action Potential (MUAP) can be acquired and amplified by electrodes located on targeted muscles changes can be recorded and analysed using sEMG devices. But, sEMG device cost up to USD 2,100 for a sEMG data acquisition device that available on market is one of the drawback to be used by impairment person that most of them has financial problem due to unable to work like before. In addition, it is a closed source system that cannot be modified to improve the accuracy and adding more features. Open source system such as Arduino has limitation of specifications that makes able to apply nonpattern recognition control methods which is simpler and easier compared to pattern recognition. However, classification accuracy is lower than pattern recognition and it cannot be applied to higher number participants from different background and gender. This research aims are to develop an open-source Arduino based sEMG data acquisition device by formulating hybrid automata algorithm to differentiate MUAP activity during wheelchair propulsion. Addition of hybrid automata algorithm to run pattern and non-pattern recognition based control methods is an advantage to increase accuracy in differentiating forward stroke or hand return activity. Electrodes are placed on Biceps (BIC), Triceps (TRI), Extensor (EXT), Flexor (FIX) and MUAP activity recorded for 30 healthy persons. Then, experiment result was validated with simulation result using OpenSim biomedical modelling software. Mean, standard deviation (SD), confidence interval (CI) and maximum point different (MPD) of MUAP were calculated and to be used as thresholds for non-pattern recognition control method in method selection experiment. Meanwhile, pattern recognition is using Probability Density Function (PDF) to determine MUAP according to type of activities. Total of ten control methods determined from population and individual data were tested against another 10 healthy persons to evaluate the algorithm performance. Assessment of each control method done by misclassification matrix looking at True Positive (TP) and False Negative (FN) of power assist system activation period. Developed sEMG data acquisition device that is operated by Arduino MEGA 2560 and Myoware muscle sensors with sampling rate of above 400Hz successfully recorded MUAP from four arm muscles. Furthermore, 2.5 ms of average data latency for device to record, analyse, validate and creating commands to activate the power assist system. Data obtained from the device shows that most active muscle during wheelchair propulsion is TRI, followed by BIC and matched to OpenSim simulation result. In method selection experiment, 96.28% of average accuracy was achieved and different control methods were selected by misclassification matrix for each of persons. This method would be a control method to activate power assist system and selected based on conditions set in the algorithm. These findings indicated that open source Arduino board is capable of running real time pattern, non-pattern recognition based control methods by producing classification accuracy up to 99.48% even though it is known as just a microcontroller that has limitation to run complex classifiers. At the same time, a device that cost less than USD200 has 400Hz of sampling rate is as good as closed source device that is come with expensive price tag to own it. Based on algorithm evaluation, it shows that one control method couldn’t fit to all persons as per proven in method selection experiment. Different person has different control method that suit them the most. Lastly, BIC and TRI can be reference muscles to activate assistive device in instrumented wheelchair that is using propulsion as indication