Hybrid wheelchair controller for handicapped and quadriplegic patients

In this dissertation, a hybrid wheelchair controller for handicapped and quadriplegic patient is proposed. The system has two sub-controllers which are the voice controller and the head tilt controller. The system aims to help quadriplegic, handicapped, elderly and paralyzed patients to control a robotic wheelchair using voice commands and head movements instead of a traditional joystick controller. The multi-input design makes the system more flexible to adapt to the available body signals. The low-cost design is taken into consideration as it allows more patients to use this system

TOWARDS MONITORING WHEELCHAIR PROPULSION IN NATURAL ENVIRONMENT USING WEARABLE SENSORS

Due to lower limb paralysis, individuals with spinal cord injury (SCI) rely on their upper limbs for activities of daily living (ADLs) and wheelchair propulsion (WP). Previous research has found that specific biomechanical parameters of WP are associated with risk of UE pain and injury. However, the repetitiveness and quality of upper limb movements during WP are unclear. Recently, wearable sensors have been used to collect mobility characteristics of wheelchair users, but little research has looked into using them to monitor the quality of UE movements for WP in the natural environment. The purpose of this thesis was to develop and evaluate a WP monitoring device that can monitor wheelchair users’ activities, and propulsion parameters in the natural environment. This thesis is organized into three studies. The first study aims to develop activity classifiers that can distinguish WP episodes from a range of ADLs. Two classifying models were built using a Machine Learning (ML) technique. The model that yielded the highest accuracy showed an overall accuracy of 88.0%. Time spent on each activity was estimated based on the classifiers, and compared with the video observation. Percentage of difference between the criterion and estimated time ranged from 2.2% to 11.6%. The second study aims to estimate temporal parameters of WP, including the stroke number (SN) and push frequency (PF), using wearable sensors. The estimated SN and PF were compared with the criterion measures using the mean absolute errors (MAE) and mean absolute percentage of error (MAPE). Intraclass Correlation Coefficients were calculated to assess the agreement. The accelerometer placed on the upper arm yielded the highest accuracy with the MAPE of 8.0% for SN and 12.9% for PF. The third study aims to estimate wheelchair propulsion forces. Propulsion forces were estimated from the accelerometer placed on the upper arm using a bagging regression technique. The estimated forces were compared with the criterion. Mean absolute errors (MAE), mean absolute percentage of error (MAPE), were calculated. The results showed an overall MAPE of 17.9%. Intraclass Correlation Coefficients and Bland-Altman plots were used to assess the agreement between the criterion and the estimated force

Physical Activity Monitoring System for Manual Wheelchair Users

People with disabilities who rely on manual wheelchairs as their primary means of mobility face daily challenges such as mobility limitations and environmental barriers when engaging in regular physical activity. Therefore, our research addressed the need for a valid and reliable physical activity monitor to assess and quantify physical activities among manual wheelchair users (MWUs) in free-living environments. Providing an accurate estimate of physical activity (PA) levels in MWUs can assist researchers and clinicians to quantify day-to-day PA levels, leading to recommendations for a healthier lifestyle. In the first stage we developed and evaluated new classification and EE estimation models for MWUs with spinal cord injury (N=45) using SenseWear, an off-the-shelf activity monitor, designed for the general population without disabilities. The results suggested that SenseWear can be used by researchers and clinicians to detect and estimate the EE for four activities tested in our study. The second phase of our research project developed an activity monitor especially designed for MWUs. Previous research in community participation of MWUs and the studies discussed above found that wheelchair mobility characteristics are necessary to study PA patterns in MWUs. This requirement led us to develop and evaluate a Physical Activity Monitor System (PAMS) composed of two components: a gyroscope based wheel rotation monitor (G-WRM for tracking wheelchair mobility and an accelerometer that quantifies upper arm movement. We tested PAMS in 45 MWUs with SCI in the structured (laboratory) and semi-structured environments (National Veterans Wheelchair Gamers 2012). In addition, we also tested a subsection of this population (N=20) a second time, in their home environments. The PAs were classified as resting, armergometry, other sedentary activities, activities involving some wheelchair movement, propulsion, basketball and caretaker pushing. The EE estimation results (error: -9.8%) and the classification results (accuracy: 89.3%) indicate that PAMS can reliably track wheelchair-based activities in laboratory and home environments. Furthermore, we used participatory action design to evaluate the usability of PAMS in six MWUs with SCI. The usability study indicated that users were very satisfied with PAMS and the information provided by the smartphone to the users about their PA levels

Design and Development of Biofeedback Stick Technology (BfT) to Improve the Quality of Life of Walking Stick Users

Biomedical engineering has seen a rapid growth in recent times, where the aim to facilitate and equip humans with the latest technology has become widespread globally. From high-tech equipment ranging from CT scanners, MRI equipment, and laser treatments, to the design, creation, and implementation of artificial body parts, the field of biomedical engineering has significantly contributed to mankind. Biomedical engineering has facilitated many of the latest developments surrounding human mobility, with advancement in mobility aids improving human movement for people with compromised mobility either caused by an injury or health condition. A review of the literature indicated that mobility aids, especially walking sticks, and appropriate training for their use, are generally prescribed by allied health professionals (AHP) to walking stick users for rehabilitation and activities of daily living (ADL). However, feedback from AHP is limited to the clinical environment, leaving walking stick users vulnerable to falls and injuries due to incorrect usage. Hence, to mitigate the risk of falls and injuries, and to facilitate a routine appraisal of individual patient’s usage, a simple, portable, robust, and reliable tool was developed which provides the walking stick users with real-time feedback upon incorrect usage during their activities of daily living (ADL). This thesis aimed to design and develop a smart walking stick technology: Biofeedback stick technology (BfT). The design incorporates the approach of patient and public involvement (PPI) in the development of BfT to ensure that BfT was developed as per the requirements of walking stick users and AHP recommendations. The newly developed system was tested quantitatively for; validity, reliability, and reproducibility against gold standard equipment such as the 3D motion capture system, force plates, optical measurement system for orientation, weight bearing, and step count. The system was also tested qualitatively for its usability by conducting semi-informal interviews with AHPs and walking stick users. The results of these studies showed that the newly developed system has good accuracy, reported above 95% with a maximum inaccuracy of 1°. The data reported indicates good reproducibility. The angles, weight, and steps recorded by the system during experiments are within the values published in the literature. From these studies, it was concluded that, BfT has the potential to improve the lives of walking stick users and that, with few additional improvements, appropriate approval from relevant regulatory bodies, and robust clinical testing, the technology has a huge potential to carve its way to a commercial market

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Instrumentation and validation of a robotic cane for transportation and fall prevention in patients with affected mobility

Dissertação de mestrado integrado em Engenharia Física, (especialização em Dispositivos, Microssistemas e Nanotecnologias)O ato de andar é conhecido por ser a forma primitiva de locomoção do ser humano, sendo que este traz muitos benefícios que motivam um estilo de vida saudável e ativo. No entanto, há condições de saúde que dificultam a realização da marcha, o que por consequência pode resultar num agravamento da saúde, e adicionalmente, levar a um maior risco de quedas. Nesse sentido, o desenvolvimento de um sistema de deteção e prevenção de quedas, integrado num dispositivo auxiliar de marcha, seria essencial para reduzir estes eventos de quedas e melhorar a qualidade de vida das pessoas. Para ultrapassar estas necessidades e limitações, esta dissertação tem como objetivo validar e instrumentar uma bengala robótica, denominada Anti-fall Robotic Cane (ARCane), concebida para incorporar um sistema de deteção de quedas e um mecanismo de atuação que possibilite a prevenção de quedas, ao mesmo tempo que assiste a marcha. Para esse fim, foi realizada uma revisão do estado da arte em bengalas robóticas para adquirir um conhecimento amplo e aprofundado dos componentes, mecanismos e estratégias utilizadas, bem como os protocolos experimentais, principais resultados, limitações e desafios em dispositivos existentes. Numa primeira fase, foi estipulado o objetivo de: (i) adaptar a missão do produto; (ii) estudar as necessidades do consumidor; e (iii) atualizar as especificações alvo da ARCane, continuação do trabalho de equipa, para obter um produto com design e engenharia compatível com o mercado. Foi depois estabelecida a arquitetura de hardware e discutidos os componentes a ser instrumentados na ARCane. Em seguida foram realizados testes de interoperabilidade a fim de validar o funcionamento singular e coletivo dos componentes. Relativamente ao controlo de movimento, foi desenvolvido um sistema inovador, de baixo custo e intuitivo, capaz de detetar a intenção do movimento e de reconhecer as fases da marcha do utilizador. Esta implementação foi validada com seis voluntários saudáveis que realizaram testes de marcha com a ARCane para testar sua operabilidade num ambiente de contexto real. Obteve-se uma precisão de 97% e de 90% em relação à deteção da intenção de movimento e ao reconhecimento da fase da marcha do utilizador. Por fim, foi projetado um método de deteção de quedas e mecanismo de prevenção de quedas para futura implementação na ARCane. Foi ainda proposta uma melhoria do método de deteção de quedas, de modo a superar as limitações associadas, bem como a proposta de dispositivos de deteção a serem implementados na ARCane para obter um sistema completo de deteção de quedas.The act of walking is known to be the primitive form of the human being, and it brings many benefits that motivate a healthy and active lifestyle. However, there are health conditions that make walking difficult, which, consequently, can result in worse health and, in addition, lead to a greater risk of falls. Thus, the development of a fall detection and prevention system integrated with a walking aid would be essential to reduce these fall events and improve people quality of life. To overcome these needs and limitations, this dissertation aims to validate and instrument a cane-type robot, called Anti-fall Robotic Cane (ARCane), designed to incorporate a fall detection system and an actuation mechanism that allow the prevention of falls, while assisting the gait. Therefore, a State-of-the-Art review concerning robotic canes was carried out to acquire a broad and in-depth knowledge of the used components, mechanisms and strategies, as well as the experimental protocols, main results, limitations and challenges on existing devices. On a first stage, it was set an objective to (i) enhance the product's mission statement; (ii) study the consumer needs; and (iii) update the target specifications of the ARCane, extending teamwork, to obtain a product with a market-compatible design and engineering that meets the needs and desires of the ARCane users. It was then established the hardware architecture of the ARCane and discussed the electronic components that will instrument the control, sensory, actuator and power units, being afterwards subjected to interoperability tests to validate the singular and collective functioning of cane components altogether. Regarding the motion control of robotic canes, an innovative, cost-effective and intuitive motion control system was developed, providing user movement intention recognition, and identification of the user's gait phases. This implementation was validated with six healthy volunteers who carried out gait trials with the ARCane, in order to test its operability in a real context environment. An accuracy of 97% was achieved for user motion intention recognition and 90% for user gait phase recognition, using the proposed motion control system. Finally, it was idealized a fall detection method and fall prevention mechanism for a future implementation in the ARCane, based on methods applied to robotic canes in the literature. It was also proposed an improvement of the fall detection method in order to overcome its associated limitations, as well as detection devices to be implemented into the ARCane to achieve a complete fall detection system

Advanced Augmentative and Alternative Communication System Based in Physiological Control

Dyskinetic Cerebral Palsy (DCP) is mainly characterized by alterations in muscle tone and involuntary movements. Therefore, these people present with difficulties in coordination and movement control, which makes walking difficult and affects their posture when seated. Additionally, their cognitive performance varies between being completely normal and severe mental retardation. People with DCP were selected as the objective of this thesis due to their multiple and complex limitations (speech problems and motor control) and because their capabilities have a great margin for improvement thanks to physiological control systems. Given their communication difficulties, some people with DCP have good motor con-trol and can communicate with written language. However, most have difficulty using Augmentative and Alternative Communication (AAC) systems. People with DCP gen-erally use concept boards to indicate the idea they want to communicate. However, most communication solutions available today are based on proprietary software that makes it difficult to customize the concept board and this type of control system. This is the motivation behind this thesis, with the aim of creating an interface with characteristics, able to be adapted to the user needs and limitations. Thus, this thesis proposes an Augmentative and Alternative Communication System for people with DCP based on physiological control. In addition, an innovative system for direct con-trol of concept boards with EMG is proposed. This control system is based on a physi-cal model that reproduces the muscular mechanical response (stiffness, inertia and viscosity). It allows for a selection of elements thanks to small pulses of EMG signal with sensors on a muscle with motor control. Its main advantage is the possibility of correcting errors during selection associated with uncontrolled muscle impulses, avoid-ing sustained muscle effort and thus reduced fatigue.La Parálisis Cerebral de tipo Discinésica (DCP) se caracteriza principalmente por las alteraciones del tono muscular y los movimientos involuntarios. Por ello, estos pacientes presentan dificultades en la coordinación y en el control de movimientos, lo cual les dificulta el caminar y afecta su postura cuando están sentados. Cabe resaltar que la capacidad cognitiva de las personas con DCP puede variar desde completamente normal, hasta un retraso mental severo. Las personas con DCP han sido seleccionadas como objetivo de esta tesis ya el margen de mejora de sus capacidades es amplio gracias a sistemas de control fisiológico, debido a sus múltiples y complejas limitaciones (problemas de habla y control motor). Debido a sus dificultades de comunicación, algunas personas con DCP se pueden comunicar con lenguaje escrito, siempre y cuando tenga un buen control motor. Sin embargo, la mayoría tienen dificultades para usar sistemas de Comunicación Aumentativos y Alternativos (AAC). De hecho, las personas con DCP utilizan generalmente tableros de conceptos para indicar la idea que quieren transmitir. Sin embargo, la mayoría las soluciones de comunicación disponibles en la actualidad están basadas en software propietario que hacen difícil la personalización del tablero de conceptos y el tipo de sistema de control. Es aquí donde surge esta tesis, con el objetivo de crear una interfaz con esas características, capaz de adaptarse a las necesidades y limitaciones del usuario. De esta forma, esta tesis propone un sistema de comunicación aumentativo y alternativo para personas con DCP basado en control fisiológico. Además, se propone un Sistema innovador de control directo sobre tableros de conceptos basado en EMG. Este Sistema de control se basa en un modelo físico que reproduce la respuesta mecánica muscular (basado en parámetros como Rigidez, Inercia y Viscosidad), permitiendo la selección de elementos gracias a pequeños pulsos de señal EMG con sensores sobre un músculo con control motor. Sus principales ventajas son la posibilidad de corregir errores durante la selección asociado a los impulsos musculares no controlados, evitar el esfuerzo muscular mantenido para alcanzar un nivel y reducir la fatiga.La Paràlisi Cerebral de tipus Discinèsica (DCP) es caracteritza principalment per les alteracions del to muscular i els moviments involuntaris. Per açò, aquests pacients presenten dificultats en la coordinació i en el control de moviments, la qual cosa els dificulta el caminar i afecta la seua postura quan estan asseguts. Cal ressaltar que la capacitat cognitiva de les persones amb DCP pot variar des de completament normal, fins a un retard mental sever. Les persones amb DCP han sigut seleccionades com a objectiu d'aquesta tesi ja el marge de millora de les seues capacitats és ampli gràcies a sistemes de control fisiològic, a causa dels seus múltiples i complexes limitacions (problemes de parla i control motor). A causa de les seues dificultats de comunicació, algunes persones amb DCP es poden comunicar amb llenguatge escrit, sempre que tinga un bon control motor. No obstant açò, la majoria tenen dificultats per a usar sistemes de Comunicació Augmentatius i Alternatius (AAC). De fet, les persones amb DCP utilitzen generalment taulers de conceptes per a indicar la idea que volen transmetre. No obstant açò, la majoria les solucions de comunicació disponibles en l'actualitat estan basades en programari propietari que fan difícil la personalització del tauler de conceptes i el tipus de sistema de control. És ací on sorgeix aquesta tesi, amb l'objectiu de crear una interfície amb aqueixes característiques, capaç d'adaptar-se a les necessitats i limitacions de l'usuari. D'aquesta forma, aquesta tesi proposa un sistema de comunicació augmentatiu i alternatiu per a persones amb DCP basat en control fisiològic. A més, es proposa un sistema innovador de control directe sobre taulers de conceptes basat en EMG. Aquest sistema de control es basa en un model físic que reprodueix la resposta mecànica muscular (basat en paràmetres com a Rigidesa, Inèrcia i Viscositat), permetent la selecció d'elements gràcies a xicotets polsos de senyal EMG amb sensors sobre un múscul amb control motor. Els seus principals avantatges són la possibilitat de corregir errors durant la selecció associat als impulsos musculars no controlats, evitar l'esforç muscular mantingut per a aconseguir un nivell i reduir la fatiga.Díaz Pineda, JA. (2017). Advanced Augmentative and Alternative Communication System Based in Physiological Control [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/90418TESI

Applications of the electric potential sensor for healthcare and assistive technologies

The work discussed in this thesis explores the possibility of employing the Electric Potential Sensor for use in healthcare and assistive technology applications with the same and in some cases better degrees of accuracy than those of conventional technologies. The Electric Potential Sensor is a generic and versatile sensing technology capable of working in both contact and non-contact (remote) modes. New versions of the active sensor were developed for specific surface electrophysiological signal measurements. The requirements in terms of frequency range, electrode size and gain varied with the type of signal measured for each application. Real-time applications based on electrooculography, electroretinography and electromyography are discussed, as well as an application based on human movement. A three sensor electrooculography eye tracking system was developed which is of interest to eye controlled assistive technologies. The system described achieved an accuracy at least as good as conventional wet gel electrodes for both horizontal and vertical eye movements. Surface recording of the electroretinogram, used to monitor eye health and diagnose degenerative diseases of the retina, was achieved and correlated with both corneal fibre and wet gel surface electrodes. The main signal components of electromyography lie in a higher bandwidth and surface signals of the deltoid muscle were recorded over the course of rehabilitation of a subject with an injured arm. Surface electromyography signals of the bicep were also recorded and correlated with the joint dynamics of the elbow. A related non-contact application of interest to assistive technologies was also developed. Hand movement within a defined area was mapped and used to control a mouse cursor and a predictive text interface