Distributed Sensing and Stimulation Systems Towards Sense of Touch Restoration in Prosthetics

Modern prostheses aim at restoring the functional and aesthetic characteristics of the lost limb. To foster prosthesis embodiment and functionality, it is necessary to restitute both volitional control and sensory feedback. Contemporary feedback interfaces presented in research use few sensors and stimulation units to feedback at most two discrete feedback variables (e.g. grasping force and aperture), whereas the human sense of touch relies on a distributed network of mechanoreceptors providing high-fidelity spatial information. To provide this type of feedback in prosthetics, it is necessary to sense tactile information from artificial skin placed on the prosthesis and transmit tactile feedback above the amputation in order to map the interaction between the prosthesis and the environment. This thesis proposes the integration of distributed sensing systems (e-skin) to acquire tactile sensation, and non-invasive multichannel electrotactile feedback and virtual reality to deliver high-bandwidth information to the user. Its core focus addresses the development and testing of close-loop sensory feedback human-machine interface, based on the latest distributed sensing and stimulation techniques for restoring the sense of touch in prosthetics. To this end, the thesis is comprised of two introductory chapters that describe the state of art in the field, the objectives and the used methodology and contributions; as well as three studies distributed over stimulation system level and sensing system level. The first study presents the development of close-loop compensatory tracking system to evaluate the usability and effectiveness of electrotactile sensory feedback in enabling real-time close-loop control in prosthetics. It examines and compares the subject\u2019s adaptive performance and tolerance to random latencies while performing the dynamic control task (i.e. position control) and simultaneously receiving either visual feedback or electrotactile feedback for communicating the momentary tracking error. Moreover, it reported the minimum time delay needed for an abrupt impairment of users\u2019 performance. The experimental results have shown that electrotactile feedback performance is less prone to changes with longer delays. However, visual feedback drops faster than electrotactile with increased time delays. This is a good indication for the effectiveness of electrotactile feedback in enabling close- loop control in prosthetics, since some delays are inevitable. The second study describes the development of a novel non-invasive compact multichannel interface for electrotactile feedback, containing 24 pads electrode matrix, with fully programmable stimulation unit, that investigates the ability of able-bodied human subjects to localize the electrotactile stimulus delivered through the electrode matrix. Furthermore, it designed a novel dual parameter -modulation (interleaved frequency and intensity) and compared it to conventional stimulation (same frequency for all pads). In addition and for the first time, it compared the electrotactile stimulation to mechanical stimulation. More, it exposes the integration of virtual prosthesis with the developed system in order to achieve better user experience and object manipulation through mapping the acquired real-time collected tactile data and feedback it simultaneously to the user. The experimental results demonstrated that the proposed interleaved coding substantially improved the spatial localization compared to same-frequency stimulation. Furthermore, it showed that same-frequency stimulation was equivalent to mechanical stimulation, whereas the performance with dual-parameter modulation was significantly better. The third study presents the realization of a novel, flexible, screen- printed e-skin based on P(VDF-TrFE) piezoelectric polymers, that would cover the fingertips and the palm of the prosthetic hand (particularly the Michelangelo hand by Ottobock) and an assistive sensorized glove for stroke patients. Moreover, it developed a new validation methodology to examine the sensors behavior while being solicited. The characterization results showed compatibility between the expected (modeled) behavior of the electrical response of each sensor to measured mechanical (normal) force at the skin surface, which in turn proved the combination of both fabrication and assembly processes was successful. This paves the way to define a practical, simplified and reproducible characterization protocol for e-skin patches In conclusion, by adopting innovative methodologies in sensing and stimulation systems, this thesis advances the overall development of close-loop sensory feedback human-machine interface used for restoration of sense of touch in prosthetics. Moreover, this research could lead to high-bandwidth high-fidelity transmission of tactile information for modern dexterous prostheses that could ameliorate the end user experience and facilitate it acceptance in the daily life

Multiple timescales in postural dynamics associated with vision and a secondary task are revealed by wavelet analysis

Discrete wavelet analysis is used to resolve the center of pressure time series data into several timescale components, providing new insights into postural control. Healthy young and elderly participants stood quietly with their eyes open or closed and either performed a secondary task or stood quietly. Without vision, both younger and older participants had reduced energy in the long time-scales, supporting the concept that vision is used to control low frequency postural sway. Furthermore, energy was increased at timescales corresponding to closed-loop (somatosensory and vestibular) and open-loop mechanisms, consistent with the idea of a shift from visual control to other control mechanisms. However, a relatively greater increase was observed for older adults. With a secondary task a similar pattern was observed—increased energy at the short and moderate timescales, decreased energy at long timescales. The possibility of a common strategy—at the timescale level—in response to postural perturbations is considered

A cognitive neuroprosthetic that uses cortical stimulation for somatosensory feedback

Present day cortical brain–machine interfaces (BMIs) have made impressive advances using decoded brain signals to control extracorporeal devices. Although BMIs are used in a closed-loop fashion, sensory feedback typically is visual only. However medical case studies have shown that the loss of somesthesis in a limb greatly reduces the agility of the limb even when visual feedback is available. Approach. To overcome this limitation, this study tested a closed-loop BMI that utilizes intracortical microstimulation to provide 'tactile' sensation to a non-human primate. Main result. Using stimulation electrodes in Brodmann area 1 of somatosensory cortex (BA1) and recording electrodes in the anterior intraparietal area, the parietal reach region and dorsal area 5 (area 5d), it was found that this form of feedback can be used in BMI tasks. Significance. Providing somatosensory feedback has the poyential to greatly improve the performance of cognitive neuroprostheses especially for fine control and object manipulation. Adding stimulation to a BMI system could therefore improve the quality of life for severely paralyzed patients

The effects of peripheral nerve impairments on postural control and mobility among people with peripheral neuropathy

Approximately 20 million Americans are suffering Peripheral Neuropathy (PN). It is estimated that the prevalence of all-cause PN is about 2.4% in the entire adult population, whereas over 8-10% in the population segment over the age of 55 (Martyn & Hughes, 1997). Peripheral Neuropathy leads to a high risk of falling, resulting from the deficits of postural control caused by the impaired peripheral nerves, especially the degenerative somatosensory system. To date, there is no effective medical treatment for the disease but pain managements. The deficits of postural control decrease the life quality of this population. The degeneration of peripheral nerves reduces sensory inputs from the somatosensory system to central nervous system via spinal reflexive loop, which should provide valuable real-time information for balance correction. Therefore, it is necessary to investigate how PN affects the somatosensory system regarding postural control. Besides that, people with PN may develop a compensatory mechanism which could be reinforced by exercise training, ultimately to improve balance and mobility in their daily life. The neuroplasticity may occur within somatosensory system by relying on relative intact sensory resources. Hence, unveiling the compensatory mechanism in people with PN may help in understanding (a) essential sensations or function of peripheral nerves to postural control, (b) effective strategy of physical treatments for people with PN, and (c) task-dependent sensory information requirements. Therefore, this dissertation discussed the roles of foot sole sensation, ankle proprioception, and stretch reflex on balance as well as gait among people with PN. Furthermore, the discussion of the coupling between small and large afferent reflexive loops may spot the compensatory mechanism in people with PN

Plantar Pressure, Cutaneous Sensation and Stochastic Resonance: An Examination of Factors Influencing the Control and Perception of Posture

The goal of this dissertation was to understand how people control posture in the context of sensory loss. To do so we explored three potential influences on the detection of external information and how they relate to the control of posture and perception of body orientation: 1) does changing posture alter the forces under the foot, and do these changes impact the ability to detect external vibrations? 2) Does decreasing the temperature of the foot influence the ability to detect external vibrations, the perception of body orientation, and the control of posture? And 3) does stochastic resonance (SR) improve the perception of body orientation and the control of posture when the sensory thresholds are elevated to clinical levels through cooling of the feet? The results of the experiments indicate that: 1) increasing the pressure under the feet, elicited by changes in posture, elevates the cutaneous sensory threshold, and that the forefoot appears to be more sensitive than the rearfoot to changes in weighting; 2) decreasing the temperature of the skin elevates cutaneous sensory thresholds, and impacts postural control by constraining the fluctuations of the medial-lateral center of pressure; and 3) applying SR to the soles of the feet improves the ability to perceive body position, with greater amounts of skin cooling resulting in greater improvements in postural performance due to SR. This dissertation demonstrates that decreasing plantar loading lowers cutaneous sensory thresholds, indicating that the changes in postural fluctuations frequently observed among those with clinical sensory loss may serve as a mechanism that allows for improved access to external information if they prove to reduce the pressure under sensory impaired portions of the feet. Additionally, we add to the growing body of literature identifying SR as a means to improve postural performance when cutaneous sensory function is impaired. From a clinical perspective, the results presented here indicate that aids designed to apply SR to the soles of the feet, as a means to improve posture and gait, should modulate their signal such that they apply a signal amplitude appropriate to the amount of loading the foot experiences

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 349)

This bibliography lists 149 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during April, 1991. Subject coverage includes: aerospace medicine and psychology, life support systems and controlled environments, safety equipment, exobiology and extraterrestrial life, and flight crew behavior and performance

Development and characterization of an intracortical closed-loop brain-computer interface

Intracortical brain-computer interfaces (BCI) have the potential to restore motor function to people with paralysis by extracting movement intent signals directly from motor cortex. While current technology has allowed individuals to perform simple object interactions with robotic arms, such demonstrations have depended exclusively on visual feedback. Additional forms of sensory feedback may lessen the dependence on vision and allow for more dexterous control. Intracortical microstimulation (ICMS) has been proposed as a method of adding somatosensory feedback to BCI by directly stimulating somatosensory cortex to evoke tactile sensations referred to the hand. Our lab recently demonstrated that ICMS can elicit graded and focal tactile sensations in an individual with spinal cord injury (SCI). However, several challenges must be resolved to demonstrate the viability of ICMS as a technique for incorporating sensory feedback in a closed-loop BCI. First, microstimulation generates large voltage transients that appear as artifacts in the neural recordings used for BCI control. These artifacts can corrupt the recorded signal throughout the entire stimulus train, and must be eliminated to allow for continuous BCI decoding. Second, it is unknown whether the sensations elicited by ICMS can be perceived quickly enough for use as a feedback signal. Here, I present several aspects of the development of a closed-loop BCI system, including a method for artifact rejection and the characterization of simple reaction times to ICMS of human somatosensory cortex. A human participant with tetraplegia due to SCI was implanted with four microelectrode arrays in primary motor and somatosensory cortices. I implemented a robust method of artifact rejection that preserves neural data as soon as 750 microseconds after each stimulus pulse by applying signal blanking and an appropriate digital filter. I validated this method by comparing BCI performance with and without ICMS and found that performance was maintained with ICMS and artifact rejection. Next, I characterized simple reaction times to single-channel ICMS, and found that responses to ICMS were comparable, and often faster, than responses to electrical stimulation on the hand. These findings suggest that ICMS is a viable method to provide feedback in a closed-loop BCI

The Influence of Casual Footwear on Human Balance

Falls are the third leading cause of unintentional death in homes and communities in the United States, causing 27,800 fatalities in 2012. The ability to maintain postural control is an essential part of activities of daily living (ADLs). However, recent types of casual footwear may be putting the body’s postural control system at a functional disadvantage, predisposing wearers to the risk of a fall. The purpose of this study was to examine the effects three forms of casual footwear (thong style flip-flops (FF), clog style Crocs® (CC), and Vibram® Five-Fingers (MIN)) have on postural control following a one mile walk at a preferred-pace. Eighteen healthy male adults (age: 22.9±2.8 years; height: 179±6.0 cm; mass: 81.3±8.8 kg) with no history of neuro-musculoskeletal disorders participated in this study. Static balance measures were recorded using eyes open (EO), eyes closed (EC), eyes open with sway referenced vision (EOSRV), and support, (EOSRP) conditions of the Sensory Organization Test (SOT). The average velocity (VEL) and root-mean-square (RMS) of the center of pressure (CoP) was used to quantify postural sway in the anterior-posterior (APVEL & APRMS) and medial-lateral (MLVEL & MLRMS) directions. Dynamic balance measures were recorded using the medium and large translations of the Motor Control Test (MCT). Muscle activity was collected at 1,500 Hz on the medial gastrocnemius (PF) and tibialis anterior (DF) using a Noraxon EMG system. Mean sway and EMG variables were analyzed using a 3x2 (footwear x time) repeated measures ANOVA. Footwear main effect significance was observed for APRMS in the EC condition (F2,34) = 7.914, p = 0.002), MLVEL (F(2,34) = 3.681, p = 0.036), and APVEL (F(2,34) = 7.469, p = 0.002) in the EOSRV condition with pairwise comparisons displaying increased instability in the CC and FF compared to MIN. Time main effect significance was seen for MLRMS in the EOSRV (F(1,17) = 6.532, p = 0.02) and EOSRP (F(1,17) = 8.982, p = 0.008) conditions with increased instability following the one-mile walk. Future research should seek to elucidate which combinations of these casual footwear characteristics are most detrimental to human balance

Role of somatosensory and vestibular cues in attenuating visually induced human postural sway

The purpose was to determine the contribution of visual, vestibular, and somatosensory cues to the maintenance of stance in humans. Postural sway was induced by full field, sinusoidal visual surround rotations about an axis at the level of the ankle joints. The influences of vestibular and somatosensory cues were characterized by comparing postural sway in normal and bilateral vestibular absent subjects in conditions that provided either accurate or inaccurate somatosensory orientation information. In normal subjects, the amplitude of visually induced sway reached a saturation level as stimulus amplitude increased. The saturation amplitude decreased with increasing stimulus frequency. No saturation phenomena was observed in subjects with vestibular loss, implying that vestibular cues were responsible for the saturation phenomenon. For visually induced sways below the saturation level, the stimulus-response curves for both normal and vestibular loss subjects were nearly identical implying that (1) normal subjects were not using vestibular information to attenuate their visually induced sway, possibly because sway was below a vestibular-related threshold level, and (2) vestibular loss subjects did not utilize visual cues to a greater extent than normal subjects; that is, a fundamental change in visual system 'gain' was not used to compensate for a vestibular deficit. An unexpected finding was that the amplitude of body sway induced by visual surround motion could be almost three times greater than the amplitude of the visual stimulus in normals and vestibular loss subjects. This occurred in conditions where somatosensory cues were inaccurate and at low stimulus amplitudes. A control system model of visually induced postural sway was developed to explain this finding. For both subject groups, the amplitude of visually induced sway was smaller by a factor of about four in tests where somatosensory cues provided accurate versus inaccurate orientation information. This implied that (1) the vestibular loss subjects did not utilize somatosensory cues to a greater extent than normal subjects; that is, changes in somatosensory system 'gain' were not used to compensate for a vestibular deficit, and (2) the threshold for the use of vestibular cues in normals was apparently lower in test conditions where somatosensory cues were providing accurate orientation information