Computational Analysis of Upper Extremity Movements for People Post-Stroke

Wearable sensors have been beneficial in assessing motor impairment after stroke. Individuals who have experienced stroke may benefit from the use of wearable sensors to quantify and assess quality of motions in unobserved environments. Seven individuals participated in a study wherein they performed various gestures from the Fugl-Meyer Assessment (FMA), a measure of post-stroke impairment. Participants performed these gestures while being monitored by wearable sensors placed on each wrist. A series of MATLAB functions were written to process recorded sensor data, extract meaningful features from the data, and prepare those features for further use with various machine learning techniques. A combination of linear and nonlinear regression was applied to frequency domain values from each gesture to determine which can more accurately predict the time spent performing the gesture, and the associated gesture FMA score. General performance suggests that linear regression techniques appear to better fit paretic gestures, while nonlinear regression techniques appear to better fit non-paretic gestures. A use of classifier techniques were used to determine if a classifier can distinguish between paretic and non-paretic gestures. The combinations include determining if a higher performance is obtained through the use of either accelerometer, rate gyroscope, or both modalities combined. Our findings indicate that, for upper-extremity motion, classifiers trained using a combination of accelerometer and rate gyroscope data performed the best (accuracy of 73.1%). Classifiers trained using accelerometer data alone and rate gyroscope data alone performed slightly worse than the combined data classifier (70.2% and 65.7%, respectively). These results suggest specific features and methods suitable for the quantification of impairment after stroke

Sensor-Based Adaptive Control and Optimization of Lower-Limb Prosthesis.

Recent developments in prosthetics have enabled the development of powered prosthetic ankles (PPA). The advent of such technologies drastically improved impaired gait by increasing balance and reducing metabolic energy consumption by providing net positive power. However, control challenges limit performance and feasibility of today’s devices. With addition of sensors and motors, PPA systems should continuously make control decisions and adapt the system by manipulating control parameters of the prostheses. There are multiple challenges in optimization and control of PPAs. A prominent challenge is the objective setup of the system and calibration parameters to fit each subject. Another is whether it is possible to detect changes in intention and terrain before prosthetic use and how the system should react and adapt to it. In the first part of this study, a model for energy expenditure was proposed using electromyogram (EMG) signals from the residual lower-limbs PPA users. The proposed model was optimized to minimize energy expenditure. Optimization was performed using a modified Nelder-Mead approach with a Latin Hypercube sampling. Results of the proposed method were compared to expert values and it was shown to be a feasible alternative for tuning in a shorter time. In the second part of the study, the control challenges regarding lack of adaptivity for PPAs was investigated. The current PPA system used is enhanced with impedance-controlled parameters that allow the system to provide different assistance. However, current systems are set to a fixed value and fail to acknowledge various terrain and intentions throughout the day. In this study, a pseudo-real-time adaptive control system was proposed to predict the changes in the gait and provide a smoother gait. The proposed control system used physiological, kinetic, and kinematic data and fused them to predict the change. The prediction was done using machine learning-based methods. Results of the study showed an accuracy of up to 89.7 percent for prediction of change for four different cases

Requirements for home-based upper extremity rehabilitation using wearable motion sensors for stroke patients:a user-centred approach

Purpose: Telerehabilitation systems have the potential to enable therapists to monitor and assist stroke patients in achieving high-intensity upper extremity exercise in the home environment. We adopted an iterative user-centred approach, including multiple data sources and meetings with end-users and stakeholders to define the user requirements for home-based upper extremity rehabilitation using wearable motion sensors for subacute stroke patients. Methods: We performed a requirement analysis consisting of the following steps: 1) context &amp; groundwork; 2) eliciting requirements; 3) modelling &amp; analysis; 4) agreeing requirements. During these steps, a pragmatic literature search, interviews and focus groups with stroke patients, physiotherapists and occupational therapists were performed. The results were systematically analysed and prioritised into “must-haves”, “should-haves”, and “could-haves”. Results: We formulated 33 functional requirements: eighteen must-have requirements related to blended care (2), exercise principles (7), exercise delivery (3), exercise evaluation (4), and usability (2); ten should-haves; and five could-haves. Six movement components, including twelve exercises and five combination exercises, are required. For each exercise, appropriate exercise measures were defined. Conclusion: This study provides an overview of functional requirements, required exercises, and required exercise measures for home-based upper extremity rehabilitation using wearable motion sensors for stroke patients, which can be used to develop home-based upper extremity rehabilitation interventions. Moreover, the comprehensive and systematic requirement analysis used in this study can be applied by other researchers and developers when extracting requirements for designing a system or intervention in a medical context.</p

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice

This Special Issue shows a range of potential opportunities for the application of wearable movement sensors in motor rehabilitation. However, the papers surely do not cover the whole field of physical behavior monitoring in motor rehabilitation. Most studies in this Special Issue focused on the technical validation of wearable sensors and the development of algorithms. Clinical validation studies, studies applying wearable sensors for the monitoring of physical behavior in daily life conditions, and papers about the implementation of wearable sensors in motor rehabilitation are under-represented in this Special Issue. Studies investigating the usability and feasibility of wearable movement sensors in clinical populations were lacking. We encourage researchers to investigate the usability, acceptance, feasibility, reliability, and clinical validity of wearable sensors in clinical populations to facilitate the application of wearable movement sensors in motor rehabilitation

Development of a Wearable Mechatronic Elbow Brace for Postoperative Motion Rehabilitation

This thesis describes the development of a wearable mechatronic brace for upper limb rehabilitation that can be used at any stage of motion training after surgical reconstruction of brachial plexus nerves. The results of the mechanical design and the work completed towards finding the best torque transmission system are presented herein. As part of this mechatronic system, a customized control system was designed, tested and modified. The control strategy was improved by replacing a PID controller with a cascade controller. Although the experiments have shown that the proposed device can be successfully used for muscle training, further assessment of the device, with the help of data from the patients with brachial plexus injury (BPI), is required to improve the control strategy. Unique features of this device include the combination of adjustability and modularity, as well as the passive adjustment required to compensate for the carrying angle

The Feasibility of Wearable Sensors for the Automation of Distal Upper Extremity Ergonomic Assessment Tools

Work-related distal upper limb musculoskeletal disorders are costly conditions that many companies and researchers spend significant resources on preventing. Ergonomic assessments evaluate the risk of developing a work-related musculoskeletal disorder (WMSD) by quantifying variables such as the force, repetition, and posture (among others) that the task requires. Accurate and objective measurements of force and posture are challenging due to equipment and location constraints. Wearable sensors like the Delsys Trigno Quattro combine inertial measurement units (IMUs) and surface electromyography to solve collection difficulties. The purpose of this work was to evaluate the joint angle estimation of IMUs and the relationship between sEMG and overall task intensity throughout a controlled wrist motion. Using a 3 degrees-of-freedom wrist manipulandum, the feasibility of a small, lightweight wearable was evaluated to collect accurate wrist flexion and extension angles and to use sEMG to quantify task intensity. The task was a repeated 95º arc in flexion/ extension with six combinations of wrist torques and grip requirements. The mean wrist angle difference (throughout the range of motion) between the WristBot and the IMU of 1.70° was not significant (p= 0.057); but significant differences existed throughout the range of motion. The largest difference between the IMU and the WristBot was 10.7° at 40° extension; this discrepancy is smaller than typical visual inspection joint angle estimate errors by ergonomists of 15.6°. All sEMG metrics (flexor muscle root mean square (RMS), extensor muscle RMS, mean RMS, integrated sEMG (iEMG), physiological cross-sectional area weighted RMS) and ratings of perceived exertion (RPE) had significant regression results with the task intensity. Variance in RPE was better explained by task intensity than the best sEMG metric (iEMG) with R2 values of 0.35 and 0.21, respectively. Wearable sensors can be used in occupational settings to increase the accuracy of postural assessments; additional research is required on relationships between sEMG and task intensity to be used effectively in ergonomics. There is potential for sEMG to be a powerful tool; however, the dynamic nature and combined exertion (grip and flexion/ extension) make it difficult to quantify task intensit

Estimating hand-grip forces causing Cumulative Trauma Disorder

Wearable sensors have garnered considerable interest because of their potential for various applications. However, much less has been studied about the Stretchsense pressure sensor characteristics and its workability for industrial application to prevent potential risk situations such as accidents and injuries. The proposed study helps investigate Stretchsense pressure sensors\u27 applicability for measuring hand-handle interface forces under static and dynamic conditions. The BendLabs sensors - a multi-axis, soft, flexible sensing system was attached to the wrist to evaluate the wrist angle deviations. In addition, the StretchSense stretch sensors were attached to the elbow joint to help estimate the elbow flexion/extension. The research tests and evaluates the real-time pressure distribution across the hand while performing given tasks and investigates the relationship between the wrist and elbow position and grip strength. The research provides objective means to assess the magnitudes of high pressures that may cause pressure-induced discomfort and pain, thereby increasing the hand\u27s stress. The experiment\u27s most significant benefit lies in its applicability to the actual tool handles outside the laboratory settings

Estimating Exerted Hand Force via Force Myography to Interact with a Biaxial Stage in Real-Time by Learning Human Intentions: A Preliminary Investigation

Force myography (FMG) signals can read volumetric changes of muscle movements, while a human participant interacts with the environment. For collaborative activities, FMG signals could potentially provide a viable solution to controlling manipulators. In this paper, a novel method to interact with a two-degree-of-freedom (DoF) system consisting of two perpendicular linear stages using FMG is investigated. The method consists in estimating exerted hand forces in dynamic arm motions of a participant using FMG signals to provide velocity commands to the biaxial stage during interactions. Five different arm motion patterns with increasing complexities, i.e., “x-direction”, “y-direction”, “diagonal”, “square”, and “diamond”, were considered as human intentions to manipulate the stage within its planar workspace. FMG-based force estimation was implemented and evaluated with a support vector regressor (SVR) and a kernel ridge regressor (KRR). Real-time assessments, where 10 healthy participants were asked to interact with the biaxial stage by exerted hand forces in the five intended arm motions mentioned above, were conducted. Both the SVR and the KRR obtained higher estimation accuracies of 90–94% during interactions with simple arm motions (x-direction and y-direction), while for complex arm motions (diagonal, square, and diamond) the notable accuracies of 82–89% supported the viability of the FMG-based interactive control

Human Motion Analysis with Wearable Inertial Sensors

High-resolution, quantitative data obtained by a human motion capture system can be used to better understand the cause of many diseases for effective treatments. Talking about the daily care of the aging population, two issues are critical. One is to continuously track motions and position of aging people when they are at home, inside a building or in the unknown environment; the other is to monitor their health status in real time when they are in the free-living environment. Continuous monitoring of human movement in their natural living environment potentially provide more valuable feedback than these in laboratory settings. However, it has been extremely challenging to go beyond laboratory and obtain accurate measurements of human physical activity in free-living environments. Commercial motion capture systems produce excellent in-studio capture and reconstructions, but offer no comparable solution for acquisition in everyday environments. Therefore in this dissertation, a wearable human motion analysis system is developed for continuously tracking human motions, monitoring health status, positioning human location and recording the itinerary. In this dissertation, two systems are developed for seeking aforementioned two goals: tracking human body motions and positioning a human. Firstly, an inertial-based human body motion tracking system with our developed inertial measurement unit (IMU) is introduced. By arbitrarily attaching a wearable IMU to each segment, segment motions can be measured and translated into inertial data by IMUs. A human model can be reconstructed in real time based on the inertial data by applying high efficient twists and exponential maps techniques. Secondly, for validating the feasibility of developed tracking system in the practical application, model-based quantification approaches for resting tremor and lower extremity bradykinesia in Parkinson’s disease are proposed. By estimating all involved joint angles in PD symptoms based on reconstructed human model, angle characteristics with corresponding medical ratings are employed for training a HMM classifier for quantification. Besides, a pedestrian positioning system is developed for tracking user’s itinerary and positioning in the global frame. Corresponding tests have been carried out to assess the performance of each system

Smartphone-based Human Fatigue Detection in an Industrial Environment Using Gait Analysis

Human fatigue due to repetitive and physically challenging jobs may result in poor performance and a Work-related Musculoskeletal Disorder (WMSD). Thus, the importance of being able to monitor fatigue to implement preventative interventions cannot be overstated. This study was designed to monitor fatigue through the development of a methodology that objectively classifies an individual’s level of fatigue in the workplace by utilizing the motion sensors embedded in smartphones. An experiment consisting of squatting tasks, primarily involving the lower extremity musculature, was conducted with 24 participants using a smartphone attached to their right shank. Using Borg’s Ratings of Perceived Exertion (RPE) to label gait data, we developed machine learning algorithms to classify each individual’s gait into two (no- vs. strong-fatigue), three (no-, medium-, and strong-fatigue) and four (no-, low-, medium-, and strong-fatigue) levels of fatigue, for which accuracy of 91%, 76%, and 61% were obtained, respectively. The outcomes of this study may facilitate the implementation of a proactive approach supporting the continuous monitoring of a worker’s fatigue level, which may subsequently enhance workers’ performance and reduce the risk of WMSDs