A Haptic Feedback System for Lower Limb Amputees Based on Gait Event Detection

Lower limb amputation has significant effects on a person’s quality of life and ability to perform activities of daily living. Prescription of prosthetic device post amputation aims to help restore some degrees of mobility function, however studies have shown evidence of low balance confidence and higher risk of falling among amputee community, especially those suffering from above knee amputation. While advanced prostheses offer better control, they often lack a form of feedback that delivers the awareness of the limb position to the prosthetic user while walking. This research presents the development and evaluation of a wearable skinstretch haptic feedback system intended to deliver cues of two crucial gait events, namely the Initial Contact (IC) and Toe-off (TO) to its wearer. The system comprises a haptic module that applies lateral skin-stretch on the upper leg or the trunk, corresponding to the gait event detection module based on Inertial Measurement Unit (IMU) attached at the shank. The design and development iterations of the haptic module is presented, and characterization of the feedback parameters is discussed. The validation of the gait event detection module is carried out and finally the integration of the haptic feedback system is described. Experimental work with healthy subjects and an amputee indicated good perceptibility of the feedback during static and dynamic (walking) condition, although higher magnitude of stretch was required to perceive the feedback during dynamic condition. User response time during dynamic activity showed that the haptic feedback system is suitable for delivering cues of IC and TO within the duration of the stance phase. In addition, feedback delivered in discernible patterns can be learned and adapted by the subjects. Finally, a case study was carried out with an above-knee amputee to assess the effects of the haptic feedback on spatio-temporal gait parameters and on the vertical ground reaction force during treadmill and overground walking. The research presented in this report introduces a novel design of a haptic feedback device. As such, the outcome includes a well-controlled skin-stretch effect which contributes to the research by investigating skin-stretch feedback for conveying discrete event information rather than conveying direction information as presented in other studies. In addition, it is found that stretch magnitude as small as 3 mm could be perceived in short duration of 150 ms during dynamic condition, making it a suitable alternative to other widely investigated haptic modality such as vibration for ambulatory feedback application. With continuous training, the haptic feedback system could possibly benefit lower limb amputees by creating awareness of the limb placement during ambulation, potentially reducing visual dependency and increasing walking confidence

Addressing the challenges posed by human machine interfaces based on force sensitive resistors for powered prostheses

Despite the advancements in the mechatronics aspect of prosthetic devices, prostheses control still lacks an interface that satisfies the needs of the majority of users. The research community has put great effort into the advancements of prostheses control techniques to address users’ needs. However, most of these efforts are focused on the development and assessment of technologies in the controlled environments of laboratories. Such findings do not fully transfer to the daily application of prosthetic systems. The objectives of this thesis focus on factors that affect the use of Force Myography (FMG) controlled prostheses in practical scenarios. The first objective of this thesis assessed the use of FMG as an alternative or synergist Human Machine Interface (HMI) to the more traditional HMI, i.e. surface Electromyography (sEMG). The assessment for this study was conducted in conditions that are relatively close to the real use case of prosthetic applications. The HMI was embedded in the custom prosthetic prototype that was developed for the pilot participant of the study using an off-the-shelf prosthetic end effector. Moreover, prostheses control was assessed as the user moved their limb in a dynamic protocol.The results of the aforementioned study motivated the second objective of this thesis: to investigate the possibility of reducing the complexity of high density FMG systems without sacrificing classification accuracies. This was achieved through a design method that uses a high density FMG apparatus and feature selection to determine the number and location of sensors that can be eliminated without significantly sacrificing the system’s performance. The third objective of this thesis investigated two of the factors that contribute to increased errors in force sensitive resistor (FSR) signals used in FMG controlled prostheses: bending of force sensors and variations in the volume of the residual limb. Two studies were conducted that proposed solutions to mitigate the negative impact of these factors. The incorporation of these solutions into prosthetic devices is discussed in these studies.It was demonstrated that FMG is a promising HMI for prostheses control. The facilitation of pattern recognition with FMG showed potential for intuitive prosthetic control. Moreover, a method for the design of a system that can determine the required number of sensors and their locations on each individual to achieve a simpler system with comparable performance to high density FMG systems was proposed and tested. The effects of the two factors considered in the third objective were determined. It was also demonstrated that the proposed solutions in the studies conducted for this objective can be used to increase the accuracy of signals that are commonly used in FMG controlled prostheses

Human Enhancement Technologies and Our Merger with Machines

A cross-disciplinary approach is offered to consider the challenge of emerging technologies designed to enhance human bodies and minds. Perspectives from philosophy, ethics, law, and policy are applied to a wide variety of enhancements, including integration of technology within human bodies, as well as genetic, biological, and pharmacological modifications. Humans may be permanently or temporarily enhanced with artificial parts by manipulating (or reprogramming) human DNA and through other enhancement techniques (and combinations thereof). We are on the cusp of significantly modifying (and perhaps improving) the human ecosystem. This evolution necessitates a continuing effort to re-evaluate current laws and, if appropriate, to modify such laws or develop new laws that address enhancement technology. A legal, ethical, and policy response to current and future human enhancements should strive to protect the rights of all involved and to recognize the responsibilities of humans to other conscious and living beings, regardless of what they look like or what abilities they have (or lack). A potential ethical approach is outlined in which rights and responsibilities should be respected even if enhanced humans are perceived by non-enhanced (or less-enhanced) humans as “no longer human” at all

Analysis of the backpack loading efects on the human gait

Gait is a simple activity of daily life and one of the main abilities of the human being. Often during leisure, labour and sports activities, loads are carried over (e.g. backpack) during gait. These circumstantial loads can generate instability and increase biomechanicalstress over the human tissues and systems, especially on the locomotor, balance and postural regulation systems. According to Wearing (2006), subjects that carry a transitory or intermittent load will be able to find relatively efficient solutions to compensate its effects.info:eu-repo/semantics/publishedVersio

Epidemiology of Injury in English Women's Super league Football: A Cohort Study

INTRODUCTION: The epidemiology of injury in male professional football has been well documented (Ekstrand, Hägglund, & Waldén, 2011) and used as a basis to understand injury trends for a number of years. The prevalence and incidence of injuries occurring in womens super league football is unknown. The aim of this study is to estimate the prevalence and incidence of injury in an English Super League Women’s Football squad. METHODS: Following ethical approval from Leeds Beckett University, players (n = 25) signed to a Women’s Super League Football club provided written informed consent to complete a self-administered injury survey. Measures of exposure, injury and performance over a 12-month period was gathered. Participants were classified as injured if they reported a football injury that required medical attention or withdrawal from participation for one day or more. Injuries were categorised as either traumatic or overuse and whether the injury was a new injury and/or re-injury of the same anatomical site RESULTS: 43 injuries, including re-injury were reported by the 25 participants providing a clinical incidence of 1.72 injuries per player. Total incidence of injury was 10.8/1000 h (95% CI: 7.5 to 14.03). Participants were at higher risk of injury during a match compared with training (32.4 (95% CI: 15.6 to 48.4) vs 8.0 (95% CI: 5.0 to 10.85)/1000 hours, p 28 days) of which there were three non-contact anterior cruciate ligament (ACL) injuries. The epidemiological incidence proportion was 0.80 (95% CI: 0.64 to 0.95) and the average probability that any player on this team will sustain at least one injury was 80.0% (95% CI: 64.3% to 95.6%) CONCLUSION: This is the first report capturing exposure and injury incidence by anatomical site from a cohort of English players and is comparable to that found in Europe (6.3/1000 h (95% CI 5.4 to 7.36) Larruskain et al 2017). The number of ACL injuries highlights a potential injury burden for a squad of this size. Multi-site prospective investigations into the incidence and prevalence of injury in women’s football are require

A Systematic Review and Meta-Analysis of the Incidence of Injury in Professional Female Soccer

The epidemiology of injury in male professional football is well documented and has been used as a basis to monitor injury trends and implement injury prevention strategies. There are no systematic reviews that have investigated injury incidence in women’s professional football. Therefore, the extent of injury burden in women’s professional football remains unknown. PURPOSE: The primary aim of this study was to calculate an overall incidence rate of injury in senior female professional soccer. The secondary aims were to provide an incidence rate for training and match play. METHODS: PubMed, Discover, EBSCO, Embase and ScienceDirect electronic databases were searched from inception to September 2018. Two reviewers independently assessed study quality using the Strengthening the Reporting of Observational Studies in Epidemiology statement using a 22-item STROBE checklist. Seven prospective studies (n=1137 professional players) were combined in a pooled analysis of injury incidence using a mixed effects model. Heterogeneity was evaluated using the Cochrane Q statistic and I2. RESULTS: The epidemiological incidence proportion over one season was 0.62 (95% CI 0.59 - 0.64). Mean total incidence of injury was 3.15 (95% CI 1.54 - 4.75) injuries per 1000 hours. The mean incidence of injury during match play was 10.72 (95% CI 9.11 - 12.33) and during training was 2.21 (95% CI 0.96 - 3.45). Data analysis found a significant level of heterogeneity (total Incidence, X2 = 16.57 P < 0.05; I2 = 63.8%) and during subsequent sub group analyses in those studies reviewed (match incidence, X2 = 76.4 (d.f. = 7), P <0.05; I2 = 90.8%, training incidence, X2 = 16.97 (d.f. = 7), P < 0.05; I2 = 58.8%). Appraisal of the study methodologies revealed inconsistency in the use of injury terminology, data collection procedures and calculation of exposure by researchers. Such inconsistencies likely contribute to the large variance in the incidence and prevalence of injury reported. CONCLUSIONS: The estimated risk of sustaining at least one injury over one football season is 62%. Continued reporting of heterogeneous results in population samples limits meaningful comparison of studies. Standardising the criteria used to attribute injury and activity coupled with more accurate methods of calculating exposure will overcome such limitations

Intelligent technologies for the aging brain: opportunities and challenges

Intelligent computing is rapidly reshaping healthcare. In light of the global burden of population aging and neurological disorders, dementia and elderly care are among the healthcare sectors that are most likely to benefit from this technological revolution. Trends in artificial intelligence, robotics, ubiquitous computing, neurotechnology and other branches of biomedical engineering are progressively enabling novel opportunities for technology-enhanced care. These Intelligent Assistive Technologies (IATs) open the prospects of supporting older adults with neurocognitive disabilities, maintain their independence, reduce the burden on caregivers and delay the need for long-term care (1, 2). While technology develops fast, yet little knowledge is available to patients and health professionals about the current availability, applicability, and capability of existing IATs. This thesis proposes a state-of-the-art analysis of IATs in dementia and elderly care. Our findings indicate that advances in intelligent technology are resulting in a rapidly expanding number and variety of assistive solutions for older adults and people with neurocognitive disabilities. However, our analysis identifies a number of challenges that negatively affect the optimal deployment and uptake of IATs among target users and care institutions. These include design issues, sub-optimal approaches to product development, translational barriers between lab and clinics, lack of adequate validation and implementation, as well as data security and cyber-risk weaknesses. Additionally, in virtue of their technological novelty, intelligent technologies raise a number of Ethical, Legal and Social Implications (ELSI). Therefore, a significant portion of this thesis is devoted to providing an early ethical Technology Assessment (eTA) of intelligent technology, hence contributing to preparing the terrain for its safe and ethically responsible adoption. This assessment is primarily focused on intelligent technologies at the human-machine interface, as these applications enable an unprecedented exposure of the intimate dimension of individuals to the digital infosphere. Issues of privacy, integrity, equality, and dual-use were addressed at the level of stakeholder analysis, normative ethics and human-rights law. Finally, this thesis is aimed at providing evidence-based recommendations for guiding participatory and responsible development in intelligent technology, and delineating governance strategies that maximize the clinical benefits of IATs for the aging world, while minimizing unintended risks