Assessment of a hand exoskeleton on proximal and distal training in virtual environments for robot mediated upper extremity rehabilitation

Stroke is the leading cause of disability in the United States with approximately 800,000 cases per year. This cerebral vascular accident results in neurological impairments that reduce limb function and limit the daily independence of the individual. Evidence suggests that therapeutic interventions with repetitive motor training can aid in functional recovery of the paretic limb. Robotic rehabilitation may present an exercise intervention that can improve training and induce motor plasticity in individuals with stroke. An active (motorized) hand exoskeleton that provides support for wrist flexion/extension, abduction/adduction, pronation/supination, and finger pinch is integrated with a pre-existing 3-Degree of Freedom (DOF) haptic robot (Haptic Master, FCS Moog) to determine the efficacy of increased DOF during proximal and distal training in Upper Extremity (UE) rehabilitation. Subjects are randomly assigned into four groups to evaluate the significance of increased DOF during virtual training: Haptic Master control group (HM), Haptic Master with Gripper (HMG), Haptic Master with Wrist (HMW), and Haptic Master with Gripper and Wrist (HMWG). Each subject group performs a Pick and Place Task in a virtual environment where the distal hand exoskeleton is mapped to the virtual representation of the hand. Subjects are instructed to transport as many virtual cubes as possible to a specified target in the allotted time period of 120s. Three cube sizes are assessed to determine efficacy of the assistive end-effector. An additional virtual task, Mailbox Task, is performed to determine the effect of training and the ability to transfer skills between virtual settings in an unfamiliar environment. The effects of viewing mediums are also investigated to determine the effect of immersion on performance using an Oculus Rift as an HMD compared to conventional projection displays. It is hypothesized that individuals with both proximal and complete distal hand control (HMWG) will see increased benefit during the Pick and Place Task than individuals without the complete distal attachment, as assisted daily living tasks are often accomplished with coordinated arm and hand movement. The purpose of this study is to investigate the additive effect of increased degrees of freedom at the hand through task-specific training of the upper arm in a virtual environment, validate the ability to transfer skills obtained in a virtual environment to an untrained task, and determine the effects of viewing mediums on performance. A feasibility study is conducted in individuals with stroke to determine if the modular gripper can assist pinch movements. These investigations represent a comprehensive investigation to assess the potential benefits of assistive devices in a virtual reality setting to retrain lost function and increase efficacy in motor control in populations with motor impairments

Computer based human-centered display system

A human centered informational display is disclosed that can be used with vehicles (e.g. aircraft) and in other operational environments where rapid human centered comprehension of an operational environment is required. The informational display integrates all cockpit information into a single display in such a way that the pilot can clearly understand with a glance, his or her spatial orientation, flight performance, engine status and power management issues, radio aids, and the location of other air traffic, runways, weather, and terrain features. With OZ the information is presented as an integrated whole, the pilot instantaneously recognizes flight path deviations, and is instinctively drawn to the corrective maneuvers. Our laboratory studies indicate that OZ transfers to the pilot all of the integrated display information in less than 200 milliseconds. The reacquisition of scan can be accomplished just as quickly. Thus, the time constants for forming a mental model are near instantaneous. The pilot's ability to keep up with rapidly changing and threatening environments is tremendously enhanced. OZ is most easily compatible with aircraft that has flight path information coded electronically. With the correct sensors (which are currently available) OZ can be installed in essentially all current aircraft

Snap2Diverse: Coordinating Information Visualizations and Virtual Environments

The field of Information Visualization is concerned with improving with how users perceive, understand, and interact with visual representations of data sets. Immersive Virtual Environments (VEs) excel at providing researchers and designers a greater comprehension of the spatial features and relations of their data, models, and scenes. This project addresses the intersection of these two fields where information is visualized in a virtual environment. Specifically we are interested in visualizing abstract information in relation to spatial information in the context of a virtual environment. We describe a set of design issues for this type of integrated visualization and demonstrate a coordinated, multiple-views system supporting 2D and 3D visualization tasks such as overview, navigation, details-on-demand, and brushing-and-linking selection. Software architecture issues are discussed with details of our implementation applied to the domain of chemical information and visualization. Lastly, we subject our system to an informal usability evaluation and identify usability issues with interaction and navigation that may guide future work in these situations

The cerebellum and motor dysfunction in neuropsychiatric disorders

The cerebellum is densely interconnected with sensory-motor areas of the cerebral cortex, and in man, the great expansion of the association areas of cerebral cortex is also paralleled by an expansion of the lateral cerebellar hemispheres. It is therefore likely that these circuits contribute to non-motor cognitive functions, but this is still a controversial issue. One approach is to examine evidence from neuropsychiatric disorders of cerebellar involvement. In this review, we narrow this search to test whether there is evidence of motor dysfunction associated with neuropsychiatric disorders consistent with disruption of cerebellar motor function. While we do find such evidence, especially in autism, schizophrenia and dyslexia, we caution that the restricted set of motor symptoms does not suggest global cerebellar dysfunction. Moreover, these symptoms may also reflect involvement of other, extra-cerebellar circuits and detailed examination of specific sub groups of individuals within each disorder may help to relate such motor symptoms to cerebellar morphology

Upper extremity rehabilitation using interactive virtual environments

Stroke affects more than 700,000 people annually in the U.S. It is the leading cause of major disability. Recovery of upper extremity function remains particularly resistant to intervention, with 80% to 95% of persons demonstrating residual upper extremity impairments lasting beyond six months after the stroke. The NJIT Robot Assistive Virtual Rehabilitation (NJIT-RAVR) system has been developed to study optimal strategies for rehabilitation of arm and hand function. Several commercial available devices, such as HapticMaster™, Cyberglove™, trakSTAR™ and Cybergrasp™, have been integrated and 11 simulations were developed to allow users to interact with virtual environments. Visual interfaces used in these simulations were programmed either in Virtools or in C++ using the Open GL library. Stereoscopic glasses were used to enhance depth perception and to present movement targets to the subjects in a 3-dimensional stereo working space. Adaptive online and offline algorithms were developed that provided appropriate task difficulty to optimize the outcomes. A pilot study was done on four stroke patients and two children with cerebral palsy to demonstrate the usability of this robot-assisted VR system. The RAVR system performed well without unexpected glitches during two weeks of training. No subjects experienced side effects such as dizziness, nausea or disorientation while interacting with the virtual environment. Each subject was able to finish the training, either with or without robotic adaptive assistance. To investigate optimal therapeutic approaches, forty stroke subjects were randomly assigned to two groups: Hand and Arm training Together (HAT) and Hand and Arm training Separately (HAS). Each group was trained in similar virtual reality training environments for three hours a day, four days a week for two weeks. In addition, twelve stroke subjects participated as a control group. They received conventional rehabilitation training of similar intensity and duration as the HAS and HAT groups. Clinical outcome measurements included the Jebsen Test of Hand Function, the Wolf Motor Function Test, and the ReachGrasp test. Secondary outcome measurements were calculated from kinematic and kinetic data collected during training in real time at 100 Hz. Both HAS and HAT groups showed significant improvement in clinical and kinematic outcome measurements. Clinical improvement compared favorably to the randomized clinical trials reported in the literature. However, there was no significant improvement difference between the two groups. Subjects from the control group improved in clinical measurements and in the ReachGrasp test. Compared to the control group, the ReachGrasp test showed a larger increase in movement speed during reaching and in the efficiency of lifting an object from the table in the combined HAS and HAT group. The NJIT-RAVR system was further modified to address the needs of children with hemiplegia due to Cerebral Palsy. Thirteen children with cerebral palsy participated in the total of nine sessions of one hour training that lasted for three weeks. Nine of the children were trained using the RAVR system alone, and another four had training with the combined Constraint-Induced Movement therapy and RAVR therapy. As a group, the children demonstrated improved performance across measurements of the Arm Range of Motion (AROM), motor function, kinematics and motor control. While subjects\u27 responses to the games varied, they performed each simulation while maintaining attention sufficient to improve in both robotic task performance and in measures of motor function

Motor learning in children with hemiplegic cerebral palsy : feedback effects on skill acquisition

Purpose. Augmented feedback is an important variable influencing motor learning. Previous studies show reduced feedback frequency benefits motor learning in young adults more than a comparison group of children, who benefit from frequent feedback during practice. It is unclear how motor and central nervous system differences in children with cerebral palsy may impact their use of feedback in motor skill acquisition. This study investigated the effect of augmented visual feedback (FB) on performance and learning of an upper extremity motor skill in children with spastic hemiplegic cerebral palsy (SHCP) as they practiced with their less affected arm, compared to typically developing children (TDC). Methods. Participants were 8-17 years with academic performance within two grade levels. Both TDC (n = 20) and participants with SHCP (n = 19) were screened for visual perception (MVPT-3) and manual dexterity (Box and Block). Children were divided into groups receiving frequent FB (100%) or faded FB (62%). Group differences for acquisition, retention, and reacquisition were compared in relation to FB level. Results. Both groups of children used visual FB to improve motor performance during skill practice. All children receiving 62% FB performed with greater error than children receiving 100% FB during the acquisition phase (p =.012), delayed retention no-feedback test (p =.017), and reacquisition phase (p =.042). Children with SHCP in both FB groups performed with significantly greater error than TDC during the entire acquisition phase (p \u3c .001), delayed retention no-feedback test (p = .031) and reacquisition phase (p = .001). While no significant within group feedback effect was found for children with SHCP, there was a trend for greater accuracy in the 100% group as compared to the 62% group during acquisition (p =.092) and this trend was seen again during reacquisition when FB was reintroduced (p =.092). Conclusions. Results suggest that for children with SHCP skill acquisition is furthered by visual FB regarding their movement accuracy. Children with SHCP use visual FB in a manner similar to TDC, although differences in learning were evident during the acquisition, delayed retention, and reacquisition phases. Further investigation is needed to determine clinical implications

Synergy-Based Human Grasp Representations and Semi-Autonomous Control of Prosthetic Hands

Das sichere und stabile Greifen mit humanoiden Roboterhänden stellt eine große Herausforderung dar. Diese Dissertation befasst sich daher mit der Ableitung von Greifstrategien für Roboterhände aus der Beobachtung menschlichen Greifens. Dabei liegt der Fokus auf der Betrachtung des gesamten Greifvorgangs. Dieser umfasst zum einen die Hand- und Fingertrajektorien während des Greifprozesses und zum anderen die Kontaktpunkte sowie den Kraftverlauf zwischen Hand und Objekt vom ersten Kontakt bis zum statisch stabilen Griff. Es werden nichtlineare posturale Synergien und Kraftsynergien menschlicher Griffe vorgestellt, die die Generierung menschenähnlicher Griffposen und Griffkräfte erlauben. Weiterhin werden Synergieprimitive als adaptierbare Repräsentation menschlicher Greifbewegungen entwickelt. Die beschriebenen, vom Menschen gelernten Greifstrategien werden für die Steuerung robotischer Prothesenhände angewendet. Im Rahmen einer semi-autonomen Steuerung werden menschenähnliche Greifbewegungen situationsgerecht vorgeschlagen und vom Nutzenden der Prothese überwacht

Stereoscopic bimanual interaction for 3D visualization

Virtual Environments (VE) are being widely used in various research fields for several decades such as 3D visualization, education, training and games. VEs have the potential to enhance the visualization and act as a general medium for human-computer interaction (HCI). However, limited research has evaluated virtual reality (VR) display technologies, monocular and binocular depth cues, for human depth perception of volumetric (non-polygonal) datasets. In addition, a lack of standardization of three-dimensional (3D) user interfaces (UI) makes it challenging to interact with many VE systems. To address these issues, this dissertation focuses on evaluation of effects of stereoscopic and head-coupled displays on depth judgment of volumetric dataset. It also focuses on evaluation of a two-handed view manipulation techniques which support simultaneous 7 degree-of-freedom (DOF) navigation (x,y,z + yaw,pitch,roll + scale) in a multi-scale virtual environment (MSVE). Furthermore, this dissertation evaluates auto-adjustment of stereo view parameters techniques for stereoscopic fusion problems in a MSVE. Next, this dissertation presents a bimanual, hybrid user interface which combines traditional tracking devices with computer-vision based "natural" 3D inputs for multi-dimensional visualization in a semi-immersive desktop VR system. In conclusion, this dissertation provides a guideline for research design for evaluating UI and interaction techniques

Bio-Inspired Motion Strategies for a Bimanual Manipulation Task

Steffen JF, Elbrechter C, Haschke R, Ritter H. Bio-Inspired Motion Strategies for a Bimanual Manipulation Task. In: International Conference on Humanoid Robots (Humanoids). 2010