Sensory Augmentation for Balance Rehabilitation Using Skin Stretch Feedback

This dissertation focuses on the development and evaluation of portable sensory augmentation systems that render skin-stretch feedback of posture for standing balance training and for postural control improvement. Falling is one of the main causes of fatal injuries among all members of the population. The high incidence of fall-related injuries also leads to high medical expenses, which cost approximately $34 billion annually in the United States. People with neurological diseases, e.g., stroke, multiple sclerosis, spinal cord injuries, and the elderly are more prone to falling when compared to healthy individuals. Falls among these populations can also lead to hip fracture, or even death. Thus, several balance and gait rehabilitation approaches have been developed to reduce the risk of falling. Traditionally, a balance-retraining program includes a series of exercises for trainees to strengthen their sensorimotor and musculoskeletal systems. Recent advances in technology have incorporated biofeedback such as visual, auditory, or haptic feedback to provide the users with extra cues about their postural sway. Studies have also demonstrated the positive effects of biofeedback on balance control. However, current applications of biofeedback for interventions in people with impaired balance are still lacking some important characteristics such as portability (in-home care), small-size, and long-term viability. Inspired by the concept of light touch, a light, small, and wearable sensory augmentation system that detects body sway and supplements skin stretch on one’s fingertip pad was first developed. The addition of a shear tactile display could significantly enhance the sensation to body movement. Preliminary results have shown that the application of passive skin stretch feedback at the fingertip enhanced standing balance of healthy young adults. Based on these findings, two research directions were initiated to investigate i) which dynamical information of postural sway could be more effectively conveyed by skin stretch feedback, and ii) how can such feedback device be easily used in the clinical setting or on a daily basis. The major sections of this research are focused on understanding how the skin stretch feedback affects the standing balance and on quantifying the ability of humans to interpret the cutaneous feedback as the cues of their physiological states. Experimental results from both static and dynamic balancing tasks revealed that healthy subjects were able to respond to the cues and subsequently correct their posture. However, it was observed that the postural sway did not generally improve in healthy subjects due to skin stretch feedback. A possible reason was that healthy subjects already had good enough quality sensory information such that the additional artificial biofeedback may have interfered with other sensory cues. Experiments incorporating simulated sensory deficits were further conducted and it was found that subjects with perturbed sensory systems (e.g., unstable surface) showed improved balance due to skin stretch feedback when compared to the neutral standing conditions. Positive impacts on balance performance have also been demonstrated among multiple sclerosis patients when they receive skin stretch feedback from a sensory augmentation walker. The findings in this research indicated that the skin stretch feedback rendered by the developed devices affected the human balance and can potentially compensate underlying neurological or musculoskeletal disorders, therefore enhancing quiet standing postural control

Sensory Augmentation for Balance Rehabilitation Using Skin Stretch Feedback

This dissertation focuses on the development and evaluation of portable sensory augmentation systems that render skin-stretch feedback of posture for standing balance training and for postural control improvement. Falling is one of the main causes of fatal injuries among all members of the population. The high incidence of fall-related injuries also leads to high medical expenses, which cost approximately $34 billion annually in the United States. People with neurological diseases, e.g., stroke, multiple sclerosis, spinal cord injuries, and the elderly are more prone to falling when compared to healthy individuals. Falls among these populations can also lead to hip fracture, or even death. Thus, several balance and gait rehabilitation approaches have been developed to reduce the risk of falling. Traditionally, a balance-retraining program includes a series of exercises for trainees to strengthen their sensorimotor and musculoskeletal systems. Recent advances in technology have incorporated biofeedback such as visual, auditory, or haptic feedback to provide the users with extra cues about their postural sway. Studies have also demonstrated the positive effects of biofeedback on balance control. However, current applications of biofeedback for interventions in people with impaired balance are still lacking some important characteristics such as portability (in-home care), small-size, and long-term viability. Inspired by the concept of light touch, a light, small, and wearable sensory augmentation system that detects body sway and supplements skin stretch on one’s fingertip pad was first developed. The addition of a shear tactile display could significantly enhance the sensation to body movement. Preliminary results have shown that the application of passive skin stretch feedback at the fingertip enhanced standing balance of healthy young adults. Based on these findings, two research directions were initiated to investigate i) which dynamical information of postural sway could be more effectively conveyed by skin stretch feedback, and ii) how can such feedback device be easily used in the clinical setting or on a daily basis. The major sections of this research are focused on understanding how the skin stretch feedback affects the standing balance and on quantifying the ability of humans to interpret the cutaneous feedback as the cues of their physiological states. Experimental results from both static and dynamic balancing tasks revealed that healthy subjects were able to respond to the cues and subsequently correct their posture. However, it was observed that the postural sway did not generally improve in healthy subjects due to skin stretch feedback. A possible reason was that healthy subjects already had good enough quality sensory information such that the additional artificial biofeedback may have interfered with other sensory cues. Experiments incorporating simulated sensory deficits were further conducted and it was found that subjects with perturbed sensory systems (e.g., unstable surface) showed improved balance due to skin stretch feedback when compared to the neutral standing conditions. Positive impacts on balance performance have also been demonstrated among multiple sclerosis patients when they receive skin stretch feedback from a sensory augmentation walker. The findings in this research indicated that the skin stretch feedback rendered by the developed devices affected the human balance and can potentially compensate underlying neurological or musculoskeletal disorders, therefore enhancing quiet standing postural control

Interação com sistema de infotainment de um veículo, implementação e avaliação de gestos e técnicas hápticas

Atualmente, a maioria dos fabricantes automóveis incorpora um ecrã táctil no sistema de infotainment dos seus veículos. Ao contrário de interfaces tradicionais, compostas por controlos físicos e tangíveis, como botões, os ecrãs tácteis não permitem receber feedback táctil sobre o posicionamento, forma, ou outras caraterísticas dos controlos. Isto leva a que a interação com estes dispositivos requeira a atenção visual do utilizador. Sendo a condução uma tarefa principalmente visual, constata-se que o uso destes sistemas modernos leva a um aumento da distração do condutor e, consequentemente, do risco de acidente ou quase-acidente. Para resolver estas desvantagens, este trabalho teve como objetivo a criação de um sistema inovador que permita interagir com o ecrã táctil de um sistema de infotainment moderno de uma forma mais intuitiva e com menos dependência da atenção visual do utilizador. Para tal, foi idealizado e desenvolvido um sistema composto por dois módulos – um módulo responsável pela interação com o ecrã táctil, e um módulo responsável por proporcionar feedback háptico ao utilizador. O primeiro módulo consiste num sistema de rastreio da mão que permite traduzir o gesto de apontar para o ecrã em uma posição discreta, permitindo fornecer feedback ao utilizador antes de realizar o toque. O segundo módulo consiste num conjunto de atuadores hápticos montados no volante, onde o condutor assenta a sua mão esquerda. Este módulo permite transmitir informação pertinente na forma de padrões de vibração. Os módulos foram desenvolvidos independentemente e integrados no sistema final após as iterações necessárias. O sistema foi avaliado através de um conjunto de tarefas comuns realizadas nos sistemas de infotainment, e foi comparado com a interação tradicional com estes sistemas, sem qualquer tipo de feedback háptico ou método de interação invulgar. Foram registadas métricas relevantes, tais como número de desvios visuais para fora da estrada, duração total desses desvios, desvio na condução, e carga de trabalho subjetiva. O sistema alcançou as expetativas, levando a uma melhoria em várias das métricas registadas, e não piorou a qualidade da condução nem a carga subjetiva de trabalho, apesar de introduzir feedback e uma nova técnica de interação.Nowadays, most carmakers incorporate touchscreens in their vehicles’ infotainment system. Unlike traditional interfaces, with tangible, physical controls, like buttons, touchscreens aren’t capable of transmitting tactile feedback about the controls’ positioning, shape, or other physical characteristics. This means that interacting with these devices requires the user’s visual attention. As driving is a mainly visual task, using these systems leads to increased driver distraction and, consequently, increased risk of accident or near-accident. To solve these disadvantages, this body of work’s main focus was creating an innovative system that allows interacting with a modern infotainment system’s touchscreen in a more intuitive fashion that requires less visual attention by the user. To accomplish this goal, a system was idealized, composed by two modules – a module responsible for the interaction with the touchscreen, and a module responsible for providing the user with haptic feedback. The first module consists of a system that tracks the user’s hand and translates the pointing gesture to a discrete position on the screen, allowing the system to provide feedback before the user touches the screen. The second module consists of a set of haptic actuators mounted on the steering wheel, where the driver rests his/her left hand. This module allows the transmission of relevant information in the form of vibration patterns. The modules were developed independently and integrated in the final system after the necessary iterations. The system was evaluated through a set of tasks commonly performed in infotainment systems, and was compared against traditional interaction with these systems, without any type of feedback or unusual interaction method. Relevant metrics, such as number of glances outside the road, the total duration of those glances, driving deviation, and subjective workload, were recorded. The system met expectations, leading to improvements across several of the recorded metrics, and did not negatively affect driving performance or the subjective workload, despite introducing feedback and a new interaction technique

Medical Robotics

The first generation of surgical robots are already being installed in a number of operating rooms around the world. Robotics is being introduced to medicine because it allows for unprecedented control and precision of surgical instruments in minimally invasive procedures. So far, robots have been used to position an endoscope, perform gallbladder surgery and correct gastroesophogeal reflux and heartburn. The ultimate goal of the robotic surgery field is to design a robot that can be used to perform closed-chest, beating-heart surgery. The use of robotics in surgery will expand over the next decades without any doubt. Minimally Invasive Surgery (MIS) is a revolutionary approach in surgery. In MIS, the operation is performed with instruments and viewing equipment inserted into the body through small incisions created by the surgeon, in contrast to open surgery with large incisions. This minimizes surgical trauma and damage to healthy tissue, resulting in shorter patient recovery time. The aim of this book is to provide an overview of the state-of-art, to present new ideas, original results and practical experiences in this expanding area. Nevertheless, many chapters in the book concern advanced research on this growing area. The book provides critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies. This book is certainly a small sample of the research activity on Medical Robotics going on around the globe as you read it, but it surely covers a good deal of what has been done in the field recently, and as such it works as a valuable source for researchers interested in the involved subjects, whether they are currently “medical roboticists” or not

Haptics: Science, Technology, Applications

This open access book constitutes the proceedings of the 12th International Conference on Human Haptic Sensing and Touch Enabled Computer Applications, EuroHaptics 2020, held in Leiden, The Netherlands, in September 2020. The 60 papers presented in this volume were carefully reviewed and selected from 111 submissions. The were organized in topical sections on haptic science, haptic technology, and haptic applications. This year's focus is on accessibility

Haptic Media Scenes

The aim of this thesis is to apply new media phenomenological and enactive embodied cognition approaches to explain the role of haptic sensitivity and communication in personal computer environments for productivity. Prior theory has given little attention to the role of haptic senses in influencing cognitive processes, and do not frame the richness of haptic communication in interaction design—as haptic interactivity in HCI has historically tended to be designed and analyzed from a perspective on communication as transmissions, sending and receiving haptic signals. The haptic sense may not only mediate contact confirmation and affirmation, but also rich semiotic and affective messages—yet this is a strong contrast between this inherent ability of haptic perception, and current day support for such haptic communication interfaces. I therefore ask: How do the haptic senses (touch and proprioception) impact our cognitive faculty when mediated through digital and sensor technologies? How may these insights be employed in interface design to facilitate rich haptic communication? To answer these questions, I use theoretical close readings that embrace two research fields, new media phenomenology and enactive embodied cognition. The theoretical discussion is supported by neuroscientific evidence, and tested empirically through case studies centered on digital art. I use these insights to develop the concept of the haptic figura, an analytical tool to frame the communicative qualities of haptic media. The concept gauges rich machine- mediated haptic interactivity and communication in systems with a material solution supporting active haptic perception, and the mediation of semiotic and affective messages that are understood and felt. As such the concept may function as a design tool for developers, but also for media critics evaluating haptic media. The tool is used to frame a discussion on opportunities and shortcomings of haptic interfaces for productivity, differentiating between media systems for the hand and the full body. The significance of this investigation is demonstrating that haptic communication is an underutilized element in personal computer environments for productivity and providing an analytical framework for a more nuanced understanding of haptic communication as enabling the mediation of a range of semiotic and affective messages, beyond notification and confirmation interactivity

Being Jacques Villeneuve: Formula One, 'Agency' and the Fan

DVD disc of supplementary material available with the print copy of this thesis, held at the University of Waikato Library.In this thesis, I analyse my fandom for the Formula One driver, Jacques Villeneuve. Despite its rampant commercialism, innovative mediation, prestige and popular status within global sport, Formula One is surprisingly an under-researched topic in academia. Moreover, 'intense' fandom has often been stigmatised; at worst associating such individuals with pathological and obsessive behaviours or refuting their affections as merely symptomatic of the socio-economic forces that transform fans into duped consumers. This thesis argues against such simplistic disqualifications and reconceptualises fandom in light of how the structure/agency binary has itself been reconceptualised within media and cultural studies. Rather than privileging either the determining social, mediated and commercial structures, or championing the 'active agential' capacities of social individuals, Grossberg's notions of 'affect' and 'structured mobility' are drawn upon to underpin a more flexible explanation of contemporary fandom. In particular, affect offers theoretical purchase for how fans form attachments with selective media objects and why these come to 'matter' for specific individuals. Furthermore, by marrying affect with 'structured mobility', affective investments are recognised for their capacity to 'anchor' individuals in specific and concrete spatial/temporal 'moments' of social reality as they navigate both the mediated apparatus of the sport and the structured social, cultural and economic terrain that shapes their mediated fandom. Such insights are developed through a 'funnelling' approach in this thesis which moves from an examination of collective Formula One fandom to my own, exploring the affective traces of a friction that Villeneuve's maverick status provided within the broader machinery of the sport and to which this fan has responded