A biomechanical investigation of seated balance and upright mobility with a robotic exoskeleton in individuals with a spinal cord injury

Spinal cord injury (SCI) is a complex medical condition with multiple sequelae. The level and severity of a lesion will determine the degree of disability and associated co- morbidities, the most obvious of which is paralysis. Other concomitant issues, such as muscle contractures, poor seated posture and fear of falling, can also lead to a reduced quality of life. Although there is currently no cure for SCI, many of the comorbidities can be managed or mitigated through technology and physical rehabilitation practices.The aim of this thesis was to inform spinal cord injury (SCI) mobility rehabilitation, focusing on postural control and upright stepping using robotic assisted gait training (RAGT). A systematic review investigating RAGT use in SCI concluded that although RAGT has the potential to benefit upright locomotion of SCI individuals, it should not replace other therapies but should be incorporated into a multi-modality rehabilitation approach.Seated postural control, upper-body posture and fear-of-falling in SCI individuals were also explored. Stability performance and control demand were compared between high- and low-level injury groups as was fear-of-falling. An individualised limit of stability boundary (LOS) facilitated the differentiation between high- and low-level injuries during static tasks; however, its use during dynamic tasks was limited and potentially influenced by fear-of-falling.Few studies have quantified the user’s motion inside a lower limb robotic exoskeleton (LEXO), and none have reported marker placement repeatability. Standard error of measurement was reported for three-dimensional trunk and pelvic orientations and hip, knee and ankle angles in the sagittal plane during level walking. This revealed the marker set and placement to produce good levels of agreement between visits, with most values falling between the accepted standard of 2-5o. These findings indicated that the marker placement was repeatable and could be used in the subsequent chapters involving motion capture of overground walking.Three-dimensional gait parameters of able-bodied individuals walking with and without a LEXO at two speeds (comfortable (CMBL) and speed-matched (SLOW) to the LEXO) were investigated. Statistical parametric mapping revealed significantly different waveforms at the ANOVA level for all kinematic variables, however minimal differences in sagittal plane lower limb kinematics were identified between LEXO and SLOW gait, suggesting LEXO gait resembled slow walking when speed-matched. Altered kinematics of the pelvis and trunk during LEXO use suggest that overground exoskeletons may provide a training environment benefiting postural control training.Finally, the biomechanical characteristics of able-bodied and SCI users walking in an overground LEXO were investigated. Variables associated with neuroplasticity in SCI (hip extension and lower limb un-loading) were not significantly different between groups, indicating that afferent stimuli to facilitate neuroplastic adaptations in individuals with a SCI can be generated during LEXO gait. Upper-body orientation facilitated stepping and maintained balance, thereby requiring the participant’s active involvement.This thesis has provided evidence that LEXOs can deliver appropriate stimuli for upright stepping and that upper-body engagement can facilitate postural control training, potentially leading to improved seated postural control

Sensores de fibra ótica para arquiteturas e-Health

In this work, optical fiber sensors were developed and optimized for biomedical applications in wearable and non-intrusive and/or invisible solutions. As it was intended that the developed devices would not interfere with the user's movements and their daily life, the fibre optic sensors presented several advantages when compared to conventional electronic sensors, among others, the following stand out: size and reduced weight, biocompatibility, safety, immunity to electromagnetic interference and high sensitivity. In a first step, wearable devices with fibre optic sensors based in Fiber Bragg gratings (FBG) were developed to be incorporated into insoles to monitor different walking parameters based on the analysis of the pressure exerted on several areas of the insole. Still within this theme, other sensors were developed using the same sensing technology, but capable of monitoring pressure and shear forces simultaneously. This work was pioneering and allowed monitoring one of the main causes of foot ulceration in people with diabetes: shear. At a later stage, the study focused on the issue related with the appearance of ulcers in people with reduced mobility and wheelchair users. In order to contribute to the mitigation of this scourge, a system was developed composed of a network of fibre optic sensors capable of monitoring the pressure at various points of the wheelchair. It not only measures the pressure at each point, but also monitors the posture of the wheelchair user and advises him/her to change posture regularly to reduce the probability of this pathology occurring. Still within this application, another work was developed where the sensor not only monitored the pressure but also the temperature in each of the analysis points, thus indirectly measuring shear. In another phase, plastic fibre optic sensors were studied and developed to monitor the body posture of an office chair user. Simultaneously, software was developed capable of monitoring and showing the user all the acquired data in real time and warning for incorrect postures, as well as advising for work breaks. In a fourth phase, the study focused on the development of highly sensitive sensors embedded in materials printed by a 3D printer. The sensor was composed of an optical fibre with a FBG and the sensor body of a flexible polymeric material called "Flexible". This material was printed on a 3D printer and during its printing the optical fibre was incorporated. The sensor proved to be highly sensitive and was able to monitor respiratory and cardiac rate, both in wearable solutions (chest and wrist) and in "invisible" solutions (office chair).Neste trabalho foram desenvolvidos e otimizados sensores em fibra ótica para aplicações biomédicas em soluções vestíveis e não intrusivas/ou invisíveis. Tendo em conta que se pretende que os dispositivos desenvolvidos não interfiram com os movimentos e o dia-a-dia do utilizador, os sensores de fibra ótica apresentam inúmeras vantagens quando comparados com os sensores eletrónicos convencionais, de entre várias, destacam-se: tamanho e peso reduzido, biocompatibilidade, segurança, imunidade a interferências eletromagnéticas e elevada sensibilidade. Numa primeira etapa, foram desenvolvidos dispositivos vestíveis com sensores de fibra ótica baseados em redes de Bragg (FBG) para incorporar em palmilhas de modo a monitorizar diferentes parâmetros da marcha com base na análise da pressão exercida em várias zonas da palmilha. Ainda no âmbito deste tema, adicionalmente, foram desenvolvidos sensores utilizando a mesma tecnologia de sensoriamento, mas capazes de monitorizar simultaneamente pressão e forças de cisalhamento. Este trabalho foi pioneiro e permitiu monitorizar um dos principais responsáveis pela ulceração dos pés em pessoas com diabetes: o cisalhamento. Numa fase posterior, o estudo centrou-se na temática relacionada com o aparecimento de úlceras em pessoas com mobilidade reduzida e utilizadores de cadeiras de rodas. De modo a contribuir para a mitigação deste flagelo, procurou-se desenvolver um sistema composto por uma rede de sensores de fibra ótica capaz de monitorizar a pressão em vários pontos de uma cadeira de rodas e não só aferir a pressão em cada ponto, mas monitorizar a postura do cadeirante e aconselhá-lo a mudar de postura com regularidade, de modo a diminuir a probabilidade de ocorrência desta patologia. Ainda dentro desta aplicação, foi publicado um outro trabalho onde o sensor não só monitoriza a pressão como também a temperatura em cada um dos pontos de análise, conseguindo aferir assim indiretamente o cisalhamento. Numa outra fase, foi realizado o estudo e desenvolvimento de sensores de fibra ótica de plástico para monitorizar a postura corporal de um utilizador de uma cadeira de escritório. Simultaneamente, foi desenvolvido um software capaz de monitorizar e mostrar ao utilizador todos os dados adquiridos em tempo real e advertir o utilizador de posturas incorretas, bem como aconselhar para pausas no trabalho. Numa quarta fase, o estudo centrou-se no desenvolvimento de sensores altamente sensíveis embebidos em materiais impressos 3D. O sensor é composto por uma fibra ótica com uma FBG e o corpo do sensor por um material polimérico flexível, denominado “Flexible”. O sensor foi impresso numa impressora 3D e durante a sua impressão foi incorporada a fibra ótica. O sensor demonstrou ser altamente sensível e foi capaz de monitorizar frequência respiratória e cardíaca, tanto em soluções vestíveis (peito e pulso) como em soluções “invisíveis” (cadeira de escritório).Programa Doutoral em Engenharia Físic

Development and Biomechanical Analysis toward a Mechanically Passive Wearable Shoulder Exoskeleton

Shoulder disability is a prevalent health issue associated with various orthopedic and neurological conditions, like rotator cuff tear and peripheral nerve injury. Many individuals with shoulder disability experience mild to moderate impairment and struggle with elevating the shoulder or holding the arm against gravity. To address this clinical need, I have focused my research on developing wearable passive exoskeletons that provide continuous at-home movement assistance. Through a combination of experiments and computational tools, I aim to optimize the design of these exoskeletons. In pursuit of this goal, I have designed, fabricated, and preliminarily evaluated a wearable, passive, cam-driven shoulder exoskeleton prototype. Notably, the exoskeleton features a modular spring-cam-wheel module, allowing customizable assistive force to compensate for different proportions of the shoulder elevation moment due to gravity. The results of my research demonstrated that this exoskeleton, providing modest one-fourth gravity moment compensation at the shoulder, can effectively reduce muscle activity, including deltoid and rotator cuff muscles. One crucial aspect of passive shoulder exoskeleton design is determining the optimal anti-gravity assistance level. I have addressed this challenge using computational tools and found that an assistance level within the range of 20-30% of the maximum gravity torque at the shoulder joint yields superior performance for specific shoulder functional tasks. When facing a new task dynamic, such as wearing a passive shoulder exoskeleton, the human neuro-musculoskeletal system adapts and modulates limb impedance at the end-limb (i.e., hand) to enhance task stability. I have presented development and validation of a realistic neuromusculoskeletal model of the upper limb that can predict stiffness modulation and motor adaptation in response to newly introduced environments and force fields. Future studies will explore the model\u27s applicability in predicting stiffness modulation for 3D movements in novel environments, such as passive assistive devices\u27 force fields

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 374)

This bibliography lists 227 reports, articles and other documents introduced into the NASA Scientific and Technical Information System during Apr. 1993. Subject coverage includes: aerospace medicine and physiology, life support systems and man/system technology, protective clothing, exobiology and extraterrestrial life, planetary biology, and flight crew behavior and performance

Gain and loss of functional locomotor recovery following contusive spinal cord injury in the adult rat.

Activity-based rehabilitation in the form of overground or body weight-supported treadmill (BWST) locomotor step training has become the most widely accepted therapy translated from preclinical animal research to spinal cord injury (SCI) patients. However, locomotor training does not provide the level of functional locomotor recovery that animal models are interpreted to promise because preclinical studies have used complete spinal cord transections that do not sufficiently mimic the clinical presentation. Furthermore, animal models do not include the same standard of care, immobilization with stretch/range-ofmotion manual therapies, SCI patients receive. Therefore, we have developed an experimental animal model that includes aspects of acute patient care, immobilization and manual therapy interventions, applied daily throughout the 8 weeks following incomplete low thoracic contusion SCI in adult rats. We hypothesize that laboratory animals with clinically relevant incomplete contusion SCI achieve maximal locomotor recovery while moving about in their cages, auto-training, within the first few weeks post-injury. Our results show that when immobilization and/or manual therapy interventions are applied the animals suffer severe short-term loss of locomotor function that significantly limits potential for long-term recovery even weeks after the interventions end. Our studies suggest that immobilization and widely practiced manual therapies may be maladaptive for functional locomotor recovery after clinically relevant incomplete SCI

A review of the effectiveness of lower limb orthoses used in cerebral palsy

To produce this review, a systematic literature search was conducted for relevant articles published in the period between the date of the previous ISPO consensus conference report on cerebral palsy (1994) and April 2008. The search terms were 'cerebral and pals* (palsy, palsies), 'hemiplegia', 'diplegia', 'orthos*' (orthoses, orthosis) orthot* (orthotic, orthotics), brace or AFO

Mobile Robots Navigation

Mobile robots navigation includes different interrelated activities: (i) perception, as obtaining and interpreting sensory information; (ii) exploration, as the strategy that guides the robot to select the next direction to go; (iii) mapping, involving the construction of a spatial representation by using the sensory information perceived; (iv) localization, as the strategy to estimate the robot position within the spatial map; (v) path planning, as the strategy to find a path towards a goal location being optimal or not; and (vi) path execution, where motor actions are determined and adapted to environmental changes. The book addresses those activities by integrating results from the research work of several authors all over the world. Research cases are documented in 32 chapters organized within 7 categories next described

Neuroprosthetic Technologies to Evaluate and Train Leg Motor Control in Neurologically Impaired Individuals

Spinal cord injury (SCI) disrupts many essential sensorimotor and autonomic functions. Consequently, individuals with SCI can face decades with permanent disabilities. Advances in clinical management have decreased morbidity, but no clinical trial has yet demonstrated the efficacy of a repair strategy. In the past decade, Courtine lab has developed neurotechnologies that restored volitional control of locomotion in animal models of SCI. The intervention acts over two-time windows. In the short-term, the delivery of epidural electrical stimulation (EES) targeting the posterior lumbar roots with timing that mimics the natural activation of the spinal cord enables stepping in otherwise paralyzed rats. In the long-term, this targeted EES with intensive robot-assisted overground training triggers a reorganization of descending pathways that reestablished voluntary control of the paralyzed legs, even without EES. These results in animal models encouraged the transfer of these technologies and concepts to clinical applications. My contribution to this translational research program forms the core of my thesis. The first section presents a software that I developed in order to enable a comprehensive yet semi-automated analysis of kinematics and muscle activity underlying locomotor functions in humans. This toolbox allows to evaluate gait features of people with neuromotor deficits, quantify locomotor performance compared to healthy people or to monitor changes in different experimental conditions or over the time course of interventions, and automatically generate comprehensive gait reports directly understandable by scientists and clinicians. The second section introduces a paradigm shift in robotic postural assistance: the gravity-assist. We demonstrated the detrimental impact of high levels of body weight support on gravity-dependent interactions during standing and walking. We developed a gravity-assist algorithm that fine-tunes the forward and upward body weight support to reestablish these interactions based on each patientâs residual capacities. We validated the personalized gravity-assist in 30 individuals with SCI or stroke. Compared to other conditions of support, the gravity-assist enabled all the patients to improve their locomotion performance. This platform establishes refined conditions to empower and train overground locomotion in a safe yet ecological environment. The third section reports the development of targeted EES in patients with chronic SCI, and the impact of an intensive 5-month rehabilitation with gravity-assist and targeted EES on the recovery of motor functions. The key findings can be summarized as follows: We established procedures to configure targeted EES that immediately enabled voluntary control of weak or paralyzed muscles; Targeted EES boosts the residual supraspinal inputs to the lumbar spinal cord, enabling all the patients to adapt their gait to specific tasks; Locomotor performance improved during the rehabilitation; All the patients regained voluntary control over previously paralyzed muscles without EES. These combined results establish the proof-of-concept on the therapeutic potential of targeted EES and intensive, robot-assisted rehabilitation to restore locomotion after SCI. Together with similar results obtained in the US in patients with severe SCI, our findings are establishing a pathway towards the development of a viable treatment to support motor functions and improve recovery after SCI

A Multi-Modal, Modified-Feedback and Self-Paced Brain-Computer Interface (BCI) to Control an Embodied Avatar's Gait

Brain-computer interfaces (BCI) have been used to control the gait of a virtual self-avatar with the aim of being used in gait rehabilitation. A BCI decodes the brain signals representing a desire to do something and transforms them into a control command for controlling external devices. The feelings described by the participants when they control a self-avatar in an immersive virtual environment (VE) demonstrate that humans can be embodied in the surrogate body of an avatar (ownership illusion). It has recently been shown that inducing the ownership illusion and then manipulating the movements of one’s self-avatar can lead to compensatory motor control strategies. In order to maximize this effect, there is a need for a method that measures and monitors embodiment levels of participants immersed in virtual reality (VR) to induce and maintain a strong ownership illusion. This is particularly true given that reaching a high level of both BCI performance and embodiment are inter-connected. To reach one of them, the second must be reached as well. Some limitations of many existing systems hinder their adoption for neurorehabilitation: 1- some use motor imagery (MI) of movements other than gait; 2- most systems allow the user to take single steps or to walk but do not allow both, which prevents users from progressing from steps to gait; 3- most of them function in a single BCI mode (cue-paced or self-paced), which prevents users from progressing from machine-dependent to machine-independent walking. Overcoming the aforementioned limitations can be done by combining different control modes and options in one single system. However, this would have a negative impact on BCI performance, therefore diminishing its usefulness as a potential rehabilitation tool. In this case, there will be a need to enhance BCI performance. For such purpose, many techniques have been used in the literature, such as providing modified feedback (whereby the presented feedback is not consistent with the user’s MI), sequential training (recalibrating the classifier as more data becomes available). This thesis was developed over 3 studies. The objective in study 1 was to investigate the possibility of measuring the level of embodiment of an immersive self-avatar, during the performing, observing and imagining of gait, using electroencephalogram (EEG) techniques, by presenting visual feedback that conflicts with the desired movement of embodied participants. The objective of study 2 was to develop and validate a BCI to control single steps and forward walking of an immersive virtual reality (VR) self-avatar, using mental imagery of these actions, in cue-paced and self-paced modes. Different performance enhancement strategies were implemented to increase BCI performance. The data of these two studies were then used in study 3 to construct a generic classifier that could eliminate offline calibration for future users and shorten training time. Twenty different healthy participants took part in studies 1 and 2. In study 1, participants wore an EEG cap and motion capture markers, with an avatar displayed in a head-mounted display (HMD) from a first-person perspective (1PP). They were cued to either perform, watch or imagine a single step forward or to initiate walking on a treadmill. For some of the trials, the avatar took a step with the contralateral limb or stopped walking before the participant stopped (modified feedback). In study 2, participants completed a 4-day sequential training to control the gait of an avatar in both BCI modes. In cue-paced mode, they were cued to imagine a single step forward, using their right or left foot, or to walk forward. In the self-paced mode, they were instructed to reach a target using the MI of multiple steps (switch control mode) or maintaining the MI of forward walking (continuous control mode). The avatar moved as a response to two calibrated regularized linear discriminant analysis (RLDA) classifiers that used the μ power spectral density (PSD) over the foot area of the motor cortex as features. The classifiers were retrained after every session. During the training, and for some of the trials, positive modified feedback was presented to half of the participants, where the avatar moved correctly regardless of the participant’s real performance. In both studies, the participants’ subjective experience was analyzed using a questionnaire. Results of study 1 show that subjective levels of embodiment correlate strongly with the power differences of the event-related synchronization (ERS) within the μ frequency band, and over the motor and pre-motor cortices between the modified and regular feedback trials. Results of study 2 show that all participants were able to operate the cued-paced BCI and the selfpaced BCI in both modes. For the cue-paced BCI, the average offline performance (classification rate) on day 1 was 67±6.1% and 86±6.1% on day 3, showing that the recalibration of the classifiers enhanced the offline performance of the BCI (p < 0.01). The average online performance was 85.9±8.4% for the modified feedback group (77-97%) versus 75% for the non-modified feedback group. For self-paced BCI, the average performance was 83% at switch control and 92% at continuous control mode, with a maximum of 12 seconds of control. Modified feedback enhanced BCI performances (p =0.001). Finally, results of study 3 show that the constructed generic models performed as well as models obtained from participant-specific offline data. The results show that there it is possible to design a participant-independent zero-training BCI.Les interfaces cerveau-ordinateur (ICO) ont été utilisées pour contrôler la marche d'un égo-avatar virtuel dans le but d'être utilisées dans la réadaptation de la marche. Une ICO décode les signaux du cerveau représentant un désir de faire produire un mouvement et les transforme en une commande de contrôle pour contrôler des appareils externes. Les sentiments décrits par les participants lorsqu'ils contrôlent un égo-avatar dans un environnement virtuel immersif démontrent que les humains peuvent être incarnés dans un corps d'un avatar (illusion de propriété). Il a été récemment démontré que provoquer l’illusion de propriété puis manipuler les mouvements de l’égo-avatar peut conduire à des stratégies de contrôle moteur compensatoire. Afin de maximiser cet effet, il existe un besoin d'une méthode qui mesure et surveille les niveaux d’incarnation des participants immergés dans la réalité virtuelle (RV) pour induire et maintenir une forte illusion de propriété. D'autre part, atteindre un niveau élevé de performances (taux de classification) ICO et d’incarnation est interconnecté. Pour atteindre l'un d'eux, le second doit également être atteint. Certaines limitations de plusieurs de ces systèmes entravent leur adoption pour la neuroréhabilitation: 1- certains utilisent l'imagerie motrice (IM) des mouvements autres que la marche; 2- la plupart des systèmes permettent à l'utilisateur de faire des pas simples ou de marcher mais pas les deux, ce qui ne permet pas à un utilisateur de passer des pas à la marche; 3- la plupart fonctionnent en un seul mode d’ICO, rythmé (cue-paced) ou auto-rythmé (self-paced). Surmonter les limitations susmentionnées peut être fait en combinant différents modes et options de commande dans un seul système. Cependant, cela aurait un impact négatif sur les performances de l’ICO, diminuant ainsi son utilité en tant qu'outil potentiel de réhabilitation. Dans ce cas, il sera nécessaire d'améliorer les performances des ICO. À cette fin, de nombreuses techniques ont été utilisées dans la littérature, telles que la rétroaction modifiée, le recalibrage du classificateur et l'utilisation d'un classificateur générique. Le projet de cette thèse a été réalisé en 3 études, avec objectif d'étudier dans l'étude 1, la possibilité de mesurer le niveau d'incarnation d'un égo-avatar immersif, lors de l'exécution, de l'observation et de l'imagination de la marche, à l'aide des techniques encéphalogramme (EEG), en présentant une rétroaction visuelle qui entre en conflit avec la commande du contrôle moteur des sujets incarnés. L'objectif de l'étude 2 était de développer un BCI pour contrôler les pas et la marche vers l’avant d'un égo-avatar dans la réalité virtuelle immersive, en utilisant l'imagerie motrice de ces actions, dans des modes rythmés et auto-rythmés. Différentes stratégies d'amélioration des performances ont été mises en œuvre pour augmenter la performance (taux de classification) de l’ICO. Les données de ces deux études ont ensuite été utilisées dans l'étude 3 pour construire des classificateurs génériques qui pourraient éliminer la calibration hors ligne pour les futurs utilisateurs et raccourcir le temps de formation. Vingt participants sains différents ont participé aux études 1 et 2. Dans l'étude 1, les participants portaient un casque EEG et des marqueurs de capture de mouvement, avec un avatar affiché dans un casque de RV du point de vue de la première personne (1PP). Ils ont été invités à performer, à regarder ou à imaginer un seul pas en avant ou la marche vers l’avant (pour quelques secondes) sur le tapis roulant. Pour certains essais, l'avatar a fait un pas avec le membre controlatéral ou a arrêté de marcher avant que le participant ne s'arrête (rétroaction modifiée). Dans l'étude 2, les participants ont participé à un entrainement séquentiel de 4 jours pour contrôler la marche d'un avatar dans les deux modes de l’ICO. En mode rythmé, ils ont imaginé un seul pas en avant, en utilisant leur pied droit ou gauche, ou la marche vers l’avant . En mode auto-rythmé, il leur a été demandé d'atteindre une cible en utilisant l'imagerie motrice (IM) de plusieurs pas (mode de contrôle intermittent) ou en maintenir l'IM de marche vers l’avant (mode de contrôle continu). L'avatar s'est déplacé en réponse à deux classificateurs ‘Regularized Linear Discriminant Analysis’ (RLDA) calibrés qui utilisaient comme caractéristiques la densité spectrale de puissance (Power Spectral Density; PSD) des bandes de fréquences µ (8-12 Hz) sur la zone du pied du cortex moteur. Les classificateurs ont été recalibrés après chaque session. Au cours de l’entrainement et pour certains des essais, une rétroaction modifiée positive a été présentée à la moitié des participants, où l'avatar s'est déplacé correctement quelle que soit la performance réelle du participant. Dans les deux études, l'expérience subjective des participants a été analysée à l'aide d'un questionnaire. Les résultats de l'étude 1 montrent que les niveaux subjectifs d’incarnation sont fortement corrélés à la différence de la puissance de la synchronisation liée à l’événement (Event-Related Synchronization; ERS) sur la bande de fréquence μ et sur le cortex moteur et prémoteur entre les essais de rétroaction modifiés et réguliers. L'étude 2 a montré que tous les participants étaient capables d’utiliser le BCI rythmé et auto-rythmé dans les deux modes. Pour le BCI rythmé, la performance hors ligne moyenne au jour 1 était de 67±6,1% et 86±6,1% au jour 3, ce qui montre que le recalibrage des classificateurs a amélioré la performance hors ligne du BCI (p <0,01). La performance en ligne moyenne était de 85,9±8,4% pour le groupe de rétroaction modifié (77-97%) contre 75% pour le groupe de rétroaction non modifié. Pour le BCI auto-rythmé, la performance moyenne était de 83% en commande de commutateur et de 92% en mode de commande continue, avec un maximum de 12 secondes de commande. Les performances de l’ICO ont été améliorées par la rétroaction modifiée (p = 0,001). Enfin, les résultats de l'étude 3 montrent que pour la classification des initialisations des pas et de la marche, il a été possible de construire des modèles génériques à partir de données hors ligne spécifiques aux participants. Les résultats montrent la possibilité de concevoir une ICO ne nécessitant aucun entraînement spécifique au participant