integration of enhanced optical tracking techniques and imaging in igrt

Patient setup/Optical tracking/IGRT/Treatment surveillance. In external beam radiotherapy, modern technologies for dynamic dose delivery and beam conformation provide high selectivity in radiation dose administration to the pathological volume. A comparable accuracy level is needed in the 3-D localization of tumor and organs at risk (OARs), in order to accomplish the planned dose distribution in the reality of each irradiation session. In-room imaging techniques for patient setup verification and tumor targeting may benefit of the combined daily use of optical tracking technologies, supported by techniques for the detection and compensation of organ motion events. Multiple solutions to enhance the use of optical tracking for the on-line correction of target localization uncertainties are described, with specific emphasis on the compensation of setup errors, breathing movements and non-rigid deformations. The final goal is the implementation of customized protocols where appropriate external landmarks, to be tracked in real-time by means of noninvasive optical devices, are selected as a function of inner target localization. The presented methodology features high accuracy in patient setup optimization, also providing a valuable tool for on-line patient surveillance, taking into account both breathing and deformation effects. The methodic application of optical tracking is put forward to represent a reliable and low cost procedure for the reduction of safety margins, once the patient-specific correlation between external landmarks and inner structures has been established. Therefore, the integration of optical tracking with in-room imaging devices is proposed as a way to gain higher confidence in the framework of Image Guided Radiation Therapy (IGRT) treatments

Wearables for Movement Analysis in Healthcare

Quantitative movement analysis is widely used in clinical practice and research to investigate movement disorders objectively and in a complete way. Conventionally, body segment kinematic and kinetic parameters are measured in gait laboratories using marker-based optoelectronic systems, force plates, and electromyographic systems. Although movement analyses are considered accurate, the availability of specific laboratories, high costs, and dependency on trained users sometimes limit its use in clinical practice. A variety of compact wearable sensors are available today and have allowed researchers and clinicians to pursue applications in which individuals are monitored in their homes and in community settings within different fields of study, such movement analysis. Wearable sensors may thus contribute to the implementation of quantitative movement analyses even during out-patient use to reduce evaluation times and to provide objective, quantifiable data on the patients’ capabilities, unobtrusively and continuously, for clinical purposes

Upper-limb Kinematic Analysis and Artificial Intelligent Techniques for Neurorehabilitation and Assistive Environments

Stroke, one of the leading causes of death and disability around the world, usually affects the motor cortex causing weakness or paralysis in the limbs of one side of the body. Research efforts in neurorehabilitation technology have focused on the development of robotic devices to restore motor and cognitive function in impaired individuals, having the potential to deliver high-intensity and motivating therapy. End-effector-based devices have become an usual tool in the upper- limb neurorehabilitation due to the ease of adapting to patients. However, they are unable to measure the joint movements during the exercise. Thus, the first part of this thesis is focused on the development of a kinematic reconstruction algorithm that can be used in a real rehabilitation environment, without disturbing the normal patient-clinician interaction. On the basis of the algorithm found in the literature that presents some instabilities, a new algorithm is developed. The proposed algorithm is the first one able to online estimate not only the upper-limb joints, but also the trunk compensation using only two non-invasive wearable devices, placed onto the shoulder and upper arm of the patient. This new tool will allow the therapist to perform a comprehensive assessment combining the range of movement with clinical assessment scales. Knowing that the intensity of the therapy improves the outcomes of neurorehabilitation, a ‘self-managed’ rehabilitation system can allow the patients to continue the rehabilitation at home. This thesis proposes a system to online measure a set of upper-limb rehabilitation gestures, and intelligently evaluates the quality of the exercise performed by the patients. The assessment is performed through the study of the performed movement as a whole as well as evaluating each joint independently. The first results are promising and suggest that this system can became a a new tool to complement the clinical therapy at home and improve the rehabilitation outcomes. Finally, severe motor condition can remain after rehabilitation process. Thus, a technology solution for these patients and people with severe motor disabilities is proposed. An intelligent environmental control interface is developed with the ability to adapt its scan control to the residual capabilities of the user. Furthermore, the system estimates the intention of the user from the environmental information and the behavior of the user, helping in the navigation through the interface, improving its independence at home.El accidente cerebrovascular o ictus es una de las causas principales de muerte y discapacidad a nivel mundial. Normalmente afecta a la corteza motora causando debilidad o parálisis en las articulaciones del mismo lado del cuerpo. Los esfuerzos de investigación dentro de la tecnología de neurorehabilitación se han centrado en el desarrollo de dispositivos robóticos para restaurar las funciones motoras y cognitivas en las personas con esta discapacidad, teniendo un gran potencial para ofrecer una terapia de alta intensidad y motivadora. Los dispositivos basados en efector final se han convertido en una herramienta habitual en la neurorehabilitación de miembro superior ya que es muy sencillo adaptarlo a los pacientes. Sin embargo, éstos no son capaces de medir los movimientos articulares durante la realización del ejercicio. Por tanto, la primera parte de esta tesis se centra en el desarrollo de un algoritmo de reconstrucción cinemática que pueda ser usado en un entorno de rehabilitación real, sin perjudicar a la interacción normal entre el paciente y el clínico. Partiendo de la base que propone el algoritmo encontrado en la literatura, el cual presenta algunas inestabilidades, se ha desarrollado un nuevo algoritmo. El algoritmo propuesto es el primero capaz de estimar en tiempo real no sólo las articulaciones del miembro superior, sino también la compensación del tronco usando solamente dos dispositivos no invasivos y portátiles, colocados sobre el hombro y el brazo del paciente. Esta nueva herramienta permite al terapeuta realizar una valoración más exhaustiva combinando el rango de movimiento con las escalas de valoración clínicas. Sabiendo que la intensidad de la terapia mejora los resultados de la recuperación del ictus, un sistema de rehabilitación ‘auto-gestionado’ permite a los pacientes continuar con la rehabilitación en casa. Esta tesis propone un sistema para medir en tiempo real un conjunto de gestos de miembro superior y evaluar de manera inteligente la calidad del ejercicio realizado por el paciente. La valoración se hace a través del estudio del movimiento ejecutado en su conjunto, así como evaluando cada articulación independientemente. Los primeros resultados son prometedores y apuntan a que este sistema puede convertirse en una nueva herramienta para complementar la terapia clínica en casa y mejorar los resultados de la rehabilitación. Finalmente, después del proceso de rehabilitación pueden quedar secuelas motoras graves. Por este motivo, se propone una solución tecnológica para estas personas y para personas con discapacidades motoras severas. Así, se ha desarrollado una interfaz de control de entorno inteligente capaz de adaptar su control a las capacidades residuales del usuario. Además, el sistema estima la intención del usuario a partir de la información del entorno y el comportamiento del usuario, ayudando en la navegación a través de la interfaz, mejorando su independencia en el hogar

Roadmap on measurement technologies for next generation structural health monitoring systems

Structural health monitoring (SHM) is the automation of the condition assessment process of an engineered system. When applied to geometrically large components or structures, such as those found in civil and aerospace infrastructure and systems, a critical challenge is in designing the sensing solution that could yield actionable information. This is a difficult task to conduct cost-effectively, because of the large surfaces under consideration and the localized nature of typical defects and damages. There have been significant research efforts in empowering conventional measurement technologies for applications to SHM in order to improve performance of the condition assessment process. Yet, the field implementation of these SHM solutions is still in its infancy, attributable to various economic and technical challenges. The objective of this Roadmap publication is to discuss modern measurement technologies that were developed for SHM purposes, along with their associated challenges and opportunities, and to provide a path to research and development efforts that could yield impactful field applications. The Roadmap is organized into four sections: distributed embedded sensing systems, distributed surface sensing systems, multifunctional materials, and remote sensing. Recognizing that many measurement technologies may overlap between sections, we define distributed sensing solutions as those that involve or imply the utilization of numbers of sensors geometrically organized within (embedded) or over (surface) the monitored component or system. Multi-functional materials are sensing solutions that combine multiple capabilities, for example those also serving structural functions. Remote sensing are solutions that are contactless, for example cell phones, drones, and satellites. It also includes the notion of remotely controlled robots

Quantifying Forearm Soft Tissue Motion and Shock Attenuation following Hand Impacts Consistent with Forward Falls using Massless Skin Surface Markers

The purpose of this thesis was twofold: 1) quantify planar (2D) displacement and velocity of, and the amount of shock attenuated by, the forearm soft tissues following a forward fall impact; and 2) compare two massless skin surface marker designs with different uniformity and visual contrast (i.e., single layer, uniform (SLU) design; stacked, non-uniform (SNU) design) in terms of how well they can be tracked over varying skin pigmentation using automated motion capture software. Simulated forward fall impacts were performed by two groups of participants (skin pigmentation: light – 9F, 8M; dark – 9F, 6M) using a torso-release apparatus, in which a high speed camera (5000 f/s) captured planar motion of the right forearm. Automated motion tracking software (ProAnalyst®) was used to quantify displacement, velocity, and shock attenuation capacity of the forearm soft tissue from manually digitized markers. Overall, the greatest mean peak soft tissue displacement (1.47 cm) and velocity (112.8 cm/s) occurred in the distal direction in proximal regions of the forearm where more soft tissue is distributed. Soft tissue displacement and velocity exhibited similar trends, increasing from distal to proximal regions of the forearm, while impact shock accelerations were not attenuated in the forearm, but instead increased by 76%. Apart from proximal rebound distance, soft tissue kinematics between females and males did not significantly differ (p \u3e 0.05). Conversely, the effects of specific tissue masses (i.e., bone mineral content, fat mass, lean mass, and wobbling mass) on tissue kinematics varied between the sexes. Significant differences were found between marker designs for displacement, rebound distance, and velocity (p ≤ 0.05), wherein the SLU design consistently produced higher values than the SNU design

Comparison of wearable measurement systems for estimating trunk postures in manual material handling, A

2017 Fall.Includes bibliographical references.Epidemiologic studies have established that awkward trunk postures during manual materials handling are associated with an increased risk of developing occupational low back disorders. With recent advances in motion capture technology, emerging wearable measurement systems have been designed to quantify trunk postures for exposure assessments. Wearable measurement systems integrate portable microelectromechanical sensors, real-time processing algorithms, and large memory capacity to effectively quantify trunk postures. Wearable measurement systems have been available primarily as research tools, but are now quickly becoming accessible to health and safety professionals for industrial application. Although some of these systems can be highly complex and deter health and safety professionals from using them, other systems can serve as a simpler, more user-friendly alternative. These simple wearable measurement systems are designed to be less intricate, allowing health and safety professionals to be more willing to utilize them in occupational posture assessments. Unfortunately, concerns regarding the comparability and agreement between simple and complex wearable measurement systems for estimating trunk postures are yet to be fully addressed. Furthermore, application of wearable measurement systems has been affected by the lack of adaptability of sensor placement to work around obstructive equipment and bulky gear workers often wear on the job. The aims of the present study were to 1) compare the Bioharness™3, a simple wearable measurement system, to Xsens™, a complex wearable measurement system, for estimating trunk postures during simulated manual material handling tasks and 2) to explore the effects of Xsens sensor placement on assessing trunk postures. Thirty participants wore the two systems simultaneously during simulated tasks in the laboratory that involved reaching, lifting, lowering, and pushing a load for ten minutes. Results indicated that the Bioharness 3 and Xsens systems are comparable for strictly estimating trunk postures that involved flexion and extension of 30° or less. Although limited to a short range of trunk postures, the Bioharness also exhibited moderate to strong agreement and correlations with the Xsens system for measuring key metrics commonly used in exposure assessments, including amplitude probability distribution functions and percent time spent in specific trunk posture categories or bins. The Bioharness is suggested to be an a more intuitive alternative to the Xsens system for posture analysis, but industrial use of the device should be warranted in the context of the exposure assessment goals. In addition, a single motion sensor from the Xsens system placed on the sternum yielded comparable and consistent estimates to a sensor secured on the sternum relative to a motion sensor on the sacrum. Estimates included descriptive measures of trunk flexion and extension and percent time spent in specific trunk posture categories. Using one motion sensor instead of two may serve as an alternative for sensor placement configuration in situations where worker portable equipment or personal preference prevents preferred sensor placement

Motor patterns evaluation of people with neuromuscular disorders for biomechanical risk management and job integration/reintegration

Neurological diseases are now the most common pathological condition and the leading cause of disability, progressively worsening the quality of life of those affected. Because of their high prevalence, they are also a social issue, burdening both the national health service and the working environment. It is therefore crucial to be able to characterize altered motor patterns in order to develop appropriate rehabilitation treatments with the primary goal of restoring patients' daily lives and optimizing their working abilities. In this thesis, I present a collection of published scientific articles I co-authored as well as two in progress in which we looked for appropriate indices for characterizing motor patterns of people with neuromuscular disorders that could be used to plan rehabilitation and job accommodation programs. We used instrumentation for motion analysis and wearable inertial sensors to compute kinematic, kinetic and electromyographic indices. These indices proved to be a useful tool for not only developing and validating a clinical and ergonomic rehabilitation pathway, but also for designing more ergonomic prosthetic and orthotic devices and controlling collaborative robots

Astigmatism and Pseudoaccommodation in Pseudophakic Eyes

noAdvanced IOLs with circumferential zones of different power provide pseudoaccommodation. We investigated the potential for power variation with meridian, namely astigmatism, to provide pseudo-accommodation. With appropriate power and axis orientations, acceptable pseudo-accommodation can be achieved

Nomadic input on mobile devices: the influence of touch input technique and walking speed on performance and offset modeling

In everyday life people use their mobile phones on-the-go with different walking speeds and with different touch input techniques. Unfortunately, much of the published research in mobile interaction does not quantify the influence of these variables. In this paper, we analyze the influence of walking speed, gait pattern and input techniques on commonly used performance parameters like error rate, accuracy and tapping speed, and we compare the results to the static condition. We examine the influence of these factors on the machine learned offset model used to correct user input and we make design recommendations. The results show that all performance parameters degraded when the subject started to move, for all input techniques. Index finger pointing techniques demonstrated overall better performance compared to thumb-pointing techniques. The influence of gait phase on tap event likelihood and accuracy was demonstrated for all input techniques and all walking speeds. Finally, it was shown that the offset model built on static data did not perform as well as models inferred from dynamic data, which indicates the speed-specific nature of the models. Also, models identified using specific input techniques did not perform well when tested in other conditions, demonstrating the limited validity of offset models to a particular input technique. The model was therefore calibrated using data recorded with the appropriate input technique, at 75% of preferred walking speed, which is the speed to which users spontaneously slow down when they use a mobile device and which presents a tradeoff between accuracy and usability. This led to an increase in accuracy compared to models built on static data. The error rate was reduced between 0.05% and 5.3% for landscape-based methods and between 5.3% and 11.9% for portrait-based methods