Influence of Muscle Fatigue on Electromyogram-Kinematic Correlation During Robot-Assisted Upper Limb Training

© The Author(s) 2020. Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us. sagepub.com/en-us/nam/open-access-at-sage).Introduction: Studies on adaptive robot-assisted upper limb training interactions do not often consider the implications of muscle fatigue sufficiently. Methods: In order to explore this, we initially assessed muscle fatigue in 10 healthy subjects using electromyogram features (average power and median power frequency) during an assist-as-needed interaction with HapticMASTER robot. Spearman’s correlation study was conducted between EMG average power and kinematic force components. Since the robotic assistance resulted in a variable fatigue profile across participants, a completely tiring experiment, without a robot in the loop, was also designed to confirm the results. Results: A significant increase in average power and a decrease in median frequency were observed in the most active muscles. Average power in the frequency band of 0.8-2.5Hz and median frequency in the band of 20-450Hz are potential fatigue indicators. Also, comparing the correlation coefficients across trials indicated that correlation was reduced as the muscles were fatigued. Conclusions: Robotic assistance based on user’s performance has resulted in lesser muscle fatigue, which caused an increase in the EMG-force correlation. We now intend to utilize the electromyogram and kinematic features for the auto-adaptation of therapeutic human-robot interactions.Peer reviewedFinal Published versio

Sensory Motor Remapping of Space in Human-Machine Interfaces

Studies of adaptation to patterns of deterministic forces have revealed the ability of the motor control system to form and use predictive representations of the environment. These studies have also pointed out that adaptation to novel dynamics is aimed at preserving the trajectories of a controlled endpoint, either the hand of a subject or a transported object. We review some of these experiments and present more recent studies aimed at understanding how the motor system forms representations of the physical space in which actions take place. An extensive line of investigations in visual information processing has dealt with the issue of how the Euclidean properties of space are recovered from visual signals that do not appear to possess these properties. The same question is addressed here in the context of motor behavior and motor learning by observing how people remap hand gestures and body motions that control the state of an external device. We present some theoretical considerations and experimental evidence about the ability of the nervous system to create novel patterns of coordination that are consistent with the representation of extrapersonal space. We also discuss the perspective of endowing human–machine interfaces with learning algorithms that, combined with human learning, may facilitate the control of powered wheelchairs and other assistive devices

A virtual hand assessment system for efficient outcome measures of hand rehabilitation

Previously held under moratorium from 1st December 2016 until 1st December 2021.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control.Hand rehabilitation is an extremely complex and critical process in the medical rehabilitation field. This is mainly due to the high articulation of the hand functionality. Recent research has focused on employing new technologies, such as robotics and system control, in order to improve the precision and efficiency of the standard clinical methods used in hand rehabilitation. However, the designs of these devices were either oriented toward a particular hand injury or heavily dependent on subjective assessment techniques to evaluate the progress. These limitations reduce the efficiency of the hand rehabilitation devices by providing less effective results for restoring the lost functionalities of the dysfunctional hands. In this project, a novel technological solution and efficient hand assessment system is produced that can objectively measure the restoration outcome and, dynamically, evaluate its performance. The proposed system uses a data glove sensorial device to measure the multiple ranges of motion for the hand joints, and a Virtual Reality system to return an illustrative and safe visual assistance environment that can self-adjust with the subject’s performance. The system application implements an original finger performance measurement method for analysing the various hand functionalities. This is achieved by extracting the multiple features of the hand digits’ motions; such as speed, consistency of finger movements and stability during the hold positions. Furthermore, an advanced data glove calibration method was developed and implemented in order to accurately manipulate the virtual hand model and calculate the hand kinematic movements in compliance with the biomechanical structure of the hand. The experimental studies were performed on a controlled group of 10 healthy subjects (25 to 42 years age). The results showed intra-subject reliability between the trials (average of crosscorrelation ρ = 0.7), inter-subject repeatability across the subject’s performance (p > 0.01 for the session with real objects and with few departures in some of the virtual reality sessions). In addition, the finger performance values were found to be very efficient in detecting the multiple elements of the fingers’ performance including the load effect on the forearm. Moreover, the electromyography measurements, in the virtual reality sessions, showed high sensitivity in detecting the tremor effect (the mean power frequency difference on the right Vextensor digitorum muscle is 176 Hz). Also, the finger performance values for the virtual reality sessions have the same average distance as the real life sessions (RSQ =0.07). The system, besides offering an efficient and quantitative evaluation of hand performance, it was proven compatible with different hand rehabilitation techniques where it can outline the primarily affected parts in the hand dysfunction. It also can be easily adjusted to comply with the subject’s specifications and clinical hand assessment procedures to autonomously detect the classification task events and analyse them with high reliability. The developed system is also adaptable with different disciplines’ involvements, other than the hand rehabilitation, such as ergonomic studies, hand robot control, brain-computer interface and various fields involving hand control

Advancing Medical Technology for Motor Impairment Rehabilitation: Tools, Protocols, and Devices

Excellent motor control skills are necessary to live a high-quality life. Activities such as walking, getting dressed, and feeding yourself may seem mundane, but injuries to the neuromuscular system can render these tasks difficult or even impossible to accomplish without assistance. Statistics indicate that well over 100 million people are affected by diseases or injuries, such as stroke, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, peripheral nerve injury, spinal cord injury, and amputation, that negatively impact their motor abilities. This wide array of injuries presents a challenge to the medical field as optimal treatment paradigms are often difficult to implement due to a lack of availability of appropriate assessment tools, the inability for people to access the appropriate medical centers for treatment, or altogether gaps in technology for treating the underlying impairments causing the disability. Addressing each of these challenges will improve the treatment of movement impairments, provide more customized and continuous treatment to a larger number of patients, and advance rehabilitative and assistive device technology. In my research, the key approach was to develop tools to assess and treat upper extremity movement impairment. In Chapter 2.1, I challenged a common biomechanical[GV1] modeling technique of the forearm. Comparing joint torque values through inverse dynamics simulation between two modeling platforms, I discovered that representing the forearm as a single cylindrical body was unable to capture the inertial parameters of a physiological forearm which is made up of two segments, the radius and ulna. I split the forearm segment into a proximal and distal segment, with the rationale being that the inertial parameters of the proximal segment could be tuned to those of the ulna and the inertial parameters of the distal segment could be tuned to those of the radius. Results showed a marked increase in joint torque calculation accuracy for those degrees of freedom that are affected by the inertial parameters of the radius and ulna. In Chapter 2.2, an inverse kinematic upper extremity model was developed for joint angle calculations from experimental motion capture data, with the rationale being that this would create an easy-to-use tool for clinicians and researchers to process their data. The results show accurate angle calculations when compared to algebraic solutions. Together, these chapters provide easy-to-use models and tools for processing movement assessment data. In Chapter 3.1, I developed a protocol to collect high-quality movement data in a virtual reality task that is used to assess hand function as part of a Box and Block Test. The goal of this chapter is to suggest a method to not only collect quality data in a research setting but can also be adapted for telehealth and at home movement assessment and rehabilitation. Results indicate that the data collected in this protocol are good and the virtual nature of this approach can make it a useful tool for continuous, data driven care in clinic or at home. In Chapter 3.2 I developed a high-density electromyography device for collecting motor unit action potentials of the arm. Traditional surface electromyography is limited by its ability to obtain signals from deep muscles and can also be time consuming to selectively place over appropriate muscles. With this high-density approach, muscle coverage is increased, placement time is decreased, and deep muscle activity can potentially be collected due to the high-density nature of the device[GV2] . Furthermore, the high-density electromyography device is built as a precursor to a high-density electromyography-electrical stimulation device for functional electrical stimulation. The customizable nature of the prototype in Chapter 3.2 allows for the implementation both recording and stimulating electrodes. Furthermore, signal results show that the electromyography data obtained from the device are of high quality and are correlated with gold standard surface electromyography sensors. One key factor in a device that can record and then stimulate based on the information from the recorded signals is an accurate movement intent decoder. High-quality movement decoders have been designed by closed-loop device controllers in the past, but they still struggle when the user interacts with objects of varying weight due to underlying alterations in muscle signals. In Chapter 4, I investigate this phenomenon by administering an experiment where participants perform a Box and Block Task with objects of 3 different weights, 0 kg, 0.02 kg, and 0.1 kg. Electromyography signals of the participants right arm were collected and co-contraction levels between antagonistic muscles were analyzed to uncover alterations in muscle forces and joint dynamics. Results indicated contraction differences between the conditions and also between movement stages (contraction levels before grabbing the block vs after touching the block) for each condition. This work builds a foundation for incorporating object weight estimates into closed-loop electromyography device movement decoders. Overall, we believe the chapters in this thesis provide a basis for increasing availability to movement assessment tools, increasing access to effective movement assessment and rehabilitation, and advance the medical device and technology field

Analysis of forearm muscles activity by means of new protocols of multichannel EMG signal recording and processing

Los movimientos voluntarios del cuerpo son controlados por el sistema nervioso central y periférico a través de la contracción de los músculos esqueléticos. La contracción se inicia al liberarse un neurotransmisor sobre la unión neuromuscular, iniciando la propagación de un biopotencial sobre la membrana de las fibras musculares que se desplaza hacia los tendones: el Potencial de Acción de la Unidad Motora (MUAP). La señal electromiográfica de superficie registra la activación continua de dichos potenciales sobre la superficie de la piel y constituye una valiosa herramienta para la investigación, diagnóstico y seguimiento clínico de trastornos musculares, así como para la identificación de la intención movimiento tanto en términos de dirección como de potencia. En el estudio de las enfermedades del sistema neuromuscular es necesario analizar el nivel de actividad, la capacidad de producción de fuerza, la activación muscular conjunta y la predisposición a la fatiga muscular, todos ellos asociados con factores fisiológicos que determinan la resultante contracción mioeléctrica. Además, el uso de matrices de electrodos facilita la investigación de las propiedades periféricas de las unidades motoras activas, las características anatómicas del músculo y los cambios espaciales en su activación, ocasionados por el tipo de tarea motora o la potencia de la misma. El objetivo principal de esta tesis es el diseño e implementación de protocolos experimentales y algoritmos de procesado para extraer información fiable de señales sEMG multicanal en 1 y 2 dimensiones del espacio. Dicha información ha sido interpretada y relacionada con dos patologías específicas de la extremidad superior: Epicondilitis Lateral y Lesión de Esfuerzo Repetitivo. También fue utilizada para identificar la dirección de movimiento y la fuerza asociada a la contracción muscular, cuyos patrones podrían ser de utilidad en aplicaciones donde la señal electromiográfica se utilice para controlar interfaces hombre-máquina como es el caso de terapia física basada en robots, entornos virtuales de rehabilitación o realimentación de la actividad muscular. En resumen, las aportaciones más relevantes de esta tesis son: * La definición de protocolos experimentales orientados al registro de señales sEMG en una región óptima del músculo. * Definición de índices asociados a la co-activación de diferentes músculos * Identificación de señales artefactuadas en registros multicanal * Selección de los canales mas relevantes para el análisis Extracción de un conjunto de características que permita una alta exactitud en la identificación de tareas motoras Los protocolos experimentales y los índices propuestos permitieron establecer que diversos desequilibrios entre músculos extrínsecos del antebrazo podrían desempeñar un papel clave en la fisiopatología de la epicondilitis lateral. Los resultados fueron consistentes en diferentes ejercicios y pueden definir un marco de evaluación para el seguimiento y evaluación de pacientes en programas de rehabilitación motora. Por otra parte, se encontró que las características asociadas con la distribución espacial de los MUAPs mejoran la exactitud en la identificación de la intención de movimiento. Lo que es más, las características extraídas de registros sEMG de alta densidad son más robustas que las extraídas de señales bipolares simples, no sólo por la redundancia de contacto implicada en HD-EMG, sino también porque permite monitorizar las regiones del músculo donde la amplitud de la señal es máxima y que varían con el tipo de ejercicio, permitiendo así una mejor estimación de la activación muscular mediante el análisis de los canales mas relevantes.Voluntary movements are achieved by the contraction of skeletal muscles controlled by the Central and Peripheral Nervous system. The contraction is initiated by the release of a neurotransmitter that promotes a reaction in the walls of the muscular fiber, producing a biopotential known as Motor Unit Action Potential (MUAP) that travels from the neuromuscular junction to the tendons. The surface electromyographic signal records the continuous activation of such potentials over the surface of the skin and constitutes a valuable tool for the diagnosis, monitoring and clinical research of muscular disorders as well as to infer motion intention not only regarding the direction of the movement but also its power. In the study of diseases of the neuromuscular system it is necessary to analyze the level of activity, the capacity of production of strength, the load-sharing between muscles and the probably predisposition to muscular fatigue, all of them associated with physiological factors determining the resultant muscular contraction. Moreover, the use of electrode arrays facilitate the investigation of the peripheral properties of the active Motor Units, the anatomical characteristics of the muscle and the spatial changes induced in their activation of as product of type of movement or power of the contraction.The main objective of this thesis was the design and implementation of experimental protocols, and algorithms to extract information from multichannel sEMG signals in 1 and 2 dimensions of the space. Such information was interpreted and related to pathological events associated to two upper-limb conditions: Lateral Epicondylitis and Repetitive Strain Injury. It was also used to identify the direction of movement and contraction strength which could be useful in applications concerning the use of biofeedback from EMG like in robotic- aided therapies and computer-based rehabilitation training.In summary, the most relevant contributions are:§The definition of experimental protocols intended to find optimal regions for the recording of sEMG signals. §The definition of indices associated to the co- activation of different muscles. §The detection of low-quality signals in multichannel sEMG recordings.§ The selection of the most relevant EMG channels for the analysis§The extraction of a set of features that led to high classification accuracy in the identification of tasks.The experimental protocols and the proposed indices allowed establishing that imbalances between extrinsic muscles of the forearm could play a key role in the pathophysiology of lateral epicondylalgia. Results were consistent in different types of motor task and may define an assessment framework for the monitoring and evaluation of patients during rehabilitation programs.On the other hand, it was found that features associated with the spatial distribution of the MUAPs improve the accuracy of the identification of motion intention. What is more, features extracted from high density EMG recordings are more robust not only because it implies contact redundancy but also because it allows the tracking of (task changing) skin surface areas where EMG amplitude is maximal and a better estimation of muscle activity by the proper selection of the most significant channels