Systematic review of textile-based electrodes for long-term and continuous surface electromyography recording

This systematic review concerns the use of smart textiles enabled applications based on myoelectric activity. Electromyography (EMG) is the technique for recording and evaluating electric signals related to muscle activity (myoelectric). EMG is a well-established technique that provides a wealth of information for clinical diagnosis, monitoring, and treatment. Introducing sensor systems that allow for ubiquitous monitoring of health conditions using textile integrated solutions not only opens possibilities for ambulatory, long-term, and continuous health monitoring outside the hospital, but also for autonomous self-administration. Textile-based electrodes have demonstrated potential as a fully operational alternative to \u27standard\u27 Ag/AgCl electrodes for recording surface electromyography (sEMG) signals. As a substitute for Ag/AgCl electrodes fastened to the skin by taping or pre-gluing adhesive, textile-based electrodes have the advantages of being soft, flexible, and air permeable; thus, they have advantages in medicine and health monitoring, especially when self-administration, real-time, and long-term monitoring is required. Such advances have been achieved through various smart textile techniques; for instance, adding functions in textiles, including fibers, yarns, and fabrics, and various methods for incorporating functionality into textiles, such as knitting, weaving, embroidery, and coating. In this work, we reviewed articles from a textile perspective to provide an overview of sEMG applications enabled by smart textile strategies. The overview is based on a literature evaluation of 41 articles published in both peer-reviewed journals and conference proceedings focusing on electrode materials, fabrication methods, construction, and sEMG applications. We introduce four textile integration levels to further describe the various textile electrode sEMG applications reported in the reviewed literature. We conclude with suggestions for future work along with recommendations for the reporting of essential benchmarking information in current and future textile electrode applications

On the use of Phantom Motor Execution for the treatment of Phantom Limb Pain

Phantom limb pain (PLP) is a common complaint among amputees and despite having been studiedfor centuries, it remains a mysterious object of debate among researcher. To date, a vast number ofways to treat PLP has been proposed in the literature, however none of them has proven to beuniversally effective, thus creating uncertainty on how to operate clinically. The uncertainty is largelyattributable to the scarcity of well conducted randomized controlled trials (RCTs) to prove the efficacyof PLP treatments.Phantom Motor Execution (PME) -exertion of voluntary phantom limb movements – aims at restoringthe control over the phantom limb and the exercise of such control has been hypothesized to reverseneural changes implicated in PLP. Preliminary evidence supporting this hypothesis has been providedby clinical investigations on upper limb amputees. The main purpose of this Licentiate thesis was toenable a RCT on the use of PME for the treatment of PLP in order to provide robust and unbiasedevidence for clinical practice. However, the implementation and kick-off of this clinical investigationrequired to complete few preparatory steps. For example, most amputees and PLP patients have lowerlimb amputation, thus PME needed to be adapted and validated for this population. Further, the RCTprotocol needed to be carefully planned and made openly accessible, as per guidelines for conductingand publishing clinical RCT. Finally, a secondary aim of this thesis emerged with the need of providinglong term relief from PLP to patient. Preliminary evidence seemed to indicate that in order to maintainpain relief, periodic rehearsal of the phantom motor skills acquired through PME is necessary. Thisraised the question of whether it is beneficial and possible to translate the technology from clinic tohome use, question that was explored employing both quantitative and qualitative methods fromengineering, medical anthropology, and user interface design.The work conducted within this thesis resulted in the extension of PME to lower limb patients byproposal and validation of a new and more user-friendly recording configuration to record EMG signals.The use of PME was then shown to be efficacious in relieving PLP with a case study on a patient. Theprotocol for the RCT was then designed and published. These two first steps permitted theestablishment of the RCT, which is currently ongoing and expected to close in March 2021. With regardto the secondary aim of this thesis, the work conducted enabled PME to be used by the patients in thecomfort of their home, while it also allowed investigate the benefits and challenges generally faced(not only by PME) in the transition from the clinic to home and its effects on treatment adherence. Thework conducted is presented in the three appended publications.Future work includes the presentation of the results of the RCT. Further, having a way to modulate PLPis an incredibly useful tool to study the neural basis of PLP. By capitalizing on this tool, we are currentlyconducting brain imaging studies using fMRI and electroencephalography that are the main focus ofthe work that lies ahead

Intarsia-sensorized band and textrodes for real-time myoelectric pattern recognition

Surface Electromyography (sEMG) has applications in prosthetics, diagnostics and neuromuscular rehabilitation. Self-adhesive Ag/AgCl are the electrodes preferentially used to capture sEMG in short-term studies, however their long-term application is limited. In this study we designed and evaluated a fully integrated smart textile band with electrical connecting tracks knitted with intarsia techniques and knitted textile electrodes. Real-time myoelectric pattern recognition for motor volition and signal-to-noise ratio (SNR) were used to compare its sensing performance versus the conventional Ag-AgCl electrodes. After a comprehending measurement and performance comparison of the sEMG recordings, no significant differences were found between the textile and the Ag-AgCl electrodes in SNR and prediction accuracy obtained from pattern recognition classifiers