Good vibrations: Guiding body movements with vibrotactile feedback

We describe the ongoing development of a system to support the teaching of good posture and bowing technique to novice violin players. Using an inertial motion capture system we can track in real-time a player’s bowing action and how it deviates from a target trajectory set by their music teacher. The system provides real-time vibrotactile feedback on the correctness of the student’s posture and bowing action. We present the findings of an initial study that shows that vibrotactile feedback can guide arm movements in one and two dimension pointing tasks. The advantages of vibrotactile feedback for teaching basic bowing technique to novice violin players are that it does not place demands on the students’ visual and auditory systems which are already heavily involved in the activity of music making, and is understood with little training

Real-Time Feedback Training to Improve Gait and Posture in Parkinson's Disease

abstract: Progressive gait disorder in Parkinson's disease (PD) is usually exhibited as reduced step/stride length and gait speed. People with PD also exhibit stooped posture, which can contribute to reduced step length and arm swing. Since gait and posture deficits in people with PD do not respond well to pharmaceutical and surgical treatments, novel rehabilitative therapies to alleviate these impairments are necessary. Many studies have confirmed that people with PD can improve their walking patterns when external cues are presented. Only a few studies have provided explicit real-time feedback on performance, but they did not report how well people with PD can follow the cues on a step-by-step basis. In a single-session study using a novel-treadmill based paradigm, our group had previously demonstrated that people with PD could follow step-length and back angle feedback and improve their gait and posture during treadmill walking. This study investigated whether a long-term (6-week, 3 sessions/week) real-time feedback training (RTFT) program can improve overground gait, upright posture, balance, and quality of life. Three subjects (mean age 70 ± 2 years) with mild to moderate PD (Hoehn and Yahr stage III or below) were enrolled and participated in the program. The RTFT sessions involved walking on a treadmill while following visual feedback of step length and posture (one at any given time) displayed on a monitor placed in front of the subject at eye-level. The target step length was set between 110-120% of the step length obtained during a baseline non-feedback walking trial and the target back angle was set at the maximum upright posture exhibited during a quiet standing task. Two subjects were found to significantly improve their posture and overground walking at post-training and these changes were retained six weeks after RTFT (follow-up) and the third subject improved his upright posture and gait rhythmicity. Furthermore, the magnitude of the improvements observed in these subjects was greater than the improvements observed in reports on other neuromotor interventions. These results provide preliminary evidence that real-time feedback training can be used as an effective rehabilitative strategy to improve gait and upright posture in people with PD.Dissertation/ThesisMasters Thesis Biomedical Engineering 201

Audio-Visual Feedback for Self-monitoring Posture in Ballet Training

An application for ballet training is presented that monitors the posture position (straightness of the spine and rotation of the pelvis) deviation from the ideal position in real-time. The human skeletal data is acquired through a Microsoft Kinect v2. The movement of the student is mirrored through an abstract skeletal figure and instructions are provided through a virtual teacher. Posture deviation is measured in the following way: Torso misalignment is calculated by comparing hip center joint, shoulder center joint and neck joint position with an ideal posture position retrieved in an initial calibration procedure. Pelvis deviation is expressed as the xz-rotation of the hip-center joint. The posture deviation is sonified via a varying cut-off frequency of a high-pass filter applied to floating water sound. The posture deviation is visualized via a curve and a rigged skeleton in which the misaligned torso parts are color-coded. In an experiment with 9-12 year-old dance students from a ballet school, comparing the audio-visual feedback modality with no feedback leads to an increase in posture accuracy (p < 0.001, Cohen's d = 1.047). Reaction card feedback and expert interviews indicate that the feedback is considered fun and useful for training independently from the teacher

A Person-Centric Design Framework for At-Home Motor Learning in Serious Games

abstract: In motor learning, real-time multi-modal feedback is a critical element in guided training. Serious games have been introduced as a platform for at-home motor training due to their highly interactive and multi-modal nature. This dissertation explores the design of a multimodal environment for at-home training in which an autonomous system observes and guides the user in the place of a live trainer, providing real-time assessment, feedback and difficulty adaptation as the subject masters a motor skill. After an in-depth review of the latest solutions in this field, this dissertation proposes a person-centric approach to the design of this environment, in contrast to the standard techniques implemented in related work, to address many of the limitations of these approaches. The unique advantages and restrictions of this approach are presented in the form of a case study in which a system entitled the "Autonomous Training Assistant" consisting of both hardware and software for guided at-home motor learning is designed and adapted for a specific individual and trainer. In this work, the design of an autonomous motor learning environment is approached from three areas: motor assessment, multimodal feedback, and serious game design. For motor assessment, a 3-dimensional assessment framework is proposed which comprises of 2 spatial (posture, progression) and 1 temporal (pacing) domains of real-time motor assessment. For multimodal feedback, a rod-shaped device called the "Intelligent Stick" is combined with an audio-visual interface to provide feedback to the subject in three domains (audio, visual, haptic). Feedback domains are mapped to modalities and feedback is provided whenever the user's performance deviates from the ideal performance level by an adaptive threshold. Approaches for multi-modal integration and feedback fading are discussed. Finally, a novel approach for stealth adaptation in serious game design is presented. This approach allows serious games to incorporate motor tasks in a more natural way, facilitating self-assessment by the subject. An evaluation of three different stealth adaptation approaches are presented and evaluated using the flow-state ratio metric. The dissertation concludes with directions for future work in the integration of stealth adaptation techniques across the field of exergames.Dissertation/ThesisDoctoral Dissertation Computer Science 201

Towards a real-time system for teaching novices good violin bowing technique

We describe the ongoing development of a system to support the teaching of good posture and bowing technique to novice violin players. Using an inertial motion capture system we can track in real-time: i) a player’s bowing action (and measure how it deviates from a target trajectory); ii) whether the player is holding their violin correctly. We detail some initial experiments that show that vibrotactile feedback can guide arm movements in one and two dimensions. We then present some preliminary findings from integrating the motion capture and feedback components into a prototype real-time training system. The advantages of vibrotactile feedback are that: i) it does not use the students’ visual and auditory systems which are already involved in the activity of music making; ii) it is an intuitive way to guide body movements

Can real-time visual feedback during gait retraining reduce metabolic demand for individuals with transtibial amputation?

The metabolic demand of walking generally increases following lower extremity amputation. This study used real-time visual feedback to modify biomechanical factors linked to an elevated metabolic demand of walking in individuals with transtibial amputation. Eight persons with unilateral, traumatic transtibial amputation and 8 uninjured controls participated. Two separate bouts of real-time visual feedback were provided during a single session of gait retraining to reduce 1) center of mass sway and 2) thigh muscle activation magnitudes and duration. Baseline and post-intervention data were collected. Metabolic rate, heart rate, frontal plane center of mass sway, quadriceps and hamstrings muscle activity, and co-contraction indices were evaluated during steady state walking at a standardized speed. Visual feedback successfully decreased center of mass sway 12% (p = 0.006) and quadriceps activity 12% (p = 0.041); however, thigh muscle co-contraction indices were unchanged. Neither condition significantly affected metabolic rate during walking and heart rate increased with center-of-mass feedback. Metabolic rate, center of mass sway, and integrated quadriceps muscle activity were all not significantly different from controls. Attempts to modify gait to decrease metabolic demand may actually adversely increase the physiological effort of walking in individuals with lower extremity amputation who are young, active and approximate metabolic rates of able-bodied adults

Trunk motion visual feedback during walking improves dynamic balance in older adults: Assessor blinded randomized controlled trial.

BACKGROUND: Virtual reality and augmented feedback have become more prevalent as training methods to improve balance. Few reports exist on the benefits of providing trunk motion visual feedback (VFB) during treadmill walking, and most of those reports only describe within session changes. RESEARCH QUESTION: To determine whether trunk motion VFB treadmill walking would improve over-ground balance for older adults with self-reported balance problems. METHODS: 40 adults (75.8 years (SD 6.5)) with self-reported balance difficulties or a history of falling were randomized to a control or experimental group. Everyone walked on a treadmill at a comfortable speed 3×/week for 4 weeks in 2 min bouts separated by a seated rest. The control group was instructed to look at a stationary bulls-eye target while the experimental group also saw a moving cursor superimposed on the stationary bulls-eye that represented VFB of their walking trunk motion. The experimental group was instructed to keep the cursor in the center of the bulls-eye. Somatosensory (monofilaments and joint position testing) and vestibular function (canal specific clinical head impulses) was evaluated prior to intervention. Balance and mobility were tested before and after the intervention using Berg Balance Test, BESTest, mini-BESTest, and Six Minute Walk. RESULTS: There were no significant differences between groups before the intervention. The experimental group significantly improved on the BESTest (p = 0.031) and the mini-BEST (p = 0.019). The control group did not improve significantly on any measure. Individuals with more profound sensory impairments had a larger improvement on dynamic balance subtests of the BESTest. SIGNIFICANCE: Older adults with self-reported balance problems improve their dynamic balance after training using trunk motion VFB treadmill walking. Individuals with worse sensory function may benefit more from trunk motion VFB during walking than individuals with intact sensory function

Visual Error Augmentation for Enhancing Motor Learning and Rehabilitative Relearning

We developed a real-time controller for a 2 degree-of-freedom robotic system using xPC Target. This system was used to investigate how different methods of performance error feedback can lead to faster and more complete motor learning in individuals asked to compensate for a novel visuo-motor transformation (a 30 degree rotation). Four groups of normal human subjects were asked to reach with their unseen arm to visual targets surrounding a central starting location. A cursor tracking hand motion was provided during each reach. For one group of subjects, deviations from the ideal compensatory hand movement (i.e. trajectory errors) were amplified with a gain of 2 whereas another group was provided visual feedback with a gain of 3.1. Yet another group was provided cursor feedback wherein the cursor was rotated by an additional (constant) offset angle. We compared the rates at which the hand paths converged to the steady-state trajectories. Our results demonstrate that error-augmentation can improve the rate and extent of motor learning of visuomotor rotations in healthy subjects. We also tested this method on straightening the movements of stroke subjects, and our early results suggest that error amplification can facilitate neurorehabilitation strategies in brain injuries such as stroke

Technology inspired design for pervasive healthcare

Pervasive healthcare technologies are increasingly using novel sensory devices that are able to measure phenomena that could not be measured before. To develop novel healthcare applications that use these largely untested technologies, it is important to have a design process that allows proper exploration of the capabilities of the novel technologies. We focus on the technology-inspired design process that was used in the development of a system to support posture and provide guidance by nudging people, and how this has lead us to explore pervasive healthcare applications

Regulating stepping during fixed-speed and self-paced treadmill walking

textBackground: Treadmill walking should closely simulate overground walking for research validation and optimal skill transfer. Traditional fixed-speed treadmill (FS) walking may not simulate natural walking because of the fixed belt speed and lack of visual cues. Self-paced (SP) treadmill walking, especially feedback controlled SP treadmill walking, enables close-to-real-time belt speed changes with users' speed changes. Different sensitivity levels of SP treadmill feedback determine how fast the treadmill respond to user's speed change. Few studies have examined the differences between FS and SP treadmill walking, or the difference between sensitivity levels of SP treadmills, and their methods were questionable because of averaging kinematics and kinetics parameters, and failing to examine directly treadmill and subjects' speed data. This study compared FS with two SP modes with variation of treadmill speed and user's speed as dependent variables. Method: Thirteen young healthy subjects participated. Subjects walked on a motorized split-belt treadmill under FS, high sensitivity SP (SP-H) and low sensitivity SP (SP-L) conditions at normal walking speed. Root mean square error (RMSE) for subject's pelvis global speed (Vpg), pelvis speed with respect to treadmill speed (Vpt), and treadmill speed (Vtg) data were collected for all trials. Results: Significant condition effects were found between FS and the two SP modes in all RMSE values (p < 0.001). The two sensitivity levels of SP had similar speed patterns. Large subject × condition interaction effects were found for all variables (p < 0.001). Only small subject effects were found. Conclusions: The results of the study reveal different walking patterns between FS and SP. However, the two sensitivity levels failed to differ much. More habituation time may be needed for subjects to learn to optimally respond to the SP algorithm. Future work should include training subjects for more natural responses, applying a feed-forward algorithm, and testing the effect of optic flow on FS and SP speed variation.Kinesiology and Health Educatio