Preliminary evaluation of SensHand V1 in assessing motor skills performance in Parkinson Disease

Nowadays, the increasing old population 65+ as well as the pace imposed by work activities lead to a high number of people that have particular injuries for limbs. In addition to persistent or temporary disabilities related to accidental injuries we must take into account that part of the population suffers from motor deficits of the hands due to stroke or diseases of various clinical nature. The most recurrent technological solutions to measure the rehabilitation or skill motor performance of the hand are glove-based devices, able to faithfully capture the movements of the hand and fingers. This paper presents a system for hand motion analysis based on 9-axis complete inertial modules and dedicated microcontroller which are fixed on fingers and forearm. The technological solution presented is able to track the patients' hand motions in real-time and then to send data through wireless communication reducing the clutter and the disadvantages of a glove equipped with sensors through a different technological structure. The device proposed has been tested in the study of Parkinson's disease

Using wearable sensor systems for objective assessment of parkinson's disease

This paper presents a novel wearable sensor system based on the integration of miniaturised IMUs for fine hand movement analysis. The system, named SensHand V1, is composed of full 9-axis inertial sensors, placed on the fingers and wrist, which are managed by a cortex-M3 microcontroller. The acquired data are sent to a data logger through the use of Bluetooth communication. In this paper, the system is used for the objective diagnosis of Parkinson's disease, which is commonly assessed by neurologists through visual examination of motor tasks and semi-quantitative rating scales. Here, these motor tasks are also assessed using the SensHand V1, and then compared with the subjective metrics. Results demonstrate that the system is adequate to support neurologists in diagnostic procedures and allows for an objective evaluation of the disease

Empowering patients in self-management of parkinson's disease through cooperative ICT systems

The objective of this chapter is to demonstrate the technical feasibility and medical effectiveness of personalised services and care programmes for Parkinson's disease, based on the combination of mHealth applications, cooperative ICTs, cloud technologies and wearable integrated devices, which empower patients to manage their health and disease in cooperation with their formal and informal caregivers, and with professional medical staff across different care settings, such as hospital and home. The presented service revolves around the use of two wearable inertial sensors, i.e. SensFoot and SensHand, for measuring foot and hand performance in the MDS-UPDRS III motor exercises. The devices were tested in medical settings with eight patients, eight hyposmic subjects and eight healthy controls, and the results demonstrated that this approach allows quantitative metrics for objective evaluation to be measured, in order to identify pre-motor/pre-clinical diagnosis and to provide a complete service of tele-health with remote control provided by cloud technologies. © 2016, IGI Global. All rights reserved

Music normalizes visual and proprioceptive control of movement in Parkinson's disease

xiv, 147 leaves : ill. ; 29 cm. --The sensory control of movements has been shown to be impaired with Parkinson’s disease. I investigated the task, reach-to-eat, in which advancing of the limb towards a target is guided by vision and withdrawal of the grasped target to the mouth is guided by somatosensation (i.e., haptics and proprioception). Parkinson’s diseased subjects display an alteration in the balance of visual and proprioceptive guidance, such that they display increased visual fixation on the target prior to movement onset that persists following the grasp. Music therapy can normalize the balance between visual and proprioceptive guidance on the reach-to-eat task, as visual fixation with the target prior to movement onset is consistent with controls, and disengagement following grasp no longer differs from mild Parkinson’s disease subjects. These results are the first to demonstrate that music can have an ameliorating effect on the sensory impairments seen in the control of forelimb movements in Parkinson’s disease

Technological advances in deep brain stimulation:Towards an adaptive therapy

Parkinson's disease (PD) is neurodegenerative movement disorder and a treatment method called deep brain stimulation (DBS) may considerably reduce the patient’s motor symptoms. The clinical procedure involves the implantation of a DBS lead, consisting of multiple electrode contacts, through which continuous high frequency (around 130 Hz) electric pulses are delivered in the brain. In this thesis, I presented the research which had the goal to improve current DBS technology, focusing on bringing the conventional DBS system a step closer to adaptive DBS, a personalized DBS therapy. The chapters in this thesis can be seen as individual building blocks for such an adaptive DBS system. After the general introduction, the first two chapters, two novel DBS lead designs are studied in a computational model. The model showed that both studied leads were able to exploit the novel distribution of the electrode contacts to shape and steer the stimulation field to activate more neurons in the chosen target compared to the conventional lead, and to counteract lead displacement. In the fourth chapter, an inverse current source density (CSD) method is applied on local field potentials (LFP) measured in a rat model. The pattern of CSD sources can act as a landmark within the STN to locate the potential stimulation target. The fifth and final chapter described the last building block of the DBS system. We introduced an inertial sensors and force sensor based measurement system, which can record hand kinematics and joint stiffness of PD patients. A system which can act as a feedback signal in an adaptive DBS system

相対的顕著性が複数肢協調運動に及ぼす影響

早大学位記番号:新7951早稲田大

Tremor Control Devices for Essential Tremor: A Systematic Literature Review

Background: There is a growing interest in nonpharmacological approaches for essential tremor (ET), including tremor cancelation devices. However, the true efficacy of such devices in ET remains unclear. Methods: A systematic literature review was conducted using standardized criteria regarding efficacy and comfortability. Devices focused on design or experimental testing in which tremor was simulated in a robot were excluded. Results: Out of 324 articles initially identified, 12 articles were included. Orthoses using biomechanical loading and neuromodulation with electrical stimulation, and external tremor cancelation devices, were the main interventions used to suppress tremor. All devices were designed to control tremor of the upper limbs at different anatomical locations. Overall, an average tremor attenuation of 50–98% was reported (level of evidence III). Interference with voluntary movements and portability was described as the main drawback. Discussion: In conclusion, this review highlights the growing interest in emerging tremor control devices and the importance of assessing comfort without affecting voluntary movements. However, the level of evidence regarding the efficacy of these tremor control devices remains low. An integrated multidisciplinary combination approach of engineering, robotics, physiology, physiotherapy, and clinical assessment is needed to improve the quality of non-pharmacological interventions for ET

Development and degeneration of the sensory control of reach-to-eat behaviour

xiv, 286 leaves : ill. ; 29 cmThe reach-to-eat movement, in which a hand is advanced towards a food item, shapes to grasp the food item, and withdrawals to place the food item into the mouth for eating, is a behaviour that is performed daily. The movement is controlled by two sensory systems, vision to guide hand advance and grasping, and somatosensation to guide hand withdrawal and mouth placement. The purpose of the present thesis was to examine how the sensory control of reaching-to-eat develops in infancy and degenerates following neurodegenerative disorder. The tight coupling of vision to hand advance and somatosensation to hand withdrawal has a developmental profile from six months to one year of age. That is, six-month-old infants rely on vision to advance their hand, grasp the target, and withdrawal the target to the mouth. By twelve months of age, infants display the adult pattern of coupling vision to hand advance and grasping. The tight coupling of vision to hand advance degenerates with basal ganglia disease, such that subjects with Parkinson’s disease and Huntington’s disease show an overreliance on vision to guide hand advance for grasping and hand withdrawal for mouth placement. The results of the thesis demonstrate that efficient use of sensory control to guide motor behaviour is an important aspect of development that is disrupted by neurodegenerative disease

다중손가락 과제 수행 시 인간의 감각 및 인지 처리 과정의 정량화

학위논문 (박사) -- 서울대학교 대학원 : 사범대학 체육교육과, 2021. 2. 박재범.The continuously varied states of human body and surrounding environment require instantaneous motor adaptations and the understanding of motor goal to achieve desired actions. These sensory and cognitive processes have been investigated as elements in motor control during last five decades. Specially, the task dependency on sensory and cognitive processes suggest the effects of movement properties in terms of environment situation and motor goal. However, these effects were mostly empirically summarized with the measurements of either neural activity or simple motor accomplishment unilaterally. The current thesis addresses the quantification of sensory and cognitive processes based on simultaneous measurements of brain activity and synergic motor performance during multi-digit actions with different movement properties. Multi-digit action as a representation of synergic movements has developed into a widespread agency to quantify the efficacy of motor control, as the reason applied in this thesis. In this thesis, multi-digit rotation and pressing tasks were performed with different movement directions, frequencies, feedback modalities, or task complexities. (Chapter 3) The changes of movement direction induced a decrease in motor synergy but regardless of which direction. (Chapter 4 and 5) Increased frequency of rhythmic movement reduced synergic motor performance associate with decreased sensory process and less efficient cognitive process. (Chapter 6) More comprehensive feedback modality improved synergic performance with increased sensory process. (Chapter 7) Increased movement complexity had a consistent but stronger effect as increased frequency on synergic performance and efficiency of cognitive process. These observations suggest that several movement properties affect the contributions of sensory and cognitive processes to motor control which can be quantified through either neural activity or synergic motor performance. Accordingly, those movement properties may be applied in the rehabilitation of motor dysfunction by developing new training programs or assistant devices. Additionally, it may be possible to develop a simplified while efficient method to estimate the contribution of sensory or cognitive process to motor control.시시각각으로 변화하는 신체 상태와 주변 환경의 상호작용 속에서 알맞은 움직임을 수행하기 위해서는 그에 따른 즉각적인 운동 적응(motor adaptation) 과정와 과제 목표에 대한 이해가 필요하다. 이를 위해 인간의 감각 및 인지 처리과정은 운동 제어 분야의 중요한 요소로 여겨졌다. 선행연구에 따르면, 운동 과제에 따라 변화하는 감각 및 인지 처리과정은 주변 환경과 과제의 목표에 따라 움직임의 특성에 영향을 미친다고 보고되어왔다. 그러나 이러한 영향은 대부분 단순한 운동과제 수행 결과 또는 측정된 신경 활동에 의해 경험적으로 요약된 결과에 국한되어 있다. 따라서 본 논문은 다양한 움직임 특성을 가진 다중 손가락 과제 수행 시, 뇌 활동 (Brain activity)과 더불어 손가락들 간의 협응적인 움직임의 수행 결과를 동시 측정하여 과제의 특성에 따른 감각 및 인지 처리과정의 변화를 분석했다. 다중 손가락 과제는 운동 제어의 성능 효율성을 정량화하기 위해 사용되는 대표적인 과제다. 본 논문에서는 다양한 조건의 움직임 방향, 움직임의 주기빈도, 감각 피드백 양식 또는 과제 난이도에 따른 다중 손가락 회전 동작 및 힘 생성 과제를 사용했다. 연구 결과로는, (문단 3) 움직임 방향이 변화하기 전에 변화할 방향에 상관없이 협응적인 움직임이 악화되었다. (문단 4와 5) 움직임의 주기빈도가 증가할수록 협응적인 움직임이 악화됐으며, 이와 관련된 감각 및 인지 처리과정의 효율성도 감소되었다. (문단 6) 단일 감각 피드백 제공조건에 비해 종합적인 감각 피드백은 증가된 감각 처리과정과 함께 협응적인 움직임을 향상시켰다. (문단 7) 과제의 난이도가 증가할수록 협응적인 움직임과 인지 처리과정의 효율성은 감소되었으며, 움직임의 주기빈도 조건에 비해 과제의 난이도에 따라 협응적인 움직임과 인지 처리과정에 미치는 영향은 상대적으로 더 크게 나타났다. 이러한 결과는 움직임 특성에 따른 뇌 활동과 협응적인 과제 수해 결과를 통해 운동 제어 과정에서 감각 및 인지 처리과정의 기여정도를 정량화할 수 있다는 점을 시사한다. 따라서 움직임 특성에 따른 감각 및 인지 처리 과정의 기여정도의 변화는 운동 기능 장애를 가진 사람들의 새로운 재활 훈련 프로그램 및 움직임 보조 장치를 개발하기 위한 실험적인 근거로 적용될 수 있다. 또한 감각 또는 인지 과정이 운동 제어에 미치는 영향을 추정하기 위한 효율적인 방법을 개발하는데 도움이 될 것이다.Chapter 1. Introduction 1 1.1 Problem statement 1 1.2 Study objective 2 1.3 Organization of dissertation 3 Chapter 2. Background 6 2.1 Motor system 6 2.1.1 Ascending pathway 6 2.1.2 Descending pathway 8 2.1.3 Brain networks 9 2.2 Motor synergy 11 2.2.1 Synergy in performance 12 2.2.2 Synergy in muscles 13 2.2.3 Synergy in neurons 14 2.3 Motor control 15 2.1.1 Sensory process 16 2.1.2 Cognitive process 19 Chapter 3. Effect of movement direction: Multi-Finger Interaction and Synergies in Finger Flexion and Extension Force Production 23 3.1 Abstract 23 3.2 Introduction 24 3.3 Method 28 3.4 Results 35 3.4.1 Maximal voluntary contraction (MVC) force and finger independency 36 3.4.2 Timing indices 37 3.4.3 Multi-finger synergy indices in mode space 39 3.4.4 Multi-finger synergy indices in force space 43 3.5 Discussion 44 3.5.1 Finger independency during finger flexion and extension 44 3.5.2 Multi-finger synergies in force and mode spaces 46 3.5.3 Anticipatory synergy adjustment 48 Chapter 4. Effect of Frequency: Brain Oxygenation Magnitude and Mechanical Outcomes during Multi-Digit Rhythmic Rotation Task 51 4.1 Abstract 51 4.2 Introduction 51 4.3 Methods 55 4.4 Results 61 4.4.1 PET imaging 61 4.4.2 Finger forces 62 4.4.3 UCM analysis 64 4.4.4 Correlation between neural activation and mechanics 65 4.5 Discussion 66 4.5.1 Regions involved in feedback 67 4.5.2 Regions involved in feedforward 69 4.5.3 Corporation of feedforward and feedback 71 4.6 Conclusions 72 Chapter 5. Effect of frequency: Prefrontal Cortex Oxygenation during Multi-Digit Rhythmic Pressing Actions using fNIRS 74 5.1 Abstract 74 5.2 Introduction 74 5.3 Method 77 5.4 Results 84 5.4.1 Performance 84 5.4.2 Multi-digit coordination indices 84 5.4.3 Functional connectivity (FC) 87 5.5 Discussion 88 5.6 Conclusion 91 Chapter 6. Effect of Sensory Modality: Multi-Sensory Integration during Multi-Digit Rotation Task with Different Frequency 92 6.1 Abstract 92 6.2 Introduction 92 6.3 Method 94 6.4 Results 100 6.4.1 Performance 100 6.4.2 Multi-digit coordination indices 101 6.5 Discussion 101 6.6 Conclusion 103 Chapter 7. Effect of Task Complexity: Prefrontal Cortex Oxygenation during Multi-Digit Pressing Actions with Different Frequency Components 104 7.1 Abstract 104 7.2 Introduction 104 7.3 Method 106 7.4 Results 112 7.4.1 Performance 112 7.4.2 Multi-finger coordination indices 113 7.4.3 Functional connectivity (FC) 114 7.5 Discussion 115 7.5.1 Relation between Frequency and task complexity 115 7.5.2 Cognitive process in motor control 116 7.5.3 Relation between motor coordination and cognitive process 118 7.6 Conclusion 119 Chapter 8. Conclusions and Future Work 120 8.1 Summary of conclusions 120 8.2 Future work 121 Bibliography 122 Abstract in Korean 160Docto