Communication difficulties following right hemisphere stroke : applying evidence to clinical management

Following reports in the 1960s that language may be affected by right hemisphere (RH) lesions, many limitations to effective communication in the right hemisphere damaged (RHD) population have been described and evidenced. However, stereotypical portrayals and descriptions of carefully selected cases may be misleading as to the extent of communication deficits. In many of the parameters in which RHD patients are presented as typically impaired, e.g. discourse skills, a less severe picture may emerge where data from the non-brain damaged (NBD) population are considered, with age and education variables controlled. Subsequent to RHD, some people show deficit on some communication measures, but many of these communication behaviours are also present in some NBD adults. Thus diagnosis of deficit must be made with reference both to the healthy peer population and the individual's pre-lesion behaviour. The authors' right RH stroke research programme includes studies of incidence of communication deficit, comparisons of RHD and NBD groups in various spoken discourse and comprehension tasks, comparison of RHD groups of different ages, detailed analysis of topic within discourse in RHD and NBD groups, family members' views of communication behaviour following RHD, and the natural course of communication change during the first year after RH stroke. The findings from several studies are summarised and used as the basis for management recommendations, which may guide future outcome research. There is an urgent need for the evaluation of communication management programmes, to determine whether therapists may with confidence offer an effective intervention service to those people whose communication skills are affected by RHD

Computational Analysis of Upper Extremity Movements for People Post-Stroke

Wearable sensors have been beneficial in assessing motor impairment after stroke. Individuals who have experienced stroke may benefit from the use of wearable sensors to quantify and assess quality of motions in unobserved environments. Seven individuals participated in a study wherein they performed various gestures from the Fugl-Meyer Assessment (FMA), a measure of post-stroke impairment. Participants performed these gestures while being monitored by wearable sensors placed on each wrist. A series of MATLAB functions were written to process recorded sensor data, extract meaningful features from the data, and prepare those features for further use with various machine learning techniques. A combination of linear and nonlinear regression was applied to frequency domain values from each gesture to determine which can more accurately predict the time spent performing the gesture, and the associated gesture FMA score. General performance suggests that linear regression techniques appear to better fit paretic gestures, while nonlinear regression techniques appear to better fit non-paretic gestures. A use of classifier techniques were used to determine if a classifier can distinguish between paretic and non-paretic gestures. The combinations include determining if a higher performance is obtained through the use of either accelerometer, rate gyroscope, or both modalities combined. Our findings indicate that, for upper-extremity motion, classifiers trained using a combination of accelerometer and rate gyroscope data performed the best (accuracy of 73.1%). Classifiers trained using accelerometer data alone and rate gyroscope data alone performed slightly worse than the combined data classifier (70.2% and 65.7%, respectively). These results suggest specific features and methods suitable for the quantification of impairment after stroke

Grasps recognition and evaluation of stroke patients for supporting rehabilitation therapy

Copyright © 2014 Beatriz Leon et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Stroke survivors often suffer impairments on their wrist and hand. Robot-mediated rehabilitation techniques have been proposed as a way to enhance conventional therapy, based on intensive repeated movements. Amongst the set of activities of daily living, grasping is one of the most recurrent. Our aim is to incorporate the detection of grasps in the machine-mediated rehabilitation framework so that they can be incorporated into interactive therapeutic games. In this study, we developed and tested a method based on support vector machines for recognizing various grasp postures wearing a passive exoskeleton for hand and wrist rehabilitation after stroke. The experiment was conducted with ten healthy subjects and eight stroke patients performing the grasping gestures. The method was tested in terms of accuracy and robustness with respect to intersubjects' variability and differences between different grasps. Our results show reliable recognition while also indicating that the recognition accuracy can be used to assess the patients' ability to consistently repeat the gestures. Additionally, a grasp quality measure was proposed to measure the capabilities of the stroke patients to perform grasp postures in a similar way than healthy people. These two measures can be potentially used as complementary measures to other upper limb motion tests.Peer reviewedFinal Published versio

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

Contributions to Pen & Touch Human-Computer Interaction

[EN] Computers are now present everywhere, but their potential is not fully exploited due to some lack of acceptance. In this thesis, the pen computer paradigm is adopted, whose main idea is to replace all input devices by a pen and/or the fingers, given that the origin of the rejection comes from using unfriendly interaction devices that must be replaced by something easier for the user. This paradigm, that was was proposed several years ago, has been only recently fully implemented in products, such as the smartphones. But computers are actual illiterates that do not understand gestures or handwriting, thus a recognition step is required to "translate" the meaning of these interactions to computer-understandable language. And for this input modality to be actually usable, its recognition accuracy must be high enough. In order to realistically think about the broader deployment of pen computing, it is necessary to improve the accuracy of handwriting and gesture recognizers. This thesis is devoted to study different approaches to improve the recognition accuracy of those systems. First, we will investigate how to take advantage of interaction-derived information to improve the accuracy of the recognizer. In particular, we will focus on interactive transcription of text images. Here the system initially proposes an automatic transcript. If necessary, the user can make some corrections, implicitly validating a correct part of the transcript. Then the system must take into account this validated prefix to suggest a suitable new hypothesis. Given that in such application the user is constantly interacting with the system, it makes sense to adapt this interactive application to be used on a pen computer. User corrections will be provided by means of pen-strokes and therefore it is necessary to introduce a recognizer in charge of decoding this king of nondeterministic user feedback. However, this recognizer performance can be boosted by taking advantage of interaction-derived information, such as the user-validated prefix. Then, this thesis focuses on the study of human movements, in particular, hand movements, from a generation point of view by tapping into the kinematic theory of rapid human movements and the Sigma-Lognormal model. Understanding how the human body generates movements and, particularly understand the origin of the human movement variability, is important in the development of a recognition system. The contribution of this thesis to this topic is important, since a new technique (which improves the previous results) to extract the Sigma-lognormal model parameters is presented. Closely related to the previous work, this thesis study the benefits of using synthetic data as training. The easiest way to train a recognizer is to provide "infinite" data, representing all possible variations. In general, the more the training data, the smaller the error. But usually it is not possible to infinitely increase the size of a training set. Recruiting participants, data collection, labeling, etc., necessary for achieving this goal can be time-consuming and expensive. One way to overcome this problem is to create and use synthetically generated data that looks like the human. We study how to create these synthetic data and explore different approaches on how to use them, both for handwriting and gesture recognition. The different contributions of this thesis have obtained good results, producing several publications in international conferences and journals. Finally, three applications related to the work of this thesis are presented. First, we created Escritorie, a digital desk prototype based on the pen computer paradigm for transcribing handwritten text images. Second, we developed "Gestures à Go Go", a web application for bootstrapping gestures. Finally, we studied another interactive application under the pen computer paradigm. In this case, we study how translation reviewing can be done more ergonomically using a pen.[ES] Hoy en día, los ordenadores están presentes en todas partes pero su potencial no se aprovecha debido al "miedo" que se les tiene. En esta tesis se adopta el paradigma del pen computer, cuya idea fundamental es sustituir todos los dispositivos de entrada por un lápiz electrónico o, directamente, por los dedos. El origen del rechazo a los ordenadores proviene del uso de interfaces poco amigables para el humano. El origen de este paradigma data de hace más de 40 años, pero solo recientemente se ha comenzado a implementar en dispositivos móviles. La lenta y tardía implantación probablemente se deba a que es necesario incluir un reconocedor que "traduzca" los trazos del usuario (texto manuscrito o gestos) a algo entendible por el ordenador. Para pensar de forma realista en la implantación del pen computer, es necesario mejorar la precisión del reconocimiento de texto y gestos. El objetivo de esta tesis es el estudio de diferentes estrategias para mejorar esta precisión. En primer lugar, esta tesis investiga como aprovechar información derivada de la interacción para mejorar el reconocimiento, en concreto, en la transcripción interactiva de imágenes con texto manuscrito. En la transcripción interactiva, el sistema y el usuario trabajan "codo con codo" para generar la transcripción. El usuario valida la salida del sistema proporcionando ciertas correcciones, mediante texto manuscrito, que el sistema debe tener en cuenta para proporcionar una mejor transcripción. Este texto manuscrito debe ser reconocido para ser utilizado. En esta tesis se propone aprovechar información contextual, como por ejemplo, el prefijo validado por el usuario, para mejorar la calidad del reconocimiento de la interacción. Tras esto, la tesis se centra en el estudio del movimiento humano, en particular del movimiento de las manos, utilizando la Teoría Cinemática y su modelo Sigma-Lognormal. Entender como se mueven las manos al escribir, y en particular, entender el origen de la variabilidad de la escritura, es importante para el desarrollo de un sistema de reconocimiento, La contribución de esta tesis a este tópico es importante, dado que se presenta una nueva técnica (que mejora los resultados previos) para extraer el modelo Sigma-Lognormal de trazos manuscritos. De forma muy relacionada con el trabajo anterior, se estudia el beneficio de utilizar datos sintéticos como entrenamiento. La forma más fácil de entrenar un reconocedor es proporcionar un conjunto de datos "infinito" que representen todas las posibles variaciones. En general, cuanto más datos de entrenamiento, menor será el error del reconocedor. No obstante, muchas veces no es posible proporcionar más datos, o hacerlo es muy caro. Por ello, se ha estudiado como crear y usar datos sintéticos que se parezcan a los reales. Las diferentes contribuciones de esta tesis han obtenido buenos resultados, produciendo varias publicaciones en conferencias internacionales y revistas. Finalmente, también se han explorado tres aplicaciones relaciones con el trabajo de esta tesis. En primer lugar, se ha creado Escritorie, un prototipo de mesa digital basada en el paradigma del pen computer para realizar transcripción interactiva de documentos manuscritos. En segundo lugar, se ha desarrollado "Gestures à Go Go", una aplicación web para generar datos sintéticos y empaquetarlos con un reconocedor de forma rápida y sencilla. Por último, se presenta un sistema interactivo real bajo el paradigma del pen computer. En este caso, se estudia como la revisión de traducciones automáticas se puede realizar de forma más ergonómica.[CA] Avui en dia, els ordinadors són presents a tot arreu i es comunament acceptat que la seva utilització proporciona beneficis. No obstant això, moltes vegades el seu potencial no s'aprofita totalment. En aquesta tesi s'adopta el paradigma del pen computer, on la idea fonamental és substituir tots els dispositius d'entrada per un llapis electrònic, o, directament, pels dits. Aquest paradigma postula que l'origen del rebuig als ordinadors prové de l'ús d'interfícies poc amigables per a l'humà, que han de ser substituïdes per alguna cosa més coneguda. Per tant, la interacció amb l'ordinador sota aquest paradigma es realitza per mitjà de text manuscrit i/o gestos. L'origen d'aquest paradigma data de fa més de 40 anys, però només recentment s'ha començat a implementar en dispositius mòbils. La lenta i tardana implantació probablement es degui al fet que és necessari incloure un reconeixedor que "tradueixi" els traços de l'usuari (text manuscrit o gestos) a alguna cosa comprensible per l'ordinador, i el resultat d'aquest reconeixement, actualment, és lluny de ser òptim. Per pensar de forma realista en la implantació del pen computer, cal millorar la precisió del reconeixement de text i gestos. L'objectiu d'aquesta tesi és l'estudi de diferents estratègies per millorar aquesta precisió. En primer lloc, aquesta tesi investiga com aprofitar informació derivada de la interacció per millorar el reconeixement, en concret, en la transcripció interactiva d'imatges amb text manuscrit. En la transcripció interactiva, el sistema i l'usuari treballen "braç a braç" per generar la transcripció. L'usuari valida la sortida del sistema donant certes correccions, que el sistema ha d'usar per millorar la transcripció. En aquesta tesi es proposa utilitzar correccions manuscrites, que el sistema ha de reconèixer primer. La qualitat del reconeixement d'aquesta interacció és millorada, tenint en compte informació contextual, com per exemple, el prefix validat per l'usuari. Després d'això, la tesi se centra en l'estudi del moviment humà en particular del moviment de les mans, des del punt de vista generatiu, utilitzant la Teoria Cinemàtica i el model Sigma-Lognormal. Entendre com es mouen les mans en escriure és important per al desenvolupament d'un sistema de reconeixement, en particular, per entendre l'origen de la variabilitat de l'escriptura. La contribució d'aquesta tesi a aquest tòpic és important, atès que es presenta una nova tècnica (que millora els resultats previs) per extreure el model Sigma- Lognormal de traços manuscrits. De forma molt relacionada amb el treball anterior, s'estudia el benefici d'utilitzar dades sintètiques per a l'entrenament. La forma més fàcil d'entrenar un reconeixedor és proporcionar un conjunt de dades "infinit" que representin totes les possibles variacions. En general, com més dades d'entrenament, menor serà l'error del reconeixedor. No obstant això, moltes vegades no és possible proporcionar més dades, o fer-ho és molt car. Per això, s'ha estudiat com crear i utilitzar dades sintètiques que s'assemblin a les reals. Les diferents contribucions d'aquesta tesi han obtingut bons resultats, produint diverses publicacions en conferències internacionals i revistes. Finalment, també s'han explorat tres aplicacions relacionades amb el treball d'aquesta tesi. En primer lloc, s'ha creat Escritorie, un prototip de taula digital basada en el paradigma del pen computer per realitzar transcripció interactiva de documents manuscrits. En segon lloc, s'ha desenvolupat "Gestures à Go Go", una aplicació web per a generar dades sintètiques i empaquetar-les amb un reconeixedor de forma ràpida i senzilla. Finalment, es presenta un altre sistema inter- actiu sota el paradigma del pen computer. En aquest cas, s'estudia com la revisió de traduccions automàtiques es pot realitzar de forma més ergonòmica.Martín-Albo Simón, D. (2016). Contributions to Pen & Touch Human-Computer Interaction [Tesis doctoral no publicada]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/68482TESI

Clinical Features to Predict the Use of a sEMG Wearable Device (REMO®) for Hand Motor Training of Stroke Patients: A Cross-Sectional Cohort Study

After stroke, upper limb motor impairment is one of the most common consequences that compromises the level of the autonomy of patients. In a neurorehabilitation setting, the implementation of wearable sensors provides new possibilities for enhancing hand motor recovery. In our study, we tested an innovative wearable (REMO®) that detected the residual surface-electromyography of forearm muscles to control a rehabilitative PC interface. The aim of this study was to define the clinical features of stroke survivors able to perform ten, five, or no hand movements for rehabilitation training. 117 stroke patients were tested: 65% of patients were able to control ten movements, 19% of patients could control nine to one movement, and 16% could control no movements. Results indicated that mild upper limb motor impairment (Fugl-Meyer Upper Extremity 18 points) predicted the control of ten movements and no flexor carpi muscle spasticity predicted the control of five movements. Finally, severe impairment of upper limb motor function (Fugl-Meyer Upper Extremity > 10 points) combined with no pain and no restrictions of upper limb joints predicted the control of at least one movement. In conclusion, the residual motor function, pain and joints restriction, and spasticity at the upper limb are the most important clinical features to use for a wearable REMO® for hand rehabilitation training

Full-body motion-based game interaction for older adults

Older adults in nursing homes often lead sedentary lifestyles, which reduces their life expectancy. Full-body motion-control games provide an opportunity for these adults to remain active and engaged; these games are not designed with age-related impairments in mind, which prevents the games from being leveraged to increase the activity levels of older adults. In this paper, we present two studies aimed at developing game design guidelines for full-body motion controls for older adults experiencing age-related changes and impairments. Our studies also demonstrate how full-body motion-control games can accommodate a variety of user abilities, have a positive effect on mood and, by extension, the emotional well-being of older adults. Based on our studies, we present seven guidelines for the design of full-body interaction in games. The guidelines are designed to foster safe physical activity among older adults, thereby increasing their quality of life. Copyright 2012 ACM

Surface electromyographic control of a novel phonemic interface for speech synthesis

Many individuals with minimal movement capabilities use AAC to communicate. These individuals require both an interface with which to construct a message (e.g., a grid of letters) and an input modality with which to select targets. This study evaluated the interaction of two such systems: (a) an input modality using surface electromyography (sEMG) of spared facial musculature, and (b) an onscreen interface from which users select phonemic targets. These systems were evaluated in two experiments: (a) participants without motor impairments used the systems during a series of eight training sessions, and (b) one individual who uses AAC used the systems for two sessions. Both the phonemic interface and the electromyographic cursor show promise for future AAC applications.F31 DC014872 - NIDCD NIH HHS; R01 DC002852 - NIDCD NIH HHS; R01 DC007683 - NIDCD NIH HHS; T90 DA032484 - NIDA NIH HHShttps://www.ncbi.nlm.nih.gov/pubmed/?term=Surface+electromyographic+control+of+a+novel+phonemic+interface+for+speech+synthesishttps://www.ncbi.nlm.nih.gov/pubmed/?term=Surface+electromyographic+control+of+a+novel+phonemic+interface+for+speech+synthesisPublished versio