Sensor Technologies for Caring People with Disabilities

Today, the population uses technology for every daily activity involving business, education, communication, entertainment, etc. Technologymay also help us to take care of peoplewho suffer some kind of disability. Complex technological ecosystems with pervasive and intelligent capabilities get along with us, facilitating the vigilance of those who need special attention or assisted living cares due to their health limitations. The advances in sensor research have enriched the powerful of these ecosystems to achieve more sophisticated monitoring and alarm systems, also taking into account the balance between the level of assistance and the people’s privacy. The Special Issue on “Sensor Technologies for Caring People with Disabilities” aims to present recent developments on sensor technologies for caring people with disabilities, focusing on the different configurations that can be used and novel applications in the field

Integração de localização baseada em movimento na aplicação móvel EduPARK

More and more, mobile applications require precise localization solutions in a variety of environments. Although GPS is widely used as localization solution, it may present some accuracy problems in special conditions such as unfavorable weather or spaces with multiple obstructions such as public parks. For these scenarios, alternative solutions to GPS are of extreme relevance and are widely studied recently. This dissertation studies the case of EduPARK application, which is an augmented reality application that is implemented in the Infante D. Pedro park in Aveiro. Due to the poor accuracy of GPS in this park, the implementation of positioning and marker-less augmented reality functionalities presents difficulties. Existing relevant systems are analyzed, and an architecture based on pedestrian dead reckoning is proposed. The corresponding implementation is presented, which consists of a positioning solution using the sensors available in the smartphones, a step detection algorithm, a distance traveled estimator, an orientation estimator and a position estimator. For the validation of this solution, functionalities were implemented in the EduPARK application for testing purposes and usability tests performed. The results obtained show that the proposed solution can be an alternative to provide accurate positioning within the Infante D. Pedro park, thus enabling the implementation of functionalities of geocaching and marker-less augmented reality.Cada vez mais, as aplicações móveis requerem soluções de localização precisa nos mais variados ambientes. Apesar de o GPS ser amplamente usado como solução para localização, pode apresentar alguns problemas de precisão em condições especiais, como mau tempo, ou espaços com várias obstruções, como parques públicos. Para estes casos, soluções alternativas ao GPS são de extrema relevância e veem sendo desenvolvidas. A presente dissertação estuda o caso do projeto EduPARK, que é uma aplicação móvel de realidade aumentada para o parque Infante D. Pedro em Aveiro. Devido à fraca precisão do GPS nesse parque, a implementação de funcionalidades baseadas no posionamento e de realidade aumentada sem marcadores apresenta dificuldades. São analisados sistemas relevantes existentes e é proposta uma arquitetura baseada em localização de pedestres. Em seguida é apresentada a correspondente implementação, que consiste numa solução de posicionamento usando os sensores disponiveis nos smartphones, um algoritmo de deteção de passos, um estimador de distância percorrida, um estimador de orientação e um estimador de posicionamento. Para a validação desta solução, foram implementadas funcionalidades na aplicação EduPARK para fins de teste, e realizados testes com utilizadores e testes de usabilidade. Os resultados obtidos demostram que a solução proposta pode ser uma alternativa para a localização no interior do parque Infante D. Pedro, viabilizando desta forma a implementação de funcionalidades baseadas no posicionamento e de realidade aumenta sem marcadores.EduPARK é um projeto financiado por Fundos FEDER através do Programa Operacional Competitividade e Internacionalização - COMPETE 2020 e por Fundos Nacionais através da FCT - Fundação para a Ciência e a Tecnologia no âmbito do projeto POCI-01-0145-FEDER-016542.Mestrado em Engenharia Informátic

Proceedings of the 1st joint workshop on Smart Connected and Wearable Things 2016

These are the Proceedings of the 1st joint workshop on Smart Connected and Wearable Things (SCWT'2016, Co-located with IUI 2016). The SCWT workshop integrates the SmartObjects and IoWT workshops. It focusses on the advanced interactions with smart objects in the context of the Internet-of-Things (IoT), and on the increasing popularity of wearables as advanced means to facilitate such interactions

Visually-guided Reaching Under Varying Cognitive and Motor Demand in Young Adult Females with a History of Concussions

Every day, vision guides one’s actions to help one successfully navigate through a complex environment. When our visual and motor systems interact efficiently, we may not fully appreciate how flawless and beneficial this process can be to our daily functioning. Yet, one’s available neural resources needed to successfully perform visually-guided movements do have limits. When an individual suffers a brain injury, such as a concussion, the available resources may be compromised. Examining the extent of this decreased resource pool requires challenging the cognitive abilities enough to observe a behavioral deficit. The purpose of this study was to examine the long-term effects of a history of concussions in young adult females on visuomotor behavior during a visually-guided reaching task of various complexities. We hypothesized that by manipulating an increase of both cognitive and motor demand, visuomotor behavior would decrease more in individuals with a history of concussion than those without a history of concussion. Twenty females without a history of concussion (age: 21.2 ± 2.16 years) and twenty females with a history of concussion (age: 22.3 ± 2.43 years) quickly and accurately performed a delayed reach to a previously cued location. To control for confounding factors, information was collected regarding the participants’ head injury history, lifestyles, and level of sports participation. The visually guided reaching task was manipulated by varying the complexities of cognitive and motor demand to alter attentional load. As both cognitive and motor load increased, task performance decreased for both groups (p \u3c .05). However, contrary to our primary hypothesis, no differences in task performance were found between the two experimental groups (p \u3e .05). While confounding variables of age, sex, time since last concussion (i.e. acute vs. long-term), stimulant use, sleep patterns, and prescription medication for mood disorders were either controlled or considered during the analysis, participants in the two groups did differ on level of sports participation (p \u3c .05), when accounting for this difference, still no changes in performance were identified (p \u3c .05) on the dependent measures. The young adult females with a history of concussion demonstrated no deficits in visuomotor behavior on an attention-mediated reaching task as compared to control participants. Future studies should include an assessment of both motivation and competitiveness of the participants. Furthermore, longitudinal studies are needed to assess if the normal declines in visuomotor behavior due to healthy aging are accentuated by a history of concussion

Wearable Sensors in the Evaluation of Gait and Balance in Neurological Disorders

The aging population and the increased prevalence of neurological diseases have raised the issue of gait and balance disorders as a major public concern worldwide. Indeed, gait and balance disorders are responsible for a high healthcare and economic burden on society, thus, requiring new solutions to prevent harmful consequences. Recently, wearable sensors have provided new challenges and opportunities to address this issue through innovative diagnostic and therapeutic strategies. Accordingly, the book “Wearable Sensors in the Evaluation of Gait and Balance in Neurological Disorders” collects the most up-to-date information about the objective evaluation of gait and balance disorders, by means of wearable biosensors, in patients with various types of neurological diseases, including Parkinson’s disease, multiple sclerosis, stroke, traumatic brain injury, and cerebellar ataxia. By adopting wearable technologies, the sixteen original research articles and reviews included in this book offer an updated overview of the most recent approaches for the objective evaluation of gait and balance disorders

Quantification of exercise training dose in phase III cardiac rehabilitation : a UK perspective

The Apple watch was a new technology first introduced in 2015. At that time, its validity and reliability for measuring stepping frequency and heart rate monitoring during exercise was unknown. Current evidence indicates that the effectiveness of cardiac rehabilitation (CR) programmes for improving patient outcomes may be questionable in the United Kingdom (UK). We postulated that the exercise dose that patients receive during Phase III CR may not be a high enough stimulus to invoke a positive physiological adaptation. Therefore, this thesis aims to examine the validity and reliability of the Apple watch for measuring heart rate and step frequency. We then planned, based on our initial findings, to apply this technology to patients undertaking Phase III CR in order to monitor and quantify exercise dose and training progression to determine the fidelity of the intervention.The aim of the first study was to examine the validity and variability of the Apple watch for measuring step count. On two occasions, 21 males completed treadmill exercise while wearing two Apple watches (left and right wrists) and an ActivPAL (criterion). Exercise involved 5 min bouts of walking, jogging, and running at speeds of 4 km.h⁻¹, 7 km.h⁻¹, and 10 km.h⁻¹, followed by 11 min of rest between each bout. There was a small under-estimation in step count during walking but large and very large over-estimations during jogging and running. There were poor to very poor correlations during walking, jogging and running. The inter-device variability showed good to nearly perfect intraclass correlations and small to moderate standardised typical errors. Intra-device variability was large to very large for all exercise intensities. The Apple watch has adequate validity for measuring step count during walking, but very poor validity during jogging and running. On this basis, we concluded that quantifying stepping frequency during Phase III CR using the Apple watch should not be pursued.The aim of the second study was to examine the validity and reliability of the Apple watch heart rate sensor during and in recovery from exercise. Twenty-one males completed treadmill exercise while wearing two Apple watches (left and right wrists) and a Polar S810i monitor (criterion). Exercise involved 5 min bouts of walking, jogging, and running at speeds of 4 km.h⁻¹, 7 km.h⁻¹, and 10 km.h⁻¹, followed by 11 min of rest between bouts. At all exercise intensities the mean bias was trivial. There were very good correlations with the criterion during walking (L: r = 0.97; R: r = 0.97), and good (L: r = 0.93; R: r = 0.92) but poor/good (L: r = 0.81; R: r = 0.86) correlations during jogging and running. Standardised typical error of the estimate was small, moderate, and moderate to large. There were good correlations following walking, but poor correlations following jogging and running. The percentage of heart rates recorded reduced with increasing intensity but increased over time. Intra-device standardised typical errors decreased with intensity. Inter-device standardised typical errors were small to moderate with very good to nearly perfect intraclass correlations. The Apple watch heart rate sensor has very good validity during walking but validity decreases with increasing intensity. On this basis, we chose to introduce the Apple watch to a Phase III CR programme for monitoring individual exercise dose via heart rate.The aim of the third study was to investigate the fidelity of a structured Phase III cardiac rehabilitation (CR) programme in the United Kingdom (UK), by monitoring and quantifying exercise training intensity. We compared the mean % heart rate reserve (%HRR) achieved during the cardiovascular training component (%HRR-CV) of a circuit-based programme, with the %HRR during the active recovery phases (%HRR-AR) in a randomly selected cohort of patients attending standard CR. We then compared the mean %HRR-CV achieved with the minimal exercise intensity threshold during supervised exercise (40% HRR) recommended by national governing bodies. The programme comprised 16 sessions over 8 weeks, where patients undertook an interval, circuit training approach within national guidelines for exercise prescription (40-70% heart rate reserve [HRR]). All patients wore an Apple watch (Series 0 or 2, Watch OS2.0.1, Apple Inc., California, USA). Thirty cardiac patients (83% male; mean age [SD] 67 [10] years; BMI 28.3 [4.6] kg∙m-2) were recruited. We captured 332 individual training sessions. The mean %HRR-CV and %HRR-AR were 37 (10) %, and 31 (13) %, respectively. There was weak evidence to support the alternative hypothesis of a difference between the %HRR-CV and 40% HRR. There was very strong evidence to accept the alternative hypothesis that the mean %HRR-AR was lower than the mean %HRR-CV (median standardised effect size 1.1 (95%CI: 0.563 to 1.669) with a moderate to large effect. Mean exercise training intensity was below the lower limit of the minimal training intensity guidelines for a Phase III CR programme. These findings may be in part responsible for previous reports highlighting the significant variability in effectiveness of UK CR services and poor CRF improvements observed from several prior investigations.The aim of the final study was to characterise the weekly progression of exercise training dose/load over an 8-week Phase III cardiac rehabilitation (CR) programme based in the United Kingdom (UK). Patients with a history of cardiovascular (CV) disease were recruited to an 8-week CR programme (16 sessions in total). During each training session, patients wore an Apple Watch (Series 0 or 2, Watch OS2.0.1, Apple Inc., California, USA) and we quantified the weekly progression of exercise training dose/load for % heart rate reserve (%HRR) during the CV training component (%HRR-CV), CV training duration, estimated changes in cardiorespiratory fitness (change in estimated METS), session rating of perceived exertion (sRPE), sRPE training load (sRPE-TL), and training impulse (TRIMP). Thirty cardiac patients [83% male; age (SD) 67.0 (10.0) years; body mass index (SD) 28.3 (4.6) kg∙m⁻²] were recruited to the Phase III CR programme. Overall our analysis is based on 332 individual training sessions. Bayesian repeated-measures ANOVA resulted in a BF₁₀ of 1.1 to 3.1, indicating weak to moderate evidence for the alternative hypothesis of an effect of time on %HRR-CV, sRPE, and change in estimated METs. Conversely, Bayesian repeated-measures ANOVA resulted in a BF10 of between 103,977 to 1,018,000, indicating extremely strong evidence for the alternative hypothesis of an effect of time on CV training duration, TRIMP, and sRPE-TL. The training principle of progressive overload is being applied consistently in CR. However, the increases observed in exercise training dose were mostly the result of increases in the duration of CV training rather than increases in exercise training intensity (%HRR-CV and sRPE). Therefore, allied health professionals must ensure that weekly increases in exercise intensity are consistently applied in order to optimise exercise training prescription and improve patient outcomes.We can conclude from the studies within this PhD thesis that allied health professionals involved in CR should undertake more advanced training in exercise training, programming and prescription to ensure that principles of training including progressive overload are understood and implemented correctly. Allied health professionals should also have a greater understanding of the benefits of exercise and physical activity, and this knowledge should be passed on to patients in the hope that they adopt a more active lifestyle beyond Phase III CR. The increased use of digital/wearable technology should be actively encouraged which will help support allied health professionals monitor, track, and up-titrate exercise dose over the course of a CR programme. Predictive heart rate training zones should be re-calculated regularly, as resting heart should be re-checked before the start of each training session. We also recommend using more cohort-specific predictive equations such as the Brawner equation which accounts for use of beta-blockers. We recommend to allied health professionals the Apple watch for monitoring heart rate throughout each training session, our studies show that at lower intensities of exercise the Apple watch is a valid and reliable tool. One downside to using the Apple watch is their excessive cost in relation to other activity trackers. Cost needs to weighed against the accuracy of the data provided

The impact of differential knee laxity on brain function/structure and postural control

Greater anterior knee laxity (AKL) is known to be a significant predictor of anterior cruciate ligament (ACL) injury. Individuals with high AKL are known to have a proprioception deficit and exhibit compensatory movement patterns. The potential altered sensory information and associated movement strategies may lead to decreased functional stability, contributing to a higher risk of ACL injury. The brain has an essential role in integrating and processing sensory information in the course of stabilizing the joint. Our brain also has the ability to reorganize its function and structure (neuroplasticity) in response to sensory changes. However, it is still unknown how sensory information, associated with ACL loading in high AKL individuals, may affect brain function and structure. Decreased proprioception influenced by high knee laxity may also negatively impact postural stability. Postural stability is impacted by visual, vestibular, somatosensory input. It is broadly understood that individuals who are ACL deficient as well as hypermobile individuals joints have poor proprioception and postural control. It is suggested that poor proprioception negatively impacts postural control. Decreased proprioception due to greater knee laxity may thus diminish postural stability. However, the influence of greater AKL on postural control is not yet understood. Therefore, the primary purpose of this study is to determine the impact of high and low knee laxity on brain function and structure as well as dynamic postural stability. Healthy and physically active female college students volunteered for this study. Anterior knee laxity was measured to assign participants to either high (N=15) or low knee laxity (N=12) groups. Functional and structural brain data were obtained through magnetic resonance imaging (MRI). Functional MRI data were analyzed in order to compare brain activation differences during anterior knee joint loading between the two groups. Structural brain data were analyzed to identify differences in gray matter volume between the groups. Time to stabilization testing following a single-leg jump landing task was recorded in order to quantify dynamic postural stability. Independent t-tests contrasted dynamic postural stability between high and low to average laxity groups. fMRI data revealed that those with high knee laxity had significantly less activation in the left superior parietal lobe and right premotor cortex, and greater activation in the right cerebellum (Crus I and II) during anterior knee joint loading. The results suggest that individuals with greater knee laxity might experience a different awareness of their body’s position and may face challenges in preplanning and preprogramming potential movements. We also observed that the high knee laxity group had a nearly significant larger gray matter volume in BA6 (premotor cortex and supplementary motor area). We suggest that the larger gray matter volume in BA6 may be a response to the challenges in preplanning movements as a compensatory strategy. However, the time to stabilization test did not reveal any differences between the high and low to average laxity group. An advanced postural control test that separated the influence of somatosensation from other sensory input (visual and vestibular) may be recommended in order to identify the differences in dynamic postural control between groups. Our study reveals valuable information concerning possible functional and structural neuroplasticity associated with knee laxity. These results may help researchers better understand the influence of knee laxity on the sensorimotor system, especially the central integration and processing components, in individuals who are at increased risk of ACL injury

Haptic Socks

Smart phones have been spreading faster than any other technologies and with them, the research for finding different alternate interaction techniques that will be quick and efficiently responsive. The best feedback response in terms of mobile usage has been a long debate and is actually not possible, so it is difficult to conclude which feedback will be effective in all environments. In navigation applications, two modalities are used as feedback; visual and auditory. This thesis presents work, experiments and results on implementing the third modality i.e. haptic feedback. The basic purpose of this work is to find out how effective wearable haptic feedback can be, than visual or auditory feedback in terms of navigation. Using hand-held GPS navigation while walking or driving a car can sometimes be dangerous if the user is focusing more on the device than on the roads. The concept of Haptic Socks can be used as a secondary interaction technique for navigation so that user can use other interaction techniques to perform their primary tasks or perform their daily life routine work. Haptic socks will consist of actuators embedded in a certain position of human foot that will give tactile feedback, helping the user in turn by turn navigation. The device can most probably be the user’s smartphone. Haptic Socks will use wireless connection with the device which in this research study will be Bluetooth. Furthermore, if the feedback results are positive then it will be easier to discuss how effective it can be made for people who are deaf-blind

Ultrasound Guided Robot for Human Liver Biopsy using High Intensity Focused Ultrasound for Hemostasis

Percutaneous liver biopsy is the gold standard among clinician\u27s tool to diagnose and guide subsequent therapy for liver disease. Ultrasound image guidance is being increasingly used to reduce associated procedural risks but post–biopsy complications still persist. The major and most common complication is hemorrhage, which is highly unpredictable and may sometimes lead to death. Though the risk of mortality is low, it is too high for a diagnostic procedure. Post-biopsy care and additional surgical intervention to arrest hemorrhage make liver biopsy a costly procedure for health care delivery systems. Non-invasive methods to stop bleeding exist like electro–cautery, microwave, lasers, radio frequency, argon–beam, and High Intensity Focused Ultrasound (HIFU). All the methods except HIFU require direct exposure of the needle puncture site for hemostasis. HIFU is an ultrasound modality and uses mechanical sound waves for focused energy delivery. Ultrasound waves are minimally affected by tissue attenuation and focus internal targets without direct exposure. Human error in focusing HIFU renders it unusable for a medical procedure especially when noninvasive. In this project we designed and developed an ultrasound guided prototype robot for accurate HIFU targeting to induce hemostasis. The robotic system performs percutaneous needle biopsy and a 7.5 cm focal length HIFU is fired at the puncture point when the needle tip retracts to the liver surface after sample collection. The robot has 4 degrees of freedom (DOF) for biopsy needle insertion, HIFU positioning, needle angle alignment and US probe image plane orientation. As the needle puncture point is always in the needle path, mechanically constraining the HIFU to focus on the needle reduced the required functionality significantly. Two mini c-arms are designed for needle angle alignment and US probe image plane orientation. This reduced the contact foot print of the robot over the patient providing a greater dexterity for positioning the robot. The robot is validated for HIFU hemostasis by a series of experiments on chicken breasts. HIFU initiated hemorrhage control with robotic biopsy ensures arrest of post-biopsy hemorrhage and decreases patient anxiety, hospital stay, morbidity, time of procedure, and cost. This can also be extended to other organs like kidneys, lungs etc. and has widespread implications such as control of hemorrhage in post-biopsies in patients with reduced ability for hemostasis. This research opens a greater scope for research for automation and design making it a physician friendly tool for eventual clinical use