Sensory supplementation system based on electrotactile tongue biofeedback of head position for balance control

The present study aimed at investigating the effects of an artificial head position-based tongue-placed electrotactile biofeedback on postural control during quiet standing under different somatosensory conditions from the support surface. Eight young healthy adults were asked to stand as immobile as possible with their eyes closed on two Firm and Foam support surface conditions executed in two conditions of No-biofeedback and Biofeedback. In the Foam condition, a 6-cm thick foam support surface was placed under the subjects' feet to alter the quality and/or quantity of somatosensory information at the plantar sole and the ankle. The underlying principle of the biofeedback consisted of providing supplementary information about the head orientation with respect to gravitational vertical through electrical stimulation of the tongue. Centre of foot pressure (CoP) displacements were recorded using a force platform. Larger CoP displacements were observed in the Foam than Firm conditions in the two conditions of No-biofeedback and Biofeedback. Interestingly, this destabilizing effect was less accentuated in the Biofeedback than No-biofeedback condition. In accordance with the sensory re-weighting hypothesis for balance control, the present findings evidence that the availability of the central nervous system to integrate an artificial head orientation information delivered through electrical stimulation of the tongue to limit the postural perturbation induced by alteration of somatosensory input from the support surface

Inside-outside: 3-D music through tissue conduction

Eliciting an auditory perception by means of mechanical transduction bypassing the peripheral hearing apparatus has been recorded as early as the 16th century. Excluding its audiometric use to assess ear pathology, bone and soft tissue conduction has received very little interest until the last two decades. Previous work during this time (Stanley and Walker 2006, MacDonald and Letowski 2006) has indicated robust lateralization is feasible via mechanical transduction. We have extended this, adding the front-back and up-down axes

Effect of haptic supplementation on postural stabilization: A comparison of fixed and mobile support conditions

International audienceIt is well known in the literature of haptic supplementation that a "light touch" (LT) with the index finger on a stable surface increases postural stability. In view of potential application in the domain of mobility aids, it should however be demonstrated that haptic supplementation is effective even when provided by an unstable stick support. The present study aimed to explore the stabilizing effect of a three-digit "light grip" (LG) of different supports (fixed or mobile stick) in young people. Eleven participants (M = 25.9 years) were tested in an upright standing task in six experimental conditions in which the mobility of the given support and its resistance in opposite direction to the body movement were manipulated. The RMS variability and the range of postural oscillations were measured. The results confirmed that the stabilizing effect of haptic supplementation is independent from the nature of the support (fixed or mobile) when sufficiently large sway-related contact forces on the fingers are provided. Future applications of this "mobile stick paradigm" to complex situations while targeting different groups of participants may help to approach everyday life situations in which an informational stick could potentially be of assistance to gain stability and mobility

Sensory Supplementation to Enhance Adaptation Following G-transitions and Traumatic Brain Injury

Sensory supplementation can be incorporated as online feedback for improving spatial orientation awareness for manual control tasks (e.g. TSAS, Shuttle ZAG study). Preliminary data with vestibular patients and TBI military population is promising for rehabilitation training. Recommend that sensory supplementation be incorporated as a training component in an integrated countermeasure approach

iBalance-ABF: a Smartphone-Based Audio-Biofeedback Balance System

International audienceThis article proposes an implementation of a Kalman Filter, using inertial sensors of a Smartphone, to estimate 3D angulation of the trunk. The developped system monitors the trunk angular evolution during bipedal stance and helps the user to improve balance through a configurable and integrated auditory-biofeedback loop. A proof-of-concept study was performed to assess the effectiveness of this so-called iBalance-ABF - smartphone-based audio-biofeedback system - in improving balance during bipedal standing. Results showed that young healthy individuals were able to efficiently use ABF on sagittal trunk tilt to improve their balance in the ML direction. These findings suggest that iBalance-ABF system as a Telerehabilitation system which could represent a suitable solution for Ambient Assisted Living technologies

Review of rehabilitation and habilitation strategies for children and young people with homonymous visual field loss caused by cerebral vision impairment

Partial and homonymous visual field loss (HVFL) is a common consequence of post-chiasmatic injury to the primary visual pathway or injury to the primary visual cortex. Different approaches to rehabilitation have been reported for older adults with HVFL and there is evidence to support the use of compensatory training over other proposed therapies. We reviewed the literature to investigate the current state of the art of rehabilitation and habilitation strategies for children and young people with HVFL, and whether there is enough evidence to support the use of these strategies in the paediatric population. We have provided an overview of the existing literature on children and young people with HVFL, a brief overview of rehabilitation strategies for adults with HVFL, and evidence on whether these different interventions have been applied with children and young people effectively. We found that there have been very few studies to investigate these strategies with children and young people, and the quality of evidence is currently low. New research is required to evaluate which strategies are effective for children and young people with HVFL and whether new strategies need to be developed

Differential postural effects of plantar-flexor muscles fatigue under normal, altered and improved vestibular and neck somatosensory conditions

The aim of the present study was to assess the effects of plantar-flexor muscles fatigue on postural control during quiet standing under normal, altered and improved vestibular and neck somatosensory conditions. To address this objective, young male university students were asked to stand upright as still as possible with their eyes closed in two conditions of No Fatigue and Fatigue of the plantar-flexor muscles. In Experiment 1 (n=15), the postural task was executed in two Neutral head and Head tilted backward postures, recognized to degrade vestibular and neck somatosensory information. In Experiment 2 (n=15), the postural task was executed in two conditions of No tactile and Tactile stimulation of the neck provided by the application of strips of adhesive bandage to the skin over and around the neck. Centre of foot pressure displacements were recorded using a force platform. Results showed that (1) the Fatigue condition yielded increased CoP displacements relative to the No Fatigue condition (Experiment 1 and Experiment 2), (2) this destabilizing effect was more accentuated in the Head tilted backward posture than Neutral head posture (Experiment 1) and (3) this destabilizing effect was less accentuated in the condition of Tactile stimulation than that of No tactile stimulation of the neck (Experiment 2). In the context of the multisensory control of balance, these results suggest an increased reliance on vestibular and neck somatosensory information for controlling posture during quiet standing in condition of altered ankle neuromuscular function

A Sound Approach Toward a Mobility Aid for Blind and Low-Vision Individuals

Reduced independent mobility of blind and low-vision individuals (BLVIs) cause considerable societal cost, burden on relatives, and reduced quality of life for the individuals, including increased anxiety, depression symptoms, need of assistance, risk of falls, and mortality. Despite the numerous electronic travel aids proposed since at least the 1940’s, along with ever-advancing technology, the mobility issues persist. A substantial reason for this is likely several and severe shortcomings of the field, both in regards to aid design and evaluation.In this work, these shortcomings are addressed with a generic design model called Desire of Use (DoU), which describes the desire of a given user to use an aid for a given activity. It is then applied on mobility of BLVIs (DoU-MoB), to systematically illuminate and structure possibly all related aspects that such an aid needs to aptly deal with, in order for it to become an adequate aid for the objective. These aspects can then both guide user-centered design as well as choice of test methods and measures.One such measure is then demonstrated in the Desire of Use Questionnaire for Mobility of Blind and Low-Vision Individuals (DoUQ-MoB), an aid-agnostic and comprehensive patient-reported outcome measure. The question construction originates from the DoU-MoB to ensure an encompassing focus on mobility of BLVIs, something that has been missing in the field. Since it is aid-agnostic it facilitates aid comparison, which it also actively promotes. To support the reliability of the DoUQ-MoB, it utilizes the best known practices of questionnaire design and has been validated once with eight orientation and mobility professionals, and six BLVIs. Based on this, the questionnaire has also been revised once.To allow for relevant and reproducible methodology, another tool presented herein is a portable virtual reality (VR) system called the Parrot-VR. It uses a hybrid control scheme of absolute rotation by tracking the user’s head in reality, affording intuitive turning; and relative movement where simple button presses on a controller moves the virtual avatar forward and backward, allowing for large-scale traversal while not walking physically. VR provides excellent reproducibility, making various aggregate movement analysis feasible, while it is also inherently safe. Meanwhile, the portability of the system facilitates testing near the participants, substantially increasing the number of potential blind and low-vision recruits for user tests.The thesis also gives a short account on the state of long-term testing in the field; it being short is mainly due to that there is not much to report. It then provides an initial investigation into possible outcome measures for such tests by taking instruments in use by Swedish orientation and mobility professionals as a starting point. Two of these are also piloted in an initial single-session trial with 19 BLVIs, and could plausibly be used for long-term tests after further evaluation.Finally, a discussion is presented regarding the Audomni project — the development of a primary mobility aid for BLVIs. Audomni is a visuo-auditory sensory supplementation device, which aims to take visual information and translate it to sound. A wide field-of-view, 3D-depth camera records the environment, which is then transformed to audio through the sonification algorithms of Audomni, and finally presented in a pair of open-ear headphones that do not block out environmental sounds. The design of Audomni leverages the DoU-MoB to ensure user-centric development and evaluation, in the aim of reaching an aid with such form and function that it grants the users better mobility, while the users still want to use it.Audomni has been evaluated with user tests twice, once in pilot tests with two BLVIs, and once in VR with a heterogenous set of 19 BLVIs, utilizing the Parrot-VR and the DoUQ-MoB. 76 % of responders (13 / 17) answered that it was very or extremely likely that they would want use Audomni along with their current aid. This might be the first result in the field demonstrating a majority of blind and low-vision participants reporting that they actually want to use a new electronic travel aid. This shows promise that eventual long-term tests will demonstrate an increased mobility of blind and low-vision users — the overarching project aim. Such results would ultimately mean that Audomni can become an aid that alleviates societal cost, reduces burden on relatives, and improves users’ quality of life and independence

NAV-VIR: an audio-tactile virtual environment to assist visually impaired people

International audienceThis paper introduces the NAV-VIR system, a multimodal virtual environment to assist visually impaired people in virtually discovering and exploring unknown areas from the safety of their home. The originality of NAV-VIR resides in (1) an optimized representation of the surrounding topography, the spatial gist, based on human spatial cognition models and the sensorimotor supplementation framework, and (2) a multimodal orientation-aware immersive virtual environment relying on two synergetic interfaces: an interactive force feedback tablet, the F2T, and an immersive HRTF-based 3D audio simulation relying on binaural recordings of real environments. This paper presents NAV-VIR functionalities and its preliminary evaluation through a simple shape and movement perception task