Development of an Electrotactile Haptic Device with Application to Balance Rehabilitation

Balance impairments affect many individuals especially those in the older age bracket, and can lead to severe complications from falls. Research has shown that the cause of these impairments can be attributed to degraded sensory inputs. With ample sensory supplementation (or sensory augmentation), these deficiencies may be overcome. The purpose of this research is to verify a design of a low-cost custom electrotactile stimulation device that can aid in balance rehabilitation purposes. To this end, a major focus will be on wearability. Presently, there is a large research gap in the field of electrotactile stimulation for achieving wearable designs. Additionally, few devices incorporate a sensing mechanism for detecting balance impairment such as with an inertial measurement unit. Many researchers still rely on expensive commercial devices that are very large and bulky. Additionally, the design and implementation of electrotactile stimulation devices require working knowledge of circuits, thus there is mainly a general lack of instructions for the design of such devices. The thesis hopes to address these gaps by studying a design that may be simple to replicate from scratch. The design includes the use of several half H-bridge circuits to produce localized dipole stimulation through a 4 by 4 electrode array. Feasibility of the design will be verified via oscilloscope measurements and a small pilot study that is aimed at obtaining user feedback. The wearable components of the device include a custom-fabricated electrode array to be worn on the wrist or arm, and also an IMU (inertial measurement unit) belt along the waist to measure the user’s sway angle along the sagittal plane. Preliminary results show that a user can detect sensations from dry-skin stimulation while wearing the electrode array. The detected sensations also include directional information. Additionally, verification with the subject showed that the device is able to provide biofeedback through an electrode array as a result of the IMU orientation information. Further design refinements such as better point discrimination, pattern generation, and consistent pulsing are required before proceeding to the human testing and validation stage

Haptics: Science, Technology, Applications

This open access book constitutes the proceedings of the 13th International Conference on Human Haptic Sensing and Touch Enabled Computer Applications, EuroHaptics 2022, held in Hamburg, Germany, in May 2022. The 36 regular papers included in this book were carefully reviewed and selected from 129 submissions. They were organized in topical sections as follows: haptic science; haptic technology; and haptic applications

Sensory Augmentation for Balance Rehabilitation Using Skin Stretch Feedback

This dissertation focuses on the development and evaluation of portable sensory augmentation systems that render skin-stretch feedback of posture for standing balance training and for postural control improvement. Falling is one of the main causes of fatal injuries among all members of the population. The high incidence of fall-related injuries also leads to high medical expenses, which cost approximately $34 billion annually in the United States. People with neurological diseases, e.g., stroke, multiple sclerosis, spinal cord injuries, and the elderly are more prone to falling when compared to healthy individuals. Falls among these populations can also lead to hip fracture, or even death. Thus, several balance and gait rehabilitation approaches have been developed to reduce the risk of falling. Traditionally, a balance-retraining program includes a series of exercises for trainees to strengthen their sensorimotor and musculoskeletal systems. Recent advances in technology have incorporated biofeedback such as visual, auditory, or haptic feedback to provide the users with extra cues about their postural sway. Studies have also demonstrated the positive effects of biofeedback on balance control. However, current applications of biofeedback for interventions in people with impaired balance are still lacking some important characteristics such as portability (in-home care), small-size, and long-term viability. Inspired by the concept of light touch, a light, small, and wearable sensory augmentation system that detects body sway and supplements skin stretch on one’s fingertip pad was first developed. The addition of a shear tactile display could significantly enhance the sensation to body movement. Preliminary results have shown that the application of passive skin stretch feedback at the fingertip enhanced standing balance of healthy young adults. Based on these findings, two research directions were initiated to investigate i) which dynamical information of postural sway could be more effectively conveyed by skin stretch feedback, and ii) how can such feedback device be easily used in the clinical setting or on a daily basis. The major sections of this research are focused on understanding how the skin stretch feedback affects the standing balance and on quantifying the ability of humans to interpret the cutaneous feedback as the cues of their physiological states. Experimental results from both static and dynamic balancing tasks revealed that healthy subjects were able to respond to the cues and subsequently correct their posture. However, it was observed that the postural sway did not generally improve in healthy subjects due to skin stretch feedback. A possible reason was that healthy subjects already had good enough quality sensory information such that the additional artificial biofeedback may have interfered with other sensory cues. Experiments incorporating simulated sensory deficits were further conducted and it was found that subjects with perturbed sensory systems (e.g., unstable surface) showed improved balance due to skin stretch feedback when compared to the neutral standing conditions. Positive impacts on balance performance have also been demonstrated among multiple sclerosis patients when they receive skin stretch feedback from a sensory augmentation walker. The findings in this research indicated that the skin stretch feedback rendered by the developed devices affected the human balance and can potentially compensate underlying neurological or musculoskeletal disorders, therefore enhancing quiet standing postural control

Sensory Augmentation for Balance Rehabilitation Using Skin Stretch Feedback

This dissertation focuses on the development and evaluation of portable sensory augmentation systems that render skin-stretch feedback of posture for standing balance training and for postural control improvement. Falling is one of the main causes of fatal injuries among all members of the population. The high incidence of fall-related injuries also leads to high medical expenses, which cost approximately $34 billion annually in the United States. People with neurological diseases, e.g., stroke, multiple sclerosis, spinal cord injuries, and the elderly are more prone to falling when compared to healthy individuals. Falls among these populations can also lead to hip fracture, or even death. Thus, several balance and gait rehabilitation approaches have been developed to reduce the risk of falling. Traditionally, a balance-retraining program includes a series of exercises for trainees to strengthen their sensorimotor and musculoskeletal systems. Recent advances in technology have incorporated biofeedback such as visual, auditory, or haptic feedback to provide the users with extra cues about their postural sway. Studies have also demonstrated the positive effects of biofeedback on balance control. However, current applications of biofeedback for interventions in people with impaired balance are still lacking some important characteristics such as portability (in-home care), small-size, and long-term viability. Inspired by the concept of light touch, a light, small, and wearable sensory augmentation system that detects body sway and supplements skin stretch on one’s fingertip pad was first developed. The addition of a shear tactile display could significantly enhance the sensation to body movement. Preliminary results have shown that the application of passive skin stretch feedback at the fingertip enhanced standing balance of healthy young adults. Based on these findings, two research directions were initiated to investigate i) which dynamical information of postural sway could be more effectively conveyed by skin stretch feedback, and ii) how can such feedback device be easily used in the clinical setting or on a daily basis. The major sections of this research are focused on understanding how the skin stretch feedback affects the standing balance and on quantifying the ability of humans to interpret the cutaneous feedback as the cues of their physiological states. Experimental results from both static and dynamic balancing tasks revealed that healthy subjects were able to respond to the cues and subsequently correct their posture. However, it was observed that the postural sway did not generally improve in healthy subjects due to skin stretch feedback. A possible reason was that healthy subjects already had good enough quality sensory information such that the additional artificial biofeedback may have interfered with other sensory cues. Experiments incorporating simulated sensory deficits were further conducted and it was found that subjects with perturbed sensory systems (e.g., unstable surface) showed improved balance due to skin stretch feedback when compared to the neutral standing conditions. Positive impacts on balance performance have also been demonstrated among multiple sclerosis patients when they receive skin stretch feedback from a sensory augmentation walker. The findings in this research indicated that the skin stretch feedback rendered by the developed devices affected the human balance and can potentially compensate underlying neurological or musculoskeletal disorders, therefore enhancing quiet standing postural control

A Haptic Feedback System for Lower Limb Amputees Based on Gait Event Detection

Lower limb amputation has significant effects on a person’s quality of life and ability to perform activities of daily living. Prescription of prosthetic device post amputation aims to help restore some degrees of mobility function, however studies have shown evidence of low balance confidence and higher risk of falling among amputee community, especially those suffering from above knee amputation. While advanced prostheses offer better control, they often lack a form of feedback that delivers the awareness of the limb position to the prosthetic user while walking. This research presents the development and evaluation of a wearable skinstretch haptic feedback system intended to deliver cues of two crucial gait events, namely the Initial Contact (IC) and Toe-off (TO) to its wearer. The system comprises a haptic module that applies lateral skin-stretch on the upper leg or the trunk, corresponding to the gait event detection module based on Inertial Measurement Unit (IMU) attached at the shank. The design and development iterations of the haptic module is presented, and characterization of the feedback parameters is discussed. The validation of the gait event detection module is carried out and finally the integration of the haptic feedback system is described. Experimental work with healthy subjects and an amputee indicated good perceptibility of the feedback during static and dynamic (walking) condition, although higher magnitude of stretch was required to perceive the feedback during dynamic condition. User response time during dynamic activity showed that the haptic feedback system is suitable for delivering cues of IC and TO within the duration of the stance phase. In addition, feedback delivered in discernible patterns can be learned and adapted by the subjects. Finally, a case study was carried out with an above-knee amputee to assess the effects of the haptic feedback on spatio-temporal gait parameters and on the vertical ground reaction force during treadmill and overground walking. The research presented in this report introduces a novel design of a haptic feedback device. As such, the outcome includes a well-controlled skin-stretch effect which contributes to the research by investigating skin-stretch feedback for conveying discrete event information rather than conveying direction information as presented in other studies. In addition, it is found that stretch magnitude as small as 3 mm could be perceived in short duration of 150 ms during dynamic condition, making it a suitable alternative to other widely investigated haptic modality such as vibration for ambulatory feedback application. With continuous training, the haptic feedback system could possibly benefit lower limb amputees by creating awareness of the limb placement during ambulation, potentially reducing visual dependency and increasing walking confidence

Haptics: Science, Technology, Applications

This open access book constitutes the proceedings of the 12th International Conference on Human Haptic Sensing and Touch Enabled Computer Applications, EuroHaptics 2020, held in Leiden, The Netherlands, in September 2020. The 60 papers presented in this volume were carefully reviewed and selected from 111 submissions. The were organized in topical sections on haptic science, haptic technology, and haptic applications. This year's focus is on accessibility

Haptics: Science, Technology, Applications

This open access book constitutes the proceedings of the 12th International Conference on Human Haptic Sensing and Touch Enabled Computer Applications, EuroHaptics 2020, held in Leiden, The Netherlands, in September 2020. The 60 papers presented in this volume were carefully reviewed and selected from 111 submissions. The were organized in topical sections on haptic science, haptic technology, and haptic applications. This year's focus is on accessibility

Multimodal interaction: developing an interaction concept for a touchscreen incorporating tactile feedback

The touchscreen, as an alternative user interface for applications that normally require mice and keyboards, has become more and more commonplace, showing up on mobile devices, on vending machines, on ATMs and in the control panels of machines in industry, where conventional input devices cannot provide intuitive, rapid and accurate user interaction with the content of the display. The exponential growth in processing power on the PC, together with advances in understanding human communication channels, has had a significant effect on the design of usable, human-factored interfaces on touchscreens, and on the number and complexity of applications available on touchscreens. Although computer-driven touchscreen interfaces provide programmable and dynamic displays, the absence of the expected tactile cues on the hard and static surfaces of conventional touchscreens is challenging interface design and touchscreen usability, in particular for distracting, low-visibility environments. Current technology allows the human tactile modality to be used in touchscreens. While the visual channel converts graphics and text unidirectionally from the computer to the end user, tactile communication features a bidirectional information flow to and from the user as the user perceives and acts on the environment and the system responds to changing contextual information. Tactile sensations such as detents and pulses provide users with cues that make selecting and controlling a more intuitive process. Tactile features can compensate for deficiencies in some of the human senses, especially in tasks which carry a heavy visual or auditory burden. In this study, an interaction concept for tactile touchscreens is developed with a view to employing the key characteristics of the human sense of touch effectively and efficiently, especially in distracting environments where vision is impaired and hearing is overloaded. As a first step toward improving the usability of touchscreens through the integration of tactile effects, different mechanical solutions for producing motion in tactile touchscreens are investigated, to provide a basis for selecting suitable vibration directions when designing tactile displays. Building on these results, design know-how regarding tactile feedback patterns is further developed to enable dynamic simulation of UI controls, in order to give users a sense of perceiving real controls on a highly natural touch interface. To study the value of adding tactile properties to touchscreens, haptically enhanced UI controls are then further investigated with the aim of mapping haptic signals to different usage scenarios to perform primary and secondary tasks with touchscreens. The findings of the study are intended for consideration and discussion as a guide to further development of tactile stimuli, haptically enhanced user interfaces and touchscreen applications