305 research outputs found

    Gait sonification for rehabilitation: adjusting gait patterns by acoustic transformation of kinematic data

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    To enhance motor learning in both sport and rehabilitation, auditory feedback has emerged as an effective tool. Since it requires less attention than visual feedback and hardly affects the visually dominated orientation in space, it can be used safely and effectively in natural locomotion such as walking. One method for generating acoustic movement feedback is the direct mapping of kinematic data to sound (movement sonification). Using this method in orthopedic gait rehabilitation could make an important contribution to the prevention of falls and secondary diseases. This would not only reduce the individual suffering of the patients, but also medical treatment costs. To determine the possible applications of movement sonification in gait rehabilitation in the context of this work, a new gait sonification method based on inertial sensor technology was developed. Against the background of current scientific findings on sensorimotor function, feedback methods, and gait analysis, three studies published in scientific journals are presented in this thesis: The first study shows the applicability and acceptance of the feedback method in patients undergoing inpatient rehabilitation after unilateral total hip arthroplasty. In addition, the direct effect of gait sonification during ten gait training sessions on the patients’ gait pattern was revealed. In the second study, the immediate follow-up effect of gait sonification on the kinematics of the same patient group is examined at four measurement points after gait training. In this context, a significant influence of sonification on the gait pattern of the patients was shown, which, however, did not meet the previously expected effects. In view of this finding, the effect of the specific sound parameter loudness of gait sonification on the gait of healthy persons was analyzed in a third study. Thus, an impact of asymmetric loudness of gait sonification on the ground contact time could be detected. Considering this cause-effect relationship can be a component in improving gait sonfication in rehabilitation. Overall, the feasibility and effectiveness of movement sonification in gait rehabilitation of patients after unilateral hip arthroplasty becomes evident. The findings thus illustrate the potential of the method to efficiently support orthopedic gait rehabilitation in the future. On the basis of the results presented, this potential can be exploited in particular by an adequate mapping of movement to sound, a systematic modification of selected sound parameters, and a target-group-specific selection of the gait sonification mode. In addition to a detailed investigation of the three factors mentioned above, an optimization and refinement of gait analysis in patients after arthroplasty using inertial sensor technology will be beneficial in the future.Akustisches Feedback kann wirkungsvoll eingesetzt werden, um das Bewegungslernen sowohl im Sport als auch in der Rehabilitation zu erleichtern. Da es weniger Aufmerksamkeit als visuelles Feedback erfordert und die visuell dominierte Orientierung im Raum kaum beeinträchtigt, kann es während einer natürlichen Fortbewegung wie dem Gehen sicher und effektiv genutzt werden. Eine Methode zur Generierung akustischen Bewegungsfeedbacks ist die direkte Abbildung kinematischer Daten auf Sound (Bewegungssonifikation). Ein Einsatz dieser Methode in der orthopädischen Gangrehabilitation könnte einen wichtigen Beitrag zur Prävention von Stürzen und Folgeerkrankungen leisten. Neben dem individuellen Leid der Patienten ließen sich so auch medizinische Behandlungskosten erheblich reduzieren. Um im Rahmen dieser Arbeit die Einsatzmöglichkeiten der Bewegungssonifikation in der Gangrehabilitation zu bestimmen, wurde eine neue Gangsonifikationsmethodik auf Basis von Inertialsensorik entwickelt. Zu der entwickelten Methodik werden, vor dem Hintergrund aktueller wissenschaftlicher Erkenntnisse zur Sensomotorik, zu Feedbackmethoden und zur Ganganalyse, in dieser Thesis drei in Fachzeitschriften publizierte Studien vorgestellt. Die erste Studie beschreibt die Anwendbarkeit und Akzeptanz der Feedbackmethode bei Patienten in stationärer Rehabilitation nach unilateraler Hüftendoprothetik. Darüber hinaus wird der direkte Effekt der Gangsonifikation während eines zehnmaligen Gangtrainings auf das Gangmuster der Patienten deutlich. In der zweiten Studie wird der unmittelbare Nacheffekt der Gangsonifikation auf die Kinematik der gleichen Patientengruppe zu vier Messzeitpunkten nach dem Gangtraining untersucht. In diesem Zusammenhang zeigte sich ein signifikanter Einfluss der Sonifikation auf das Gangbild der Patienten, der allerdings nicht den zuvor erwarteten Effekten entsprach. Aufgrund dieses Ergebnisses wurde in einer dritten Studie die Wirkung des spezifischen Klangparameters Lautstärke der Gangsonifikation auf das Gangbild von gesunden Personen analysiert. Dabei konnte ein Einfluss von asymmetrischer Lautstärke der Gangsonifikation auf die Bodenkontaktzeit nachgewiesen werden. Die Berücksichtigung dieses Ursache-Wirkungs-Zusammenhangs kann einen Baustein bei der Verbesserung der Gangsonifikation in der Rehabilitation darstellen. Insgesamt wird die Anwendbarkeit und Wirksamkeit von Bewegungssonifikation in der Gangrehabilitation bei Patienten nach unilateraler Hüftendoprothetik evident. Die gewonnenen Erkenntnisse verdeutlichen das Potential der Methode, die orthopädische Gangrehabilitation zukünftig effizient zu unterstützen. Ausschöpfen lässt sich dieses Potential auf Grundlage der vorgestellten Ergebnisse insbesondere anhand einer adäquaten Zuordnung von Bewegung zu Sound, einer systematischen Modifikation ausgewählter Soundparameter sowie einer zielgruppenspezifischen Wahl des Modus der Sonifikation. Neben einer differenzierten Untersuchung der genannten Faktoren, erscheint zukünftig eine Optimierung und Verfeinerung der Ganganalyse bei Patienten nach Endoprothetik unter Einsatz von Inertialsensorik notwendig

    Differences in well-being:the biological and environmental causes, related phenotypes, and real-time assessment

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    Well-being is a complex, and multifaceted construct that includes feeling good and functioning well. There is a growing global recognition of well-being as an important research topic and public policy goal. Well-being is related to less behavioral and emotional problems, and is associated with many positive aspects of daily life, including longevity, higher educational achievement, happier marriage, and more productivity at work. People differ in their levels of well-being, i.e., some people are in general happier or more satisfied with their lives than others. These individual differences in well-being can arise from many different factors, including biological (genetic) influences and environmental influences. To enhance the development of future mental health prevention and intervention strategies to increase well-being, more knowledge about these determinants and factors underlying well-being is needed. In this dissertation, I aimed to increase the understanding of the etiology in a series of studies using different methods, including systematic reviews, meta-analyses, twin designs, and molecular genetic designs. In part I, we brought together all published studies on the neural and physiological factors underlying well-being. This overview allowed us to critically investigate the claims made about the biology involved in well-being. The number of studies on the neural and physiological factors underlying well-being is increasing and the results point towards potential correlates of well-being. However, samples are often still small, and studies focus mostly on a single biomarker. Therefore, more well-powered, data-driven, and integrative studies across biological categories are needed to better understand the neural and physiological pathways that play a role in well-being. In part II, we investigated the overlap between well-being and a range of other phenotypes to learn more about the etiology of well-being. We report a large overlap with phenotypes including optimism, resilience, and depressive symptoms. Furthermore, when removing the genetic overlap between well-being and depressive symptoms, we showed that well-being has unique genetic associations with a range of phenotypes, independently from depressive symptoms. These results can be helpful in designing more effective interventions to increase well-being, taking into account the overlap and possible causality with other phenotypes. In part III, we used the extreme environmental change during the COVID-19 pandemic to investigate individual differences in the effects of such environmental changes on well-being. On average, we found a negative effect of the pandemic on different aspects of well-being, especially further into the pandemic. Whereas most previous studies only looked at this average negative effect of the pandemic on well-being, we focused on the individual differences as well. We reported large individual differences in the effects of the pandemic on well-being in both chapters. This indicates that one-size-fits-all preventions or interventions to maintain or increase well-being during the pandemic or lockdowns will not be successful for the whole population. Further research is needed for the identification of protective factors and resilience mechanisms to prevent further inequality during extreme environmental situations. In part IV, we looked at the real-time assessment of well-being, investigating the feasibility and results of previous studies. The real-time assessment of well-being, related variables, and the environment can lead to new insights about well-being, i.e., results that we cannot capture with traditional survey research. The real-time assessment of well-being is therefore a promising area for future research to unravel the dynamic nature of well-being fluctuations and the interaction with the environment in daily life. Integrating all results in this dissertation confirmed that well-being is a complex human trait that is influenced by many interrelated and interacting factors. Future directions to understand individual differences in well-being will be a data-driven approach to investigate the complex interplay of neural, physiological, genetic, and environmental factors in well-being

    The Role of Autonomic Nervous System in Pain Chronicity

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    The role of the autonomic nervous system (ANS) in chronic pain (CP) and in its chronicity is considered secondary and reactive to the nociceptive processes in the somatic nervous system (SomNS). However, research and clinical data strongly suggest the opposite. The ANS is an ancient, complex and ample part of the nervous system. It serves and controls visceral organs and somatic tissues. The ANS takes part in all aspects of all types of pain and influences its mechanisms at both peripheral and central levels. In this chapter we bring together the evidence from biomedical disciplines and clinical practice to support an alternative theory which contradicts the traditional views on the subject. We also raise questions which require further research to consolidate facts, advance our knowledge and improve treatment strategies for CP. The importance of this topic is difficult to overestimate because of the significant impact of CP on society and the lack of understanding, efficient therapy or cure

    Graphonomics and your Brain on Art, Creativity and Innovation : Proceedings of the 19th International Graphonomics Conference (IGS 2019 – Your Brain on Art)

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    [Italiano]: “Grafonomia e cervello su arte, creatività e innovazione”. Un forum internazionale per discutere sui recenti progressi nell'interazione tra arti creative, neuroscienze, ingegneria, comunicazione, tecnologia, industria, istruzione, design, applicazioni forensi e mediche. I contributi hanno esaminato lo stato dell'arte, identificando sfide e opportunità, e hanno delineato le possibili linee di sviluppo di questo settore di ricerca. I temi affrontati includono: strategie integrate per la comprensione dei sistemi neurali, affettivi e cognitivi in ambienti realistici e complessi; individualità e differenziazione dal punto di vista neurale e comportamentale; neuroaesthetics (uso delle neuroscienze per spiegare e comprendere le esperienze estetiche a livello neurologico); creatività e innovazione; neuro-ingegneria e arte ispirata dal cervello, creatività e uso di dispositivi di mobile brain-body imaging (MoBI) indossabili; terapia basata su arte creativa; apprendimento informale; formazione; applicazioni forensi. / [English]: “Graphonomics and your brain on art, creativity and innovation”. A single track, international forum for discussion on recent advances at the intersection of the creative arts, neuroscience, engineering, media, technology, industry, education, design, forensics, and medicine. The contributions reviewed the state of the art, identified challenges and opportunities and created a roadmap for the field of graphonomics and your brain on art. The topics addressed include: integrative strategies for understanding neural, affective and cognitive systems in realistic, complex environments; neural and behavioral individuality and variation; neuroaesthetics (the use of neuroscience to explain and understand the aesthetic experiences at the neurological level); creativity and innovation; neuroengineering and brain-inspired art, creative concepts and wearable mobile brain-body imaging (MoBI) designs; creative art therapy; informal learning; education; forensics

    Maintaining the Integrity Over Wear Time of a Hydrocolloid-based Ostomy Adhesive Whilst Maintaining Skin Barrier Function

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    In this extensive body of work, a thorough exploration delves into hydrocolloid based adhesives, with a focus on addressing challenges faced by stoma patients, particularly the susceptibility of ostomy adhesives to breakdown upon exposure to liquids. Stoma patients, compelled to wear pouching systems continuously, encounter issues like the compromise of skin barrier integrity, leading to medical adhesive-related skin injuries. The primary objective of this thesis is to reinforce the structural integrity of ostomy adhesives while preserving the skin barrier during pouching system use, an aspect often overlooked in current literature due to the hydrophilic nature of hydrocolloid based adhesives. The study introduces novel aims, examining the potential link between handedness and the preferred direction of adhesive removal, and its impact on peristomal skin complications as well as a novel skin capacitive imagery stitching technique. Another goal involves developing hierarchical structures on adhesive surfaces to enhance integrity, initial tack, and minimize skin contact for optimal skin health. The introduction provides a detailed breakdown of hydrocolloid-based ostomy adhesives, stoma anatomy, and the purpose of pouching systems. A comprehensive literature review, utilizing the PICO approach, encompasses stoma anatomy, physiology, indications for stoma surgery, and methods for assessing skin health. The review explores various methodologies to improve the durability of hydrocolloid-based adhesives, incorporating hydrodynamics, crosslinking, and layering systems. The potential influence of handedness on adhesive removal techniques is examined, considering its impact on peristomal skin complications. Results reveal the consistent performance of Welland Medical Ltd.'s hydrocolloid based adhesive but highlight the need for improved integrity over wear time. Strategies include modifying sodium-carboxymethylcellulose degree of substitution and increasing pectin degree of esterification, resulting in enhanced fluid handling capabilities and reduced susceptibility to degradation. Residual testing indicates that residual particles on the skin can impair the barrier function, remedied by a silicone-based adhesive remover. Surveys show that a patient's dominant hand and following the skin's natural langer lines during adhesive removal may minimize skin trauma. The results also show that structured surface profiles on hydrocolloid-based adhesive surfaces impact the skin's functional barrier recovery time. The research goal of this project and its objectives have been reached, the approaches have been explained clearly and implementations have been assessed using experimental findings. This project's findings contribute to advancements in ostomy care by enhancing adhesive performance, understanding patient behaviour, and improving the overall user experience. It also facilitates the efficient detachment of the adhesive from the skin surface

    Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning

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    Virtual reality exposure therapy (VRET) is a novel intervention technique that allows individuals to experience anxiety-evoking stimuli in a safe environment, recognise specific triggers and gradually increase their exposure to perceived threats. Public-speaking anxiety (PSA) is a prevalent form of social anxiety, characterised by stressful arousal and anxiety generated when presenting to an audience. In self-guided VRET, participants can gradually increase their tolerance to exposure and reduce anxiety-induced arousal and PSA over time. However, creating such a VR environment and determining physiological indices of anxiety-induced arousal or distress is an open challenge. Environment modelling, character creation and animation, psychological state determination and the use of machine learning (ML) models for anxiety or stress detection are equally important, and multi-disciplinary expertise is required. In this work, we have explored a series of ML models with publicly available data sets (using electroencephalogram and heart rate variability) to predict arousal states. If we can detect anxiety-induced arousal, we can trigger calming activities to allow individuals to cope with and overcome distress. Here, we discuss the means of effective selection of ML models and parameters in arousal detection. We propose a pipeline to overcome the model selection problem with different parameter settings in the context of virtual reality exposure therapy. This pipeline can be extended to other domains of interest where arousal detection is crucial. Finally, we have implemented a biofeedback framework for VRET where we successfully provided feedback as a form of heart rate and brain laterality index from our acquired multimodal data for psychological intervention to overcome anxiety

    Exploring neural markers of language processing using fNIRS in typically developed children and children with Developmental Language Disorder

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    Background: Developmental language disorder (DLD) is a life-long condition with no clear biological causes that affects approximately 8% of the population. The diagnosis currently relies on behavioural testing that is not reliably performed on children younger than school age. Consequently, the diagnosis and treatment of DLD is often delayed until after children enter formal education. Early work in the field suggests that neural markers of language processing could be used to develop an objective diagnostic tool that will allow for accurate and early identification of DLD in preschool years and thus access to early interventions. Here we propose the use of a novel non-invasive neuroimaging technique called functional near infrared spectroscopy (fNIRS) to identify neural markers of language processing in children with DLD. Additionally, we argue that to understand atypical language processing, it is imperative to also investigate typical cortical activations in response to language processing to establish the developmental trajectories of the language network. Parallel to these studies we also investigate patterns of neural synchrony during parent-child interactions. Speech and language development in children is thought to rely on successful parent-child interactions, however, little is known regarding the underlying neural mechanisms from which they arise. Methods: Cross-Sectional fNIRS Studies: A total of 36 participants aged 6–16-year-old (1 participant with DLD) were recruited in two cross-sectional fNIRS studies. Participants underwent a 10-minute resting state imaging session and completed a series of computer-administered language and cognitive tasks while their brain activity was recorded using fNIRS from the bilateral inferior frontal gyrus (IFG) and the bilateral auditory cortices. Hyperscanning fNIRS Study: 12 children aged between 3 and 5 years old and their mothers participated in this study. Neural synchrony in mother-child dyads was measured bilaterally over frontal and temporal areas using fNIRS whilst the dyads were asked to play together (interactive condition) and separately (independent condition). Communication patterns were captured via video recordings and conversational turns were coded. Survey Study: 43 parents of children with DLD and 44 clinicians with DLD expertise completed a qualitative online survey detailing their views, concerns and recommendations regarding the use of neuroimaging-based tool for the diagnosis and monitoring of DLD. Results: Cross sectional fNIRS studies: In typically developed children and adolescents, widespread connections between the language regions and the right IFG appear to continue decreasing as age increases. In contrast connections between temporal regions are well established by late childhood. Increased activity over right auditory regions is associated with decreased language skills. Whilst data from the DLD participant is described, further analysis was not possible due to the limited sample size (n=1). Hyperscanning fNIRS study: We successfully recorded inter-brain synchrony in bilateral prefrontal and temporal cortices in mother-child dyads while they engaged in cooperative and independent play. Compared to the independent condition, mother-child dyads showed increased neural synchrony in the interactive condition across the prefrontal cortex and temporo-parietal junction. There was no significant relationship found between neural synchrony and turn-taking, but neural synchrony was negatively correlated with the child’s levels of surgency. Survey study: Clinicians and parents perceived that a potential tool that could diagnose children with DLD earlier would positively impact the children as it would allow them to access interventions earlier. This study offered a unique account of the factors to be considered in the design and implementation of clinical measures for language disorders from the viewpoints of parents and language professionals. Conclusions: Overall, this research aimed to identify neural markers of language processing in children with DLD and typically developed children to help develop an objective early diagnostic tool. Ultimately, this research might help maximize the benefits of speech and language therapies to improve the quality of life for children with DLD. This can be very impactful translational research in language development given that currently no objective neural-based tools exist for DLD
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