Acute Biceps and Supraspinatus Tendon Changes Associated with Wheelchair Propulsion

Manual wheelchair uses rely on their upper limbs for mobility and activities of daily living. Unfortunately more than half of manual wheelchair users will experience shoulder pain, due in part to repetitive loading during wheelchair propulsion and transfers. While chronic upper extremity pathology has been well documented, no research has investigated acute rotator cuff changes that occur as a result of wheelchair propulsion. Ultrasound is a non-invasive, convenient method to examine soft tissue structures of the shoulder, but tendinosis is rated subjectively by the operator. Here we apply image analysis techniques to quantify tendon size, echogenicity, and greyscale texture. We have developed a standardized protocol, and custom reference marker, to maximize reliability of these measures. Further, content validity was established by relating greyscale-based quantitative ultrasound measures to known risk factors for shoulder pain and pathology including increased age, duration of wheelchair use, and body weight. Quantitative ultrasound measures also correlated to clinically graded tendinosis and discriminated between people with and without symptoms on physical examination. Sixty-seven manual wheelchair users underwent quantitative ultrasound examinations of the biceps and supraspinatus tendons before and after an intense wheelchair propulsion task. Biceps tendon greyscale texture post-propulsion was significantly impacted by clinically graded tendinopathy, duration of wheelchair use, resultant force, and stroke frequency when controlling for pre-propulsion ultrasound image texture. Subjects with tendinopathy or a longer duration of wheelchair use tended to have a darker, less organized tendon microstructure following propulsion likely due to the presence of inflammatory factors or other fluid. In contrast, subjects who used a higher stroke frequency or resultant force showed a brighter, more aligned tendon fibrillar structure due to mechanical loading of the tendon. In a subsample of subjects, we found that increased shoulder forces and moments during propulsion correlated with more severe supraspinatus tendinopathy. These subjects also experienced a larger decrease in supraspinatus tendon width and greyscale variance following the intense propulsion task. Quantitative ultrasound measures describe tendon microstructure and are sensitive to risk factors for shoulder pain and pathology. This technique may help identify the best interventions to reduce an individual's risk of developing upper limb pathology

Autonomy Infused Teleoperation with Application to BCI Manipulation

Robot teleoperation systems face a common set of challenges including latency, low-dimensional user commands, and asymmetric control inputs. User control with Brain-Computer Interfaces (BCIs) exacerbates these problems through especially noisy and erratic low-dimensional motion commands due to the difficulty in decoding neural activity. We introduce a general framework to address these challenges through a combination of computer vision, user intent inference, and arbitration between the human input and autonomous control schemes. Adjustable levels of assistance allow the system to balance the operator's capabilities and feelings of comfort and control while compensating for a task's difficulty. We present experimental results demonstrating significant performance improvement using the shared-control assistance framework on adapted rehabilitation benchmarks with two subjects implanted with intracortical brain-computer interfaces controlling a seven degree-of-freedom robotic manipulator as a prosthetic. Our results further indicate that shared assistance mitigates perceived user difficulty and even enables successful performance on previously infeasible tasks. We showcase the extensibility of our architecture with applications to quality-of-life tasks such as opening a door, pouring liquids from containers, and manipulation with novel objects in densely cluttered environments

Craniux: A LabVIEW-Based Modular Software Framework for Brain-Machine Interface Research

This paper presents “Craniux,” an open-access, open-source software framework for brain-machine interface (BMI) research. Developed in LabVIEW, a high-level graphical programming environment, Craniux offers both out-of-the-box functionality and a modular BMI software framework that is easily extendable. Specifically, it allows researchers to take advantage of multiple features inherent to the LabVIEW environment for on-the-fly data visualization, parallel processing, multithreading, and data saving. This paper introduces the basic features and system architecture of Craniux and describes the validation of the system under real-time BMI operation using simulated and real electrocorticographic (ECoG) signals. Our results indicate that Craniux is able to operate consistently in real time, enabling a seamless work flow to achieve brain control of cursor movement. The Craniux software framework is made available to the scientific research community to provide a LabVIEW-based BMI software platform for future BMI research and development

Microstimulation of human somatosensory cortex evokes task-dependent, spatially patterned responses in motor cortex

The primary motor (M1) and somatosensory (S1) cortices play critical roles in motor control but the signaling between these structures is poorly understood. To fill this gap, we recorded – in three participants in an ongoing human clinical trial (NCT01894802) for people with paralyzed hands – the responses evoked in the hand and arm representations of M1 during intracortical microstimulation (ICMS) in the hand representation of S1. We found that ICMS of S1 activated some M1 neurons at short, fixed latencies consistent with monosynaptic activation. Additionally, most of the ICMS-evoked responses in M1 were more variable in time, suggesting indirect effects of stimulation. The spatial pattern of M1 activation varied systematically: S1 electrodes that elicited percepts in a finger preferentially activated M1 neurons excited during that finger’s movement. Moreover, the indirect effects of S1 ICMS on M1 were context dependent, such that the magnitude and even sign relative to baseline varied across tasks. We tested the implications of these effects for brain-control of a virtual hand, in which ICMS conveyed tactile feedback. While ICMS-evoked activation of M1 disrupted decoder performance, this disruption was minimized using biomimetic stimulation, which emphasizes contact transients at the onset and offset of grasp, and reduces sustained stimulation

Altered modulation of sensorimotor rhythms with chronic paralysis

After paralysis, the disconnection between the cortex and its peripheral targets leads to neuroplasticity throughout the nervous system. However, it is unclear how chronic paralysis specifically impacts cortical oscillations associated with attempted movement of impaired limbs. We hypothesized that μ- (8-13 Hz) and β- (15-30 Hz) event-related desynchronization (ERD) would be less modulated for individuals with hand paralysis due to cervical spinal cord injury (SCI). To test this, we compared the modulation of ERD from magnetoencephalography (MEG) during attempted and imagined grasping performed by participants with cervical SCI ( = 12) and able-bodied controls ( = 13). Seven participants with tetraplegia were able to generate some electromyography (EMG) activity during attempted grasping, whereas the other five were not. The peak and area of ERD were significantly decreased for individuals without volitional muscle activity when they attempted to grasp compared with able-bodied subjects and participants with SCI,with some residual EMG activity. However, no significant differences were found between subject groups during mentally simulated tasks (i.e., motor imagery) where no muscle activity or somatosensory consequences were expected. These findings suggest that individuals who are unable to produce muscle activity are capable of generating ERD when attempting to move, but the characteristics of this ERD are altered. However, for people who maintain volitional muscle activity after SCI, there are no significant differences in ERD characteristics compared with able-bodied controls. These results provide evidence that ERD is dependent on the level of intact muscle activity after SCI. Source space MEG was used to investigate sensorimotor cortical oscillations in individuals with SCI. This study provides evidence that individuals with cervical SCI exhibit decreased ERD when they attempt to grasp if they are incapable of generating muscle activity. However, there were no significant differences in ERD between paralyzed and able-bodied participants during motor imagery. These results have important implications for the design and evaluation of new therapies, such as motor imagery and neurofeedback interventions

Altered modulation of sensorimotor rhythms with chronic paralysis

After paralysis, the disconnection between the cortex and its peripheral targets leads to neuroplasticity throughout the nervous system. However, it is unclear how chronic paralysis specifically impacts cortical oscillations associated with attempted movement of impaired limbs. We hypothesized that μ- (8-13 Hz) and β- (15-30 Hz) event-related desynchronization (ERD) would be less modulated for individuals with hand paralysis due to cervical spinal cord injury (SCI). To test this, we compared the modulation of ERD from magnetoencephalography (MEG) during attempted and imagined grasping performed by participants with cervical SCI ( = 12) and able-bodied controls ( = 13). Seven participants with tetraplegia were able to generate some electromyography (EMG) activity during attempted grasping, whereas the other five were not. The peak and area of ERD were significantly decreased for individuals without volitional muscle activity when they attempted to grasp compared with able-bodied subjects and participants with SCI,with some residual EMG activity. However, no significant differences were found between subject groups during mentally simulated tasks (i.e., motor imagery) where no muscle activity or somatosensory consequences were expected. These findings suggest that individuals who are unable to produce muscle activity are capable of generating ERD when attempting to move, but the characteristics of this ERD are altered. However, for people who maintain volitional muscle activity after SCI, there are no significant differences in ERD characteristics compared with able-bodied controls. These results provide evidence that ERD is dependent on the level of intact muscle activity after SCI. Source space MEG was used to investigate sensorimotor cortical oscillations in individuals with SCI. This study provides evidence that individuals with cervical SCI exhibit decreased ERD when they attempt to grasp if they are incapable of generating muscle activity. However, there were no significant differences in ERD between paralyzed and able-bodied participants during motor imagery. These results have important implications for the design and evaluation of new therapies, such as motor imagery and neurofeedback interventions