Uso de redes neuro-borrosas RFNN para la aproximación del comportamiento de una neuroprótesis de antebrazo en pacientes con daño cerebral

Las neuroprótesis son sistemas basados en la técnica de estimulación eléctrica funcional que provocan contracciones musculares mediante la excitación artificial de nervios periféricos, y son utilizadas para sustituir funciones motrices/sensoriales en aplicaciones tanto asistivas como terapéuticas. Este trabajo presenta la posibilidad de utilizar redes neuro-borrosas recurrentes para obtener modelos capaces de extraer las características principales del resultado de la aplicación de una neuroprótesis de miembro superior en distintos pacientes. Se ha entrenado una Recurrent Fuzzy Neural Network (RFNN) con datos reales obtenidos de pacientes crónicos de daño cerebral adquirido. Se han analizado distintas estrategias y estructuras y los resultados preliminares muestran la capacidad de estas redes de aprender las características principales de distintos sujetos y de proporcionar información fácilmente interpretable

A foot drop compensation device based on surface multi-field functional electrical stimulation—Usability study in a clinical environment

Functional electrical stimulation applies electrical pulses to the peripheral nerves to artificially achieve a sensory/motor function. When applied for the compensation of foot drop it provides both assistive and therapeutic effects. Multi-field electrodes have shown great potential but may increase the complexity of these systems. Usability aspects should be checked to ensure their success in clinical environments. We developed the Fesia Walk device, based on a surface multi-field electrode and an automatic calibration algorithm, and carried out a usability study to check the feasibility of integrating this device in therapeutic programs in clinical environments. The study included 4 therapists and 10 acquired brain injury subjects (8 stroke and 2 traumatic brain injury).The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Part of this study was supported by the European Regional Development Funds through the Interreg Sudoe Program, project SOE1/P1/F0370

Usability study of a device for compensation of foot drop based on FES and surface multi-field electrodes in a clinical environment

Functional Electrical Stimulation (FES) has shown successful assistive and rehabilitation effects in people affected by foot drop dysfunction caused by neurological disorders [1]. Still, FES-based foot drop devices are not present in regular therapy programs of many countries due to barriers caused by technological, usability or reliability issues [2]. FES devices based on surface multi-field electrodes bring new broader stimulation possibilities and features like compensation of eversion/inversion and thus, potentially increase the configuration options. In this study, the satisfaction and usability aspects of a multi-field based FES device were analyzed in a clinical environment. Method The FES device used in this study was the Fesia Walk device for compensation of foot drop, which is based on a multi-field surface electrode and an inertial sensor for gait phase detection. 10 acquired brain injury subjects in chronic stage and 4 therapists participated in the study. The therapists received a two-hour training session prior to the therapy sessions. Every subject was assigned to one therapist and received 3 sessions of habituation and 6 sessions of over ground walking with the Fesia Walk during three weeks. Both therapists and users were evaluated with the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST). Additionally, the therapists were evaluated with the System Usability Scale (SUS). An individual interview was carried out with each of the participants. Results The device received good scores in both the QUEST and SUS scales, with mean scores of 4.14 out of 5 and 85.6 out of 100 respectively. Furthermore, most users and all therapists showed interest to continue using the device after the study. Discussion and conclusions This usability study indicated that it is possible to include surface multi-field based FES devices for the compensation of foot drop in practical therapeutic programs and that they can be used as regular tools by therapists in clinical environments

ARMassist: A low-cost device for telerehabiltation of post-stroke arm deficits

Motor deficits in the growing population of stroke survivors are creating a pressing need for new strategies and new tools to provide efficient and effective delivery of patient care. A summary if existing devices for upper-limb rehabilitation is presented, including the modes of feedback provided and whether the intended market is clinical or personal use. The design requirements for a new portable device are outlined from both patient and therapist viewpoints. Embodiments of the device combine planar gravitational support of the arm, low-cost sensors, passive or active movement assistance, visual and haptic feedback, and wireless communication protocol to produce an affordable but effective device for in-home therapy. The device targets the treatment of upper-limb motor deficits resulting from conditions such as stroke, traumatic injury, and disuse. The development of a passive first prototype ARMassist device is presented.Peer reviewe

Wie geht Kultur unter die Haut?

Aktuelle lebenswissenschaftliche Forschungen problematisieren zunehmend die Grenze zwischen Natur und Kultur. Ob Adipositas, Alzheimer, psychiatrische Störungen, Gedächtnisleistung oder Stress - all diese Phänomene entziehen sich simplen biologischen Erklärungsmodellen und erfordern neuartige theoretische wie methodische Ansätze. Die internationale empirische Wissenschaftsforschung analysiert diese Entwicklungen und kontextualisiert sie historisch, praxistheoretisch und biopolitisch. Erstmalig für den deutschen Sprachraum bietet dieser Band einen Überblick aktueller Analysen führender Wissenschaftler_innen aus Deutschland, der Schweiz, Kanada und den USA

The effect of visual cues on the number and duration of freezing episodes in Parkinson's patients

Freezing of gait is a phenomenon common in Parkinson's patients and significantly affects quality of life. Sensory cues have been known to improve walking performance and reduce freezing of gait. Visual cues are reported to be particularly effective for this purpose. So far, sensory cues have generally been provided continuously, even when currently not needed. However, a recent approach suggests the provision of cues just in the case that freezing actually occurs. The arguments in favor of this on-demand cueing are reduced intrusiveness and reduced habituation to cues. Here, we analyzed the effect of visual cues on the number and duration of freezing episodes when activated either just on-demand or continuously and compare it to the baseline condition where no cue is provided. For this purpose, 7 Parkinson's patients regularly suffering from freezing of gait repeatedly walked a pre-defined course and their reaction to parallel laser lines projected in front of them on the floor was analyzed. The results show that, in comparison to the baseline condition, the mean duration of freezing was reduced by 51% in continuous cueing and by 69% in on-demand cueing. Concerning the number of freezing episodes, 43% fewer episodes were observed for continuous cueing and 9% less episodes for on-demand cueing.Peer reviewe

Comparison of Configuration Postures for a Foot Drop Multi-field FES Device

Publisher Copyright: © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.Functional electrical stimulation (FES) is a popular technique to treat foot drop, a common gait impairment caused by inadequate dorsiflexion of the ankle. Multi-field surface electrodes provide easier and faster electrode donning and doffing and higher selectivity of stimulation, solving the problems of traditional FES devices. It also allows an automatic configuration of the device. This pilot study analyses the effectivity of different postures for the automatic configuration of the Fesia Walk system, a commercial multifield technology-based FES device. 5 healthy subjects participated in the study, and 5 configurations where held at 3 body postures within 5 days. The analysis focused on the ability of the system to classify the movements (dorsiflexion, plantarflexion, eversion and inversion) of the ankle in the 3 configuration postures. Results show that sitting on top of a table with both knees extended and ankle and foot hanging freely is the most appropriate posture for configuration as it only presents limitations to generate inversion.This work has been supported in part by FIK.Peer reviewe

SEMG-based detection of poor posture: A feasibility study

The cost of the medical treatment of low back pain (LBP) was estimated to be $24 billion in the early 90s. Also, 80% of the LBP is estimated to be due to poor or inappropriate posture. The ultimate goal of the project is to develop a surface electromyography (sEMG)-based device that could be used to prevent and treat LBP by postural re-education or simply for on-the-spot sEMG feedback. In this paper we present the results and conclusions of a feasibility study for sEMG-based poor posture classifier. The results show that a s-EMG based poor posture classifier could be possible. The sensitivity for the best linear classifier model was 72% and the specificity was 78%. The same signal feature returned very different results from one participant to another. This inter-subject variability could be due to different muscular activation patterns during posture correction.Peer reviewe

EMG Topography of Low Back Muscles as a Tool for Posture Evaluation and for the Assessment of Lumbalgia Treatments Progress

Publisher Copyright: © 2013, Springer-Verlag Berlin Heidelberg.We measured bipolar surface electromyography signals (sEMG) from 6 muscles of low back in 4 patients with Low Back Pain (LBP) in two recording sessions during sitting and standing. The goal of the measurements was to present an appropriate assessment method for differentiation between correct and habitual (normally, wrong) posture and to assess recovery progress, based on sEMG topography. We calculated topography maps from the sEMG amplitude and introduced three parameters: left/right symmetry, amplitude modulation, and slope of the sEMG topography map. The results indicate that these parameters might be used as assessment tool of recovery progress and for differentiation of corrected and habitual postures in LBP patients.The work on this paper was partly supported by the Ministry of Education and Science, Republic of Serbia.Peer reviewe

Clinical Trial Protocol for Analyzing the Effect of the Intensity of FES-Based Therapy on Post-stroke Foot Drop

Publisher Copyright: © Springer International Publishing AG 2017.Positive assistive and therapeutic effects of FES have been proved for post-stroke subjects suffering from foot drop. However, the published studies are very heterogeneous in terms of methodology, therapy duration, session duration and session frequency, where most studies rely on intensive FES-based therapy. In this document a clinical protocol is proposed for analyzing the effect of medium and low intensity of FES-based therapy. The protocol is designed to be used with a surface multi-field FES system and it is based on available studies on literature and preliminary results with chronic post-stroke subjects. The proposed clinical trials could help determining the minimum necessary FES-based therapy intensity for obtaining positive therapeutic results.Acknowledgments This work has been supported by grants of the Basque Government (PI2013-10) and the ERA-NET EU/MINECO project (INDIGO-DBT2-051).Peer reviewe