Développement des critères d'apprentissage pour le contrôle d'un bras robot manipulateur à 7 DDL par le traitement des signaux EMG chez les blessés médullaires

L'interaction homme-machine représente un défi de taille pour les personnes à mobilité réduite qui doivent contrôler leur environnement avec des capacités musculaires limitées. Une interface myoélectrique semble tout indiquée pour ce type de population puisqu'elle est intuitive et que les mouvements effectués pour le contrôle peuvent être adaptés aux usagers. Ce mémoire propose l'utilisation de l'analyse discriminante (Linear Discrimante Analysis) pour l'étude de signaux myoélectriques continus servant à la classification de plusieurs mouvements du haut du corps chez les blessés médullaires (BM) de haut niveau lésionnel. Le but de ce travail est de permettre un contrôle sur 16 commandes différentes en utilisant des critères génériques d'apprentissage et d'analyse. Pour ce faire, les signaux électromyographiques (EMG) provenant de 23 sujets (12 sujets sains et 11 BM) ont été analysés. L'étude se penche sur l'influence des paramètres d'apprentissage et d'analyse du classificateur ainsi que sur les mouvements les plus susceptibles d'être classifiés avec succès. De plus, ce travail propose l'analyse des mouvements et stratégies de communication pouvant être utilisées pour la transmission des commandes à un bras robot manipulateur. Le résultat principal de cette étude est que la condition des sujets influence peu les résultats du classificateur et que l'utilisation de paramètres génériques, autant pour l'apprentissage que pour l'analyse des signaux, permet un taux de succès supérieur à 95% dans la classification de cinq groupes (quatre mouvements plus le tonus musculaire) pour tous les sujets BM. L'algorithme de classification permet aussi un taux de succès de 90% pour la classification de neuf groupes (huit mouvements plus le tonus musculaire) et de 82% pour la classification de 13 groupes (12 mouvements plus le tonus musculaire) et ce, pour les sujets sains et BM. Les mouvements préférés pour une interface EMG sont les mouvements unilatéraux d''élévation de l'épaule et de flexion du coude. Les stratégies de communication permettant les meilleurs résultats de classification sont les mouvements de moyenne et de longue durée, les mouvements de forte amplitude ainsi que les séries de deux "clicks". De plus, une investigation sous forme de questionnaire a permis de déterminer que la population des BM était peu encline à utiliser une interface EMG pour le contrôle d'une aide technique et que le joystick standard de leur fauteuil roulant motorisé serait préféré

JACO assistive robotic device : empowering people with disabilities through innovative algorithms

JACO is a commercially available robotic assistive device designed to help people with upper body disabilities gaining more autonomy in their daily life. The device consists of an arm and hand (gripper) mounted on a power wheelchair. This assistance is possible through basic functions such as tri-dimensional displacement of the gripper in space, finger opening and closing and orientation of the wrist. Although these basic functionalities allow the user to perform many tasks, advanced functionalities were required to further empower the users. This paper presents advanced functionalities that were implemented in JACO in order to increase the users’ safety and to enhance their autonomy by increasing the number of achievable tasks and diminishing the time and effort needed to achieve them

Intuitive wireless control of a robotic arm for people living with an upper body disability

Assistive Technologies (ATs) also called extrinsic enablers are useful tools for people living with various disabilities. The key points when designing such useful devices not only concern their intended goal, but also the most suitable human-machine interface (HMI) that should be provided to users. This paper describes the design of a highly intuitive wireless controller for people living with upper body disabilities with a residual or complete control of their neck and their shoulders. Tested with JACO, a six-degree-of-freedom (6-DOF) assistive robotic arm with 3 flexible fingers on its end-effector, the system described in this article is made of low-cost commercial off-the-shelf components and allows a full emulation of JACO's standard controller, a 3 axis joystick with 7 user buttons. To do so, three nine-degree-of-freedom (9-DOF) inertial measurement units (IMUs) are connected to a microcontroller and help measuring the user's head and shoulders position, using a complementary filter approach. The results are then transmitted to a base-station via a 2.4-GHz low-power wireless transceiver and interpreted by the control algorithm running on a PC host. A dedicated software interface allows the user to quickly calibrate the controller, and translates the information into suitable commands for JACO. The proposed controller is thoroughly described, from the electronic design to implemented algorithms and user interfaces. Its performance and future improvements are discussed as well

Involvement of end users in the development of serious games for health care professions education : systematic descriptive review

Background: On the basis of ethical and methodological arguments, numerous calls have been made to increase the involvement of end users in the development of serious games (SGs). Involving end users in the development process is considered a way to give them power and control over educational software that is designed for them. It can also help identify areas for improvement in the design of SGs and improve their efficacy in targeted learning outcomes. However, no recognized guidelines or frameworks exist to guide end users’ involvement in SG development. Objective: The aim of this study is to describe how end users are involved in the development of SGs for health care professions education. Methods: We examined the literature presenting the development of 45 SGs that had reached the stage of efficacy evaluation in randomized trials. One author performed data extraction using an ad hoc form based on a design and development framework for SGs. Data were then coded and synthesized on the basis of similarities. The coding scheme was refined iteratively with the involvement of a second author. Results are presented using frequencies and percentages. Results: End users’ involvement was mentioned in the development of 21 of 45 SGs. The number of end users involved ranged from 12 to 36. End users were often involved in answering specific concerns that arose during the SG design (n=6) or in testing a prototype (n=12). In many cases, researchers solicited input from end users regarding the goals to reach (n=10) or the functional esthetics of the SGs (n=7). Most researchers used self-reported questionnaires (n=7). Conclusions: Researchers mentioned end users’ involvement in the development of less than half of the identified SGs, and this involvement was also poorly described. These findings represent significant limitations to evaluating the impact of the involvement of end users on the efficacy of SGs and in making recommendations regarding their involvement

Prevalence of symptoms of vaginal fi stula in 19 sub-Saharan Africa countries: a meta-analysis of national household survey data

Background Vaginal fi stula is a serious medical disorder characterised by an abnormal opening between the vagina and the bladder or rectum, which results in continuous leakage of urine or stool. The burden of this disorder in sub- Saharan Africa is uncertain. We estimated the lifetime and point prevalence of symptoms of vaginal fi stula in this region using national household surveys based on self-report of symptoms. Methods We considered all Demographic and Health Surveys (DHS) and Multiple Indicators Cluster Surveys (MICS) from sub-Saharan Africa and included data for women of reproductive age (15–49 years). We estimated lifetime prevalence and point prevalence of vaginal fi stula with use of Bayesian hierarchical meta-analysis. Findings We included 19 surveys in our analysis, including 262 100 respondents. Lifetime prevalence was 3·0 cases (95% credible interval 1·3–5·5) per 1000 women of reproductive age. After imputation of missing data, point prevalence was 1·0 case (0·3–2·4) per 1000 women of reproductive age. Ethiopia had the largest number of women who presently have symptoms of vaginal fi stula. Interpretation This study is the fi rst to estimate the burden of vaginal fi stula in 19 sub-Saharan Africa countries using nationally representative survey data. Point prevalence was slightly lower than previously estimated but these earlier estimates are within the prevalence’s credible intervals. Although vaginal fi stula is relatively rare, it is still too common in sub-Saharan Africa

Differentiating the design principles of virtual simulations and serious games to enhance nurses’ clinical reasoning

Virtual simulations and serious games are e-learning interventions with the potential to enhance nurses' clinical reasoning. However, distinctions in the design principles of each intervention remain ambiguous. Clarifications are needed to distinguish both interventions and ease the articulation between their design principles and the development of clinical reasoning. In this study, we examine the overlapping and unique design principles of virtual simulations and serious games

Kinova modular robot arms for service robotics applications

This article presents Kinova's modular robotic systems, including the robots JACO2 and MICO2, actuators and grippers. Kinova designs and manufactures robotics platforms and components that are simple, sexy and safe under two business units: Assistive Robotics empowers people living with disabilities to push beyond their current boundaries and limitations while Service Robotics empowers people in industry to interact with their environment more efficiently and safely. Kinova is based in Boisbriand, Québec, Canada. Its technologies are exploited in over 25 countries and are used in many applications, including as service robotics, physical assistance, medical applications, mobile manipulation, rehabilitation, teleoperation and in research in different areas such as computer vision, artificial intelligence, grasping, planning and control interfaces. The article describes Kinova's hardware platforms, their different control modes (position, velocity and torque), control features and possible control interfaces. Integration to other systems and application examples are also presented

Efficacy of serious games in healthcare professions education : a systematic review and meta-analysis

Summary Statement Serious games (SGs) are interactive and entertaining software designed primarily with an educational purpose. This systematic review synthesizes evidence from experimental studies regarding the efficacy of SGs for supporting engagement and improving learning outcomes in healthcare professions education. Randomized controlled trials (RCTs) published between January 2005 and April 2019 were included. Reference selection and data extraction were performed in duplicate, independently. Thirty-seven RCTs were found and 29 were included in random-effect meta-analyses. Compared with other educational interventions, SGs did not lead to more time spent with the intervention {mean difference 23.21 minutes [95% confidence interval (CI) = −1.25 to 47.66]}, higher knowledge acquisition [standardized mean difference (SMD) = 0.16 (95% CI = −0.20 to 0.52)], cognitive [SMD 0.08 (95% CI = −0.73 to 0.89)], and procedural skills development [SMD 0.05 (95% CI = −0.78 to 0.87)], attitude change [SMD = −0.09 (95% CI = −0.38 to 0.20)], nor behavior change [SMD = 0.2 (95% CI = −0.11 to 0.51)]. Only a small SMD of 0.27 (95% CI = 0.01 to 0.53) was found in favor of SGs for improving confidence in skills

Effectiveness of serious games and impact of design elements on engagement and educational outcomes in healthcare professionals and students : a systematic review and meta-analysis protocol

Introduction Serious games (SGs) are interactive and entertaining digital software with an educational purpose. They engage the learner by proposing challenges and through various design elements (DEs; eg, points, difficulty adaptation, story). Recent reviews suggest the effectiveness of SGs in healthcare professionals’ and students’ education is mixed. This could be explained by the variability in their DEs, which has been shown to be highly variable across studies. The aim of this systematic review is to identify, appraise and synthesise the best available evidence regarding the effectiveness of SGs and the impact of DEs on engagement and educational outcomes of healthcare professionals and students. Methods and analysis A systematic search of the literature will be conducted using a combination of medical subject headings terms and keywords in Cumulative Index of Nursing and Allied Health, Embase, Education Resources Information Center, PsycInFO, PubMed and Web of Science. Studies assessing SGs on engagement and educational outcomes will be included. Two independent reviewers will conduct the screening as well as the data extraction process. The risk of bias of included studies will also be assessed by two reviewers using the Effective Practice and Organisation of Care criteria. Data regarding DEs in SGs will first be synthesised qualitatively. A meta-analysis will then be performed, if the data allow it. Finally, the quality of the evidence regarding the effectiveness of SGs on each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. Ethics and dissemination As this systematic review only uses already collected data, no Institutional Review Board approval is required. Its results will be submitted in a peerreviewed journal by the end of 2018

Fistula in sub-Saharan Africa – Authors' reply

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