Kinematic synergies of hand grasps ::a comprehensive study on a large publicly available dataset

Background: Hand grasp patterns require complex coordination. The reduction of the kinematic dimensionality is a key process to study the patterns underlying hand usage and grasping. It allows to define metrics for motor assessment and rehabilitation, to develop assistive devices and prosthesis control methods. Several studies were presented in this field but most of them targeted a limited number of subjects, they focused on postures rather than entire grasping movements and they did not perform separate analysis for the tasks and subjects, which can limit the impact on rehabilitation and assistive applications. This paper provides a comprehensive mapping of synergies from hand grasps targeting activities of daily living. It clarifies several current limits of the field and fosters the development of applications in rehabilitation and assistive robotics. Methods: In this work, hand kinematic data of 77 subjects, performing up to 20 hand grasps, were acquired with a data glove (a 22-sensor CyberGlove II data glove) and analyzed. Principal Component Analysis (PCA) and hierarchical cluster analysis were used to extract and group kinematic synergies that summarize the coordination patterns available for hand grasps. Results: Twelve synergies were found to account for > 80% of the overall variation. The first three synergies accounted for more than 50% of the total amount of variance and consisted of: the flexion and adduction of the Metacarpophalangeal joint (MCP) of fingers 3 to 5 (synergy #1), palmar arching and flexion of the wrist (synergy #2) and opposition of the thumb (synergy #3). Further synergies refine movements and have higher variability among subjects. Conclusion: Kinematic synergies are extracted from a large number of subjects (77) and grasps related to activities of daily living (20). The number of motor modules required to perform the motor tasks is higher than what previously described. Twelve synergies are responsible for most of the variation in hand grasping. The first three are used as primary synergies, while the remaining ones target finer movements (e.g. independence of thumb and index finger). The results generalize the description of hand kinematics, better clarifying several limits of the field and fostering the development of applications in rehabilitation and assistive robotics

The effects of robotic assistance on upper limb spatial muscle synergies in healthy people during planar upper-limb training

BackgroundRobotic rehabilitation is a commonly adopted technique used to restore motor functionality of neurological patients. However, despite promising results were achieved, the effects of human-robot interaction on human motor control and the recovery mechanisms induced with robot assistance can be further investigated even on healthy subjects before translating to clinical practice. In this study, we adopt a standard paradigm for upper-limb rehabilitation (a planar device with assistive control) with linear and challenging curvilinear trajectories to investigate the effect of the assistance in human-robot interaction in healthy people.MethodsTen healthy subjects were instructed to perform a large set of radial and curvilinear movements in two interaction modes: 1) free movement (subjects hold the robot handle with no assistance) and 2) assisted movement (with a force tunnel assistance paradigm). Kinematics and EMGs from representative upper-limb muscles were recorded to extract phasic muscle synergies. The free and assisted interaction modes were compared assessing the level of assistance, error, and muscle synergy comparison between the two interaction modes.ResultsIt was found that in free movement error magnitude is higher than with assistance, proving that task complexity required assistance also on healthy controls. Moreover, curvilinear tasks require more assistance than standard radial paths and error is higher. Interestingly, while assistance improved task performance, we found only a slight modification of phasic synergies when comparing assisted and free movement.ConclusionsWe found that on healthy people, the effect of assistance was significant on task performance, but limited on muscle synergies. The findings of this study can find applications for assessing human-robot interaction and to design training to maximize motor recovery

Biomechanical Assessments of the Upper Limb for Determining Fatigue, Strain and Effort from the Laboratory to the Industrial Working Place: A Systematic Review

Recent human-centered developments in the industrial field (Industry 5.0) lead companies and stakeholders to ensure the wellbeing of their workers with assessments of upper limb performance in the workplace, with the aim of reducing work-related diseases and improving awareness of the physical status of workers, by assessing motor performance, fatigue, strain and effort. Such approaches are usually developed in laboratories and only at times they are translated to on-field applications; few studies summarized common practices for the assessments. Therefore, our aim is to review the current state-of-the-art approaches used for the assessment of fatigue, strain and effort in working scenarios and to analyze in detail the differences between studies that take place in the laboratory and in the workplace, in order to give insights on future trends and directions. A systematic review of the studies aimed at evaluating the motor performance, fatigue, strain and effort of the upper limb targeting working scenarios is presented. A total of 1375 articles were found in scientific databases and 288 were analyzed. About half of the scientific articles are focused on laboratory pilot studies investigating effort and fatigue in laboratories, while the other half are set in working places. Our results showed that assessing upper limb biomechanics is quite common in the field, but it is mostly performed with instrumental assessments in laboratory studies, while questionnaires and scales are preferred in working places. Future directions may be oriented towards multi-domain approaches able to exploit the potential of combined analyses, exploitation of instrumental approaches in workplace, targeting a wider range of people and implementing more structured trials to translate pilot studies to real practice

Kinect V2 Performance Assessment in Daily-Life Gestures: Cohort Study on Healthy Subjects for a Reference Database for Automated Instrumental Evaluations on Neurological Patients

Background. The increase of sanitary costs related to poststroke rehabilitation requires new sustainable and cost-effective strategies for promoting autonomous and dehospitalized motor training. In the Riprendo@Home and Future Home for Future Communities research projects, the promising approach of introducing low-cost technologies that promote home rehabilitation is exploited. In order to provide reliable evaluation of patients, a reference database of healthy people’s performances is required and should consider variability related to healthy people performances. Methods. 78 healthy subjects performed several repetitions of daily-life gestures, the reaching movement (RM) and hand-to-mouth (HtMM) movement with both the dominant and nondominant upper limbs. Movements were recorded with a Kinect V2. A synthetic biomechanical protocol based on kinematical, dynamical, and motor control parameters was used to assess motor performance of the healthy people. The investigation was conducted by clustering participants depending on their limb dominancy (right/left), gender (male/female), and age (young/middle/senior) as sources of variability. Results. Results showed that limb dominancy has minor relevance in affecting RM and HtMM; gender has relevance in affecting the HtMM; age has major effect in affecting RM and HtMM. Conclusions. An investigation of healthy subjects’ upper limb performances during daily-life gestures was performed with the Kinect V2 sensor. Findings will be the basis for a database of normative data for neurological patients’ motor evaluation

Mechanical correlates of dyspnea in bronchial asthma.

We hypothesized that dyspnea and its descriptors, that is, chest tightness, inspiratory effort, unrewarded inspiration, and expiratory difficulty in asthma reflect different mechanisms of airflow obstruction and their perception varies with the severity of bronchoconstriction. Eighty-three asthmatics were studied before and after inhalation of methacholine doses decreasing the 1-sec forced expiratory volume by ~15% (mild bronchoconstriction) and ~25% (moderate bronchoconstriction). Symptoms were examined as a function of changes in lung mechanics. Dyspnea increased with the severity of obstruction, mostly because of inspiratory effort and chest tightness. At mild bronchoconstriction, multivariate analysis showed that dyspnea was related to the increase in inspiratory resistance at 5 Hz (R 5) (r (2) = 0.10, P = 0.004), chest tightness to the decrease in maximal flow at 40% of control forced vital capacity, and the increase in R 5 at full lung inflation (r (2) = 0.15, P = 0.006), inspiratory effort to the temporal variability in R 5-19 (r (2) = 0.13, P = 0.003), and unrewarded inspiration to the recovery of R 5 after deep breath (r (2) = 0.07, P = 0.01). At moderate bronchoconstriction, multivariate analysis showed that dyspnea and inspiratory effort were related to the increase in temporal variability in inspiratory reactance at 5 Hz (X 5) (r (2) = 0.12, P = 0.04 and r (2) = 0.18, P < 0.001, respectively), and unrewarded inspiration to the decrease in X 5 at maximum lung inflation (r (2) = 0.07, P = 0.04). We conclude that symptom perception is partly explained by indexes of airway narrowing and loss of bronchodilatation with deep breath at low levels of bronchoconstriction, but by markers of ventilation heterogeneity and lung volume recruitment when bronchoconstriction becomes more severe

Robotic Assistance for Upper Limbs May Induce Slight Changes in Motor Modules Compared With Free Movements in Stroke Survivors: A Cluster-Based Muscle Synergy Analysis

Background: The efficacy of robot-assisted rehabilitation as a technique for achieving motor recovery is still being debated. The effects of robotic assistance are generally measured using standard clinical assessments. Few studies have investigated the value of human-centered instrumental analysis, taking the modular organization of the human neuromotor system into account in assessing how stroke survivors interact with robotic set-ups. In this paper, muscle synergy analysis was coupled with clustering procedures to elucidate the effect of human-robot interaction on the spatial and temporal features, and directional tuning of motor modules during robot-assisted movements.Methods: Twenty-two stroke survivors completed a session comprising a series of hand-to-mouth movements with and without robotic assistance. Patients were assessed instrumentally, recording kinematic, and electromyographic data to extract spatial muscle synergies and their temporal components. Patients' spatial synergies were grouped by means of a cluster analysis, matched pairwise across conditions (free and robot-assisted movement), and compared in terms of their spatial and temporal features, and directional tuning, to examine how robotic assistance altered their motor modules.Results: Motor synergies were successfully extracted for all 22 patients in both conditions. Seven clusters (spatial synergies) could describe the original datasets, in both free and robot-assisted movements. Interacting with the robot slightly altered the spatial synergies' features (to a variable extent), as well as their temporal components and directional tuning.Conclusions: Slight differences were identified in the characteristics of spatial synergies, temporal components and directional tuning of the motor modules of stroke survivors engaging in free and robot-assisted movements. Such effects are worth investigating in the framework of a modular description of the neuromusculoskeletal system to shed more light on human-robot interaction, and the effects of robotic assistance and rehabilitation

Evidence of synergy coordination patterns of upper-limb motor control in stroke patients with mild and moderate impairment

Objectives: Previous studies showed that the central nervous system (CNS) controls movements by recruiting a low-dimensional set of modules, usually referred to as muscle synergies. Stroke alters the structure and recruitment patterns of muscle synergies, leading to abnormal motor performances. Some studies have shown that muscle synergies can be used as biomarkers for assessing motor function. However, coordination patterns of muscle synergies in post-stroke patients need more investigation to characterize how they are modified in functional movements.Methods: Thirteen mild-to-moderate stroke patients and twenty age-matched healthy subjects were recruited to perform two upper-limb movements, hand-to-mouth movement and reaching movement. Muscle synergies were extracted with nonnegative matrix factorization. We identified a set of reference synergies (i.e., averaged across healthy subjects) and typical synergies (i.e., averaged across stroke subjects) from the healthy group and stroke group respectively, and extracted affected synergies from each patient. Synergy similarity between groups was computed and analyzed. Synergy reconstruction analysis was performed to verify synergy coordination patterns in post-stroke patients.Results: On average, three synergies were extracted from both the healthy and stroke groups, while the mild impairment group had a significantly higher number of synergies than the healthy group. The similarity analysis showed that synergy structure was more consistent in the healthy group, and stroke instead altered synergy structure and induced more variability. Synergy reconstruction analysis at group and individual levels showed that muscle synergies of patients often showed a combination of healthy reference synergies in the analyzed movements. Finally, this study associated four synergy coordination patterns with patients: merging (equilibrium and disequilibrium), sharing (equilibrium and disequilibrium), losing, and preservation. The preservation was mainly represented in the mild impairment group, and the moderate impairment group showed more merging and sharing.Conclusion: This study concludes that stroke shows more synergy variability compared to the healthy group and the alterations of muscle synergies can be described as a combination of reference synergies by four synergy coordination patterns. These findings deepen the understanding of the underlying neurophysiological mechanisms and possible motor control strategies adopted by the CNS in post-stroke patients

Biomechanical assessment of the ipsilesional upper limb in post-stroke patients during multi-joint reaching tasks: A quantitative study

In hemiplegic patients with stroke, investigating the ipsilesional limb may shed light on the upper limb motor control, impairments and mechanisms of functional recovery. Usually investigation of motor impairment and rehabilitative interventions in patients are performed only based on the contralesional limb. Previous studies found that also the ipsilesional limb presents motor deficits, mostly evaluated with clinical scales which could lack of sensibility. To quantitatively evaluate the performance of the ipsilesional limb in patient with stroke, we conducted an observational study in which 49 hemiplegic patients were enrolled, divided in subgroups based on the severity of impairment of the contralesional limb, and assessed with a kinematic, dynamic and motor control evaluation protocol on their ipsilesional upper limb during reaching movements. Measurements were repeated in the acute and subacute phases and compared to healthy controls. Our results showed that the ipsilesional limb presented lower kinematic and dynamic performances with respect to the healthy controls. Patients performed the movements slower and with a reduced range of motion, indicating a difficulty in controlling the motion of the arm. The energy and the power outputs were lower in both shoulder and elbow joint with a high significance level, confirming the limitation found in kinematics. Moreover, we showed that motor deficits were higher in the acute phase with respect to the subacute one and we found higher significant differences in the group with a more severe contralesional limb impairment. Ipsilesional upper limb biomechanics adds significant and more sensible measures for assessments based on multi-joints dynamics, providing a better insight on the upper limb motor control after stroke. These results could have clinical implications while evaluating and treating ipsilesional and contralesional upper limb impairments and dysfunctions in patients with stroke

Proprioceptivity and Upper-Extremity Dynamics in Robot-Assisted Reaching Movement

Abstract-Reaching-against-gravity movements feature some remarkable aspects of human motion, like a wide exploration of the upper extremity workspace and high dynamics. In clinical rehabilitation protocols the recovery of the reaching movement capability is considered as a "paradigm" because of its fundamental role as a precursor for the use of the hand in activities of daily living. Reaching-based protocol may take advantage of robot usage, which has become a standard procedure in rehabilitation of neurological patients although the efficacy of the robot-assisted treatment is still matter of discussion. Even fewer studies in literature investigate proprioception, upper-extremity dynamics and their mutual relationship. Robot-assistance introduces alterations in the dynamics of movements, e.g. limited maximum velocities and accelerations, partial upper-extremity weight support, interaction forces between the robot and a subject. As a consequence, the subjects' proprioception may be altered too. The purpose of this preliminary work is to investigate the relationship between upper-extremity dynamics and proprioception by comparing the estimation of shoulder torques and EMG activation pattern with the evaluation given by the subjects on the quality of the perceived movements during different reaching trials with and without robot assistance. Results show that slow free (nonassisted) reaching movements are felt as uncomfortable and figure large shoulder torques and EMG cocontraction levels. Comfortable movements are those displaying shoulder torques and cocontraction levels comparable to those in natural free reaching, suggesting the strong correlation of torques patterns and co-contractions in motion comfort