scholarly journals Robotic Assessment of Wrist Proprioception During Kinaesthetic Perturbations: A Neuroergonomic Approach

2021 ◽  
Vol 15 ◽  
Author(s):  
Erika D'Antonio ◽  
Elisa Galofaro ◽  
Jacopo Zenzeri ◽  
Fabrizio Patané ◽  
Jürgen Konczak ◽  
...  
Keyword(s):  
Degrees Of Freedom ◽  
Neurological Diseases ◽  
External Perturbation ◽  
Recovery Process ◽  
Position Sense ◽  
Matching Task ◽  
Experimental Conditions ◽  
Clinical Scales ◽  
Flexion Extension ◽  
Presentation Sequence

Position sense refers to an aspect of proprioception crucial for motor control and learning. The onset of neurological diseases can damage such sensory afference, with consequent motor disorders dramatically reducing the associated recovery process. In regular clinical practice, assessment of proprioceptive deficits is run by means of clinical scales which do not provide quantitative measurements. However, existing robotic solutions usually do not involve multi-joint movements but are mostly applied to a single proximal or distal joint. The present work provides a testing paradigm for assessing proprioception during coordinated multi-joint distal movements and in presence of kinaesthetic perturbations: we evaluated healthy subjects' ability to match proprioceptive targets along two of the three wrist's degrees of freedom, flexion/extension and abduction/adduction. By introducing rotations along the pronation/supination axis not involved in the matching task, we tested two experimental conditions, which differed in terms of the temporal imposition of the external perturbation: in the first one, the disturbance was provided after the presentation of the proprioceptive target, while in the second one, the rotation of the pronation/ supination axis was imposed during the proprioceptive target presentation. We investigated if (i) the amplitude of the perturbation along the pronation/supination would lead to proprioceptive miscalibration; (ii) the encoding of proprioceptive target, would be influenced by the presentation sequence between the target itself and the rotational disturbance. Eighteen participants were tested by means of a haptic neuroergonomic wrist device: our findings provided evidence that the order of disturbance presentation does not alter proprioceptive acuity. Yet, a further effect has been noticed: proprioception is highly anisotropic and dependent on perturbation amplitude. Unexpectedly, the configuration of the forearm highly influences sensory feedbacks, and significantly alters subjects' performance in matching the proprioceptive targets, defining portions of the wrist workspace where kinaesthetic and proprioceptive acuity are more sensitive. This finding may suggest solutions and applications in multiple fields: from general haptics where, knowing how wrist configuration influences proprioception, might suggest new neuroergonomic solutions in device design, to clinical evaluation after neurological damage, where accurately assessing proprioceptive deficits can dramatically complement regular therapy for a better prediction of the recovery path.

scholarly journals Effectiveness of BoNT A in Parkinson's Disease Upper Limb Tremor Management

2013 ◽  
Vol 40 (5) ◽  
pp. 663-669 ◽  
Author(s):  
Fariborz Rahimi ◽  
Carina Bee ◽  
Derek Debicki ◽  
Angela C. Roberts ◽  
Priya Bapat ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Upper Limb ◽  
Clinical Judgment ◽  
Degrees Of Freedom ◽  
Focal Therapy ◽  
Open Label ◽  
Line Drawings ◽  
Clinical Scales ◽  
Flexion Extension

Abstract:Objective:One the greatest challenges of BoNT A therapy for tremor lies in the complexity and variation of components involved in tremor movement, and the lack of objective measures to determine these components. This 3 month open-label single injection study aims to couple clinician best judgment with kinematics to improve effect of BoNT A (incobotulinumtoxinA) injection in 7 patients with upper limb Parkinson's disease (PD) tremor.Methods:Injection was guided with clinical and kinematic assessment of tremor using angular wrist position in 3 degrees of freedom: flexion/extension, pronation/supination, and radial/ulnar deviation. Overall tremor severity and change were measured by linear finger acceleration.Results:Kinematic data from static and functional tasks demonstrate no improvement at one month post-injection, but significant improvement at two and three months. Clinical scales across UPDRS Items 20 (1, 2, 3 months post) and 21 (2 months), and spiral drawings (3 months) showed significant improvement from baseline, while line drawings did not.Conclusions:This study suggests injection of BoNT A as a viable focal management option for upper limb PD tremor. In addition to clinical judgment, objective quantification of tremor dynamics by kinematics may be a feasible assessment and guidance tool which can be used to optimize injection conditions for focal tremor therapy. Kinematic analysis of tremor across a variety of joints in all degrees of movement may provide important insight into tremor dynamics, allowing optimized, targeted focal therapy.

Effectiveness of Kinaesthetic Exercise program on Position Sense, Pain, and Disability in Chronic Neck Pain Patients with Cervical Spondylosis – A Randomized Comparative Trial

2020 ◽  
Author(s):  
Ravi Shankar Yerragonda Reddy ◽  
Arun G Maiya ◽  
Sharath Kumar Rao ◽  
Khalid A Alahmari ◽  
Jaya Shanker Tedla ◽  
...  
Keyword(s):  
Neck Pain ◽  
Pain Intensity ◽  
Cervical Spondylosis ◽  
Chronic Neck Pain ◽  
Position Sense ◽  
Study Group ◽  
Position Errors ◽  
Flexion Extension ◽  
Comparative Group ◽  
Neck Disability

Abstract Background Chronic neck pain (CNP) is a significant health problem with only a few evidence-based treatment options. There is growing evidence for the effectiveness of kinaesthetic rehabilitation in musculoskeletal disorders. This study aims to assess kinaesthetic exercise programs' efficacy on cervical position sense, pain, and disability in subjects with cervical spondylosis (CS). Methods CNP subjects (>3 months) with a diagnosis of CS were randomly assigned to either a study group (n=125) who received kinesthetic exercises or to a comparative group (n=125) who received isometric neck exercises and deep cervical flexor (DCF) strengthening exercises. Both group subjects participated in the individualized training program for 24 sessions in 6 weeks. The outcome measures were cervical joint position errors (JPE’s) in flexion, extension, rotation left and right, pain intensity, and neck disability. Results All outcomes were improved significantly from baseline to post 24 sessions of intervention. When compared between groups, there was a significant reduction in JPE’s in flexion (mean difference [MD]= 071, CI=0.22–1.20, p=0.001), extension (MD=1.26, CI=0.70–1.81, p< 0.001) and right rotation (MD=1.08, CI=0.58–1.58, p<0.001), pain intensity (MD=1.58, CI=1.09–2.08, p<0.001), and neck disability (MD=10.27, CI=7.42–13.12, p<0.001) after 24 sessions of intervention favoring the study group. Conclusion Study group subjects who received kinesthetic rehabilitation showed more significant improvements in terms of improved proprioception, decreased pain intensity and disability following 24 sessions of interventions compared with the comparative group.

scholarly journals Annular Defects Impair the Mechanical Stability of the Intervertebral Disc

2021 ◽  
pp. 219256822110060
Author(s):  
Jun-Xin Chen ◽  
Yun-He Li ◽  
Jian Wen ◽  
Zhen Li ◽  
Bin-Sheng Yu ◽  
...  
Keyword(s):  
Intervertebral Disc ◽  
Degrees Of Freedom ◽  
Mechanical Stability ◽  
Biomechanical Testing ◽  
Bending Stiffness ◽  
Biomechanical Study ◽  
Torsional Stiffness ◽  
P Value ◽  
Lateral Bending ◽  
Flexion Extension

Study Design: A biomechanical study. Objectives: The purpose of this study was to investigate the effects of cruciform and square incisions of annulus fibrosus (AF) on the mechanical stability of bovine intervertebral disc (IVD) in multiple degrees of freedom. Methods: Eight bovine caudal IVD motion segments (bone-disc-bone) were obtained from the local abattoir. Cruciform and square incisions were made at the right side of the specimen’s annulus using a surgical scalpel. Biomechanical testing of three-dimensional 6 degrees of freedom was then performed on the bovine caudal motion segments using the mechanical testing and simulation (MTS) machine. Force, displacement, torque and angle were recorded synchronously by the MTS system. P value <.05 was considered statistically significant. Results: Cruciform and square incisions of the AF reduced both axial compressive and torsional stiffness of the IVD and were significantly lower than those of the intact specimens ( P < .01). Left-side axial torsional stiffness of the cruciform incision was significantly higher than a square incision ( P < .01). Neither incision methods impacted flexional-extensional stiffness or lateral-bending stiffness. Conclusions: The cruciform and square incisions of the AF obviously reduced axial compression and axial rotation, but they did not change the flexion-extension and lateral-bending stiffness of the bovine caudal IVD. This mechanical study will be meaningful for the development of new approaches to AF repair and the rehabilitation of the patients after receiving discectomy.

Comparison of the Position-Matching and Position-Reproducing Tasks to Detect Deficits in Knee Position Sense After Reconstruction of the Anterior Cruciate Ligament

2020 ◽  
Vol 29 (1) ◽  
pp. 87-92
Author(s):  
Takuma Hoshiba ◽  
Hiroki Nakata ◽  
Yasuaki Saho ◽  
Kazuyuki Kanosue ◽  
Toru Fukubayashi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Sport Participation ◽  
Cruciate Ligament ◽  
Knee Extension ◽  
Position Sense ◽  
Matching Task ◽  
Control Group ◽  
Knee Position ◽  
Anterior Cruciate

Context: Deficits in knee position sense following reconstruction of the anterior cruciate ligament (ACL) can delay an athlete’s return to sport participation and increase the risk of reinjury. Deficits in position sense postreconstruction have been evaluated using either a position-reproducing or position-matching task. Objective: The aim of our study was to combine both to determine which assessment would be more effective to identify deficits in knee position sense. Design: Longitudinal laboratory-based study. Participants: Eleven athletes (6 men and 5 women; mean age, 20.5 [1.2] y), who had undergone ACL reconstruction with an ipsilateral hamstring autograft, and 12 age-matched controls. Interventions: Position sense was evaluated at 6 and 12 months postreconstruction and once for the control group. In addition, peak isokinetic knee extension and flexion strength, at 60°/s and 180°/s, was assessed for the ACL reconstruction group to evaluate possible influences of muscle strength on knee joint position sense. Main Outcome Measures: The variables include the angular differences between the reference limb and indicator limb, and peak torque values of isokinetic knee extension and flexion. Results: Significant matching differences were identified at 6 months postsurgery on the position-matching task, but not at 12 months postsurgery. No significant between-group and within-subject differences were identified on the position-reproducing task. No significant matching errors were identified for the control group. There was no correlation between errors in position sense and maximum isokinetic strength. Conclusion: The position-matching task is more sensitive than the position-reproducing task to identify deficits in knee position sense over the first year following ACL reconstruction surgery.

Inter-Personal Motor Synergy: Co-working Strategy Depends on Task Constraints

2021 ◽  
Author(s):  
Sara Honarvar ◽  
Mia Caminita ◽  
Hossein Ehsani ◽  
Hyun Joon Kwon ◽  
Yancy Diaz-Mercado ◽  
...  
Keyword(s):  
Force Production ◽  
Matching Task ◽  
Task Constraint ◽  
Experimental Conditions ◽  
Task Constraints ◽  
Force Matching ◽  
Additional Task ◽  
Central Nervous Systems ◽  
Fixed Condition ◽  
Motor Synergy

We investigated the role of task constraints on inter-personal interactions. Twenty-one pairs of co-workers performed a finger force production task on force sensors placed at two ends of a seesaw-like apparatus and matched a combined target force of 20N for 23 seconds over ten trials. There were two experimental conditions: 1) FIXED: the seesaw apparatus was mechanically held in place so that the only task constraint was to match the 20N resultant force, and 2) MOVING: the lever in the apparatus was allowed to rotate freely around its fulcrum, acting like a seesaw, so an additional task constraint to (implicitly) balance the resultant moment was added. We hypothesized that the additional task constraint of moment stabilization imposed on the MOVING condition would deteriorate task performance compared to the FIXED condition; however, this was rejected as the performance of the force matching task was similar between two conditions. We also hypothesized that the central nervous systems (CNSs) would employ distinct co-working strategies or inter-personal motor synergy (IPMS) between conditions to satisfy different task constraints, which was supported by our results. Negative covariance between co-worker's forces in the FIXED condition suggested a force stabilization strategy, while positive covariance in the MOVING condition suggested a moment stabilization strategy, implying that independent CNSs adopt distinct IPMSs depending on task constraints. We speculate that, in the absence of a central neural controller, shared visual and mechanical connections between co-workers may suffice to trigger modulations in the cerebellum of each CNS to satisfy competing task constraints.

SYMPOSIUM: BEHAVIOR MODIFICATION BY DRUGS

PEDIATRICS ◽  
1972 ◽  
Vol 49 (5) ◽  
pp. 702-708 ◽  
Author(s):  
C. Keith Conners
Keyword(s):  
Task Force ◽  
Neurological Diseases ◽  
Brain Dysfunction ◽  
Magnesium Pemoline ◽  
Experimental Conditions ◽  
Drug Study ◽  
Stimulant Medications ◽  
Hyperkinetic Child ◽  
Historical Accident

A number of myths have grown up regarding the behavioral effects and use of stimulant medications with children. The first is that there is a type of child uniquely responsive to stimulant compounds, namely, the hyperkinetic child. The second is that the hyperkinetic child is any child who is sufficiently overactive to be considered a menace by adults. The third is that the stimulant medications act primarily to reduce motor activity in a paradoxical "sedative" fashion; and finally, that the drugs do not influence cognitive and perceptual functioning in these children. I believe that these myths are due partly to the historical accident of the manner in which they were first studied, partly to the imprecision in diagnosis and terminology of classification of patients, and partly to the paucity of systematic data on sufficiently large samples under sufficiently varied experimental conditions. I would like to present the results of studies which bear on these issues, and try to draw some general conclusions regarding the present state of knowledge with regard to the use of the various psychostimulants. In this paper I will deal with dextroamphetamine, methylphenidate, and magnesium pemoline. I. METHYLPHENIDATE AND DEXTROAMPHETAMINE The children for this study were referred from schools, pediatricians, and social agencies for either academic or behavioral difficulties, or both. The subjects retained for the drug study comprised about ⅔ of the original referral sample. They were selected to fit the description of the child with "minimal brain dysfunction" as defined by the National Institute of Neurological Diseases and Stroke (NINDS) Task Force I report.

Finite Element Model of the Human Knee Joint to Study Tibio-Femoral Contact Mechanics

2000 ◽  
Author(s):  
Tammy Haut Donahue ◽  
Maury L. Hull ◽  
Mark M. Rashid ◽  
Christopher R. Jacobs
Keyword(s):  
Finite Element ◽  
Finite Element Model ◽  
Degrees Of Freedom ◽  
Soft Tissues ◽  
Element Model ◽  
Human Knee ◽  
Human Knee Joint ◽  
Solid Models ◽  
Flexion Extension ◽  
A New Technique

Abstract A finite element model of the tibio-femoral joint in the human knee was created using a new technique for developing accurate solid models of soft tissues (i.e. cartilage and menisci). The model was used to demonstrate that constraining rotational degrees of freedom other than flexion/extension when the joint is loaded in compression markedly affects the load distribution between the medial and lateral sides of the joint. The model also was used to validate the assumption that the bones can be treated as rigid.

scholarly journals Displacement Analysis and Design of a (2–RRU)–URR Parallel Mechanism Performing 2R1T Output Motion for Thumb Rehabilitation

Robotics ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. 67
Author(s):  
Woo-hyeok Choi ◽  
Yukio Takeda
Keyword(s):  
Parallel Mechanism ◽  
Degrees Of Freedom ◽  
Human Hand ◽  
Displacement Analysis ◽  
Analysis And Design ◽  
Reachable Workspace ◽  
Flexion Extension ◽  
Basic Characteristics ◽  
Narrow Space ◽  
Input Torque

The thumb assists other fingers, and any damage in its functionality prevents the human hand from performing dexterous functions. In this paper, the kinematic design of the (2–RRU)–URR parallel mechanism as the application of the thumb rehabilitation device is proposed. This mechanism is an over-constrained mechanism capable of achieving the required mobility with fewer joints. Three degrees of freedom exist—two rotational and one translational mobility—that are related to each thumb movement: adduction–abduction and flexion–extension. Considering the narrow space of the hand, actuators are designed to divide its placement into the surface of the palm. To avoid the collisions between the device and the hand, an offset was adopted. The displacement analysis problem is solved by dividing it into two parts: the planar motion generator (PMG) and orientation generator (OG), according to each functional motion, and the corresponding equations and procedures are presented. To clarify the basic characteristics of this mechanism, the reachable workspace of the PMG and rotational ability and sensitivity of the OG is demonstrated numerically. Because a large input torque difference is dangerous in the rehabilitation mechanism, the effective workspace is determined according to the magnitude of the input torque differences and compared with the measured thumb movements.

scholarly journals Position Sense Deficits at the Lower Limbs in Early Multiple Sclerosis: Clinical and Neural Correlates

2020 ◽  
Vol 34 (3) ◽  
pp. 260-270 ◽  
Author(s):  
Riccardo Iandolo ◽  
Giulia Bommarito ◽  
Laura Falcitano ◽  
Simona Schiavi ◽  
Niccolò Piaggio ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diffusion Tensor ◽  
Neural Correlates ◽  
Position Sense ◽  
Standing Balance ◽  
Lower Limbs ◽  
Quiet Standing ◽  
Matching Task ◽  
Functional Changes ◽  
Limb Position

Background/Objective. Position sense, defined as the ability to identify joint and limb position in space, is crucial for balance and gait but has received limited attention in patients with multiple sclerosis (MS). We investigated lower limb position sense deficits, their neural correlates, and their effects on standing balance in patients with early MS. Methods. A total of 24 patients with early relapsing-remitting MS and 24 healthy controls performed ipsilateral and contralateral matching tasks with the right foot during functional magnetic resonance imaging. Corpus callosum (CC) integrity was estimated with diffusion tensor imaging. Patients also underwent an assessment of balance during quiet standing. We investigated differences between the 2 groups and the relations among proprioceptive errors, balance performance, and functional/structural correlates. Results. During the contralateral matching task, patients demonstrated a higher matching error than controls, which correlated with the microstructural damage of the CC and with balance ability. In contrast, during the ipsilateral task, the 2 groups showed a similar matching performance, but patients displayed a functional reorganization involving the parietal areas. Neural activity in the frontoparietal regions correlated with the performance during both proprioceptive matching tasks and quiet standing. Conclusion. Patients with early MS had subtle, clinically undetectable, position sense deficits at the lower limbs that, nevertheless, affected standing balance. Functional changes allowed correct proprioception processing during the ipsilateral matching task but not during the more demanding bilateral task, possibly because of damage to the CC. These findings provide new insights into the mechanisms underlying disability in MS and could influence the design of neurorehabilitation protocols.

Multibody Analysis and Control of a Full-Wrist Exoskeleton for Tremor Alleviation

2020 ◽  
Vol 142 (12) ◽  
Author(s):  
Jiamin Wang ◽  
Oumar R. Barry
Keyword(s):  
Degrees Of Freedom ◽  
Controller Design ◽  
Wrist Joint ◽  
Three Dimensional ◽  
Design Parameters ◽  
Light Power ◽  
Multibody Modeling ◽  
Flexion Extension ◽  
Reliable Performance ◽  
Rotational Joint

Abstract Uncontrollable shaking in the human wrist, caused by pathological tremor, can significantly undermine the power and accuracy in object manipulation. In this paper, the design of a tremor alleviating wrist exoskeleton (TAWE) is introduced. Unlike the works in the literature that only consider the flexion/extension (FE) motion, in this paper, we model the wrist joint as a constrained three-dimensional (3D) rotational joint accounting for the coupled FE and radial/ulnar deviation (RUD) motions. Hence TAWE, which features a six degrees-of-freedom (DOF) rigid linkage structure, aims to accurately monitor, suppress tremors, and provide light-power augmentation in both FE and RUD wrist motions. The presented study focuses on providing a fundamental understanding of the feasibility of TAWE through theoretical analyses. The analytical multibody modeling of the forearm–TAWE assembly provides insight into the necessary conditions for control, which indicates that reliable control conditions in the desired workspace can be acquired by tuning the design parameters. Nonlinear regressions are then implemented to identify the information that is crucial to the controller design from the unknown wrist kinematics. The proposed analytical model is validated numerically with V-REP and the result shows good agreement. Simulations also demonstrate the reliable performance of TAWE under controllers designed for tremor suppression and movement assistance.

Sign in / Sign up

Export Citation Format

Share Document