An Adaptive Multi-Modal Control Strategy to Attenuate the Limb Position Effect in Myoelectric Pattern Recognition

Over the last few decades, pattern recognition algorithms have shown promising results in the field of upper limb prostheses myoelectric control and are now gradually being incorporated in commercial devices. A widely used approach is based on a classifier which assigns a specific input value to a selected hand motion. While this method guarantees good performance and robustness within each class, it still shows limitations in adapting to different conditions encountered in real-world applications, such as changes in limb position or external loads. This paper proposes an adaptive method based on a pattern recognition classifier that takes advantage of an augmented dataset—i.e., representing variations in limb position or external loads—to selectively adapt to underrepresented variations. The proposed method was evaluated using a series of target achievement control tests with ten able-bodied volunteers. Results indicated a higher median completion rate >3.33% for the adapted algorithm compared to a classical pattern recognition classifier used as a baseline model. Subject-specific performance showed the potential for improved control after adaptation and a ≤13% completion rate; and in many instances, the adapted points were able to provide new information within classes. These preliminary results show the potential of the proposed method and encourage further development.

Elbow valgus stability of the transverse bundle of the ulnar collateral ligament

Background The purpose of this study was to clarify elbow valgus stability of the transverse bundle (TB). We hypothesized that the transverse bundle is involved in elbow valgus stability. Methods Twelve elbows of six Japanese Thiel-embalmed cadavers were evaluated. The skin, subcutaneous tissue and origin of forearm flexors were removed from about 5 cm proximal to the elbow to about 5 cm distal to the elbow, and the ulnar collateral ligament was dissected (intact state). The cut state was defined as the state when the TB was cut in the middle. The joint space of the humeroulnar joint (JS) was measured in the intact state and then in the cut state. With the elbow flexed to 30°, elbow valgus stress was gradually increased to 30, 60 N using the Telos Stress Device, and the JS was measured by ultrasonography under each load condition. Paired t-testing was performed to compare the JS between the intact and cut states under each load. Results No significant difference in JS was identified between the intact and cut state at start limb position. The JS was significantly higher in the cut state than in the intact state at both 30 N and 60 N. Conclusion The findings from this study suggested that the TB may be involved in elbow valgus stability.

Virtual Reality in Fibromyalgia: Does Altering Visual Feedback Impact on Pain and Movement During Reaching?

People with fibromyalgia (FM) have movement-related fear impacting on daily activities. While virtual reality has been used as a distractor to promote exercise, it can be used to manipulate visual feedback (VF) about movement, potentially influencing pain and movement. Objectives: A. To determine whether altered VF modulates pain during movement; B. To compare adaptation to an altered VF between FM participants and healthy controls (HC); C. To explore relationships between adaptation, limb position sense, kinesiophobia and pain. 20 FM participants and 20 HC performed a reaching task during two sessions in a KINARM exoskeleton including a virtual reality interface allowing to replace their arm with a virtual arm. In one session, VF was altered to show GREATER movements while in the other it showed SMALLER movements (randomized order). Pain was assessed periodically using a numerical rating scale. Movement amplitude was assessed during exposure to altered VF (adaptation) and pre-/post-exposure (without VF; after-effects). Limb position sense was assessed with a KINARM task, and kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK-11). Pain intensity increased slightly with movement repetitions (p < 0.001), but did not differ between the VF conditions (GREATER vs. SMALLER). Both groups exhibited visuomotor adaptation, as shown by VF-dependent changes in movement amplitude and speed during exposure to altered VF, and by the presence of VF-dependent after-effects (p < 0.001 for all variables). However, no differences were observed across groups for any of these variables, despite the fact that FM had significantly more difficulty to correctly detect VF conditions than HC (p = 0.046). No clear limb position sense deficits were observed in FM participants, and no significant relationships were found between TSK-11 scores and changes in pain intensity during exposure to altered VF. Altering VF did not influence pain during a reaching task in the FM group. Surprisingly, both groups adapted similarly to altered VF. Visuomotor adaptation is therefore preserved in FM, despite impairments in sensory perception and the poor ability to detect VF alterations in the present study. Further research is warranted to clarify the relationship between sensory perceptions and motor control in FM.

Integration of vestibular and hindlimb inputs by vestibular nucleus neurons: multisensory influences on postural control

Vestibular nucleus neurons receive convergent information from hindlimb somatosensory inputs and vestibular inputs. In this study, extracellular single-unit recordings of vestibular nucleus neurons during conditions of passively applied limb movement, passive whole body rotations, and combined stimulation were well fit by an additive model. The integration of hindlimb somatosensory inputs with vestibular inputs at the first stage of vestibular processing suggests that vestibular nucleus neurons account for limb position in determining vestibulospinal responses to postural perturbations.

Effects of lower limb and pelvic pin positions on leg length and offset measurement errors in experimental total hip arthroplasty

Background Leg length (LL) and offset (OS) are important factors in total hip arthroplasty (THA). Because most LL and OS callipers used in THA depend on fixed points on the pelvis and the femur, limb position could affect measurement error. This study was conducted on a THA simulator to clarify the effects of lower limb position and iliac pin position on LL and OS errors and to determine the permissible range of limb position for accurate LL and OS measurement. Methods An LL and OS measurement instrument was used. Two pin positions were tested: the iliac tubercle and the top of the iliac crest intersecting with the extension of the femoral axis. First, the limb was moved in one direction (flexion-extension, abduction-adduction, or internal-external rotation), and LL and OS were measured for each pin position. Next, the limb was moved in combinations of the three directions. Then, the permissible range of combined limb position, which resulted in LL and OS measurement error within ±2 mm, was determined for each pin position. Results Only 4° of abduction/adduction caused 5–7 mm error in LL and 2–4 mm error in OS, irrespective of pin position. The effects of flexion–extension and internal–external rotation on LL error were smaller for the top of the iliac crest than for the iliac tubercle, though OS error was similar for both pin positions. For LL, the permissible range of the combined limb position was wider for the top of the iliac crest than for the iliac tubercle. Conclusion To minimize LL and OS measurement errors in THA, adduction–abduction must be maintained. The iliac pin position in the top of the iliac crest is preferred because it provides less LL measurement error and a wider permissible range of combined limb position for accurate LL measurement.