RESUMO
Assistive and rehabilitative powered exoskeletons for spinal cord injury (SCI) and stroke subjects have recently reached the clinic. Proper tension and joint alignment are critical to ensuring safety. Challenges still exist in adjustment and fitting, with most current systems depending on personnel experience for appropriate individual fastening. Paraplegia and tetraplegia patients using these devices have impaired sensation and cannot signal if straps are uncomfortable or painful. Excessive pressure and blood-flow restriction can lead to skin ulcers, necrotic tissue and infections. Tension must be just enough to prevent slipping and maintain posture. Research in pressure dynamics is extensive for wheelchairs and mattresses, but little research has been done on exoskeleton straps. We present a system to monitor pressure exerted by physical human-machine interfaces and provide data about levels of skin/body pressure in fastening straps. The system consists of sensing arrays, signal processing hardware with wireless transmission, and an interactive GUI. For validation, a lower-body powered exoskeleton carrying the full weight of users was used. Experimental trials were conducted with one SCI and one able-bodied subject. The system can help prevent skin injuries related to excessive pressure in mobility-impaired patients using powered exoskeletons, supporting functionality, independence and better overall quality of life.
Assuntos
Aparelhos Ortopédicos , Paraplegia/terapia , Humanos , Pressão , Qualidade de Vida , Traumatismos da Medula Espinal/terapiaRESUMO
BACKGROUND: Several studies have shown that post-stroke patients develop divergent activity in the sensorimotor areas of the affected hemisphere of the brain compared to healthy people during motor tasks. Proper mathematical models will help us understand this activity and clarify the associated underlying mechanisms. New Method. This research describes an anatomically based brain computer model in post-stroke patients. We simulate an ischemic region for arm motion using the bidomain approach. Two scenarios are considered: a healthy subject and a post-stroke patient with motion impairment. Next, we limit the volume of propagation considering only the sensorimotor area of the brain. Comparison with existing methods. In comparison to existing methods, we combine the use of the bidomain for modeling the propagation of the electrical activity across the brain volume with functional information to limit the volume of propagation and the position of the expected stimuli, given a specific task. Whereas just using the bidomain without limiting the functional volume, propagates the electrical activity into non-expected areas. RESULTS: To validate the simulation, we compare the activity with patient measurements using functional near-infrared spectroscopy during arm motion (n=5) against controls (n=3). The results are consistent with empirical measurements and previous research and show that there is a disparity between position and number of spikes in post-stroke patients in contrast to healthy subjects. CONCLUSIONS: These results hold promise in improving the understanding of brain deterioration in stroke patients and the re-arrangement of brain networks. Furthermore, shows the use of functionality based brain modeling.
Assuntos
Córtex Sensório-Motor , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral , Simulação por Computador , Humanos , Espectroscopia de Luz Próxima ao Infravermelho , Acidente Vascular Cerebral/complicaçõesRESUMO
Walking rehabilitation processes include many repetitions of the same physical movements in order to replicate, as close as possible, the normal gait trajectories, and kinematics of all leg joints. In these conventional therapies, the therapist's ability to discover patient's limitations-and gradually reduce them-is key to the success of the therapy. Lower-limb robotic exoskeletons have strong deficiencies in this respect as compared to an experienced therapist. Most of the currently available robotic solutions are not able to properly adapt their trajectories to the biomechanical limitations of the patient. With this in mind, much research and development is still required in order to improve artificial human-like walking patterns sufficiently for valuable clinical use. The work herein reported develops and presents a method to acquire and saliently analyze subject-specific gait data while the subject dons a passive lower-limb exoskeleton. Furthermore, the method can generate adjustable, yet subject-specific, kinematic gait trajectories useful in programming controllers for future robotic rehabilitation protocols. A human-user study with ten healthy subjects provides the experimental setup to validate the proposed method. The experimental protocol consists in capturing kinematic data while subjects walk, with the donned H2 lower-limb exoskeleton, across three experimental conditions: walking with three different pre-determined step lengths marked on a lane. The captured ankle trajectories in the sagittal plane were found by normalizing all trials of each test from one heel strike to the next heel strike independent of the specific gait features of each individual. Prior literature suggests analyzing gait in phases. A preliminary data analysis, however, suggests that there exist six key events of the gait cycle, events that can adequately characterize gait for the purposes required of robotic rehabilitation including gait analysis and reference trajectory generation. Defining the ankle as an end effector and the hip as the origin of the coordinate frame and basing the linear regression calculations only on the six key events, i.e., Heel Strike, Toe Off, Pre-Swing, Initial Swing, Mid-Swing, and Terminal Swing, it is possible to generate a new calculated ankle trajectory with an arbitrary step length. The Leave-One-Out Cross Validation algorithm was used to estimate the fitting error of the calculated trajectory vs. the characteristic captured trajectory per subject, showing a fidelity average value of 95.2, 96.1, and 97.2%, respectively, for each step-length trial including all subjects. This research presents method to capture ankle trajectories from subjects and generate human-like ankle trajectories that could be scaled and computed on-line, could be adjusted to different gait scenarios, and could be used not only to generate reference trajectories for gait controllers, but also as an accurate and salient benchmark to test the human likeness of gait trajectories employed by existing robotic exoskeletal devices.
RESUMO
OBJECTIVE: Advancements in robot-assisted gait rehabilitation and brain-machine interfaces may enhance stroke physiotherapy by engaging patients while providing information about robot-induced cortical adaptations. We investigate the feasibility of decoding walking from brain activity in stroke survivors during therapy using a powered exoskeleton integrated with an electroencephalography-based brain-machine interface. DESIGN: The H2 powered exoskeleton was designed for overground gait training with actuated hip, knee, and ankle joints. It was integrated with active-electrode electroencephalography and evaluated in hemiparetic stroke survivors for 12 sessions per 4 wks. A continuous-time Kalman decoder operating on delta-band electroencephalography was designed to estimate gait kinematics. RESULTS: Five chronic stroke patients completed the study with improvements in walking distance and speed training for 4 wks, correlating with increased offline decoding accuracy. Accuracies of predicted joint angles improved with session and gait speed, suggesting an improved neural representation for gait, and the feasibility to design an electroencephalography-based brain-machine interface to monitor brain activity or control a rehabilitative exoskeleton. CONCLUSIONS: The Kalman decoder showed increased accuracies as the longitudinal training intervention progressed in the stroke participants. These results demonstrate the feasibility of studying changes in patterns of neuroelectric cortical activity during poststroke rehabilitation and represent the first step in developing a brain-machine interface for controlling powered exoskeletons.
Assuntos
Eletroencefalografia , Exoesqueleto Energizado , Transtornos Neurológicos da Marcha/reabilitação , Reabilitação do Acidente Vascular Cerebral/métodos , Adulto , Idoso , Interfaces Cérebro-Computador , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paresia/reabilitação , Projetos PilotoRESUMO
Mobile Brain-Body Imaging (MoBI) technology was deployed to record multi-modal data from 209 participants to examine the brain's response to artistic stimuli at the Museo de Arte Contemporáneo (MARCO) in Monterrey, México. EEG signals were recorded as the subjects walked through the exhibit in guided groups of 6-8 people. Moreover, guided groups were either provided with an explanation of each art piece (Guided-E), or given no explanation (Guided-NE). The study was performed using portable Muse (InteraXon, Inc, Toronto, ON, Canada) headbands with four dry electrodes located at AF7, AF8, TP9, and TP10. Each participant performed a baseline (BL) control condition devoid of artistic stimuli and selected his/her favorite piece of art (FP) during the guided tour. In this study, we report data related to participants' demographic information and aesthetic preference as well as effects of art viewing on neural activity (EEG) in a select subgroup of 18-30 year-old subjects (Nc = 25) that generated high-quality EEG signals, on both BL and FP conditions. Dependencies on gender, sensor placement, and presence or absence of art explanation were also analyzed. After denoising, clustering of spectral EEG models was used to identify neural patterns associated with BL and FP conditions. Results indicate statistically significant suppression of beta band frequencies (15-25 Hz) in the prefrontal electrodes (AF7 and AF8) during appreciation of subjects' favorite painting, compared to the BL condition, which was significantly different from EEG responses to non-favorite paintings (NFP). No significant differences in brain activity in relation to the presence or absence of explanation during exhibit tours were found. Moreover, a frontal to posterior asymmetry in neural activity was observed, for both BL and FP conditions. These findings provide new information about frequency-related effects of preferred art viewing in brain activity, and support the view that art appreciation is independent of the artists' intent or original interpretation and related to the individual message that viewers themselves provide to each piece.
RESUMO
El Cu y el Zn desempeñan un papel muy importante en los procesos biológicos de los seres vivos. El primero forma algunas proteínas, el segundo es esencial para el funcionamiento de algunas enzimas. El Cu en exceso es tóxico y esto se debe a una combinación con los grupos tiol de algunas enzimas y a la inhibición glicolítica de los extractos musculares. La deficiencia de Zn causa retraso en el crecimiento, debido a pérdida del apetito y deficiente utilización de los alimentos por el organismo. La determinación cuantitativa de estos elementos se llevó a cabo en dos tipos de poblaciones; uno de personas hospitalizadas ("pacientes") y otro de personas donadoras de sangre ("normales") del Instituto Nacional de Neurología y Neurocirugía de México. Se analizaron 25 sujetos, los resultados obtenidos fueron los siguientes: Cu en plasma en sujetos normales mediante dilución: (0.69 + ou - 0.08) ppm. Cu en plasma en pacientes mediante dilución (1.27 + ou - 0.29) ppm. Zn en eritrocitos en sujetos normales mediante hemólisis: (9.32 + ou - 0.89) ppm. Zn en eritrocitos con pacientes mediante hemólisis: (11.61 + ou - 1.60) ppm. La desviación estándar en la mayoría de las determinaciones no es significativa, tomando en cuenta que las concentraciones están expresadas en partes por millón