Parkinson's Disease Wearable Gait Analysis: Kinematic and Dynamic Markers for Diagnosis.

Introduction: Gait features differ between Parkinson's disease (PD) and healthy subjects (HS). Kinematic alterations of gait include reduced gait speed, swing time, and stride length between PD patients and HS. Stride time and swing time variability are increased in PD patients with respect to HS. Additionally, dynamic parameters of asymmetry of gait are significantly different among the two groups. The aim of the present study is to evaluate which kind of gait analysis (dynamic or kinematic) is more informative to discriminate PD and HS gait features. Methods: In the present study, we analyzed gait dynamic and kinematic features of 108 PD patients and 88 HS from four cohorts of two datasets. Results: Kinematic features showed statistically significant differences among PD patients and HS for gait speed and time Up and Go test and for selected kinematic dispersion indices (standard deviation and interquartile range of swing, stance, and double support time). Dynamic features did not show any statistically significant difference between PD patients and HS. Discussion: Despite kinematics features like acceleration being directly proportional to dynamic features like ground reaction force, the results of this study showed the so-called force/rhythm dichotomy since kinematic features were more informative than dynamic ones.

A Wearable System with Embedded Conductive Textiles and an IMU for Unobtrusive Cardio-Respiratory Monitoring.

The continuous and simultaneous monitoring of physiological parameters represents a key aspect in clinical environments, remote monitoring and occupational settings. In this regard, respiratory rate (RR) and heart rate (HR) are correlated with several physiological and pathological conditions of the patients/workers, and with environmental stressors. In this work, we present and validate a wearable device for the continuous monitoring of such parameters. The proposed system embeds four conductive sensors located on the user's chest which allow retrieving the breathing activity through their deformation induced during cyclic expansion and contraction of the rib cage. For monitoring HR we used an embedded IMU located on the left side of the chest wall. We compared the proposed device in terms of estimating HR and RR against a reference system in three scenarios: sitting, standing and supine. The proposed system reliably estimated both RR and HR, showing low error averaged along subjects in all scenarios. This is the first study focused on the feasibility assessment of a wearable system based on a multi-sensor configuration (i.e., conductive sensors and IMU) for RR and HR monitoring. The promising results encourage the application of this approach in clinical and occupational settings.

Breath-Jockey: Development and Feasibility Assessment of a Wearable System for Respiratory Rate and Kinematic Parameter Estimation for Gallop Athletes.

In recent years, wearable devices for physiological parameter monitoring in sports and physical activities have been gaining momentum. In particular, some studies have focused their attention on using available commercial monitoring systems mainly on horses during training sessions or competitions. Only a few studies have focused on the jockey's physiological and kinematic parameters. Although at a glance, it seems jockeys do not make a lot of effort during riding, it is quite the opposite. Indeed, especially during competitions, they profuse a short but high intensity effort. To this extend, we propose a wearable system integrating conductive textiles and an M-IMU to simultaneously monitor the respiratory rate (RR) and kinematic parameters of the riding activity. Firstly, we tested the developed wearable system on a healthy volunteer mimicking the typical riding movements of jockeys and compared the performances with a reference instrument. Lastly, we tested the system on two gallop jockeys during the "137∘ Derby Italiano di Galoppo". The proposed system is able to track both the RR and the kinematic parameters during the various phases of the competition both at rest and during the race.

Wrist redundancy management during pointing tasks remains stable over time and in presence of a visuomotor perturbation.

Pointing at a screen using wrist and forearm movements is a kinematically redundant task, and the Central Nervous System seems to manage this redundancy by using a simplifying strategy, named Donders' Law for the wrist. In this work we investigated (1) whether this simplifying approach is stable over time and (2) whether a visuomotor perturbation provided in the task space influences the strategy used to solve the redundancy problem. We conducted two experiments asking participants to perform the same pointing task in four different days (first experiment), and providing a visual perturbation, i.e. a visuomotor rotation to the controlled cursor (second experiment), while recording their wrist and forearm rotations. Results showed that the participant-specific wrist redundancy management (described by the Donders' surfaces) (1) neither changes over time (2) nor varies when a visuomotor perturbation is provided in the task space.

Comparing end-effector position and joint angle feedback for online robotic limb tracking.

Somatosensation greatly increases the ability to control our natural body. This suggests that supplementing vision with haptic sensory feedback would also be helpful when a user aims at controlling a robotic arm proficiently. However, whether the position of the robot and its continuous update should be coded in a extrinsic or intrinsic reference frame is not known. Here we compared two different supplementary feedback contents concerning the status of a robotic limb in 2-DoFs configuration: one encoding the Cartesian coordinates of the end-effector of the robotic arm (i.e., Task-space feedback) and another and encoding the robot joints angles (i.e., Joint-space feedback). Feedback was delivered to blindfolded participants through vibrotactile stimulation applied on participants' leg. After a 1.5-hour training with both feedbacks, participants were significantly more accurate with Task compared to Joint-space feedback, as shown by lower position and aiming errors, albeit not faster (i.e., similar onset delay). However, learning index during training was significantly higher in Joint space feedback compared to Task-space feedback. These results suggest that Task-space feedback is probably more intuitive and more suited for activities which require short training sessions, while Joint space feedback showed potential for long-term improvement. We speculate that the latter, despite performing worse in the present work, might be ultimately more suited for applications requiring long training, such as the control of supernumerary robotic limbs for surgical robotics, heavy industrial manufacturing, or more generally, in the context of human movement augmentation.

New Methods for Unraveling Imitation Accuracy Differences Between Children with Autism and Typically Developing Peers.

This study applies methods used in sign language and gesture research to better understand reduced imitation accuracy (IA) of actions and gestures in children with autism spectrum disorder (ASD), and we addressed contrasting theories on IA in ASD and the role of objects and meanings in imitation. Eight male children with ASD with a mean chronological age (CA) of 86.76 months (SD = 10.74, range 70.5-104.4) and 22 male and female peers with typical development (TD) and a mean CA of 85.44 months (SD = 7.95, range 73.4-96.7) imitated videos of an adult performing actions with objects, representational gestures, conventional gestures and meaningless gestures. We measured accuracy as ability to effectively reproduce features (handshape, palm orientation, location, movement direction and type) and timing (speed) of observed actions/gestures, after ruling out cases of specular (i.e., mirror-like) versus anatomical imitation. Results highlighted significantly lower feature and timing accuracy in children with ASD with respect to the TD group across tasks, and these findings supported sensory-motor theories of IA in ASD. Our data also showed the different impact of objects and meanings within groups. Overall, these results suggest validity to our assessment method and suggested the importance of considering both discreet variables (i.e., variables describing action/gesture feature accuracy, e.g. handshape, movement direction) and continuous variables (i.e., kinematic variables, e.g. speed) in evaluating IA in autism.

Manipulating The Body Representation: Assessment Of A Novel Platform.

The Rubber Hand Illusion can be used to induce the illusion that a fake hand is part of one's own body. Thus, it can be used to alter the body representation. It was also reported that the Rubber Hand Illusion induces a proprioceptive drift of one's real hand toward the fake hand. The Rubber Hand Illusion can be induced when the fake hand is placed farther in the sagittal plane (distally) compared to the real hand. In this case, the induced update of the body representation is an elongation of the arm. Virtual Reality and haptic technologies can be used to manipulate the perceived scenario in a virtual version of the Rubber Hand Illusion, the Virtual Hand Illusion. We developed a novel platform consisting in a virtual reality application integrating an optical motion capture device and haptic stimulators to study the manipulation of the body representation. We developed two experimental protocols to induce embodiment of an elongated arm: one validated in previous studies, that employs congruent visuo-motor-tactile stimulation, and one reproducing the typical Virtual Hand Illusion where only congruent visuo-tactile stimulation was employed. We tested both protocols with healthy participants.

PDMeter: A Wrist Wearable Device for an at-Home Assessment of the Parkinson's Disease Rigidity.

This work focuses on the design and the validation of a wearable mechatronic device for an at-home assessment of wrist stiffness in patients affected by Parkinson's Disease (PD). The device includes one actuated joint and four passive revolute joints with a high overall intrinsic backdriveability. In order to allow the user to freely move the wrist during activities of daily living, we implemented a transparent controller on the basis of the interaction force sensed by the embedded load cell. Conversely, in order to provide perturbations for estimating the wrist flexion-extension rigidity, we implemented a torque controller. Firstly, we report a pilot study that aimed at characterizing the device in terms of range of motion (ROM) allowed, transparency perceived and torque-tracking capability. Then, we present a case study in which we tested our device with seven PD patients in both drug-OFF and drug-ON conditions and we compared the measured stiffness with the one measured in fourteen healthy controls and with the outcome of the most used clinical scale (MDS-UPDRS). The device allowed to successfully estimate the stiffness as different depending on the movement direction. Indeed, extension stiffness was higher than the flexion one, accordingly to the literature. Moreover, the device allowed to discriminate both Healthy subjects from PD subjects, and PD subjects in OFF condition from PD subjects in ON condition. In conclusion, we demonstrate the feasibility of the device in measuring wrist rigidity, thus enabling the possibility to implement an at-home assessment of the PD rigidity.