Sensor-Based Evaluation of Physical Therapy Exercises.

Physical therapy is important for the treatment and prevention of musculoskeletal injuries, as well as recovery from surgery. In this paper, we explore techniques for automatically determining whether an exercise was performed correctly or not, based on camera images and wearable sensors. Classifiers were tested on data collected from 30 patients during normally-scheduled physical therapy appointments. We considered two lower limb exercises, and asked how well classifiers could generalize to the assessment of individuals for whom no prior data were available. We found that our classifiers performed well relative to several metrics (mean accuracy: 0.76, specificity: 0.90), but often returned low sensitivity (mean: 0.34). For one of the two exercises considered, these classifiers compared favorably with human performance.

Motor cortical correlates of arm resting in the context of a reaching task and implications for prosthetic control.

Prosthetic devices are being developed to restore movement for motor-impaired individuals. A robotic arm can be controlled based on models that relate motor-cortical ensemble activity to kinematic parameters. The models are typically built and validated on data from structured trial periods during which a subject actively performs specific movements, but real-world prosthetic devices will need to operate correctly during rest periods as well. To develop a model of motor cortical modulation during rest, we trained monkeys (Macaca mulatta) to perform a reaching task with their own arm while recording motor-cortical single-unit activity. When a monkey spontaneously put its arm down to rest between trials, our traditional movement decoder produced a nonzero velocity prediction, which would cause undesired motion when applied to a prosthetic arm. During these rest periods, a marked shift was found in individual units' tuning functions. The activity pattern of the whole population during rest (Idle state) was highly distinct from that during reaching movements (Active state), allowing us to predict arm resting from instantaneous firing rates with 98% accuracy using a simple classifier. By cascading this state classifier and the movement decoder, we were able to predict zero velocity correctly, which would avoid undesired motion in a prosthetic application. Interestingly, firing rates during hold periods followed the Active pattern even though hold kinematics were similar to those during rest with near-zero velocity. These findings expand our concept of motor-cortical function by showing that population activity reflects behavioral context in addition to the direct parameters of the movement itself.

Comparison of brain-computer interface decoding algorithms in open-loop and closed-loop control.

Neuroprosthetic devices such as a computer cursor can be controlled by the activity of cortical neurons when an appropriate algorithm is used to decode motor intention. Algorithms which have been proposed for this purpose range from the simple population vector algorithm (PVA) and optimal linear estimator (OLE) to various versions of Bayesian decoders. Although Bayesian decoders typically provide the most accurate off-line reconstructions, it is not known which model assumptions in these algorithms are critical for improving decoding performance. Furthermore, it is not necessarily true that improvements (or deficits) in off-line reconstruction will translate into improvements (or deficits) in on-line control, as the subject might compensate for the specifics of the decoder in use at the time. Here we show that by comparing the performance of nine decoders, assumptions about uniformly distributed preferred directions and the way the cursor trajectories are smoothed have the most impact on decoder performance in off-line reconstruction, while assumptions about tuning curve linearity and spike count variance play relatively minor roles. In on-line control, subjects compensate for directional biases caused by non-uniformly distributed preferred directions, leaving cursor smoothing differences as the largest single algorithmic difference driving decoder performance.

Cortical control of a prosthetic arm for self-feeding.

Arm movement is well represented in populations of neurons recorded from the motor cortex. Cortical activity patterns have been used in the new field of brain-machine interfaces to show how cursors on computer displays can be moved in two- and three-dimensional space. Although the ability to move a cursor can be useful in its own right, this technology could be applied to restore arm and hand function for amputees and paralysed persons. However, the use of cortical signals to control a multi-jointed prosthetic device for direct real-time interaction with the physical environment ('embodiment') has not been demonstrated. Here we describe a system that permits embodied prosthetic control; we show how monkeys (Macaca mulatta) use their motor cortical activity to control a mechanized arm replica in a self-feeding task. In addition to the three dimensions of movement, the subjects' cortical signals also proportionally controlled a gripper on the end of the arm. Owing to the physical interaction between the monkey, the robotic arm and objects in the workspace, this new task presented a higher level of difficulty than previous virtual (cursor-control) experiments. Apart from an example of simple one-dimensional control, previous experiments have lacked physical interaction even in cases where a robotic arm or hand was included in the control loop, because the subjects did not use it to interact with physical objects-an interaction that cannot be fully simulated. This demonstration of multi-degree-of-freedom embodied prosthetic control paves the way towards the development of dexterous prosthetic devices that could ultimately achieve arm and hand function at a near-natural level.