Wearable haptic anklets for gait and freezing improvement in Parkinson's disease: a proof-of-concept study.

BACKGROUND AND OBJECTIVE: In a proof-of-concept study, we aimed to verify whether the wearable haptic anklets, a device that delivers personalized suprathreshold alternating exteroceptive stimulation at the anklets on demand, may improve the quality of walking, including the freezing of gate (FOG), in idiopathic Parkinson's disease (PD) patients. The clinical relevance of the presented device as a walking pacemaker to compensate the disturbed locomotion through the generation of a more physiological internal walking rhythm should be verified in a dedicated clinical trial. METHODS: We tested 15 patients diagnosed as idiopathic PD, during their regular treatment regimen. Patients were evaluated during walking with the device switched on and off, personalized at their most comfortable cadence. Stride velocity, variance, and length, as well as FOG episode duration during walking or turning of 180°, were quantified by an optical high-performance motion capture VICON system. RESULTS: The alternating, rhythmic, sensory stimulation significantly improved either walking velocity or reduced inter-stride variance. Effects were more variable on stride length. The significant reduction of FOG episodes' duration correlated with clinical severity of scales rating gate and balance. No safety problems occurred. CONCLUSIONS: The WEARHAP-PD device, whose Technology Readiness Level (TRL) is 6, significantly improved some walking abilities (walking velocity and stride variance) and reduced the duration of FOG episodes in idiopathic PD patients. Unlike the traditional auditory and visual explicit cues that require the user's allocation of attention for correct functioning, the interaction of the patients with the surrounding environment was preserved, due to the likely implicit processing of haptic stimuli.

Crowd Navigation in VR: Exploring Haptic Rendering of Collisions.

Virtual reality (VR) is a valuable experimental tool for studying human movement, including the analysis of interactions during locomotion tasks for developing crowd simulation algorithms. However, these studies are generally limited to distant interactions in crowds, due to the difficulty of rendering realistic sensations of collisions in VR. In this article, we explore the use of wearable haptics to render contacts during virtual crowd navigation. We focus on the behavioral changes occurring with or without haptic rendering during a navigation task in a dense crowd, as well as on potential after-effects introduced by the use haptic rendering. Our objective is to provide recommendations for designing VR setup to study crowd navigation behavior. To the end, we designed an experiment (N=23) where participants navigated in a crowded virtual train station without, then with, and then again without haptic feedback of their collisions with virtual characters. Results show that providing haptic feedback improved the overall realism of the interaction, as participants more actively avoided collisions. We also noticed a significant after-effect in the users' behavior when haptic rendering was once again disabled in the third part of the experiment. Nonetheless, haptic feedback did not have any significant impact on the users' sense of presence and embodiment.

Power Wheelchair Navigation Assistance Using Wearable Vibrotactile Haptics.

People with severe disabilities often rely on power wheelchairs for moving around. However, if their driving abilities are affected by their condition, driving a power wheelchair can become very dangerous, both for themselves and the surrounding environment. This article proposes the use of wearable vibrotactile haptics for wheelchair navigation assistance. We use one or two haptic armbands, each composed of four evenly-spaced vibrotactile actuators, for providing different navigation information to power wheelchair users. With respect to other available solutions, our approach provides rich navigation information while always leaving the patient in control of the wheelchair motion. Moreover, our armbands can be easily adapted for different limbs and can be used by all those patients who are unable to safely maneuver a kinesthetic interface. The results of two human subjects studies show the viability and effectiveness of the proposed technique with respect to not providing any environmental cue. Collisions were reduced by 49% when using the vibrotactile armbands. Moreover, most subjects expressed a preference for receiving haptic feedback and found the armbands comfortable to wear and use.

Hand-tool-tissue interaction forces in neurosurgery for haptic rendering.

Haptics provides sensory stimuli that represent the interaction with a virtual or tele-manipulated object, and it is considered a valuable navigation and manipulation tool during tele-operated surgical procedures. Haptic feedback can be provided to the user via cutaneous information and kinesthetic feedback. Sensory subtraction removes the kinesthetic component of the haptic feedback, having only the cutaneous component provided to the user. Such a technique guarantees a stable haptic feedback loop, while it keeps the transparency of the tele-operation system high, which means that the system faithfully replicates and render back the user's directives. This work focuses on checking whether the interaction forces during a bench model neurosurgery operation can lie in the solely cutaneous perception of the human finger pads. If this assumption is found true, it would be possible to exploit sensory subtraction techniques for providing surgeons with feedback from neurosurgery. We measured the forces exerted to surgical tools by three neurosurgeons performing typical actions on a brain phantom, using contact force sensors, while the forces exerted by the tools to the phantom tissue were recorded using a load cell placed under the brain phantom box. The measured surgeon-tool contact forces were 0.01-3.49 N for the thumb and 0.01-6.6 N for index and middle finger, whereas the measured tool-tissue interaction forces were from six to 11 times smaller than the contact forces, i.e., 0.01-0.59 N. The measurements for the contact forces fit the range of the cutaneous sensitivity for the human finger pad; thus, we can say that, in a tele-operated robotic neurosurgery scenario, it would possible to render forces at the fingertip level by conveying haptic cues solely through the cutaneous channel of the surgeon's finger pads. This approach would allow high transparency and high stability of the haptic feedback loop in a tele-operation system.