Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Neural basis of lower-limb visual feedback therapy: an EEG study in healthy subjects.","authors":"Ahmed Adham, Ba Thien Le, Julien Bonnal, Hugo Bessaguet, Etienne Ojardias, Pascal Giraux, Pascal Auzou","doi":"10.1186/s12984-024-01408-8","DOIUrl":"10.1186/s12984-024-01408-8","url":null,"abstract":"<p><strong>Background: </strong>Video-feedback observational therapy (VOT) is an intensive rehabilitation technique based on movement repetition and visualization that has shown benefits for motor rehabilitation of the upper and lower limbs. Despite an increase in recent literature on the neurophysiological effects of VOT in the upper limb, there is little knowledge about the cortical effects of visual feedback therapies when applied to the lower limbs. The aim of our study was to better understand the neurophysiological effects of VOT. Thus, we identified and compared the EEG biomarkers of healthy subjects undergoing lower limb VOT during three tasks: passive observation, observation and motor imagery, observation and motor execution.</p><p><strong>Methods: </strong>We recruited 38 healthy volunteers and monitored their EEG activity while they performed a right ankle dorsiflexion task in the VOT. Three graded motor tasks associated with action observation were tested: action observation alone (O), motor imagery with action observation (OI), and motor execution synchronized with action observation (OM). The alpha and beta event-related desynchronization (ERD) and event-related synchronization (or beta rebound, ERS) rhythms were used as biomarkers of cortical activation and compared between conditions with a permutation test. Changes in connectivity during the task were computed with phase locking value (PLV).</p><p><strong>Results: </strong>During the task, in the alpha band, the ERD was comparable between O and OI activities across the precentral, central and parietal electrodes. OM involved the same regions but had greater ERD over the central electrodes. In the beta band, there was a gradation of ERD intensity in O, OI and OM over central electrodes. After the task, the ERS changes were weak during the O task but were strong during the OI and OM (Cz) tasks, with no differences between OI and OM.</p><p><strong>Conclusion: </strong>Alpha band ERD results demonstrated the recruitment of mirror neurons during lower limb VOT due to visual feedback. Beta band ERD reflects strong recruitment of the sensorimotor cortex evoked by motor imagery and action execution. These results also emphasize the need for an active motor task, either motor imagery or motor execution task during VOT, to elicit a post-task ERS, which is absent during passive observation. Trial Registration NCT05743647.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"114"},"PeriodicalIF":5.2,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11229246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CFI: a VR motor rehabilitation serious game design framework integrating rehabilitation function and game design principles with an upper limb case.","authors":"Chengjie Zhang, Suiran Yu, Jiancheng Ji","doi":"10.1186/s12984-024-01373-2","DOIUrl":"10.1186/s12984-024-01373-2","url":null,"abstract":"<p><p>Virtual reality (VR) Rehabilitation holds the potential to address the challenge that patients feel bored and give up long-term rehabilitation training. Despite the introduction of gaming elements by some researchers in rehabilitation training to enhance engagement, there remains a notable lack of in-depth research on VR rehabilitation serious game design methods, particularly the absence of a concrete design framework for VR rehabilitation serious games. Hence, we introduce the Clinical-Function-Interesting (CFI): a VR rehabilitation serious game design framework, harmonizing rehabilitation function and game design theories. The framework initiates with clinic information, defining game functions through the functional decomposition of rehabilitation training. Subsequently, it integrates gaming elements identified through the analysis and comparison of related literature to provide enduring support for long-term training. Furthermore, VR side-effect and enhancement are considered. Building upon this design framework, we have developed an upper limb VR rehabilitation serious game tailored for mild to moderate stroke patients and aligned our framework with another developed VR rehabilitation serious game to validate its practical feasibility. Overall, the proposed design framework offers a systematic VR rehabilitation serious game design methodology for the VR rehabilitation field, assisting developers in more accurately designing VR rehabilitation serious games that are tailored to specific rehabilitation goals.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"113"},"PeriodicalIF":5.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11218288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141476755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trend change analysis of postural balance in Parkinson's disease discriminates between medication state.","authors":"Piotr Wodarski, Jacek Jurkojć, Marta Chmura, Elke Warmerdam, Robbin Romijnders, Markus A Hobert, Walter Maetzler, Krzysztof Cygoń, Clint Hansen","doi":"10.1186/s12984-024-01411-z","DOIUrl":"https://doi.org/10.1186/s12984-024-01411-z","url":null,"abstract":"<p><strong>Background: </strong>Maintaining static balance is relevant and common in everyday life and it depends on a correct intersegmental coordination. A change or reduction in postural capacity has been linked to increased risk of falls. People with Parkinson's disease (pwPD) experience motor symptoms affecting the maintenance of a stable posture. The aim of the study is to understand the intersegmental changes in postural sway and to apply a trend change analysis to uncover different movement strategies between pwPD and healthy adults.</p><p><strong>Methods: </strong>In total, 61 healthy participants, 40 young (YO), 21 old participants (OP), and 29 pwPD (13 during medication off, PDoff; 23 during medication on, PDon) were included. Participants stood quietly for 10 s as part of the Short Physical Performance Battery. Inertial measurement units (IMU) at the head, sternum, and lumbar region were used to extract postural parameters and a trend change analysis (TCA) was performed to compare between groups.</p><p><strong>Objective: </strong>This study aims to explore the potential application of TCA for the assessment of postural stability using IMUs, and secondly, to employ this analysis within the context of neurological diseases, specifically Parkinson's disease.</p><p><strong>Results: </strong>Comparison of sensors locations revealed significant differences between head, sternum and pelvis for almost all parameters and cohorts. When comparing PDon and PDoff, the TCA revealed differences that were not seen by any other parameter.</p><p><strong>Conclusions: </strong>While all parameters could differentiate between sensor locations, no group differences could be uncovered except for the TCA that allowed to distinguish between the PD on/off. The potential of the TCA to assess disease progression, response to treatment or even the prodromal PD phase should be explored in future studies.</p><p><strong>Trial registration: </strong>The research procedure was approved by the ethical committee of the Medical Faculty of Kiel University (D438/18). The study is registered in the German Clinical Trials Register (DRKS00022998).</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"112"},"PeriodicalIF":5.2,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11212256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable biofeedback device to assess gait features and improve gait pattern in people with parkinson's disease: a case series.","authors":"Thomas Bowman, Andrea Pergolini, Maria Chiara Carrozza, Tiziana Lencioni, Alberto Marzegan, Mario Meloni, Nicola Vitiello, Simona Crea, Davide Cattaneo","doi":"10.1186/s12984-024-01403-z","DOIUrl":"10.1186/s12984-024-01403-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;People with Parkinson's Disease (PD) show abnormal gait patterns compromising their independence and quality of life. Among all gait alterations due to PD, reduced step length, increased cadence, and decreased ground-reaction force during the loading response and push-off phases are the most common. Wearable biofeedback technologies offer the possibility to provide correlated single or multi-modal stimuli associated with specific gait events or gait performance, hence promoting subjects' awareness of their gait disturbances. Moreover, the portability and applicability in clinical and home settings for gait rehabilitation increase the efficiency in the management of PD. The Wearable Vibrotactile Bidirectional Interface (BI) is a biofeedback device designed to extract gait features in real-time and deliver a customized vibrotactile stimulus at the waist of PD subjects synchronously with specific gait phases. The aims of this study were to measure the effect of the BI on gait parameters usually compromised by the typical bradykinetic gait and to assess its usability and safety in clinical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this case series, seven subjects (age: 70.4 ± 8.1 years; H&Y: 2.7 ± 0.3) used the BI and performed a test on a 10-meter walkway (10mWT) and a two-minute walk test (2MWT) as pre-training (Pre-trn) and post-training (Post-trn) assessments. Gait tests were executed in random order with (Bf) and without (No-Bf) the activation of the biofeedback stimulus. All subjects performed three training sessions of 40 min to familiarize themselves with the BI during walking activities. A descriptive analysis of gait parameters (i.e., gait speed, step length, cadence, walking distance, double-support phase) was carried out. The 2-sided Wilcoxon sign-test was used to assess differences between Bf and No-Bf assessments (p &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After training subjects improved gait speed (Pre-trn_No-Bf: 0.72(0.59,0.72) m/sec; Post-trn_Bf: 0.95(0.69,0.98) m/sec; p = 0.043) and step length (Pre-trn_No-Bf: 0.87(0.81,0.96) meters; Post-trn_Bf: 1.05(0.96,1.14) meters; p = 0.023) using the biofeedback during the 10mWT. Similarly, subjects' walking distance improved (Pre-trn_No-Bf: 97.5 (80.3,110.8) meters; Post-trn_Bf: 118.5(99.3,129.3) meters; p = 0.028) and the duration of the double-support phase decreased (Pre-trn_No-Bf: 29.7(26.8,31.7) %; Post-trn_Bf: 27.2(24.6,28.7) %; p = 0.018) during the 2MWT. An immediate effect of the BI was detected in cadence (Pre-trn_No-Bf: 108(103.8,116.7) step/min; Pre-trn_Bf: 101.4(96.3,111.4) step/min; p = 0.028) at Pre-trn, and in walking distance at Post-trn (Post-trn_No-Bf: 112.5(97.5,124.5) meters; Post-trn_Bf: 118.5(99.3,129.3) meters; p = 0.043). SUS scores were 77.5 in five subjects and 80.3 in two subjects. In terms of safety, all subjects completed the protocol without any adverse events.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The BI seems to be usable an","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"110"},"PeriodicalIF":5.2,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meta-analysis of the quantitative assessment of lower extremity motor function in elderly individuals based on objective detection.","authors":"Wen Liu, Jinzhu Bai","doi":"10.1186/s12984-024-01409-7","DOIUrl":"10.1186/s12984-024-01409-7","url":null,"abstract":"<p><strong>Objective: </strong>To avoid deviation caused by the traditional scale method, the present study explored the accuracy, advantages, and disadvantages of different objective detection methods in evaluating lower extremity motor function in elderly individuals.</p><p><strong>Methods: </strong>Studies on lower extremity motor function assessment in elderly individuals published in the PubMed, Web of Science, Cochrane Library and EMBASE databases in the past five years were searched. The methodological quality of the included trials was assessed using RevMan 5.4.1 and Stata, followed by statistical analyses.</p><p><strong>Results: </strong>In total, 19 randomized controlled trials with a total of 2626 participants, were included. The results of the meta-analysis showed that inertial measurement units (IMUs), motion sensors, 3D motion capture systems, and observational gait analysis had statistical significance in evaluating the changes in step velocity and step length of lower extremity movement in elderly individuals (P < 0.00001), which can be used as a standardized basis for the assessment of motor function in elderly individuals. Subgroup analysis showed that there was significant heterogeneity in the assessment of step velocity [SMD=-0.98, 95%CI(-1.23, -0.72), I² = 91.3%, P < 0.00001] and step length [SMD=-1.40, 95%CI(-1.77, -1.02), I² = 86.4%, P < 0.00001] in elderly individuals. However, the sensors (I² = 9%, I² = 0%) and 3D motion capture systems (I² = 0%) showed low heterogeneity in terms of step velocity and step length. The sensitivity analysis and publication bias test demonstrated that the results were stable and reliable.</p><p><strong>Conclusion: </strong>observational gait analysis, motion sensors, 3D motion capture systems, and IMUs, as evaluation means, play a certain role in evaluating the characteristic parameters of step velocity and step length in lower extremity motor function of elderly individuals, which has good accuracy and clinical value in preventing motor injury. However, the high heterogeneity of observational gait analysis and IMUs suggested that different evaluation methods use different calculation formulas and indicators, resulting in the failure to obtain standardized indicators in clinical applications. Thus, multimodal quantitative evaluation should be integrated.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"111"},"PeriodicalIF":5.2,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11202321/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A gamified virtual environment intervention for gait rehabilitation in Parkinson's Disease: co-creation and feasibility study.","authors":"Pere Bosch-Barceló, Maria Masbernat-Almenara, Oriol Martínez-Navarro, Carlos Tersa-Miralles, Anni Pakarinen, Helena Fernández-Lago","doi":"10.1186/s12984-024-01399-6","DOIUrl":"10.1186/s12984-024-01399-6","url":null,"abstract":"<p><strong>Background: </strong>Treadmill gait training has been shown to improve gait performance in People with Parkinson's Disease (PwPD), and in combination with Virtual Reality, it can be an effective tool for gait rehabilitation. The addition of gamification elements can create a more stimulating and adherent intervention. However, implementation of new technologies in healthcare can be challenging. This study aimed to develop and evaluate the feasibility of a treadmill rehabilitation program in a Gamified Virtual Reality Environment (GVRE) for PwPD.</p><p><strong>Methods: </strong>The GVRE was developed following a user-centered design approach, involving both PwPD and physiotherapists in the development and evaluation of the intervention. The intervention consisted of a walking simulation in three different environments (countryside, city, and park), which had a progressive increase in difficulty. To test its feasibility, three sessions were carried out with four PwPD and four physiotherapists. To assess the usability, the System Usability Scale (SUS), Assistive Technology Usability Questionnaire for people with Neurological diseases (NATU Quest) and Simulator Sickness Questionnaire (SSQ) were used. To assess the intervention's acceptability, feedback and in-game performance was collected from participants.</p><p><strong>Results: </strong>Results showed the feasibility of the intervention, with a SUS score of 74.82 ± 12.62, and a NATU Quest score of 4.49 ± 0.62, and positive acceptability feedback. Participants showed clear preferences for naturalistic environments, and gamification elements were seen as positive. Difficulty settings worked as intended, but lowered enjoyment of the experience in some cases.</p><p><strong>Conclusions: </strong>This intervention was successfully shown as a feasible option for the training of gait under Dual Task conditions for PwPD. It offers a safe and replicable environment in which complex situations can be trained. However, further iterations of the intervention need to be improved in order to guarantee accurate tracking and a more realistic training progression.</p><p><strong>Trial registration number: </strong>NCT05243394-01/20/2022.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"107"},"PeriodicalIF":5.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robot-aided assessment and associated brain lesions of impaired ankle proprioception in chronic stroke.","authors":"Qiyin Huang, Naveen Elangovan, Mingming Zhang, Ann Van de Winckel, Jürgen Konczak","doi":"10.1186/s12984-024-01396-9","DOIUrl":"10.1186/s12984-024-01396-9","url":null,"abstract":"<p><strong>Background: </strong>Impaired ankle proprioception strongly predicts balance dysfunction in chronic stroke. However, only sparse data on ankle position sense and no systematic data on ankle motion sense dysfunction in stroke are available. Moreover, the lesion sites underlying impaired ankle proprioception have not been comprehensively delineated. Using robotic technology, this study quantified ankle proprioceptive deficits post-stroke and determined the associated brain lesions.</p><p><strong>Methods: </strong>Twelve adults with chronic stroke and 13 neurotypical adults participated. A robot passively plantarflexed a participant's ankle to two distinct positions or at two distinct velocities. Participants subsequently indicated which of the two movements was further/faster. Based on the stimulus-response data, psychometric just-noticeable-difference (JND) thresholds and intervals of uncertainty (IU) were derived as measures on proprioceptive bias and precision. To determine group differences, Welch's t-test and the Wilcoxon-Mann-Whitney test were performed for the JND threshold and IU, respectively. Voxel-based lesion subtraction analysis identified the brain lesions associated with observed proprioceptive deficits in adults with stroke.</p><p><strong>Results: </strong>83% of adults with stroke exhibited abnormalities in either position or motion sense, or both. JND and IU measures were significantly elevated compared to the control group (Position sense: + 77% in JND, + 148% in IU; Motion sense: +153% in JND, + 78% in IU). Adults with stroke with both impaired ankle position and motion sense had lesions in the parietal, frontal, and temporoparietal regions.</p><p><strong>Conclusions: </strong>This is the first study to document the magnitude and frequency of ankle position and motion sense impairment in adults with chronic stroke. Proprioceptive dysfunction was characterized by elevated JND thresholds and increased uncertainty in perceiving ankle position/motion. Furthermore, the associated cortical lesions for impairment in both proprioceptive senses were largely overlapping.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"109"},"PeriodicalIF":5.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of repetitive transcranial magnetic stimulation on cortical activity: a systematic review and meta-analysis utilizing functional near-infrared spectroscopy evaluation.","authors":"Shao-Yu Chen, Meng-Hsuan Tsou, Kuan-Yu Chen, Yan-Ci Liu, Meng-Ting Lin","doi":"10.1186/s12984-024-01407-9","DOIUrl":"10.1186/s12984-024-01407-9","url":null,"abstract":"<p><strong>Background: </strong>Repeated transcranial magnetic stimulation (rTMS) could induce alterations in cortical excitability and promote neuroplasticity. To precisely quantify these effects, functional near-infrared spectroscopy (fNIRS), an optical neuroimaging modality adept at detecting changes in cortical hemodynamic responses, has been employed concurrently alongside rTMS to measure and tailor the impact of diverse rTMS protocols on the brain cortex.</p><p><strong>Objective: </strong>This systematic review and meta-analysis aimed to elucidate the effects of rTMS on cortical hemodynamic responses over the primary motor cortex (M1) as detected by fNIRS.</p><p><strong>Methods: </strong>Original articles that utilized rTMS to stimulate the M1 cortex in combination with fNIRS for the assessment of cortical activity were systematically searched across the PubMed, Embase, and Scopus databases. The search encompassed records from the inception of these databases up until April, 2024. The assessment for risk of bias was also conducted. A meta-analysis was also conducted in studies with extractable raw data.</p><p><strong>Results: </strong>Among 312 studies, 14 articles were eligible for qualitative review. 7 studies were eligible for meta-analysis. A variety of rTMS protocols was employed on M1 cortex. In inhibitory rTMS, multiple studies observed a reduction in the concentration of oxygenated hemoglobin [HbO] at the ipsilateral M1, contrasted by an elevation at the contralateral M1. Meta-analysis also corroborated this consistent trend. Nevertheless, certain investigations unveiled diminished [HbO] in bilateral M1. Several studies also depicted intricate inhibitory or excitatory interplay among distinct cortical regions.</p><p><strong>Conclusion: </strong>Diverse rTMS protocols led to varied patterns of cortical activity detected by fNIRS. Meta-analysis revealed a trend of increasing [HbO] in the contralateral cortices and decreasing [HbO] in the ipsilateral cortices following low frequency inhibitory rTMS. However, due to the heterogeneity between studies, further research is necessary to comprehensively understand rTMS-induced alterations in brain activity.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"108"},"PeriodicalIF":5.2,"publicationDate":"2024-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11194950/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141446315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing fall risk assessment: instrumenting vision with deep learning during walks.","authors":"Jason Moore, Robert Catena, Lisa Fournier, Pegah Jamali, Peter McMeekin, Samuel Stuart, Richard Walker, Thomas Salisbury, Alan Godfrey","doi":"10.1186/s12984-024-01400-2","DOIUrl":"10.1186/s12984-024-01400-2","url":null,"abstract":"<p><strong>Background: </strong>Falls are common in a range of clinical cohorts, where routine risk assessment often comprises subjective visual observation only. Typically, observational assessment involves evaluation of an individual's gait during scripted walking protocols within a lab to identify deficits that potentially increase fall risk, but subtle deficits may not be (readily) observable. Therefore, objective approaches (e.g., inertial measurement units, IMUs) are useful for quantifying high resolution gait characteristics, enabling more informed fall risk assessment by capturing subtle deficits. However, IMU-based gait instrumentation alone is limited, failing to consider participant behaviour and details within the environment (e.g., obstacles). Video-based eye-tracking glasses may provide additional insight to fall risk, clarifying how people traverse environments based on head and eye movements. Recording head and eye movements can provide insights into how the allocation of visual attention to environmental stimuli influences successful navigation around obstacles. Yet, manual review of video data to evaluate head and eye movements is time-consuming and subjective. An automated approach is needed but none currently exists. This paper proposes a deep learning-based object detection algorithm (VARFA) to instrument vision and video data during walks, complementing instrumented gait.</p><p><strong>Method: </strong>The approach automatically labels video data captured in a gait lab to assess visual attention and details of the environment. The proposed algorithm uses a YoloV8 model trained on with a novel lab-based dataset.</p><p><strong>Results: </strong>VARFA achieved excellent evaluation metrics (0.93 mAP50), identifying, and localizing static objects (e.g., obstacles in the walking path) with an average accuracy of 93%. Similarly, a U-NET based track/path segmentation model achieved good metrics (IoU 0.82), suggesting that the predicted tracks (i.e., walking paths) align closely with the actual track, with an overlap of 82%. Notably, both models achieved these metrics while processing at real-time speeds, demonstrating efficiency and effectiveness for pragmatic applications.</p><p><strong>Conclusion: </strong>The instrumented approach improves the efficiency and accuracy of fall risk assessment by evaluating the visual allocation of attention (i.e., information about when and where a person is attending) during navigation, improving the breadth of instrumentation in this area. Use of VARFA to instrument vision could be used to better inform fall risk assessment by providing behaviour and context data to complement instrumented e.g., IMU data during gait tasks. That may have notable (e.g., personalized) rehabilitation implications across a wide range of clinical cohorts where poor gait and increased fall risk are common.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"106"},"PeriodicalIF":5.2,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11193231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ankle dorsiflexion kinetics demand to increase swing phase foot-ground clearance: implications for assistive device design and energy demands.","authors":"Soheil Bajelan, W A Tony Sparrow, Rezaul Begg","doi":"10.1186/s12984-024-01394-x","DOIUrl":"10.1186/s12984-024-01394-x","url":null,"abstract":"<p><strong>Background: </strong>The ankle is usually highly effective in modulating the swing foot's trajectory to ensure safe ground clearance but there are few reports of ankle kinetics and mechanical energy exchange during the gait cycle swing phase. Previous work has investigated ankle swing mechanics during normal walking but with developments in devices providing dorsiflexion assistance, it is now essential to understand the minimal kinetic requirements for increasing ankle dorsiflexion, particularly for devices employing energy harvesting or utilizing lighter and lower power energy sources or actuators.</p><p><strong>Methods: </strong>Using a real-time treadmill-walking biofeedback technique, swing phase ankle dorsiflexion was experimentally controlled to increase foot-ground clearance by 4 cm achieved via increased ankle dorsiflexion. Swing phase ankle moments and dorsiflexor muscle forces were estimated using AnyBody modeling system. It was hypothesized that increasing foot-ground clearance by 4 cm, employing only the ankle joint, would require significantly higher dorsiflexion moments and muscle forces than a normal walking control condition.</p><p><strong>Results: </strong>Results did not confirm significantly increased ankle moments with augmented dorsiflexion, with 0.02 N.m/kg at toe-off reducing to zero by the end of swing. Tibialis Anterior muscle force incremented significantly from 2 to 4 N/kg after toe-off, due to coactivation with the Soleus. To ensure an additional 4 cm mid swing foot-ground clearance, an estimated additional 0.003 Joules/kg is required to be released immediately after toe-off.</p><p><strong>Conclusion: </strong>This study highlights the interplay between ankle moments, muscle forces, and energy demands during swing phase ankle dorsiflexion, offering insights for the design of ankle assistive technologies. External devices do not need to deliver significantly greater ankle moments to increase ankle dorsiflexion but, they should offer higher mechanical power to provide rapid bursts of energy to facilitate quick dorsiflexion transitions before reaching Minimum Foot Clearance event. Additionally, for ankle-related bio-inspired devices incorporating artificial muscles or humanoid robots that aim to replicate natural ankle biomechanics, the inclusion of supplementary Tibialis Anterior forces is crucial due to Tibialis Anterior and Soleus co-activation. These design strategies ensures that ankle assistive technologies are both effective and aligned with the biomechanical realities of human movement.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"21 1","pages":"105"},"PeriodicalIF":5.2,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11191291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141436956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}