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Guerrero-Mendez CD, Lopez-Delis A, Blanco-Diaz CF, Bastos-Filho TF, Jaramillo-Isaza S, Ruiz-Olaya AF. Continuous reach-to-grasp motion recognition based on an extreme learning machine algorithm using sEMG signals. Phys Eng Sci Med 2024:10.1007/s13246-024-01454-5. [PMID: 38954380 DOI: 10.1007/s13246-024-01454-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 05/30/2024] [Indexed: 07/04/2024]
Abstract
Recognizing user intention in reach-to-grasp motions is a critical challenge in rehabilitation engineering. To address this, a Machine Learning (ML) algorithm based on the Extreme Learning Machine (ELM) was developed for identifying motor actions using surface Electromyography (sEMG) during continuous reach-to-grasp movements, involving multiple Degrees of Freedom (DoFs). This study explores feature extraction methods based on time domain and autoregressive models to evaluate ELM performance under different conditions. The experimental setup encompassed variations in neuron size, time windows, validation with each muscle, increase in the number of features, comparison with five conventional ML-based classifiers, inter-subjects variability, and temporal dynamic response. To evaluate the efficacy of the proposed ELM-based method, an openly available sEMG dataset containing data from 12 participants was used. Results highlight the method's performance, achieving Accuracy above 85%, F-score above 90%, Recall above 85%, Area Under the Curve of approximately 84% and compilation times (computational cost) of less than 1 ms. These metrics significantly outperform standard methods (p < 0.05). Additionally, specific trends were found in increasing and decreasing performance in identifying specific tasks, as well as variations in the continuous transitions in the temporal dynamics response. Thus, the ELM-based method effectively identifies continuous reach-to-grasp motions through myoelectric data. These findings hold promise for practical applications. The method's success prompts future research into implementing it for more reliable and effective Human-Machine Interface (HMI) control. This can revolutionize real-time upper limb rehabilitation, enabling natural and complex Activities of Daily Living (ADLs) like object manipulation. The robust results encourages further research and innovative solutions to improve people's quality of life through more effective interventions.
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Affiliation(s)
- Cristian D Guerrero-Mendez
- Faculty of Mechanical, Electronics and Biomedical Engineering, Antonio Nariño University (UAN), Bogota D.C, Colombia.
- Postgraduate Program in Electrical Engineering, Federal University of Espirito Santo (UFES), Vitoria, 29075-910, Brazil.
| | | | - Cristian F Blanco-Diaz
- Faculty of Mechanical, Electronics and Biomedical Engineering, Antonio Nariño University (UAN), Bogota D.C, Colombia
- Postgraduate Program in Electrical Engineering, Federal University of Espirito Santo (UFES), Vitoria, 29075-910, Brazil
| | - Teodiano F Bastos-Filho
- Postgraduate Program in Electrical Engineering, Federal University of Espirito Santo (UFES), Vitoria, 29075-910, Brazil
| | - Sebastian Jaramillo-Isaza
- Faculty of Mechanical, Electronics and Biomedical Engineering, Antonio Nariño University (UAN), Bogota D.C, Colombia
| | - Andres F Ruiz-Olaya
- Faculty of Mechanical, Electronics and Biomedical Engineering, Antonio Nariño University (UAN), Bogota D.C, Colombia
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Amin F, Waris A, Syed S, Amjad I, Umar M, Iqbal J, Omer Gilani S. Effectiveness of Immersive Virtual Reality-Based Hand Rehabilitation Games for Improving Hand Motor Functions in Subacute Stroke Patients. IEEE Trans Neural Syst Rehabil Eng 2024; 32:2060-2069. [PMID: 38801680 DOI: 10.1109/tnsre.2024.3405852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Stroke rehabilitation faces challenges in attaining enduring improvements in hand motor function and is frequently constrained by interventional limitations. This research aims to present an innovative approach to the integration of cognitive engagement within visual feedback incorporated into fully immersive virtual reality (VR) based games to achieve enduring improvements. These innovative aspects of interaction provide more functional advantages beyond motivation to efficiently execute repeatedly hand motor tasks. The effectiveness of virtual reality games incorporated with innovative aspects has been investigated for improvements in hand motor functions. A randomized controlled trial was conducted, a total of (n=56) subacute stroke patients were assessed for eligibility and (n=52) patients fulfilled the inclusion criteria. (n=26) patients were assigned to the experimental group and (n=26) patients were assigned to the control group. VR intervention involves four VR based games, developed based on hand movements including flexion/extension, close/open, supination/pronation and pinch. All patients got therapy of 24 sessions, lasting 4 days/week for a total of 6 weeks. Five clinical outcome measures were Fugl- Meyer Assessment-Upper Extremity, Action Research Arm Test, Box and Block Test, Modified Barthel Index, and Stroke-Specific Quality of Life were assessed to evaluate patients' performance. Results revealed that after therapy there was significant improvement between the groups (p<0.05) and within groups (p<0.05) in all assessment weeks in all clinical outcome measures however, improvement was observed significantly greater in the experimental group due to fully immersive VR-based games. Results indicated that cognitive engagement within visual feedback incorporated in VR-based hand games effectively improved hand motor functions.
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Hussain I, Jany R. Interpreting Stroke-Impaired Electromyography Patterns through Explainable Artificial Intelligence. SENSORS (BASEL, SWITZERLAND) 2024; 24:1392. [PMID: 38474928 DOI: 10.3390/s24051392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/14/2024]
Abstract
Electromyography (EMG) proves invaluable myoelectric manifestation in identifying neuromuscular alterations resulting from ischemic strokes, serving as a potential marker for diagnostics of gait impairments caused by ischemia. This study aims to develop an interpretable machine learning (ML) framework capable of distinguishing between the myoelectric patterns of stroke patients and those of healthy individuals through Explainable Artificial Intelligence (XAI) techniques. The research included 48 stroke patients (average age 70.6 years, 65% male) undergoing treatment at a rehabilitation center, alongside 75 healthy adults (average age 76.3 years, 32% male) as the control group. EMG signals were recorded from wearable devices positioned on the bicep femoris and lateral gastrocnemius muscles of both lower limbs during indoor ground walking in a gait laboratory. Boosting ML techniques were deployed to identify stroke-related gait impairments using EMG gait features. Furthermore, we employed XAI techniques, such as Shapley Additive Explanations (SHAP), Local Interpretable Model-Agnostic Explanations (LIME), and Anchors to interpret the role of EMG variables in the stroke-prediction models. Among the ML models assessed, the GBoost model demonstrated the highest classification performance (AUROC: 0.94) during cross-validation with the training dataset, and it also overperformed (AUROC: 0.92, accuracy: 85.26%) when evaluated using the testing EMG dataset. Through SHAP and LIME analyses, the study identified that EMG spectral features contributing to distinguishing the stroke group from the control group were associated with the right bicep femoris and lateral gastrocnemius muscles. This interpretable EMG-based stroke prediction model holds promise as an objective tool for predicting post-stroke gait impairments. Its potential application could greatly assist in managing post-stroke rehabilitation by providing reliable EMG biomarkers and address potential gait impairment in individuals recovering from ischemic stroke.
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Affiliation(s)
- Iqram Hussain
- Department of Anesthesiology, Weill Cornell Medicine, Cornell University, New York, NY 10065, USA
| | - Rafsan Jany
- Department of Computer Science and Engineering, Islamic University and Technology (IUT), Gazipur 1704, Bangladesh
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Iqbal H, Zheng J, Chai R, Chandrasekaran S. Electric powered wheelchair control using user-independent classification methods based on surface electromyography signals. Med Biol Eng Comput 2024; 62:167-182. [PMID: 37749368 PMCID: PMC10758377 DOI: 10.1007/s11517-023-02921-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/22/2023] [Indexed: 09/27/2023]
Abstract
Wheelchairs are one of the most popular assistive technology (AT) among individuals with motor impairments due to their comfort and mobility. People with finger problems may find it difficult to operate wheelchairs using the conventional joystick control method. Therefore, in this research study, a hand gesture-based control method is developed for operating an electric-powered wheelchair (EPW). This study selected a comfort-based hand position to determine the stop maneuver. An additional exploration was undertaken to investigate four gesture recognition methods: linear regression (LR), regularized linear regression (RLR), decision tree (DT), and multi-class support vector machine (MC-SVM). The first two methods, LR and RLR, have promising accuracy values of 94.85% and 95.88%, respectively, but each new user must be trained. To overcome this limitation, this study explored two user-independent classification methods: MC-SVM and DT. These methods effectively addressed the finger dependency issue and demonstrated remarkable success in recognizing gestures across different users. MC-SVM has about 99.05% of both precision and accuracy, and the DT has about 97.77% accuracy and precision. All six participants were successful in controlling the EPW without any collisions. According to the experimental results, the proposed approach has high accuracy and can address finger dependency issues.
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Affiliation(s)
- Hassam Iqbal
- Department of Engineering Technologies, Swinburne University of Technology, John Street, 3122, Melbourne, Victoria, Australia.
| | - Jinchuan Zheng
- Department of Engineering Technologies, Swinburne University of Technology, John Street, 3122, Melbourne, Victoria, Australia
| | - Rifai Chai
- Department of Engineering Technologies, Swinburne University of Technology, John Street, 3122, Melbourne, Victoria, Australia
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Bonilla D, Bravo M, Bonilla SP, Iragorri AM, Mendez D, Mondragon IF, Alvarado-Rojas C, Colorado JD. Progressive Rehabilitation Based on EMG Gesture Classification and an MPC-Driven Exoskeleton. Bioengineering (Basel) 2023; 10:770. [PMID: 37508798 PMCID: PMC10376571 DOI: 10.3390/bioengineering10070770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/13/2023] [Accepted: 06/15/2023] [Indexed: 07/30/2023] Open
Abstract
Stroke is a leading cause of disability and death worldwide, with a prevalence of 200 millions of cases worldwide. Motor disability is presented in 80% of patients. In this context, physical rehabilitation plays a fundamental role for gradually recovery of mobility. In this work, we designed a robotic hand exoskeleton to support rehabilitation of patients after a stroke episode. The system acquires electromyographic (EMG) signals in the forearm, and automatically estimates the movement intention for five gestures. Subsequently, we developed a predictive adaptive control of the exoskeleton to compensate for three different levels of muscle fatigue during the rehabilitation therapy exercises. The proposed system could be used to assist the rehabilitation therapy of the patients by providing a repetitive, intense, and adaptive assistance.
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Affiliation(s)
- Daniel Bonilla
- School of Engineering, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | - Manuela Bravo
- School of Engineering, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | - Stephany P Bonilla
- School of Engineering, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | - Angela M Iragorri
- Neurology, School of Medicine, Hospital Universitario San Ignacio, Bogota 110231, Colombia
| | - Diego Mendez
- School of Engineering, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | - Ivan F Mondragon
- School of Engineering, Pontificia Universidad Javeriana, Bogota 110231, Colombia
| | | | - Julian D Colorado
- School of Engineering, Pontificia Universidad Javeriana, Bogota 110231, Colombia
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Bu D, Guo S, Guo J, Li H, Wang H. Low-Density sEMG-Based Pattern Recognition of Unrelated Movements Rejection for Wrist Joint Rehabilitation. MICROMACHINES 2023; 14:555. [PMID: 36984962 PMCID: PMC10056026 DOI: 10.3390/mi14030555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/16/2023] [Accepted: 02/25/2023] [Indexed: 06/18/2023]
Abstract
sEMG-based pattern recognition commonly assumes a limited number of target categories, and the classifiers often predict each target category depending on probability. In wrist rehabilitation training, the patients may make movements that do not belong to the target category unconsciously. However, most pattern recognition methods can only identify limited patterns and are prone to be disturbed by abnormal movement, especially for wrist joint movements. To address the above the problem, a sEMG-based rejection method for unrelated movements is proposed to identify wrist joint unrelated movements using center loss. In this paper, the sEMG signal collected by the Myo armband is used as the input of the sEMG control method. First, the sEMG signal is processed by sliding signal window and image coding. Then, the CNN with center loss and softmax loss is used to describe the spatial information from the sEMG image to extract discriminative features and target movement recognition. Finally, the deep spatial information is used to train the AE to reject unrelated movements based on the reconstruction loss. The results show that the proposed method can realize the target movements recognition and reject unrelated movements with an F-score of 93.4% and a rejection accuracy of 95% when the recall is 0.9, which reveals the effectiveness of the proposed method.
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Affiliation(s)
- Dongdong Bu
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Shuxiang Guo
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information Technology, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Jin Guo
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
- Key Laboratory of Convergence Medical Engineering System and Healthcare Technology, Ministry of Industry and Information Technology, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - He Li
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Hanze Wang
- School of Life Science, Beijing Institute of Technology, Beijing 100081, China
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Anastasiev A, Kadone H, Marushima A, Watanabe H, Zaboronok A, Watanabe S, Matsumura A, Suzuki K, Matsumaru Y, Ishikawa E. Supervised Myoelectrical Hand Gesture Recognition in Post-Acute Stroke Patients with Upper Limb Paresis on Affected and Non-Affected Sides. SENSORS (BASEL, SWITZERLAND) 2022; 22:8733. [PMID: 36433330 PMCID: PMC9692557 DOI: 10.3390/s22228733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
In clinical practice, acute post-stroke paresis of the extremities fundamentally complicates timely rehabilitation of motor functions; however, recently, residual and distorted musculoskeletal signals have been used to initiate feedback-driven solutions for establishing motor rehabilitation. Here, we investigate the possibilities of basic hand gesture recognition in acute stroke patients with hand paresis using a novel, acute stroke, four-component multidomain feature set (ASF-4) with feature vector weight additions (ASF-14NP, ASF-24P) and supervised learning algorithms trained only by surface electromyography (sEMG). A total of 19 (65.9 ± 12.4 years old; 12 men, seven women) acute stroke survivors (12.4 ± 6.3 days since onset) with hand paresis (Brunnstrom stage 4 ± 1/4 ± 1, SIAS 3 ± 1/3 ± 2, FMA-UE 40 ± 20) performed 10 repetitive hand movements reflecting basic activities of daily living (ADLs): rest, fist, pinch, wrist flexion, wrist extension, finger spread, and thumb up. Signals were recorded using an eight-channel, portable sEMG device with electrode placement on the forearms and thenar areas of both limbs (four sensors on each extremity). Using data preprocessing, semi-automatic segmentation, and a set of extracted feature vectors, support vector machine (SVM), linear discriminant analysis (LDA), and k-nearest neighbors (k-NN) classifiers for statistical comparison and validity (paired t-tests, p-value < 0.05), we were able to discriminate myoelectrical patterns for each gesture on both paretic and non-paretic sides. Despite any post-stroke conditions, the evaluated total accuracy rate by the 10-fold cross-validation using SVM among four-, five-, six-, and seven-gesture models were 96.62%, 94.20%, 94.45%, and 95.57% for non-paretic and 90.37%, 88.48%, 88.60%, and 89.75% for paretic limbs, respectively. LDA had competitive results using PCA whereas k-NN was a less efficient classifier in gesture prediction. Thus, we demonstrate partial efficacy of the combination of sEMG and supervised learning for upper-limb rehabilitation procedures for early acute stroke motor recovery and various treatment applications.
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Affiliation(s)
- Alexey Anastasiev
- Department of Neurosurgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Hideki Kadone
- Center for Cybernics Research, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8573, Ibaraki, Japan
| | - Aiki Marushima
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Hiroki Watanabe
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Alexander Zaboronok
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Shinya Watanabe
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Akira Matsumura
- Ibaraki Prefectural University of Health Sciences, 4669-2 Amicho, Inashiki 300-0394, Ibaraki, Japan
| | - Kenji Suzuki
- Center for Cybernics Research, Artificial Intelligence Laboratory, Faculty of Engineering Information and Systems, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8573, Ibaraki, Japan
| | - Yuji Matsumaru
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
| | - Eiichi Ishikawa
- Department of Neurosurgery, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Ibaraki, Japan
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Song X, van de Ven SS, Chen S, Kang P, Gao Q, Jia J, Shull PB. Proposal of a Wearable Multimodal Sensing-Based Serious Games Approach for Hand Movement Training After Stroke. Front Physiol 2022; 13:811950. [PMID: 35721546 PMCID: PMC9204487 DOI: 10.3389/fphys.2022.811950] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 05/11/2022] [Indexed: 11/25/2022] Open
Abstract
Stroke often leads to hand motor dysfunction, and effective rehabilitation requires keeping patients engaged and motivated. Among the existing automated rehabilitation approaches, data glove-based systems are not easy to wear for patients due to spasticity, and single sensor-based approaches generally provided prohibitively limited information. We thus propose a wearable multimodal serious games approach for hand movement training after stroke. A force myography (FMG), electromyography (EMG), and inertial measurement unit (IMU)-based multi-sensor fusion model was proposed for hand movement classification, which was worn on the user’s affected arm. Two movement recognition-based serious games were developed for hand movement and cognition training. Ten stroke patients with mild to moderate motor impairments (Brunnstrom Stage for Hand II-VI) performed experiments while playing interactive serious games requiring 12 activities-of-daily-living (ADLs) hand movements taken from the Fugl Meyer Assessment. Feasibility was evaluated by movement classification accuracy and qualitative patient questionnaires. The offline classification accuracy using combined FMG-EMG-IMU was 81.0% for the 12 movements, which was significantly higher than any single sensing modality; only EMG, only FMG, and only IMU were 69.6, 63.2, and 47.8%, respectively. Patients reported that they were more enthusiastic about hand movement training while playing the serious games as compared to conventional methods and strongly agreed that they subjectively felt that the proposed training could be beneficial for improving upper limb motor function. These results showed that multimodal-sensor fusion improved hand gesture classification accuracy for stroke patients and demonstrated the potential of this proposed approach to be used as upper limb movement training after stroke.
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Affiliation(s)
- Xinyu Song
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| | - Shirdi Shankara van de Ven
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| | - Shugeng Chen
- The Department of Rehabilitation Medicine, The National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Peiqi Kang
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| | - Qinghua Gao
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
| | - Jie Jia
- The Department of Rehabilitation Medicine, The National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Peter B Shull
- The State Key Laboratory of Mechanical System and Vibration, Shanghai Jiao Tong University, Shanghai, China
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Marcos-Antón S, Gor-García-Fogeda MD, Cano-de-la-Cuerda R. An sEMG-Controlled Forearm Bracelet for Assessing and Training Manual Dexterity in Rehabilitation: A Systematic Review. J Clin Med 2022; 11:jcm11113119. [PMID: 35683503 PMCID: PMC9181798 DOI: 10.3390/jcm11113119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The ability to perform activities of daily living (ADL) is essential to preserving functional independence and quality of life. In recent years, rehabilitation strategies based on new technologies, such as MYO Armband®, have been implemented to improve dexterity in people with upper limb impairment. Over the last few years, many studies have been published focusing on the accuracy of the MYO Armband® to capture electromyographic and inertial data, as well as the clinical effects of using it as a rehabilitation tool in people with loss of upper limb function. Nevertheless, to our knowledge, there has been no systematic review of this subject. Methods: A systematically comprehensive literature search was conducted in order to identify original studies that answered the PICO question (patient/population, intervention, comparison, and outcome): What is the accuracy level and the clinical effects of the MYO Armband® in people with motor impairment of the upper limb compared with other assessment techniques or interventions or no intervention whatsoever? The following data sources were used: Pubmed, Scopus, Web of Science, ScienceDirect, Physiotherapy Evidence Database, and the Cochrane Library. After identifying the eligible articles, a cross-search of their references was also completed for additional studies. The following data were extracted from the papers: study design, disease or condition, intervention, sample, dosage, outcome measures or data collection procedure and data analysis and results. The authors independently collected these data following the CONSORT 2010 statement when possible, and eventually reached a consensus on the extracted data, resolving disagreements through discussion. To assess the methodological quality of papers included, the tool for the critical appraisal of epidemiological cross-sectional studies was used, since only case series studies were identified after the search. Additionally, the articles were classified according to the levels of evidence and grades of recommendation for diagnosis studies established by the Oxford Center for Evidence-Based Medicine. Also, The Cochrane Handbook for Systematic Reviews of Interventions was used by two independent reviewers to assess risk of bias, assessing the six different domains. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed to carry out this review. Results: 10 articles with a total 180 participants were included in the review. The characteristics of included studies, sample and intervention characteristics, outcome measures, the accuracy of the system and effects of the interventions and the assessment of methodological quality of the studies and risk of bias are shown. Conclusions: Therapy with the MYO Armband® has shown clinical changes in range of motion, dexterity, performance, functionality and satisfaction. It has also proven to be an accurate system to capture signals from the forearm muscles in people with motor impairment of the upper limb. However, further research should be conducted using bigger samples, well-defined protocols, comparing with control groups or comparing with other assessment or therapeutic tools, since the studies published so far present a high risk of bias and low level of evidence and grade of recommendation.
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Affiliation(s)
- Selena Marcos-Antón
- International Doctorate School, Rey Juan Carlos University, 28008 Madrid, Spain;
| | - María Dolores Gor-García-Fogeda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcon, Spain;
| | - Roberto Cano-de-la-Cuerda
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Rey Juan Carlos University, 28922 Alcorcon, Spain;
- Correspondence: ; Tel.: +34-914-888-674
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10
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Kim J, Koo B, Nam Y, Kim Y. sEMG-Based Hand Posture Recognition Considering Electrode Shift, Feature Vectors, and Posture Groups. SENSORS 2021; 21:s21227681. [PMID: 34833756 PMCID: PMC8624257 DOI: 10.3390/s21227681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022]
Abstract
Surface electromyography (sEMG)-based gesture recognition systems provide the intuitive and accurate recognition of various gestures in human-computer interaction. In this study, an sEMG-based hand posture recognition algorithm was developed, considering three main problems: electrode shift, feature vectors, and posture groups. The sEMG signal was measured using an armband sensor with the electrode shift. An artificial neural network classifier was trained using 21 feature vectors for seven different posture groups. The inter-session and inter-feature Pearson correlation coefficients (PCCs) were calculated. The results indicate that the classification performance improved with the number of training sessions of the electrode shift. The number of sessions necessary for efficient training was four, and the feature vectors with a high inter-session PCC (r > 0.7) exhibited high classification accuracy. Similarities between postures in a posture group decreased the classification accuracy. Our results indicate that the classification accuracy could be improved with the addition of more electrode shift training sessions and that the PCC is useful for selecting the feature vector. Furthermore, hand posture selection was as important as feature vector selection. These findings will help in optimizing the sEMG-based pattern recognition algorithm more easily and quickly.
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11
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Li Q, Liu Y, Zhu J, Chen Z, Liu L, Yang S, Zhu G, Zhu B, Li J, Jin R, Tao J, Chen L. Upper-Limb Motion Recognition Based on Hybrid Feature Selection: Algorithm Development and Validation. JMIR Mhealth Uhealth 2021; 9:e24402. [PMID: 34473067 PMCID: PMC8446846 DOI: 10.2196/24402] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 04/30/2021] [Accepted: 07/15/2021] [Indexed: 02/05/2023] Open
Abstract
Background For rehabilitation training systems, it is essential to automatically record and recognize exercises, especially when more than one type of exercise is performed without a predefined sequence. Most motion recognition methods are based on feature engineering and machine learning algorithms. Time-domain and frequency-domain features are extracted from original time series data collected by sensor nodes. For high-dimensional data, feature selection plays an important role in improving the performance of motion recognition. Existing feature selection methods can be categorized into filter and wrapper methods. Wrapper methods usually achieve better performance than filter methods; however, in most cases, they are computationally intensive, and the feature subset obtained is usually optimized only for the specific learning algorithm. Objective This study aimed to provide a feature selection method for motion recognition of upper-limb exercises and improve the recognition performance. Methods Motion data from 5 types of upper-limb exercises performed by 21 participants were collected by a customized inertial measurement unit (IMU) node. A total of 60 time-domain and frequency-domain features were extracted from the original sensor data. A hybrid feature selection method by combining filter and wrapper methods (FESCOM) was proposed to eliminate irrelevant features for motion recognition of upper-limb exercises. In the filter stage, candidate features were first selected from the original feature set according to the significance for motion recognition. In the wrapper stage, k-nearest neighbors (kNN), Naïve Bayes (NB), and random forest (RF) were evaluated as the wrapping components to further refine the features from the candidate feature set. The performance of the proposed FESCOM method was verified using experiments on motion recognition of upper-limb exercises and compared with the traditional wrapper method. Results Using kNN, NB, and RF as the wrapping components, the classification error rates of the proposed FESCOM method were 1.7%, 8.9%, and 7.4%, respectively, and the feature selection time in each iteration was 13 seconds, 71 seconds, and 541 seconds, respectively. Conclusions The experimental results demonstrated that, in the case of 5 motion types performed by 21 healthy participants, the proposed FESCOM method using kNN and NB as the wrapping components achieved better recognition performance than the traditional wrapper method. The FESCOM method dramatically reduces the search time in the feature selection process. The results also demonstrated that the optimal number of features depends on the classifier. This approach serves to improve feature selection and classification algorithm selection for upper-limb motion recognition based on wearable sensor data, which can be extended to motion recognition of more motion types and participants.
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Affiliation(s)
- Qiaoqin Li
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Yongguo Liu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Jiajing Zhu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Zhi Chen
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Lang Liu
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Shangming Yang
- Knowledge and Data Engineering Laboratory of Chinese Medicine, School of Information and Software Engineering, University of Electronic Science and Technology of China, Chengdu, China
| | - Guanyi Zhu
- College of Electrical and Information Engineering, Hunan University, Changsha, China
| | - Bin Zhu
- Chengdu Chronic Diseases Hospital, Chengdu, China
| | - Juan Li
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rongjiang Jin
- College of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lidian Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
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12
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Prediction of Myoelectric Biomarkers in Post-Stroke Gait. SENSORS 2021; 21:s21165334. [PMID: 34450776 PMCID: PMC8399186 DOI: 10.3390/s21165334] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 08/05/2021] [Accepted: 08/05/2021] [Indexed: 12/17/2022]
Abstract
Electromyography (EMG) is sensitive to neuromuscular changes resulting from ischemic stroke and is considered a potential predictive tool of post-stroke gait and rehabilitation management. This study aimed to evaluate the potential myoelectric biomarkers for the classification of stroke-impaired muscular activity of the stroke patient group and the muscular activity of the control healthy adult group. We also proposed an EMG-based gait monitoring system consisting of a portable EMG device, cloud-based data processing, data analytics, and a health advisor service. This system was investigated with 48 stroke patients (mean age 70.6 years, 65% male) admitted into the emergency unit of a hospital and 75 healthy elderly volunteers (mean age 76.3 years, 32% male). EMG was recorded during walking using the portable device at two muscle positions: the bicep femoris muscle and the lateral gastrocnemius muscle of both lower limbs. The statistical result showed that the mean power frequency (MNF), median power frequency (MDF), peak power frequency (PKF), and mean power (MNP) of the stroke group differed significantly from those of the healthy control group. In the machine learning analysis, the neural network model showed the highest classification performance (precision: 88%, specificity: 89%, accuracy: 80%) using the training dataset and highest classification performance (precision: 72%, specificity: 74%, accuracy: 65%) using the testing dataset. This study will be helpful to understand stroke-impaired gait changes and decide post-stroke rehabilitation.
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13
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Assist-As-Needed Exoskeleton for Hand Joint Rehabilitation Based on Muscle Effort Detection. SENSORS 2021; 21:s21134372. [PMID: 34206714 PMCID: PMC8271787 DOI: 10.3390/s21134372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 06/09/2021] [Accepted: 06/18/2021] [Indexed: 11/17/2022]
Abstract
Robotic-assisted systems have gained significant traction in post-stroke therapies to support rehabilitation, since these systems can provide high-intensity and high-frequency treatment while allowing accurate motion-control over the patient's progress. In this paper, we tackle how to provide active support through a robotic-assisted exoskeleton by developing a novel closed-loop architecture that continually measures electromyographic signals (EMG), in order to adjust the assistance given by the exoskeleton. We used EMG signals acquired from four patients with post-stroke hand impairments for training machine learning models used to characterize muscle effort by classifying three muscular condition levels based on contraction strength, co-activation, and muscular activation measurements. The proposed closed-loop system takes into account the EMG muscle effort to modulate the exoskeleton velocity during the rehabilitation therapy. Experimental results indicate the maximum variation on velocity was 0.7 mm/s, while the proposed control system effectively modulated the movements of the exoskeleton based on the EMG readings, keeping a reference tracking error <5%.
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14
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Liu Y, Li X, Zhu A, Zheng Z, Zhu H. Design and evaluation of a surface electromyography-controlled lightweight upper arm exoskeleton rehabilitation robot. INT J ADV ROBOT SYST 2021. [DOI: 10.1177/17298814211003461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Nowadays, the rehabilitation robot has been developed for rehabilitation therapy. However, there are few studies on upper arm exoskeletons for rehabilitation training of muscle strength. This article aims to design a surface electromyography-controlled lightweight exoskeleton rehabilitation robot for home-based progressive resistance training. The exoskeleton’s lightweight structure is designed based on the kinematic model of the elbow joint and ergonomics sizes of the arm. At the same time, the overall weight of the exoskeleton is controlled at only 3.03 kg. According to the rehabilitation training task, we use torque limit mode to ensure stable torque output at variable velocity. We also propose a surface electromyography-based control method, which uses k- Nearest Neighbor algorithm to classify surface electromyographic signals under progressive training loads, and utilizes principal component analysis to improve the recognition accuracy to control the exoskeleton to provide muscle strength compensation. The assessment experiment of the exoskeleton rehabilitation robot shows that the dynamic recognition accuracy of this control method is 80.21%. Muscle activity of biceps brachii and triceps brachii under each training load decreases significantly when subjects with the exoskeleton robot. The results indicate that the exoskeleton rehabilitation robot can output the corresponding torque to assist in progressive resistance training. This study provides a solution to potential problems in the family-oriented application of exoskeleton rehabilitation robots.
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Affiliation(s)
- Yang Liu
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Xiaoling Li
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Aibin Zhu
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Ziming Zheng
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
| | - Huijin Zhu
- School of Mechanical Engineering, Xi’an Jiaotong University, Xi’an, China
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15
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Zhou H, Zhang Q, Zhang M, Shahnewaz S, Wei S, Ruan J, Zhang X, Zhang L. Toward Hand Pattern Recognition in Assistive and Rehabilitation Robotics Using EMG and Kinematics. Front Neurorobot 2021; 15:659876. [PMID: 34054455 PMCID: PMC8155590 DOI: 10.3389/fnbot.2021.659876] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 04/09/2021] [Indexed: 11/13/2022] Open
Abstract
Wearable hand robots are becoming an attractive means in the facilitating of assistance with daily living and hand rehabilitation exercises for patients after stroke. Pattern recognition is a crucial step toward the development of wearable hand robots. Electromyography (EMG) is a commonly used biological signal for hand pattern recognition. However, the EMG based pattern recognition performance in assistive and rehabilitation robotics post stroke remains unsatisfactory. Moreover, low cost kinematic sensors such as Leap Motion is recently used for pattern recognition in various applications. This study proposes feature fusion and decision fusion method that combines EMG features and kinematic features for hand pattern recognition toward application in upper limb assistive and rehabilitation robotics. Ten normal subjects and five post stroke patients participating in the experiments were tested with eight hand patterns of daily activities while EMG and kinematics were recorded simultaneously. Results showed that average hand pattern recognition accuracy for post stroke patients was 83% for EMG features only, 84.71% for kinematic features only, 96.43% for feature fusion of EMG and kinematics, 91.18% for decision fusion of EMG and kinematics. The feature fusion and decision fusion was robust as three different levels of noise was given to the classifiers resulting in small decrease of classification accuracy. Different channel combination comparisons showed the fusion classifiers would be robust despite failure of specific EMG channels which means that the system has promising potential in the field of assistive and rehabilitation robotics. Future work will be conducted with real-time pattern classification on stroke survivors.
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Affiliation(s)
- Hui Zhou
- School of Automation, Nanjing University of Science and Technology, Nanjing, China
| | - Qianqian Zhang
- School of Automation, Nanjing University of Science and Technology, Nanjing, China
| | - Mengjun Zhang
- School of Automation, Nanjing University of Science and Technology, Nanjing, China
| | - Sameer Shahnewaz
- School of Automation, Nanjing University of Science and Technology, Nanjing, China
| | - Shaocong Wei
- School of Automation, Nanjing University of Science and Technology, Nanjing, China
| | - Jingzhi Ruan
- School of Automation, Nanjing University of Science and Technology, Nanjing, China
| | - Xinyan Zhang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Lingling Zhang
- Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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16
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Jiang S, Kang P, Song X, Lo B, Shull P. Emerging Wearable Interfaces and Algorithms for Hand Gesture Recognition: A Survey. IEEE Rev Biomed Eng 2021; 15:85-102. [PMID: 33961564 DOI: 10.1109/rbme.2021.3078190] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Hands are vital in a wide range of fundamental daily activities, and neurological diseases that impede hand function can significantly affect quality of life. Wearable hand gesture interfaces hold promise to restore and assist hand function and to enhance human-human and human-computer communication. The purpose of this review is to synthesize current novel sensing interfaces and algorithms for hand gesture recognition, and the scope of applications covers rehabilitation, prosthesis control, sign language recognition, and human-computer interaction. Results showed that electrical, dynamic, acoustical/vibratory, and optical sensing were the primary input modalities in gesture recognition interfaces. Two categories of algorithms were identified: 1) classification algorithms for predefined, fixed hand poses and 2) regression algorithms for continuous finger and wrist joint angles. Conventional machine learning algorithms, including linear discriminant analysis, support vector machines, random forests, and non-negative matrix factorization, have been widely used for a variety of gesture recognition applications, and deep learning algorithms have more recently been applied to further facilitate the complex relationship between sensor signals and multi-articulated hand postures. Future research should focus on increasing recognition accuracy with larger hand gesture datasets, improving reliability and robustness for daily use outside of the laboratory, and developing softer, less obtrusive interfaces.
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17
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Chen Y, Yu S, Cai Q, Huang S, Ma K, Zheng H, Xie L. A spasticity assessment method for voluntary movement using data fusion and machine learning. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2020.102353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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18
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On the Use of Fuzzy and Permutation Entropy in Hand Gesture Characterization from EMG Signals: Parameters Selection and Comparison. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10207144] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The surface electromyography signal (sEMG) is widely used for gesture characterization; its reliability is strongly connected to the features extracted from sEMG recordings. This study aimed to investigate the use of two complexity measures, i.e., fuzzy entropy (FEn) and permutation entropy (PEn) for hand gesture characterization. Fourteen upper limb movements, sorted into three sets, were collected on ten subjects and the performances of FEn and PEn for gesture descriptions were analyzed for different computational parameters. FEn and PEn were able to properly cluster the expected numbers of gestures, but computational parameters were crucial for ensuring clusters’ separability and proper gesture characterization. FEn and PEn were also compared with other eighteen classical time and frequency domain features through the minimum redundancy maximum relevance algorithm and showed the best predictive importance scores in two gesture sets; they also had scores within the subset of the best five features in the remaining one. Further, the classification accuracies of four different feature sets presented remarkable increases when FEn and PEn are included as additional features. Outcomes support the use of FEn and PEn for hand gesture description when computational parameters are properly selected, and they could be useful in supporting the development of robotic arms and prostheses myoelectric control.
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