Kinematic analysis of multiple constraints on a pointing task

Sensorimotor Challenges in Minimally Invasive Surgery: A Theoretically-Oriented Review

OBJECTIVE

This review surveys the literature on sensorimotor challenges impacting performance in laparoscopic minimally invasive surgery (MIS).

BACKGROUND

Despite its well-known benefits for patients, achieving proficiency in MIS can be challenging for surgeons due to many factors including altered visual perspectives and fulcrum effects in instrument handling. Research on these and other sensorimotor challenges has been hindered by imprecise terminology and the lack of a unified theoretical framework to guide research questions in the field.

METHOD

We conducted a systematic survey of the MIS literature, focusing on studies investigating sensorimotor challenges affecting laparoscopic performance. To provide a common foundation for cross-study comparisons, we propose a standardized taxonomy that distinguishes between different experimental paradigms used in the literature. We then show how the computational motor learning perspective provides a unifying theoretical framework for the field that can facilitate progress and motivate future research along clearer, hypothesis-driven lines.

RESULTS

The survey identified diverse sensorimotor perturbations in MIS, which can be effectively categorized according to our proposed taxonomy. Studies investigating monitor-, camera-, and tool-based perturbations were systematically analyzed, elucidating their impact on surgical performance. We also show how the computational motor learning perspective provides deeper insights and potential strategies to mitigate challenges.

CONCLUSION

Sensorimotor challenges significantly impact MIS, necessitating a systematic, empirically informed approach. Our proposed taxonomy and theoretical framework shed light on the complexities involved, paving the way for more structured research and targeted training approaches to enhance surgical proficiency.

APPLICATION

Understanding the sensorimotor challenges inherent to MIS can guide the design of improved training curricula and inform the configuration of setups in the operating room to enhance surgeon performance and ultimately patient outcomes. This review offers key insights for surgeons, educators, and researchers in surgical performance and technology development.

Age-related changes in motor planning for prior intentions: a mouse tracking reach-to-click task

When we complete sequential movements with different intentions, we plan our movements and adjust ahead. Such a phenomenon is called anticipatory planning for prior intentions and is known to decline with age. In daily life activities, we often need to consider and plan for multiple demands in one movement sequence. However, previous studies only considered one dimension of prior intentions, either different types of onward actions or different precisions of fit or placement. Therefore, in this study, we investigated anticipatory planning for both extrinsic (movement direction) and intrinsic (fit precision) target-related properties in a computer-based movement task and analyzed the computer cursor movement kinematics of both young and older adults. We found that older people consider and adjust for different properties step-by-step, with movement direction being considered as a prior intention during reach movement and fit precision as a motor constraint during drop movement. The age-related changes in the completion of onward actions are constrained by one's general cognitive ability, sensorimotor performance and effective motor planning for prior intentions. Age-related decline in motor planning can manifest as counterproductive movement profiles, resulting in suboptimal performance of intended actions.

Smoothness discriminates physical from motor imagery practice of arm reaching movements

Physical practice (PP) and motor imagery practice (MP) lead to the execution of fast and accurate arm movements. However, there is currently no information about the influence of MP on movement smoothness, nor about which performance parameters best discriminate these practices. In the current study, we assessed motor performances with an arm pointing task with constrained precision before and after PP (n= 15), MP (n= 15), or no practice (n= 15). We analyzed gains between Pre- and Post-Test for five performance parameters: movement duration, mean and maximal velocities, total displacements, and the number of velocity peaks characterizing movement smoothness. The results showed an improvement of performance after PP and MP for all parameters, except for total displacements. The gains for movement duration, and mean and maximal velocities were statistically higher after PP and MP than after no practice, and comparable between practices. However, motor gains for the number of velocity peaks were higher after PP than MP, suggesting that movements were smoother after PP than after MP. A discriminant analysis also identified the number of velocity peaks as the most relevant parameter that differentiated PP from MP. The current results provide evidence that PP and MP specifically modulate movement smoothness during arm reaching tasks. This difference may rely on online corrections through sensory feedback integration, available during PP but not during MP.

Effects of exoskeleton design and precision requirements on physical demands and quality in a simulated overhead drilling task

We compared three passive exoskeleton designs in a mock drilling task under three precision requirements levels, defined by required hole sizes, in terms of physical demands (perceived exertion and muscular activation) and quality. The investigated designs were: 1) an upper-body exoskeleton mainly supporting the shoulder; and both 2) full-body, and 3) upper-body exoskeletons, each with connected supernumerary arms. At a fixed pace, participants (n = 12) repeated "drilling" two same-sized holes for 2 min. A fairly consistent result across exoskeleton designs was that higher precision demands increased some muscle activation levels and deteriorated quality. Designs with supernumerary arms led to the largest reductions in quality and increased physical demands overall, mainly in the low back. The shoulder-focused exoskeleton reduced shoulder demands but appeared to reduce quality with the highest precision requirement. Although future work is needed under more diverse/realistic scenarios, these results might be useful to (re)design occupational exoskeletons.

Examining associations between action game play and motor control

The effects of playing action video games have been investigated across a wide range of attentional and cognitive abilities. However, few studies have examined the association between motor control and action gaming experience. We report data from two discrete pointing tasks, manipulating the index of difficulty (ID) by movement distance and target size, respectively. Participants' gaming experience ranged from non-players to individuals who played several hours a night. Our results indicated greater experience playing action games, but not video games in general, was associated with shorter movement times (MT), higher velocities, and shallower ID-MT slopes when difficulty was manipulated across increasingly further distances and smaller target sizes. Additionally casual players, those who only play action games a couple times a week, were able to achieve a similar level of performance as more experienced players.

Kinematic analysis of direct pointing in projection-based stereoscopic environments

This work investigated the effects of visual information, parallax, and target positions on movement performances in projection-based stereoscopic displays (PSDs). Fifteen (26.5 ± 3.83 years) self-declared right-handed individuals, with normal or corrected to normal visual acuity, completed pointing tasks in stereoscopic and real environments (RE). Three-dimensional spatial data, recorded by a motion system composed of six infrared cameras, was used to compute kinematics of reaching a real/virtual object at a combination of three parallax and nine frontal planar positions. The results indicated that movement in the PSD was slower and needed longer confirmation time than that in the RE. This might be because of the difficulty and misperception of distance associated with PSD. The motions were initiated faster but took longer to complete in vision-based conditions. The overall kinematic parameters were better as targets were presented closer to participants and around the center of displays. However, during pointing at a target that was continuously visible or presented briefly and disappeared, participants applied similar movement strategies to approach the visual objects. The comparable kinematics and movement behaviors in stereoscopic displays encourage the use of direct pointing that would enhance reaching and grasping tasks - which are important in applications such as rehabilitation, surgical training, and other programs that employ upper limbs. In addition, the more natural interaction by direct pointing minimizes the effort of learning new skills to use other devices.

Egocentric distance perception and performance of direct pointing in stereoscopic displays

In this study, the interaction performances and spatial perceptions in stereoscopic environments were investigated. The experiment compared direct user interactions during pointing at a target, which was continuously visible or presented briefly and disappeared, in both stereoscopic and real environments, at three parallax/depth levels. The position data, collected by a motion system, were used to compute accuracy, signed error, movement time, and throughput. The results showed inaccurate egocentric distance judgment in stereoscopic displays and accurate perceptions in the real world. The overall inaccuracy, which was overestimation of about 10 cm, was relatively better than that achieved in previous studies. The overestimation decreased as the egocentric distance increased. However, providing visual objects did not improve the accuracy. The study concluded that direct pointing could minimize the underestimation problems commonly reported in stereoscopic viewing studies and showed practical significance for developers to focus on incorporating more direct and natural human-virtual reality interactions for improved performance. The findings of this study provide insight towards the development of less expensive displays and their applications. Implications of this work and engineering solutions are also discussed.

Effects of Background Lighting Color and Movement Distance on Reaching Times Among Participants With Low Vision, Myopia, and Normal Vision

This study investigated the effects of target distance (30, 35, and 40 cm) and the color of background lighting (red, green, blue, and yellow) on the duration of movements made by participants with low vision, myopia, and normal vision while performing a reaching task; 48 students (21 women, 27 men; M age = 21.8 year, SD = 2.4) participated in the study. Participants reached for a target (a white LED light) whose vertical position varied randomly across trials, ranging in distance from 30 to 40 cm. Movement time was analyzed using a 3 (participant group) × [4 (color of background lighting) × 3 (movement distance)] mixed-design ANOVA model. Results indicated longer times for completing a reaching movement when: participants belonged to the low vision group; the target distance between the starting position and the target position was longer (40 cm); and the reaching movement occurred in the red-background lighting condition. These results are particularly relevant for situations in which a user is required to respond to a signal by reaching toward a button or an icon.

The impact of concurrent visual feedback on coding of on-line and pre-planned movement sequences

The purpose of this study was to determine the extent to which participants could effectively switch from on-line (OL) to pre-planned (PP) control (or vice versa) depending on previous practice conditions and whether concurrent visual feedback was available during transfer testing. The task was to reproduce a 2000 ms spatial-temporal pattern of a sequence of elbow flexions and extensions. Participants were randomly assigned to one of two practice conditions termed OL or PP. In the OL condition the criterion waveform and the cursor were provided during movement production while this information was withheld during movement production for the PP condition. A retention test and two effector transfer tests were administered to half of the participants in each acquisition conditions under OL conditions and the other half under PP conditions. The mirror effector transfer test required the same pattern of muscle activation and limb joint angles as required during acquisition. The non-mirror transfer test required movements to the same visual-spatial locations as experienced during acquisition. The results indicated that when visual information was available during the transfer tests performers could switch from PP to OL. When visual information was withdrawn, they shifted from the OL to the PP-control mode. This finding suggests that performers adopt a mode of control consistent with the feedback conditions provided during testing.

A Nonlinear Model for Mouse Pointing Task Movement Time Analysis Based on Both System and Human Effects

This paper provides a detailed model for analyzing movement time performance during rapid goal-directed point- and-click motions with a computer mouse. Twelve typically developed individuals and eleven youths with cerebral palsy conducted point and click computer tasks from which the model was developed. The proposed model is nonlinear and based on both system (target width and movement amplitude) and human effects (erroneous clicks, number of submovements, number of slip-offs, curvature index, and average speed). To ensure successful targeting by youths with cerebral palsy, the index of difficulty was limited to a range of 1.58 - 3.0 bits. For consistency, the same range was used with both groups. The most significant contributing human effect to movement time was found to be the curvature index for both typically developed individuals and individuals with cerebral palsy. This model will assist in algorithm development to improve cursor speed and accuracy for youths with cerebral palsy.

Perceptual grouping effects on cursor movement expectations

OBJECTIVE

Two studies were conducted to develop an understanding of factors that drive user expectations when navigating between discrete elements on a display via a limited degree-of-freedom cursor control device.

BACKGROUND

For the Orion Crew Exploration Vehicle spacecraft, a free-floating cursor with a graphical user interface (GUI) would require an unachievable level of accuracy due to expected acceleration and vibration conditions during dynamic phases of flight. Therefore, Orion program proposed using a "caged" cursor to "jump" from one controllable element (node) on the GUI to another. However, nodes are not likely to be arranged on a rectilinear grid, and so movements between nodes are not obvious.

METHOD

Proximity between nodes, direction of nodes relative to each other, and context features may all contribute to user cursor movement expectations. In an initial study, we examined user expectations based on the nodes themselves. In a second study, we examined the effect of context features on user expectations.

RESULTS

The studies established that perceptual grouping effects influence expectations to varying degrees. Based on these results, a simple rule set was developed to support users in building a straightforward mental model that closely matches their natural expectations for cursor movement.

CONCLUSION

The results will help designers of display formats take advantage of the natural context-driven cursor movement expectations of users to reduce navigation errors, increase usability, and decrease access time.

APPLICATION

The rules set and guidelines tie theory to practice and can be applied in environments where vibration or acceleration are significant, including spacecraft, aircraft, and automobiles.

Tailoring reach-to-grasp to intended action: the role of motor practice

Motor learning results from repeated exposure to the same movement and allows a mover to increase movement optimality. Typically, this has only been considered in single-step movements. In sequential movements, an initial reach movement is tailored to the demands of the onward movement. However, the exact role of motor practice in the tailoring to onward task demands is unknown. Eighteen adults performed blocks of 15 movements; each movement consisted of a reach phase and an onward phase (the object was placed in a tight-fitting hole, placed in a loose-fitting hole or thrown). Simple practice effects were seen; for the reach phase, the amount of time spent decelerating decreased over trials, and for the onward phase, the accuracy of the place/throw movements increased over trials. Furthermore, approximately 30 % of variance in the practice effect of the onward phase could be explained by the practice effect in the reach phase. Therefore, we suggest that the changes in the reach phase are directly linked to the changes in the efficiency of action and that this is necessary but not sufficient for explaining the calibration of the onward action.

A kinematic analysis of directional effects on mouse control

The directional effects associated with cursor movement controlled by a computer mouse have long been studied to improve mouse performance during precise tasks. However, those studies have rarely considered the kinematic variables associated with directional effects and have only analysed the projection of trajectories along the main axes of movement, eventually reducing the original dimensions of the data. In addition, as the angle of approach has a limited number of levels, it has been difficult to observe singular behaviour in the horizontal directions. In this study, we investigated the directional effects on kinematic variables when using a mouse to select circular targets. In this experiment, the measured trajectory of 16 different angles of approach was measured after separating the x and y components. The results revealed interesting biomechanical and cognitive features of mouse control and led to the suggestion of two improvements to be made upon the typical mouse design.

Effects of age and psychomotor ability on kinematics of mouse-mediated aiming movement

The objective of this research is to understand the influence of age and age-related psychomotor ability on the process of mouse-mediated aiming movement. It is premised on the notions that (1) mouse-mediated aiming movements can be better understood via studying its kinematics and (2) age is a surrogate variable in kinematic differences, and that age-influenced fundamental factors such as psychomotor ability may have a more direct effect. As expected, age kinematic differences were detected. However, when comparing with age, age-influenced psychomotor ability (i.e. manual dexterity) contributed more substantially to the variances of kinematics in the ballistic phase. For homing phase, in addition to manual dexterity, age-influenced wrist-finger speed was also a significant contributor. In future studies, it is suggested that components of visual processing should be included for better understanding of its role as an age-influenced fundamental ability in aiming movements. Applications of this research are discussed.

PRACTITIONER SUMMARY

This paper presents empirical data showing age effects in movement kinematics are chiefly mediated by age-related changes in psychomotor ability. Our findings provide additional data for existing and newer performance enhancement solutions, especially for those targeting older adults.

Viewing another person's body as a target object: a behavioural and PET study of pointing

Humans usually point at objects to communicate with other persons, although they generally avoid pointing at the other's body. Moreover, patients with heterotopagnosia after left parietal damage cannot point at another person's body parts, although they can point at objects and at their own body parts and although they can grasp the others' body parts. Strikingly, their performance gradually improves for figurative human body targets. Altogether, this suggests that the body of another real person holds a specific status in communicative pointing. Here, we test in healthy individuals whether performance for communicative pointing is influenced by the communicative capacity of the target. In Experiment 1, pointing at another real person's body parts was compared to pointing at objects, and in Experiment 2, the person was replaced by a manikin. While reaction times for pointing at objects were shorter compared to pointing at other person's body parts, they were similar for objects and manikin body parts. By adapting Experiment 1 to PET-scan imaging (Experiment 3), we showed that, compared to pointing at objects, the brain network for pointing at other person's body parts involves the left posterior intraparietal sulcus, lesion of which could cause heterotopagnosia. Taken together, our results indicate that the specificity of pointing at another person's body goes beyond the visuo-spatial features of the human body and might rather rely on its communicative capacity.

The effect of direction on cursor moving kinematics

There have been only few studies to substantiate the kinematic characteristics of cursor movement. In this study, a quantitative experimental research method was used to explore the effect of moving direction on the kinematics of cursor movement in 24 typical young persons using our previously developed computerized measuring program. The results of multiple one way repeated measures ANOVAs and post hoc LSD tests demonstrated that the moving direction had effects on average velocity, movement time, movement unit and peak velocity. Moving leftward showed better efficiency than moving rightward, upward and downward from the kinematic evidences such as velocity, movement unit and time. Moreover, the unique pattern of the power spectral density (PSD) of velocity (strategy for power application) explained why the smoothness was still maintained while moving leftward even under an unstable situation with larger momentum. Moreover, the information from this cursor moving study can guide us to relocate the toolbars and icons in the window interface, especially for individuals with physical disabilities whose performances are easily interrupted while controlling the cursor in specific directions.

Test of Validity of Fitts' Index of Difficulty as a Measure of Task Difficulty

This study investigated the validity of Fitts' index of difficulty as a measure of task difficulty perceived by the performer. Eight subjects performed self-terminated horizontal elbow-extension movements toward targets of three indices of difficulty in two task conditions. In the target-size condition, triceps and biceps activities during acceleration and deceleration respectively decreased with increasing index of difficulty, resulting in a lower peak velocity and longer movement time. In the movement amplitude condition, however, triceps activity after movement onset and biceps activity during deceleration increased with increasing index of difficulty, resulting in a higher peak velocity. The movement time also increased as a function of the index of difficulty given increase in the distance traveled by the limb. These results suggest that Fitts' index of difficulty may not reflect the difficulty of task performance because its effect on the pattern of motor output is dependent upon the task variable manipulated in measuring the index of difficulty.