NeuroRex: a clinical neural interface roadmap for EEG-based brain machine interfaces to a lower body robotic exoskeleton

Neuro-motor controlled wearable augmentations: current research and emerging trends

Wearable augmentations (WAs) designed for movement and manipulation, such as exoskeletons and supernumerary robotic limbs, are used to enhance the physical abilities of healthy individuals and substitute or restore lost functionality for impaired individuals. Non-invasive neuro-motor (NM) technologies, including electroencephalography (EEG) and sufrace electromyography (sEMG), promise direct and intuitive communication between the brain and the WA. After presenting a historical perspective, this review proposes a conceptual model for NM-controlled WAs, analyzes key design aspects, such as hardware design, mounting methods, control paradigms, and sensory feedback, that have direct implications on the user experience, and in the long term, on the embodiment of WAs. The literature is surveyed and categorized into three main areas: hand WAs, upper body WAs, and lower body WAs. The review concludes by highlighting the primary findings, challenges, and trends in NM-controlled WAs. This review motivates researchers and practitioners to further explore and evaluate the development of WAs, ensuring a better quality of life.

A novel noninvasive brain-computer interface by imagining isometric force levels

Physiological circuits differ across increasing isometric force levels during unilateral contraction. Therefore, we first explored the possibility of predicting the force level based on electroencephalogram (EEG) activity recorded during a single trial of unilateral 5% or 40% of maximal isometric voluntary contraction (MVC) in right-hand grip imagination. Nine healthy subjects were involved in this study. The subjects were required to randomly perform 20 trials for each force level while imagining a right-hand grip. We proposed the use of common spatial patterns (CSPs) and coherence between EEG signals as features in a support vector machine for force level prediction. The results showed that the force levels could be predicted through single-trial EEGs while imagining the grip (mean accuracy = 81.4 ± 13.29%). Additionally, we tested the possibility of online control of a ball game using the above paradigm through unilateral grip imagination at different force levels (i.e., 5% of MVC imagination and 40% of MVC imagination for right-hand movement control). Subjects played the ball games effectively by controlling direction with our novel BCI system (n = 9, mean accuracy = 76.67 ± 9.35%). Data analysis validated the use of our BCI system in the online control of a ball game. This information may provide additional commands for the control of robots by users through combinations with other traditional brain-computer interfaces, e.g., different limb imaginations.

Application of Wearable Sensors in Actuation and Control of Powered Ankle Exoskeletons: A Comprehensive Review

Powered ankle exoskeletons (PAEs) are robotic devices developed for gait assistance, rehabilitation, and augmentation. To fulfil their purposes, PAEs vastly rely heavily on their sensor systems. Human–machine interface sensors collect the biomechanical signals from the human user to inform the higher level of the control hierarchy about the user’s locomotion intention and requirement, whereas machine–machine interface sensors monitor the output of the actuation unit to ensure precise tracking of the high-level control commands via the low-level control scheme. The current article aims to provide a comprehensive review of how wearable sensor technology has contributed to the actuation and control of the PAEs developed over the past two decades. The control schemes and actuation principles employed in the reviewed PAEs, as well as their interaction with the integrated sensor systems, are investigated in this review. Further, the role of wearable sensors in overcoming the main challenges in developing fully autonomous portable PAEs is discussed. Finally, a brief discussion on how the recent technology advancements in wearable sensors, including environment—machine interface sensors, could promote the future generation of fully autonomous portable PAEs is provided.

Mobile Electroencephalography for Studying Neural Control of Human Locomotion

Walking or running in real-world environments requires dynamic multisensory processing within the brain. Studying supraspinal neural pathways during human locomotion provides opportunities to better understand complex neural circuity that may become compromised due to aging, neurological disorder, or disease. Knowledge gained from studies examining human electrical brain dynamics during gait can also lay foundations for developing locomotor neurotechnologies for rehabilitation or human performance. Technical barriers have largely prohibited neuroimaging during gait, but the portability and precise temporal resolution of non-invasive electroencephalography (EEG) have expanded human neuromotor research into increasingly dynamic tasks. In this narrative mini-review, we provide a (1) brief introduction and overview of modern neuroimaging technologies and then identify considerations for (2) mobile EEG hardware, (3) and data processing, (4) including technical challenges and possible solutions. Finally, we summarize (5) knowledge gained from human locomotor control studies that have used mobile EEG, and (6) discuss future directions for real-world neuroimaging research.

Versatile Dynamic Motion Generation Framework: Demonstration With a Crutch-Less Exoskeleton on Real-Life Obstacles at the Cybathlon 2020 With a Complete Paraplegic Person

Lower-limb exoskeletons are a promising option to increase the mobility of persons with leg impairments in a near future. However, it is still challenging for them to ensure the necessary stability and agility to face obstacles, particularly the variety that makes the urban environment. That is why most of the lower-limb exoskeletons must be used with crutches: the stability and agility features are deferred to the patient. Clinical experience shows that the use of crutches not only leads to shoulder pain and exhaustion, but also fully occupies the hands for daily tasks. In November 2020, Wandercraft presented Atalante Evolution, the first self-stabilized and crutch-less exoskeleton, to the powered exoskeleton race of the Cybathlon 2020 Global Edition. The Cybathlon aims at promoting research and development in the field of powered assistive technology to the public, contrary to the Paralympics where only participants with unpowered assistive technology are allowed. The race is designed to represent the challenges that a person could face every day in their environment: climbing stairs, walking through rough terrain, or descending ramps. Atalante Evolution is a 12 degree-of-freedom exoskeleton capable of moving dynamically with a complete paraplegic person. The challenge of this competition is to generate and execute new dynamic motions in a short time, to achieve different tasks. In this paper, an overview of Atalante Evolution system and of our framework for dynamic trajectory generation based on the direct collocation method will be presented. Next, the flexibility and efficiency of the dynamic motion generation framework are demonstrated by our tools developed for generating the important variety of stable motions required by the competition. A smartphone application has been developed to allow the pilot to choose between different modes and to control the motion direction according to the real situation to reach a destination. The advanced mechatronic design and the active cooperation of the pilot with the device will also be highlighted. As a result, Atalante Evolution allowed the pilot to complete four out of six obstacles, without crutches. Our developments lead to stable dynamic movements of the exoskeleton, hands-free walking, more natural stand-up and turning moves, and consequently a better physical condition of the pilot after the race compared to the challengers. The versatility and good results of these developments give hope that exoskeletons will soon be able to evolve in challenging everyday-life environments, allowing patients to live a normal life in complete autonomy.

Systematic review on wearable lower-limb exoskeletons for gait training in neuromuscular impairments

Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what is the methodology used in the clinical validations of wearable lower-limb exoskeletons?, and (3) what are the benefits and current evidence on clinical efficacy of wearable lower-limb exoskeletons? We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.

A Systematic Review Establishing the Current State-of-the-Art, the Limitations, and the DESIRED Checklist in Studies of Direct Neural Interfacing With Robotic Gait Devices in Stroke Rehabilitation

Background: Stroke is a disease with a high associated disability burden. Robotic-assisted gait training offers an opportunity for the practice intensity levels associated with good functional walking outcomes in this population. Neural interfacing technology, electroencephalography (EEG), or electromyography (EMG) can offer new strategies for robotic gait re-education after a stroke by promoting more active engagement in movement intent and/or neurophysiological feedback. Objectives: This study identifies the current state-of-the-art and the limitations in direct neural interfacing with robotic gait devices in stroke rehabilitation. Methods: A pre-registered systematic review was conducted using standardized search operators that included the presence of stroke and robotic gait training and neural biosignals (EMG and/or EEG) and was not limited by study type. Results: From a total of 8,899 papers identified, 13 articles were considered for the final selection. Only five of the 13 studies received a strong or moderate quality rating as a clinical study. Three studies recorded EEG activity during robotic gait, two of which used EEG for BCI purposes. While demonstrating utility for decoding kinematic and EMG-related gait data, no EEG study has been identified to close the loop between robot and human. Twelve of the studies recorded EMG activity during or after robotic walking, primarily as an outcome measure. One study used multisource information fusion from EMG, joint angle, and force to modify robotic commands in real time, with higher error rates observed during active movement. A novel study identified used EMG data during robotic gait to derive the optimal, individualized robot-driven step trajectory. Conclusions: Wide heterogeneity in the reporting and the purpose of neurobiosignal use during robotic gait training after a stroke exists. Neural interfacing with robotic gait after a stroke demonstrates promise as a future field of study. However, as a nascent area, direct neural interfacing with robotic gait after a stroke would benefit from a more standardized protocol for biosignal collection and processing and for robotic deployment. Appropriate reporting for clinical studies of this nature is also required with respect to the study type and the participants' characteristics.

Prediction of gait intention from pre-movement EEG signals: a feasibility study

BACKGROUND

Prediction of Gait intention from pre-movement Electroencephalography (EEG) signals is a vital step in developing a real-time Brain-computer Interface (BCI) for a proper neuro-rehabilitation system. In that respect, this paper investigates the feasibility of a fully predictive methodology to detect the intention to start and stop a gait cycle by utilizing EEG signals obtained before the event occurrence.

METHODS

An eight-channel, custom-made, EEG system with electrodes placed around the sensorimotor cortex was used to acquire EEG data from six healthy subjects and two amputees. A discrete wavelet transform-based method was employed to capture event related information in alpha and beta bands in the time-frequency domain. The Hjorth parameters, namely activity, mobility, and complexity, were extracted as features while a two-sample unpaired Wilcoxon test was used to get rid of redundant features for better classification accuracy. The feature set thus obtained was then used to classify between 'walk vs. stop' and 'rest vs. start' classes using support vector machine (SVM) classifier with RBF kernel in a ten-fold cross-validation scheme.

RESULTS

Using a fully predictive intention detection system, 76.41±4.47% accuracy, 72.85±7.48% sensitivity, and 79.93±5.50% specificity were achieved for 'rest vs. start' classification. While for 'walk vs. stop' classification, the obtained mean accuracy, sensitivity, and specificity were 74.12±4.12%, 70.24±6.45%, and 77.78±7.01% respectively. Overall average True Positive Rate achieved by this methodology was 72.06±8.27% with 1.45 False Positives/min.

CONCLUSION

Extensive simulations and resulting classification results show that it is possible to achieve statistically similar intention detection accuracy using either only pre-movement EEG features or trans-movement EEG features. The classifier performance shows the potential of the proposed methodology to predict human movement intention exclusively from the pre-movement EEG signal to be applied in real-life prosthetic and neuro-rehabilitation systems.

Decoding Movement From Electrocorticographic Activity: A Review

Electrocorticography (ECoG) holds promise to provide efficient neuroprosthetic solutions for people suffering from neurological disabilities. This recording technique combines adequate temporal and spatial resolution with the lower risks of medical complications compared to the other invasive methods. ECoG is routinely used in clinical practice for preoperative cortical mapping in epileptic patients. During the last two decades, research utilizing ECoG has considerably grown, including the paradigms where behaviorally relevant information is extracted from ECoG activity with decoding algorithms of different complexity. Several research groups have advanced toward the development of assistive devices driven by brain-computer interfaces (BCIs) that decode motor commands from multichannel ECoG recordings. Here we review the evolution of this field and its recent tendencies, and discuss the potential areas for future development.

Brain-machine interfaces for controlling lower-limb powered robotic systems

OBJECTIVE

Lower-limb, powered robotics systems such as exoskeletons and orthoses have emerged as novel robotic interventions to assist or rehabilitate people with walking disabilities. These devices are generally controlled by certain physical maneuvers, for example pressing buttons or shifting body weight. Although effective, these control schemes are not what humans naturally use. The usability and clinical relevance of these robotics systems could be further enhanced by brain-machine interfaces (BMIs). A number of preliminary studies have been published on this topic, but a systematic understanding of the experimental design, tasks, and performance of BMI-exoskeleton systems for restoration of gait is lacking.

APPROACH

To address this gap, we applied standard systematic review methodology for a literature search in PubMed and EMBASE databases and identified 11 studies involving BMI-robotics systems. The devices, user population, input and output of the BMIs and robot systems respectively, neural features, decoders, denoising techniques, and system performance were reviewed and compared.

MAIN RESULTS

Results showed BMIs classifying walk versus stand tasks are the most common. The results also indicate that electroencephalography (EEG) is the only recording method for humans. Performance was not clearly presented in most of the studies. Several challenges were summarized, including EEG denoising, safety, responsiveness and others.

SIGNIFICANCE

We conclude that lower-body powered exoskeletons with automated gait intention detection based on BMIs open new possibilities in the assistance and rehabilitation fields, although the current performance, clinical benefits and several key challenging issues indicate that additional research and development is required to deploy these systems in the clinic and at home. Moreover, rigorous EEG denoising techniques, suitable performance metrics, consistent trial reporting, and more clinical trials are needed to advance the field.

Online adaptive neural control of a robotic lower limb prosthesis

OBJECTIVE

The purpose of this study was to develop and evaluate an adaptive intent recognition algorithm that continuously learns to incorporate a lower limb amputee's neural information (acquired via electromyography (EMG)) as they ambulate with a robotic leg prosthesis.

APPROACH

We present a powered lower limb prosthesis that was configured to acquire the user's neural information and kinetic/kinematic information from embedded mechanical sensors, and identify and respond to the user's intent. We conducted an experiment with eight transfemoral amputees over multiple days. EMG and mechanical sensor data were collected while subjects using a powered knee/ankle prosthesis completed various ambulation activities such as walking on level ground, stairs, and ramps. Our adaptive intent recognition algorithm automatically transitioned the prosthesis into the different locomotion modes and continuously updated the user's model of neural data during ambulation.

MAIN RESULTS

Our proposed algorithm accurately and consistently identified the user's intent over multiple days, despite changing neural signals. The algorithm incorporated 96.31% [0.91%] (mean, [standard error]) of neural information across multiple experimental sessions, and outperformed non-adaptive versions of our algorithm-with a 6.66% [3.16%] relative decrease in error rate.

SIGNIFICANCE

This study demonstrates that our adaptive intent recognition algorithm enables incorporation of neural information over long periods of use, allowing assistive robotic devices to accurately respond to the user's intent with low error rates.

Differences in neuroplasticity after spinal cord injury in varying animal models and humans

Rats have been the primary model to study the process and underlying mechanisms of recovery after spinal cord injury. Two weeks after a severe spinal cord contusion, rats can regain weight-bearing abilities without therapeutic interventions, as assessed by the Basso, Beattie and Bresnahan locomotor scale. However, many human patients suffer from permanent loss of motor function following spinal cord injury. While rats are the most understood animal model, major differences in sensorimotor pathways between quadrupeds and bipeds need to be considered. Understanding the major differences between the sensorimotor pathways of rats, non-human primates, and humans is a start to improving targets for treatments of human spinal cord injury. This review will discuss the neuroplasticity of the brain and spinal cord after spinal cord injury in rats, non-human primates, and humans. A brief overview of emerging interventions to induce plasticity in humans with spinal cord injury will also be discussed.

EEG-Based BCI Control Schemes for Lower-Limb Assistive-Robots

Over recent years, brain-computer interface (BCI) has emerged as an alternative communication system between the human brain and an output device. Deciphered intents, after detecting electrical signals from the human scalp, are translated into control commands used to operate external devices, computer displays and virtual objects in the real-time. BCI provides an augmentative communication by creating a muscle-free channel between the brain and the output devices, primarily for subjects having neuromotor disorders, or trauma to nervous system, notably spinal cord injuries (SCI), and subjects with unaffected sensorimotor functions but disarticulated or amputated residual limbs. This review identifies the potentials of electroencephalography (EEG) based BCI applications for locomotion and mobility rehabilitation. Patients could benefit from its advancements such as wearable lower-limb (LL) exoskeletons, orthosis, prosthesis, wheelchairs, and assistive-robot devices. The EEG communication signals employed by the aforementioned applications that also provide feasibility for future development in the field are sensorimotor rhythms (SMR), event-related potentials (ERP) and visual evoked potentials (VEP). The review is an effort to progress the development of user's mental task related to LL for BCI reliability and confidence measures. As a novel contribution, the reviewed BCI control paradigms for wearable LL and assistive-robots are presented by a general control framework fitting in hierarchical layers. It reflects informatic interactions, between the user, the BCI operator, the shared controller, the robotic device and the environment. Each sub layer of the BCI operator is discussed in detail, highlighting the feature extraction, classification and execution methods employed by the various systems. All applications' key features and their interaction with the environment are reviewed for the EEG-based activity mode recognition, and presented in form of a table. It is suggested to structure EEG-BCI controlled LL assistive devices within the presented framework, for future generation of intent-based multifunctional controllers. Despite the development of controllers, for BCI-based wearable or assistive devices that can seamlessly integrate user intent, practical challenges associated with such systems exist and have been discerned, which can be constructive for future developments in the field.

Effects of Cable Sway, Electrode Surface Area, and Electrode Mass on Electroencephalography Signal Quality during Motion

More neuroscience researchers are using scalp electroencephalography (EEG) to measure electrocortical dynamics during human locomotion and other types of movement. Motion artifacts corrupt the EEG and mask underlying neural signals of interest. The cause of motion artifacts in EEG is often attributed to electrode motion relative to the skin, but few studies have examined EEG signals under head motion. In the current study, we tested how motion artifacts are affected by the overall mass and surface area of commercially available electrodes, as well as how cable sway contributes to motion artifacts. To provide a ground-truth signal, we used a gelatin head phantom with embedded antennas broadcasting electrical signals, and recorded EEG with a commercially available electrode system. A robotic platform moved the phantom head through sinusoidal displacements at different frequencies (0–2 Hz). Results showed that a larger electrode surface area can have a small but significant effect on improving EEG signal quality during motion and that cable sway is a major contributor to motion artifacts. These results have implications in the development of future hardware for mobile brain imaging with EEG.

The Development and Preliminary Test of a Powered Alternately Walking Exoskeleton With the Wheeled Foot for Paraplegic Patients

Upright walking has both physical and social meanings for paraplegic patients. The main purpose of this paper is to reduce the automatic functioning of the powered exoskeleton and enable the user to fully control the walking procedure in real-time, aiming to further improve the engagement of the patient during rehabilitation training. For this prototype, a custom-made hub motor was placed at the bottom of the exoskeleton's foot, and a pair of crutches with the embedded wireless controller were utilized as the auxiliary device. The user could alternatively press the button of the crutch to control the movement of the leg and by repeating this procedure, the user could complete a continuous walking motion. For safety, an automatic brake and mechanical limitation for maximum step length were implemented. A gait analysis was performed to evaluate the exoskeleton's motion capability and corresponding response of user's major muscles. The kinematic results of this paper showed that this exoskeleton could assist the user to walk in a motion trend close to the normally walk, especially for ankle joint. The electromyography results indicated that this exoskeleton could decrease the loading burden of the user's lower limb while requiring more involvements of upper-limb muscles to maintain balance while walking.

Unscented Kalman filter for neural decoding of human treadmill walking from non-invasive electroencephalography

The feasibility of decoding lower limb kinematics in human treadmill walking from noninvasive electroencephalography (EEG) has been demonstrated with linear Wiener filter. However, nonlinear relationship between neural activities and limb movements may challenge the linear decoders in real-time brain computer interface (BCI) applications. In this study, we propose a nonlinear neural decoder using an Unscented Kalman Filter (UKF) to infer lower limb joint angles from noninvasive scalp EEG signals during human treadmill walking. Our results demonstrate that lower limb joint angles during treadmill walking can be decoded from the fluctuations in the amplitude of slow cortical potentials in the delta band (0.1-3Hz). Overall, the average decoding accuracy were 0.43 ± 0.18 for Pearson's r value and 1.82 ± 3.07 for signal to noise ratio (SNR), and robust to ocular, muscle, or movement artifacts. Moreover, the signal preprocessing scheme and the design of UKF allow the implementation of the proposed EEG-based BCI for real-time applications. This has implications for the development of closed-loop EEG-based BCI systems for gait rehabilitation after stroke.

A muscle-driven approach to restore stepping with an exoskeleton for individuals with paraplegia

BACKGROUND

Functional neuromuscular stimulation, lower limb orthosis, powered lower limb exoskeleton, and hybrid neuroprosthesis (HNP) technologies can restore stepping in individuals with paraplegia due to spinal cord injury (SCI). However, a self-contained muscle-driven controllable exoskeleton approach based on an implanted neural stimulator to restore walking has not been previously demonstrated, which could potentially result in system use outside the laboratory and viable for long term use or clinical testing. In this work, we designed and evaluated an untethered muscle-driven controllable exoskeleton to restore stepping in three individuals with paralysis from SCI.

METHODS

The self-contained HNP combined neural stimulation to activate the paralyzed muscles and generate joint torques for limb movements with a controllable lower limb exoskeleton to stabilize and support the user. An onboard controller processed exoskeleton sensor signals, determined appropriate exoskeletal constraints and stimulation commands for a finite state machine (FSM), and transmitted data over Bluetooth to an off-board computer for real-time monitoring and data recording. The FSM coordinated stimulation and exoskeletal constraints to enable functions, selected with a wireless finger switch user interface, for standing up, standing, stepping, or sitting down. In the stepping function, the FSM used a sensor-based gait event detector to determine transitions between gait phases of double stance, early swing, late swing, and weight acceptance.

RESULTS

The HNP restored stepping in three individuals with motor complete paralysis due to SCI. The controller appropriately coordinated stimulation and exoskeletal constraints using the sensor-based FSM for subjects with different stimulation systems. The average range of motion at hip and knee joints during walking were 8.5°-20.8° and 14.0°-43.6°, respectively. Walking speeds varied from 0.03 to 0.06 m/s, and cadences from 10 to 20 steps/min.

CONCLUSIONS

A self-contained muscle-driven exoskeleton was a feasible intervention to restore stepping in individuals with paraplegia due to SCI. The untethered hybrid system was capable of adjusting to different individuals' needs to appropriately coordinate exoskeletal constraints with muscle activation using a sensor-driven FSM for stepping. Further improvements for out-of-the-laboratory use should include implantation of plantar flexor muscles to improve walking speed and power assist as needed at the hips and knees to maintain walking as muscles fatigue.

Multiple Kernel Based Region Importance Learning for Neural Classification of Gait States from EEG Signals

With the development of Brain Machine Interface (BMI) systems, people with motor disabilities are able to control external devices to help them restore movement abilities. Longitudinal validation of these systems is critical not only to assess long-term performance reliability but also to investigate adaptations in electrocortical patterns due to learning to use the BMI system. In this paper, we decode the patterns of user's intended gait states (e.g., stop, walk, turn left, and turn right) from scalp electroencephalography (EEG) signals and simultaneously learn the relative importance of different brain areas by using the multiple kernel learning (MKL) algorithm. The region of importance (ROI) is identified during training the MKL for classification. The efficacy of the proposed method is validated by classifying different movement intentions from two subjects—an able-bodied and a spinal cord injury (SCI) subject. The preliminary results demonstrate that frontal and fronto-central regions are the most important regions for the tested subjects performing gait movements, which is consistent with the brain regions hypothesized to be involved in the control of lower-limb movements. However, we observed some regional changes comparing the able-bodied and the SCI subject. Moreover, in the longitudinal experiments, our findings exhibit the cortical plasticity triggered by the BMI use, as the classification accuracy and the weights for important regions—in sensor space—generally increased, as the user learned to control the exoskeleton for movement over multiple sessions.

A convolutional neural network for steady state visual evoked potential classification under ambulatory environment

The robust analysis of neural signals is a challenging problem. Here, we contribute a convolutional neural network (CNN) for the robust classification of a steady-state visual evoked potentials (SSVEPs) paradigm. We measure electroencephalogram (EEG)-based SSVEPs for a brain-controlled exoskeleton under ambulatory conditions in which numerous artifacts may deteriorate decoding. The proposed CNN is shown to achieve reliable performance under these challenging conditions. To validate the proposed method, we have acquired an SSVEP dataset under two conditions: 1) a static environment, in a standing position while fixated into a lower-limb exoskeleton and 2) an ambulatory environment, walking along a test course wearing the exoskeleton (here, artifacts are most challenging). The proposed CNN is compared to a standard neural network and other state-of-the-art methods for SSVEP decoding (i.e., a canonical correlation analysis (CCA)-based classifier, a multivariate synchronization index (MSI), a CCA combined with k-nearest neighbors (CCA-KNN) classifier) in an offline analysis. We found highly encouraging SSVEP decoding results for the CNN architecture, surpassing those of other methods with classification rates of 99.28% and 94.03% in the static and ambulatory conditions, respectively. A subsequent analysis inspects the representation found by the CNN at each layer and can thus contribute to a better understanding of the CNN’s robust, accurate decoding abilities.

Development of an Intraoral Interface for Human-Ability Extension Robots

[abstFig src='/00280006/05.jpg' width='300' text='The headset type intraoral interface' ] An extra degree of freedom to human body movement could assist people in a variety of tasks. To this end, we have previously proposed a human-ability extension system through a supernumerary limb. The system comprises of a manipulator that acts as a third arm, a feedback device that displays its status, and an interface that allows for its hands-free operation. Herein, we present this novel, intraoral interface that utilizes tongue motions and expiratory pressure. In contrast to the conventional intraoral interfaces that suffer from a lack of degrees of freedom and stability, our advanced interface is equipped with inertial measurement units and a pressure sensor to solve these problems without sacrificing the ease of use. The proposed interface is utile not only in our ongoing “Third Arm” project, but also in various other applications. We conclude with experimental evaluation of the system’s usability and its efficacy for human-ability extension systems.

A Mixed-Signal VLSI System for Producing Temporally Adapting Intraspinal Microstimulation Patterns for Locomotion

Neural pathways can be artificially activated through the use of electrical stimulation. For individuals with a spinal cord injury, intraspinal microstimulation, using electrical currents on the order of 125 μ A, can produce muscle contractions and joint torques in the lower extremities suitable for restoring walking. The work presented here demonstrates an integrated circuit implementing a state-based control strategy where sensory feedback and intrinsic feed forward control shape the stimulation waveforms produced on-chip. Fabricated in a 0.5 μ m process, the device was successfully used in vivo to produce walking movements in a model of spinal cord injury. This work represents progress towards an implantable solution to be used for restoring walking in individuals with spinal cord injuries.

The Evolution of Neuroprosthetic Interfaces

The ideal neuroprosthetic interface permits high-quality neural recording and stimulation of the nervous system while reliably providing clinical benefits over chronic periods. Although current technologies have made notable strides in this direction, significant improvements must be made to better achieve these design goals and satisfy clinical needs. This article provides an overview of the state of neuroprosthetic interfaces, starting with the design and placement of these interfaces before exploring the stimulation and recording platforms yielded from contemporary research. Finally, we outline emerging research trends in an effort to explore the potential next generation of neuroprosthetic interfaces.

Electrocortical activity distinguishes between uphill and level walking in humans

The objective of this study was to determine if electrocortical activity is different between walking on an incline compared with level surface. Subjects walked on a treadmill at 0% and 15% grades for 30 min while we recorded electroencephalography (EEG). We used independent component (IC) analysis to parse EEG signals into maximally independent sources and then computed dipole estimations for each IC. We clustered cortical source ICs and analyzed event-related spectral perturbations synchronized to gait events. Theta power fluctuated across the gait cycle for both conditions, but was greater during incline walking in the anterior cingulate, sensorimotor and posterior parietal clusters. We found greater gamma power during level walking in the left sensorimotor and anterior cingulate clusters. We also found distinct alpha and beta fluctuations, depending on the phase of the gait cycle for the left and right sensorimotor cortices, indicating cortical lateralization for both walking conditions. We validated the results by isolating movement artifact. We found that the frequency activation patterns of the artifact were different than the actual EEG data, providing evidence that the differences between walking conditions were cortically driven rather than a residual artifact of the experiment. These findings suggest that the locomotor pattern adjustments necessary to walk on an incline compared with level surface may require supraspinal input, especially from the left sensorimotor cortex, anterior cingulate, and posterior parietal areas. These results are a promising step toward the use of EEG as a feed-forward control signal for ambulatory brain-computer interface technologies.

A lower limb exoskeleton control system based on steady state visual evoked potentials

OBJECTIVE

We have developed an asynchronous brain-machine interface (BMI)-based lower limb exoskeleton control system based on steady-state visual evoked potentials (SSVEPs).

APPROACH

By decoding electroencephalography signals in real-time, users are able to walk forward, turn right, turn left, sit, and stand while wearing the exoskeleton. SSVEP stimulation is implemented with a visual stimulation unit, consisting of five light emitting diodes fixed to the exoskeleton. A canonical correlation analysis (CCA) method for the extraction of frequency information associated with the SSVEP was used in combination with k-nearest neighbors.

MAIN RESULTS

Overall, 11 healthy subjects participated in the experiment to evaluate performance. To achieve the best classification, CCA was first calibrated in an offline experiment. In the subsequent online experiment, our results exhibit accuracies of 91.3 ± 5.73%, a response time of 3.28 ± 1.82 s, an information transfer rate of 32.9 ± 9.13 bits/min, and a completion time of 1100 ± 154.92 s for the experimental parcour studied.

SIGNIFICANCE

The ability to achieve such high quality BMI control indicates that an SSVEP-based lower limb exoskeleton for gait assistance is becoming feasible.

Real-time strap pressure sensor system for powered exoskeletons

Assistive and rehabilitative powered exoskeletons for spinal cord injury (SCI) and stroke subjects have recently reached the clinic. Proper tension and joint alignment are critical to ensuring safety. Challenges still exist in adjustment and fitting, with most current systems depending on personnel experience for appropriate individual fastening. Paraplegia and tetraplegia patients using these devices have impaired sensation and cannot signal if straps are uncomfortable or painful. Excessive pressure and blood-flow restriction can lead to skin ulcers, necrotic tissue and infections. Tension must be just enough to prevent slipping and maintain posture. Research in pressure dynamics is extensive for wheelchairs and mattresses, but little research has been done on exoskeleton straps. We present a system to monitor pressure exerted by physical human-machine interfaces and provide data about levels of skin/body pressure in fastening straps. The system consists of sensing arrays, signal processing hardware with wireless transmission, and an interactive GUI. For validation, a lower-body powered exoskeleton carrying the full weight of users was used. Experimental trials were conducted with one SCI and one able-bodied subject. The system can help prevent skin injuries related to excessive pressure in mobility-impaired patients using powered exoskeletons, supporting functionality, independence and better overall quality of life.

Extraction of time and frequency features from grip force rates during dexterous manipulation

The time course of grip force from object contact to onset of manipulation has been extensively studied to gain insight into the underlying control mechanisms. Of particular interest to the motor neuroscience and clinical communities is the phenomenon of bell-shaped grip force rate (GFR) that has been interpreted as indicative of feedforward force control. However, this feature has not been assessed quantitatively. Furthermore, the time course of grip force may contain additional features that could provide insight into sensorimotor control processes. In this study, we addressed these questions by validating and applying two computational approaches to extract features from GFR in humans: 1) fitting a Gaussian function to GFR and quantifying the goodness of the fit [root-mean-square error, (RMSE)]; and 2) continuous wavelet transform (CWT), where we assessed the correlation of the GFR signal with a Mexican Hat function. Experiment 1 consisted of a classic pseudorandomized presentation of object mass (light or heavy), where grip forces developed to lift a mass heavier than expected are known to exhibit corrective responses. For Experiment 2, we applied our two techniques to analyze grip force exerted for manipulating an inverted T-shaped object whose center of mass was changed across blocks of consecutive trials. For both experiments, subjects were asked to grasp the object at either predetermined or self-selected grasp locations ("constrained" and "unconstrained" task, respectively). Experiment 1 successfully validated the use of RMSE and CWT as they correctly distinguished trials with versus without force corrective responses. RMSE and CWT also revealed that grip force is characterized by more feedback-driven corrections when grasping at self-selected contact points. Future work will examine the application of our analytical approaches to a broader range of tasks, e.g., assessment of recovery of sensorimotor function following clinical intervention, interlimb differences in force control, and force coordination in human-machine interactions.

Control strategies for active lower extremity prosthetics and orthotics: a review

: Technological advancements have led to the development of numerous wearable robotic devices for the physical assistance and restoration of human locomotion. While many challenges remain with respect to the mechanical design of such devices, it is at least equally challenging and important to develop strategies to control them in concert with the intentions of the user.This work reviews the state-of-the-art techniques for controlling portable active lower limb prosthetic and orthotic (P/O) devices in the context of locomotive activities of daily living (ADL), and considers how these can be interfaced with the user's sensory-motor control system. This review underscores the practical challenges and opportunities associated with P/O control, which can be used to accelerate future developments in this field. Furthermore, this work provides a classification scheme for the comparison of the various control strategies.As a novel contribution, a general framework for the control of portable gait-assistance devices is proposed. This framework accounts for the physical and informatic interactions between the controller, the user, the environment, and the mechanical device itself. Such a treatment of P/Os--not as independent devices, but as actors within an ecosystem--is suggested to be necessary to structure the next generation of intelligent and multifunctional controllers.Each element of the proposed framework is discussed with respect to the role that it plays in the assistance of locomotion, along with how its states can be sensed as inputs to the controller. The reviewed controllers are shown to fit within different levels of a hierarchical scheme, which loosely resembles the structure and functionality of the nominal human central nervous system (CNS). Active and passive safety mechanisms are considered to be central aspects underlying all of P/O design and control, and are shown to be critical for regulatory approval of such devices for real-world use.The works discussed herein provide evidence that, while we are getting ever closer, significant challenges still exist for the development of controllers for portable powered P/O devices that can seamlessly integrate with the user's neuromusculoskeletal system and are practical for use in locomotive ADL.

Powered Lower-Limb Exoskeletons to Restore Gait for Individuals with Paraplegia - a Review

Individuals with paraplegia due to spinal cord injury rank restoration of walking high on the list of priorities to improving their quality of life. Powered lower-limb exoskeleton technology provides the ability to restore standing up, sitting down, and walking movements for individuals with paraplegia. The robotic exoskeletons generally have electrical motors located at the hip and knee joint centers, which move the wearers' lower limbs through the appropriate range of motion for gait according to control systems using either trajectory control or impedance control. Users of exoskeletons are able to walk at average gait speeds of 0.26 m/s and distances ranging between 121-171 m. However, the achieved gait speeds and distances fall short of those required for full community ambulation (0.8 m/s and at least 230 m), restricting use of the devices to limited community use with stand-by assist or supervised rehabilitation settings. Improvement in the gait speed and distance may be achievable by combining a specially designed powered exoskeleton with neuromuscular stimulation technologies resulting in a hybrid system that fully engages the user and achieves the necessary requirements to ambulate in the community environment with benefits of muscle contraction.

Identifying Engineering, Clinical and Patient's Metrics for Evaluating and Quantifying Performance of Brain-Machine Interface (BMI) Systems

Brain-machine interface (BMI) devices have unparalleled potential to restore functional movement capabilities to stroke, paralyzed and amputee patients. Although BMI systems have achieved success in a handful of investigative studies, translation of closed-loop neuroprosthetic devices from the laboratory to the market is challenged by gaps in the scientific data regarding long-term device reliability and safety, uncertainty in the regulatory, market and reimbursement pathways, lack of metrics for evaluating and quantifying performance in BMI systems, as well as patient-acceptance challenges that impede their fast and effective translation to the end user. This review focuses on the identification of engineering, clinical and user's BMI metrics for new and existing BMI applications.