Sensorized toys for measuring manipulation capabilities of infants at home

Wireless Pressure Sensor Array Module for Sensorized Object

To complement rehabilitation assessments that involve hand-object interaction with additional information on the grasping parameters, we sensorized an object with a pressure sensor array module that can generate a pressure distribution map. The module can be customized for cylindrical and cuboid objects with up to 1024 sensing elements and it supports the efficient transfer of data wirelessly at more than 30 Hz. Although the module uses inexpensive materials, it is sensitive to changes in pressure distribution. It can also depict the shape of various objects with reasonable details as shown in the small errors for object pose estimation and high accuracy scores for hand grasp classification. The module's modular design and wireless functionality help to simplify integration with existing objects to create a smart sensing surface.Clinical relevance The resulting pressure distribution map allows the therapist to analyze grasping parameters that cannot be determined from visual observations alone.

Motivating Spontaneous Infant Kicking Motions through Long Term Learning Utilizing a Robotic Mobile System

Our research investigates methods and systems to allow for early detection of motor impairment in infants and innovative interventions with the goal of improving longterm outcomes. A robotic baby mobile is utilized to motivate spontaneous kicking motions, which is used as a marker for predicting the potential of motor development delays. Our previous work investigated how the different stimuli modalities of a baby mobile can encourage infant kicking. We utilized a 3D camera system to detect the kicking motions, as well as recorded specific metrics of each kicking episode. In this work, we investigate the possibility of an infant having a preference of baby mobile stimuli that results in increased and sustained kicking motions. This preference is learned over multiple sessions with one infant and utilizes a Markov Decision Process to develop a policy.

Early intervention at home in infants with congenital brain lesion with CareToy revised: a RCT protocol

BACKGROUND

Congenital brain lesions expose infants to be at high-risk for being affected by neurodevelopmental disorders such as cerebral palsy (CP). Early interventions programs can significantly impact and improve their neurodevelopment. Recently, in the framework of the European CareToy (CT) Project ( www.caretoy.eu ), a new medical device has been created to deliver an early, intensive, customized, intervention program, carried out at home by parents but remotely managed by expert and trained clinicians. Reviewing results of previous studies on preterm infants without congenital brain lesion, the CT platform has been revised and a new system created (CT-R). This study describes the protocol of a randomised controlled trial (RCT) aimed to evaluate, in a sample of infants at high-risk for CP, the efficacy of CT-R intervention compared to the Infant Massage (IM) intervention.

METHODS/DESIGN

This RCT will be multi-centre, paired and evaluator-blinded. Eligible subjects will be preterm or full-term infants with brain lesions, in first year of age with predefined specific gross motor abilities. Recruited infants will be randomized into CT-R and IM groups at baseline (T0). Based on allocation, infants will perform an 8-week programme of personalized CareToy activities or Infant Massage. The primary outcome measure will be the Infant Motor Profile. On the basis of power calculation, it will require a sample size of 42 infants. Moreover, Peabody Developmental Motor Scales-Second Edition, Teller Acuity Cards, standardized video-recordings of parent-infant interaction and wearable sensors (Actigraphs) will be included as secondary outcome measures. Finally, parents will fill out questionnaires (Bayley Social-Emotional, Parents Stress Index). All outcome measures will be carried out at the beginning (T0) and at end of 8-weeks intervention period, primary endpoint (T1). Primary outcome and some secondary outcomes will be carried out also after 2 months from T1 and at 18 months of age (T2 and T3, respectively). The Bayley Cognitive subscale will be used as additional assessment at T3.

DISCUSSION

This study protocol paper is the first study aimed to test CT-R system in infants at high-risk for CP. This paper will present the scientific background and trial methodology.

TRIAL REGISTRATION

NCT03211533 and NCT03234959 ( www.clinicaltrials.gov ).

Tele-UPCAT: study protocol of a randomised controlled trial of a home-based Tele-monitored UPper limb Children Action observation Training for participants with unilateral cerebral palsy

INTRODUCTION

A new rehabilitative approach, called UPper Limb Children Action Observation Training (UPCAT), based on the principles of action observation training (AOT), has provided promising results for upper limb rehabilitation in children with unilateral cerebral palsy (UCP). This study will investigate if a new information and communication technology platform, named Tele-UPCAT, is able to deliver AOT in a home setting and will test its efficacy on children and young people with UCP.

METHODS AND ANALYSIS

A randomised, allocation concealed (waitlist control) and evaluator-blinded clinical trial with two investigative arms will be carried out. The experimental group will perform AOT at home for 3 weeks using a customised Tele-UPCAT system where they will watch video sequences of goal-directed actions and then complete the motor training of the same actions. The control group will receive usual care for 3 weeks, which may include upper limb training. They will be offered AOT at home after 3 weeks. Twenty-four children with UCP will be recruited for 12 participants per group. The primary outcome will be measured using Assisting Hand Assessment. The Melbourne Assessment 2, ABILHAND, Participation and Environment Measure-Children and Youth and Cerebral Palsy Quality of Life Questionnaire will be included as secondary measures. Quantitative measures from sensorised objects and participants worn Actigraphs GXT3+ will be analysed. The assessment points will be the week before (T0) and after (T1) the period of AOT/standard care. Further assessments will be at T1 plus, the week after the AOT period for the waitlist group and at 8 weeks (T2) and 24 weeks (T3) after AOT training.

ETHICS AND DISSEMINATION

The trial has been approved by the Tuscany Paediatric Ethics Committee (169/2016). Publication of all outcomes will be in peer-reviewed journals and conference presentations.

TRIAL REGISTRATION

NCT03094455.

Quantifying infant physical interactions using sensorized toys in a natural play environment

Infants with developmental delays must be detected early in their development to minimize the progression of motor and neurological impairments. Our objective is to quantify how sensorized toys in a natural play environment can promote infant-toy physical interactions. We created a hanging elephant toy, equipped with an inertial measurement unit (IMU), a pressure transducer, and multiple feedback sensors, to be a hand-grasping toy. We used a 3 DoF robotic model with inputs from the IMU to calculate multiple kinematic metrics and an equation to calculate haptic metrics from the pressure transducer. Six typical infants were tested in the gym set-up. Three infants interacted with the toy for more than half the trial time. The youngest infant exhibited the largest toy displacement with ΔD = 27.6 cm, while the oldest infant squeezed the toy with the largest mean pressure of 4.5 kPa. More data on on both typical and atypical infants needs to be collected. After testing atypical infants in the SmarToyGym set-up, we will be able to identify interaction metrics that differentiate atypical and typical infants.

CareToy: Stimulation and Assessment of Preterm Infant's Activity Using a Novel Sensorized System

Early intervention programs aim at improving cognitive and motor outcomes of preterm infants. Intensive custom-tailored training activities are usually accompanied by assessment procedures, which have shortcomings, such as subjectivity, complex setups, and need for structured environments. A novel sensorized system, called CareToy, was designed to provide stimulation in the form of goal-directed activity training scenarios and motor pattern assessment of main developmental milestones, such as rolling activity, grasping, and postural stability. A group of 28 differently skilled preterm infants were enrolled. Acquired measurement data were analysed with dedicated sensor data processing algorithms, along with clinical evaluation of motor ability. High correlation among technically determined parameters and Alberta Infant Motor Scale values was determined by Pearson correlation coefficients. Due to good accuracy and possibility of single motor skill subfield analysis, results confirm system suitability for motor ability assessment. Statistical analysis of inter-motor ability group and inter-training goal data comparisons demonstrate system's appropriateness for goal-directed activity stimulation. The proposed system has evident potential of being an important contribution to the field of infant motor development assessment, expanding accessibility of early intervention programs and affecting rehabilitation effectiveness of preterm infants.