Transitioning to a microprocessor-controlled prosthetic knee: Executive functioning during single and dual-task gait

Using mobile eye tracking to measure cognitive load through gaze behavior during walking in lower limb prosthesis users: A preliminary assessment

BACKGROUND

Lower limb amputation does not affect only physical and psychological functioning but the use of a prosthetic device can also lead to increased cognitive demands. Measuring cognitive load objectively is challenging, and therefore, most studies use questionnaires that are easy to apply but can suffer from subjective bias. Motivated by this, the present study investigated whether a mobile eye tracker can be used to objectively measure cognitive load by monitoring gaze behavior during a set of motor tasks.

METHODS

Five prosthetic users and eight able-bodied controls participated in this study. Eye tracking data and kinematics were recorded during a set of motor tasks (level ground walking, walking on uneven terrain, obstacle avoidance, stairs up and ramp down, as well as ramp up and stairs down) while the participants were asked to focus their gaze on a visual target for as long as possible. Target fixation times and increase in pupil diameters were determined and correlated to subjective ratings of cognitive load.

FINDINGS

Overall, target fixation time and pupil diameter showed strong negative and positive correlations, respectively, to the subjective rating of cognitive load in the able-bodied controls (-0.75 and 0.80, respectively). However, the individual correlation strength, and in some cases, even the sign, was different across participants. A similar trend could be observed in prosthetic users.

INTERPRETATION

The results of this study showed that a mobile eye tracker may be used to estimate cognitive load in prosthesis users during locomotor tasks. This paves the way to establish a new approach to assessing cognitive load, which is objective and yet practical and simple to administer. Nevertheless, future studies should corroborate these results by comparing them to other objective measures as well as focus on translating the proposed approach outside of a laboratory.

Gender differences in cognitive and affective interpersonal emotion regulation in couples: an fNIRS hyperscanning

Emotion regulation is vital in maintaining romantic relationships in couples. Although gender differences exist in cognitive and affective strategies during 'intrapersonal' emotion regulation, it is unclear how gender differences through affective bonds work in 'interpersonal' emotion regulation (IER) in couples. Thirty couple dyads and 30 stranger dyads underwent functional near-infrared spectroscopy hyperscanning recordings when targets complied with their partner's cognitive engagement (CE) and affective engagement (AE) strategies after viewing sad and neutral videos. Behaviorally, for males, CE was less effective than AE in both groups, but little difference occurred for females between AE and CE. For couples, Granger causality analysis showed that male targets had less neural activity than female targets in CH06, CH13 and CH17 during CE. For inflow and outflow activities on CH06 and CH13 (frontopolar cortex), respectively, male targets had less activity in the CE condition than in the AE condition, while for outflow activities on CH 17 (dorsolateral prefrontal cortex), female targets had more activity in the CE condition than in the AE condition. However, these differences were not observed in strangers. These results suggest gender differences in CE but not in AE and dissociable flow patterns in male and female targets in couples during sadness regulation.

Affective or cognitive interpersonal emotion regulation in couples: an fNIRS hyperscanning study

Sadness regulation is crucial for maintaining the romantic relationships of couples. Interpersonal emotion regulation, including affective engagement (AE) and cognitive engagement (CE), activates social brain networks. However, it is unclear how AE and CE regulate sadness in couples through affective bonds. We recruited 30 heterosexual couple dyads and 30 heterosexual stranger dyads and collected functional near-infrared spectroscopy hyperscanning data while each dyad watched sad or neutral videos and while the regulator regulated the target's sadness. Then, we characterized interbrain synchronization (IBS) and Granger causality (GC). The results indicated that AE and CE were more effective for couples than for strangers and that sadness evaluation of female targets was lower than that of male targets. CE-induced IBS at CH13 (BA10, right middle frontal gyrus) was lower for female targets than for male targets, while no gender difference in AE was detected. GC change at CH13 during CE was lower in the sad condition for male targets than for female targets, while no gender difference in AE was discovered. These observations suggest that AE and CE activate affective bonds but that CE was more effective for regulating sadness in female targets, revealing different neural patterns of cognitive and affective sadness regulation in couples.

A review of user needs to drive the development of lower limb prostheses

Background

The development of bionic legs has seen substantial improvements in the past years but people with lower-limb amputation still suffer from impairments in mobility (e.g., altered balance and gait control) due to significant limitations of the contemporary prostheses. Approaching the problem from a human-centered perspective by focusing on user-specific needs can allow identifying critical improvements that can increase the quality of life. While there are several reviews of user needs regarding upper limb prostheses, a comprehensive summary of such needs for those affected by lower limb loss does not exist.

Methods

We have conducted a systematic review of the literature to extract important needs of the users of lower-limb prostheses. The review included 56 articles in which a need (desire, wish) was reported explicitly by the recruited people with lower limb amputation (N = 8149).

Results

An exhaustive list of user needs was collected and subdivided into functional, psychological, cognitive, ergonomics, and other domain. Where appropriate, we have also briefly discussed the developments in prosthetic devices that are related to or could have an impact on those needs. In summary, the users would like to lead an independent life and reintegrate into society by coming back to work and participating in social and leisure activities. Efficient, versatile, and stable gait, but also support to other activities (e.g., sit to stand), contribute to safety and confidence, while appearance and comfort are important for the body image. However, the relation between specific needs, objective measures of performance, and overall satisfaction and quality of life is still an open question.

Conclusions

Identifying user needs is a critical step for the development of new generation lower limb prostheses that aim to improve the quality of life of their users. However, this is not a simple task, as the needs interact with each other and depend on multiple factors (e.g., mobility level, age, gender), while evolving in time with the use of the device. Hence, novel assessment methods are required that can evaluate the impact of the system from a holistic perspective, capturing objective outcomes but also overall user experience and satisfaction in the relevant environment (daily life).

Finger orthoses for management of joint hypermobility disorders: Relative effects on hand function and cognitive load

BACKGROUND

Joint hypermobility refers to joints that move beyond their normal limits. Individuals with hypermobility of the fingers experience difficulties in activities of daily living. Finger orthoses are available for managing hypermobility of the fingers, but their effectiveness has received little attention in scholarly literature.

OBJECTIVES

To determine if use of custom fit finger orthoses leads to improvements in time needed to perform standardised hand function tests, and attentional demand required to perform these tests, in individuals with joint hypermobility syndrome, Hypermobile Ehlers-Danlos syndrome or Classical Ehlers-Danlos syndrome.

STUDY DESIGN

Repeated-measures study.

METHODS

Fourteen participants performed three different hand function tests (target box and block test, writing and picking up coins), with and without their finger orthoses. Time to complete each test was recorded as a measure of functional performance. Brain activity was recorded in the pre-frontal cortices as a measure of attentional demand.

RESULTS

Functional performance significantly improved for all but one test (picking up coins with non-dominant hand) when participants wore finger orthoses (p < 0.05). Activity in the pre-frontal cortex was lower when using the orthosis to perform the coin test (dominant hand; p < 0.05). No differences were observed in other tests (p > 0.05).

CONCLUSIONS

Results suggested that finger orthoses improved hand function and provided limited evidence to suggest that they may also affect attentional demand. While the limited sample does not provide conclusive evidence supporting the use of finger orthosis in this clinical population, results warrant further investigation in large scale longitudinal studies or randomised controlled trials.