A wireless lingual feedback device to reduce overpressures in seated posture: a feasibility study

Development of a sitting posture monitoring system for children using pressure sensors: An application of convolutional neural network

BACKGROUND

Today, sedentary lifestyles are very common for children. Therefore, maintaining a good posture while sitting is very important to prevent musculoskeletal disorders. To maintain a good posture, the formation of good postural habit must be encouraged through posture correction. However, long-term observation is required for effective posture correction. Additionally, posture correction is more effective when it is performed in real time.

OBJECTIVE

The goal of this study is to classify nine representative sitting postures of children by applying a machine learning technique using pressure distribution data according to the sitting postures.

METHODS

In this study, a customized film-type pressure sensor was developed and pressure distribution data from nine sitting postures was collected from seven to twelve year-old children. A convolutional neural network (CNN) was applied to classify the sitting postures and three experiments were conducted to evaluate the performance of the model in three applicable usage scenarios: usage by familiar identifiable users, usage by familiar, but unidentifiable users, and usage by unfamiliar users.

RESULTS

The results of our experiments revealed model accuracies of 99.66%, 99.40%, and 77.35%, respectively. When comparing the recall values for each posture, leaning left and leaning right postures had high recall values, but good posture, leaning forward, and crossed-legs postures had low recall values.

CONCLUSION

The results of experiments indicated that CNN is an excellent classification method to classify the posture when the pressure distribution data is used as input data. This study is expected to contribute a development of system to aid in observing the natural sitting behavior of children and correcting poor posture in real time.

Reduction of Prolonged Excessive Pressure in Seated Persons With Paraplegia Using Wireless Lingual Tactile Feedback: A Randomized Controlled Trial

Pressure ulcers (PU) are known to be a high-cost disease with a risk of severe morbidity. This paper evaluates a new clinical strategy based on an innovative medical device [Tongue Display Unit (TDU)] that implements perceptive supplementation in order to reduce prolonged excessive pressure, recognized as one of the main causes of PU. A randomized, controlled, and parallel-group trial was carried out with 12 subjects with spinal cord injuries (SCI). Subjects were assigned to the control (without TDU, [Formula: see text]) or intervention (with TDU, [Formula: see text]) group. Each subject took part in two sessions, during which the subject, seated on a pressure map sensor, watched a movie for one hour. The TDU was activated during the second session of the intervention group. Intention-to-treat analysis showed that the improvement in adequate weight shifting between the two sessions was higher in the intervention group (0.84 [0.24; 0.89]) than in the control group (0.01 [-0.01; 0.09]; [Formula: see text]) and that the ratio of prolonged excessive pressure between the two sessions was lower in the intervention group (0.74 [0.37; 1.92]) than in the control group (1.72 [1.32; 2.56]; [Formula: see text]). The pressure map sensor was evaluated as being convenient for use in daily life; however, this was not the case for the TDU. This paper shows that persons with SCI could benefit from a system based on perceptive supplementation that alerts and guides the user on how to adapt their posture in order to reduce prolonged excessive pressure, one of the main causes of PU.

Assistive technologies for self-managed pressure ulcer prevention in spinal cord injury: a scoping review

Pressure ulcers (PUs) in individuals with spinal cord injury (SCI) present a persistent and costly problem. Continuing effort in developing new technologies that support self-managed care is an important prevention strategy. Specifically, the aims of this scoping review are to review the key concepts and factors related to self-managed prevention of PUs in individuals with SCI and appraise the technologies available to assist patients in self-management of PU prevention practices. There is broad consensus that sustaining long-term adherence to prevention regimens is a major concern. Recent literature highlights the interactions between behavioral and physiological risk factors. We identify four technology categories that support self-management: computer-based educational technologies demonstrated improved short-term gains in knowledge (2 studies), interface pressure mapping technologies demonstrated improved adherence to pressure-relief schedules up to 3 mo (5 studies), electrical stimulation confirmed improvements in tissue tolerance after 8 wk of training (3 studies), and telemedicine programs demonstrated improvements in independence and reduced hospital visits over 6 mo (2 studies). Overall, self-management technologies demonstrated low-to-moderate effectiveness in addressing a subset of risk factors. However, the effectiveness of technologies in preventing PUs is limited due to a lack of incidence reporting. In light of the key findings, we recommend developing integrated technologies that address multiple risk factors.

Electrotactile Augmentation for Carving Guidance

In this study, we presented an efficient and unobtrusive tactile feedback system, which is used to train dental technicians in carving tasks using a wax stick and knife. First, we developed a method for generating performance metrics using a model-based estimation of clearance angles between an object's surface and the carving blade. The calculated clearance angles are compared with desired angles obtained from expert operators. Then, angular errors are presented as tactile cues to the user's finger pads through electrical stimuli at the middle phalanx of the index finger and the thumb. Subsequently, we conducted a feasibility test with novice dental technicians, who showed improvement in initial clearance angles of carving strokes. Moreover, the results showed significant reduction in the occurrence rate of poor-carving when using the proposed system. From these results, we concluded that electrotactile augmentation can provide effective guidance for carving tasks.

Electrotactile vision substitution for 3D trajectory following

Navigation for blind persons represents a challenge for researchers in vision substitution. In this field, one of the used techniques to navigate is guidance. In this study, we develop a new approach for 3D trajectory following in which the requested task is to track a light path using computer input devices (keyboard and mouse) or a rigid body handled in front of a stereoscopic camera. The light path is visualized either on direct vision or by way of a electro-stimulation device, the Tongue Display Unit, a 12 × 12 matrix of electrodes. We improve our method by a series of experiments in which the effect of the modality of perception and that of the input device. Preliminary results indicated a close correlation between the stimulated and recorded trajectories.

Effect of saccades in tongue electrotactile stimulation for vision substitution applications

The visual substitution paradigm aims to facilitate the life of blind people. Generally one uses electro-stimulating devices where electrodes are arranged into arrays to stimulate the skin or the tongue mucosa to send signals of visual type to the subjects. When an electro-stimulation signal is applied continuously (e.g. when static visual scenes are displayed for a long period of time), the receptors of the affected region can get saturated and the patient may lose the displayed information. We propose here some mechanisms that ameliorate the quality of perception of the electro-stimulation information. The electrical signal is encoded as 2D scenes projected onto the tongue via a Tongue Display Unit, i.e. an electro-tactile stimulator formed by a 12×12 matrix of electrodes. We propose to apply stochastic saccades on this signal. Our assumption is that this eye-inspired mechanism should make the visual substitution more efficient (by improving the perception) because of the reduction of the tactile receptors saturation. The influence of saccades was evaluated by a series of experiments. Results revealed a benefit on the persistence of perception due to saccades. This work helps to prevent the saturation of receptors on the tongue. Therefore increasing the quality of vision by the way of the electro-stimulation. It allows new enhancement features to retinal prosthesis devices which suffer from the same phenomenon.

Influence of sparkle and saccades on tongue electro-stimulation-based vision substitution of 2D vectors

Vision substitution by electro-stimulation has been studied since the 60s beginning with P. Bach-y-Rita. Camera pictures or movies encoded in gray levels are displayed using an electro-stimulation display device on the surface of a body part, such as the skin or the tongue. Medical-technical devices have been developed on this principle to compensate for sensory-motor disabilities such as blindness or loss of balance, or to guide specific actions, such as surgery. However, the electrical signals of stationary or moving slowly moving objects, displayed on a Tongue display unit (TDU), are quickly lost due to saturation of receptors undergoing electrostimulation. We propose to add random saccades or sparkle to the displayed visual scene to increase the quality of pattern recognition by the subjects. In the present experimental trimodal study (normal vision, TDU vision substitution, or both), we show that the presence of a moderate sparkle level enhances the perception of the direction of lines drawn on a TDU and reduces the response time.

The tongue display unit (TDU) for electrotactile spatiotemporal pattern presentation

The Tongue Display Unit (TDU) is a 144-channel programmable pulse generator that delivers dc-balanced voltage pulses suitable for electrotactile (electrocutaneous) stimulation of the anterior-dorsal tongue, through a matrix of surface electrodes. This article reviews the theory of operation and a design overview of the TDU, as well as selected applications. These include sensory substitution, tactile information display and neurorehabilitation via induced neuroplasticity.

The development of a sensory substitution system for the sexual rehabilitation of men with chronic spinal cord injury

INTRODUCTION

Sexual health is often severely impacted after spinal cord injury (SCI). Current research has primarily addressed male erection and fertility, when in fact pleasure and orgasm are top priorities for functional recovery. Sensory substitution technology operates by communicating input from a lost sensory pathway to another intact sensory modality. It was hypothesized that through training and neuroplasticity, mapped tongue sensations would be interpreted as sensory perceptions arising from insensate genitalia, and improve the sexual experience.

AIM

To report the development of a sensory substitution system for the sexual rehabilitation of men with chronic SCI.

METHODS

Subjects performed sexual self-stimulation while using a novel sensory substitution device that mapped the stroking motion of the hand to a congruous flow of electrocutaneous sensations on the tongue.

MAIN OUTCOME MEASURES

Three questionnaires, along with structured interviews, were used to rate the perceived sexual sensations following each training session.

RESULTS

Subjects completed 20 sessions over approximately 8 weeks of training. Each subject reported an increased level of sexual pleasure soon after training with the device. Each subject also reported specific perceptions of cutaneous-like sensations below their lesion that matched their hand motion. Later sessions, while remaining pleasurable and interesting, were inconsistent, and no subject reported an orgasmic feeling during a session. The subjects were all interested in continuing training with the device at home, if possible, in the future.

CONCLUSIONS

This study is the first to show that sensory substitution is a possible therapeutic avenue for sexual rehabilitation in people lacking normal genital sexual sensations. However more research, for instance on frequency and duration of training, is needed in order to induce functional lasting neuroplasticity. In the near term, SCI rehabilitation should more fully address sexuality and the role of neuroplasticity for promoting the maximal potential for sexual pleasure and orgasm.