1
|
Ersoy T, Kaya P, Hocaoglu E, Unal R. I-BaR: integrated balance rehabilitation framework. Front Neurorobot 2024; 18:1401931. [PMID: 39021504 PMCID: PMC11252086 DOI: 10.3389/fnbot.2024.1401931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 06/10/2024] [Indexed: 07/20/2024] Open
Abstract
Neurological diseases are observed in approximately 1 billion people worldwide. A further increase is foreseen at the global level as a result of population growth and aging. Individuals with neurological disorders often experience cognitive, motor, sensory, and lower extremity dysfunctions. Thus, the possibility of falling and balance problems arise due to the postural control deficiencies that occur as a result of the deterioration in the integration of multi-sensory information. We propose a novel rehabilitation framework, Integrated Balance Rehabilitation (I-BaR), to improve the effectiveness of the rehabilitation with objective assessment, individualized therapy, convenience with different disability levels and adoption of assist-as-needed paradigm and, with integrated rehabilitation process as whole, that is, ankle-foot preparation, balance, and stepping phases, respectively. Integrated Balance Rehabilitation allows patients to improve their balance ability by providing multi-modal feedback: visual via utilization of virtual reality; vestibular via anteroposterior and mediolateral perturbations with the robotic platform; proprioceptive via haptic feedback.
Collapse
Affiliation(s)
- Tugce Ersoy
- Department of Mechanical Engineering, Human-Centered Design Laboratory, Ozyegin University, Istanbul, Türkiye
| | - Pınar Kaya
- Department of Physiotherapy and Rehabilitation, Istanbul Medipol University, Istanbul, Türkiye
| | - Elif Hocaoglu
- Department of Electrical and Electronics Engineering, Living Robotics Laboratory, Istanbul Medipol University, Istanbul, Türkiye
- SABITA (Research Institute for Health Sciences and Technologies), Istanbul Medipol University, Istanbul, Türkiye
| | - Ramazan Unal
- Department of Mechanical Engineering, Human-Centered Design Laboratory, Ozyegin University, Istanbul, Türkiye
| |
Collapse
|
2
|
The Efficacy of a Newly Developed Cueing Device for Gait Mobility in Parkinson’s Disease. PARKINSON'S DISEASE 2022; 2022:7360414. [PMID: 35634541 PMCID: PMC9132693 DOI: 10.1155/2022/7360414] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/26/2022] [Indexed: 11/17/2022]
Abstract
Background. External cues are effective in improving gait in people with Parkinson’s disease (PD). However, the most effective cueing method has yet to be determined. Objective. The aim of this study was to compare the immediate effects of using visual, auditory, or somatosensory cues on their own or in combination during walking compared to no cues in people with PD. Methods. This was a single blinded, randomly selected, controlled study. Twenty people with PD with an age range of 46–79 years and Hoehn and Yahr scores of 1–3 were recruited. Participants were studied under 4 cueing conditions; no cue, visual, auditory, or somatosensory cues, which were randomly selected individually or in a combination. Results. A repeated measures ANOVA with pairwise comparisons using Bonferroni correction showed that any single or combination of the cues resulted in an improvement in gait velocity and stride length compared to no cue. Some significant differences were also seen when comparing different combinations of cues, specifically stride length showed significant improvements when additional cues were added to the light cue. The statistically significant difference was set at
. Conclusions. Walking using visual, auditory, or somatosensory cues can immediately improve gait mobility in people with PD. Any or a combination of the cues tested could be chosen depending on the ability of the individual to use that cue.
Collapse
|
3
|
De Angelis S, Princi AA, Dal Farra F, Morone G, Caltagirone C, Tramontano M. Vibrotactile-Based Rehabilitation on Balance and Gait in Patients with Neurological Diseases: A Systematic Review and Metanalysis. Brain Sci 2021; 11:brainsci11040518. [PMID: 33921655 PMCID: PMC8072538 DOI: 10.3390/brainsci11040518] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 04/10/2021] [Accepted: 04/14/2021] [Indexed: 01/06/2023] Open
Abstract
Postural instability and fear of falling represent two major causes of decreased mobility and quality of life in cerebrovascular and neurologic diseases. In recent years, rehabilitation strategies were carried out considering a combined sensorimotor intervention and an active involvement of the patients during the rehabilitation sessions. Accordingly, new technological devices and paradigms have been developed to increase the effectiveness of rehabilitation by integrating multisensory information and augmented feedback promoting the involvement of the cognitive paradigm in neurorehabilitation. In this context, the vibrotactile feedback (VF) could represent a peripheral therapeutic input, in order to provide spatial proprioceptive information to guide the patient during task-oriented exercises. The present systematic review and metanalysis aimed to explore the effectiveness of the VF on balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. A total of 18 studies met the inclusion criteria and were included. Due to the lack of high-quality studies and heterogeneity of treatments protocols, clinical practice recommendations on the efficacy of VF cannot be made. Results show that VF-based intervention could be a safe complementary sensory-motor approach for balance and gait rehabilitation in patients with neurological and cerebrovascular diseases. More high-quality randomized controlled trials are needed.
Collapse
Affiliation(s)
- Sara De Angelis
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | | | | | - Giovanni Morone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | - Carlo Caltagirone
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
| | - Marco Tramontano
- Fondazione Santa Lucia IRCCS, 00179 Rome, Italy; (S.D.A.); (A.A.P.); (G.M.); (C.C.)
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00185 Rome, Italy
- Correspondence: ; Tel.: +39-06-5150-1420
| |
Collapse
|
4
|
Ayena JC, Chioukh L, Otis MJD, Deslandes D. Risk of Falling in a Timed Up and Go Test Using an UWB Radar and an Instrumented Insole. SENSORS (BASEL, SWITZERLAND) 2021; 21:722. [PMID: 33494509 PMCID: PMC7866057 DOI: 10.3390/s21030722] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/16/2021] [Accepted: 01/18/2021] [Indexed: 12/15/2022]
Abstract
Previously, studies reported that falls analysis is possible in the elderly, when using wearable sensors. However, these devices cannot be worn daily, as they need to be removed and recharged from time-to-time due to their energy consumption, data transfer, attachment to the body, etc. This study proposes to introduce a radar sensor, an unobtrusive technology, for risk of falling analysis and combine its performance with an instrumented insole. We evaluated our methods on datasets acquired during a Timed Up and Go (TUG) test where a stride length (SL) was computed by the insole using three approaches. Only the SL from the third approach was not statistically significant (p = 0.2083 > 0.05) compared to the one provided by the radar, revealing the importance of a sensor location on human body. While reducing the number of force sensors (FSR), the risk scores using an insole containing three FSRs and y-axis of acceleration were not significantly different (p > 0.05) compared to the combination of a single radar and two FSRs. We concluded that contactless TUG testing is feasible, and by supplementing the instrumented insole to the radar, more precise information could be available for the professionals to make accurate decision.
Collapse
Affiliation(s)
- Johannes C. Ayena
- Communications and Microelectronic Integration Laboratory (LACIME), Department of Electrical Engineering, École de Technologie Supérieure, 1100 Rue Notre-Dame Ouest, Montréal, QC H3C 1K3, Canada; (J.C.A.); (D.D.)
| | - Lydia Chioukh
- Communications and Microelectronic Integration Laboratory (LACIME), Department of Electrical Engineering, École de Technologie Supérieure, 1100 Rue Notre-Dame Ouest, Montréal, QC H3C 1K3, Canada; (J.C.A.); (D.D.)
| | - Martin J.-D. Otis
- Laboratory of Automation and Robotic Interaction (LAR.i), Department of Applied Science, University of Quebec at Chicoutimi, 555 Blvd of University, Chicoutimi, QC G7H 2B1, Canada;
| | - Dominic Deslandes
- Communications and Microelectronic Integration Laboratory (LACIME), Department of Electrical Engineering, École de Technologie Supérieure, 1100 Rue Notre-Dame Ouest, Montréal, QC H3C 1K3, Canada; (J.C.A.); (D.D.)
| |
Collapse
|
5
|
Ayena JC, Otis MJD. Dimensional reduction of balance parameters in risk of falling evaluation using a minimal number of force-sensitive resistors. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2020; 28:507-518. [PMID: 32807037 DOI: 10.1080/10803548.2020.1811516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose. As the instrumented insole is available for a wide commercial range in the retail trade, this study aims to reduce its overall cost using fewer sensors by carrying out an effective risk of falling evaluation. Methods. We compared the effect of reducing balance parameters using four and three force-sensing resistors (FSRs) of an instrumented insole. Data were previously collected among elderly participants during a Timed Up and Go (TUG) test. Results. While reducing the number of balance parameters, during sit-to-stand and stand-to-sit activities, the risk scores using four FSRs were not significantly different compared with three FSRs. Parameter reduction did not show any significant loss of information among the study population using four FSRs. For certain configurations of three FSRs, a significant effect of information loss was found in the study participants, revealing the importance of investigating the sensor locations in the process. Conclusions. We conclude that it is feasible to estimate a risk index during a TUG test not only after reducing the number of needed sensing units from four to three FSRs but also after reducing the number of balance parameters. The three FSRs should be located at strategic positions to avoid a significant loss of information.
Collapse
Affiliation(s)
- Johannes C Ayena
- Otis Laboratory of Automation and Robotic interaction (LAR.i), Department of Applied Sciences, University of Quebec at Chicoutimi (UQAC), Chicoutimi, Qc., Canada
| | - Martin J-D Otis
- Otis Laboratory of Automation and Robotic interaction (LAR.i), Department of Applied Sciences, University of Quebec at Chicoutimi (UQAC), Chicoutimi, Qc., Canada
| |
Collapse
|
6
|
Ayena JC, Otis MJD. Validation of Minimal Number of Force Sensitive Resistors to Predict Risk of Falling During a Timed Up and Go Test. J Med Biol Eng 2020. [DOI: 10.1007/s40846-020-00512-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
7
|
Chapwouo Tchakoute LD, Menelas BAJ. Perception of a Haptic Stimulus Presented Under the Foot Under Workload. SENSORS 2020; 20:s20082421. [PMID: 32344624 PMCID: PMC7219483 DOI: 10.3390/s20082421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 03/27/2020] [Accepted: 04/17/2020] [Indexed: 12/16/2022]
Abstract
It is clear that the haptic channel can be exploited as a communication medium for several tasks of everyday life. Here we investigated whether such communication can be altered in a cognitive load situation. We studied the perception of a vibrotactile stimulus presented under the foot when the attention is loaded by another task (cognitive load). The results demonstrated a significant influence of workload on the perception of the vibrotactile stimulus. Overall, we observed that the average score in the single-task (at rest) condition was greater than the overall mean score in the dual-task conditions (counting forwards, counting backwards, and walking). The walking task was the task that most influenced the perception of the vibrotactile stimulus presented under the foot.
Collapse
|
8
|
Response Time to a Vibrotactile Stimulus Presented on the Foot at Rest and During Walking on Different Surfaces. SENSORS 2018; 18:s18072088. [PMID: 29966251 PMCID: PMC6069424 DOI: 10.3390/s18072088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/11/2018] [Accepted: 06/26/2018] [Indexed: 11/22/2022]
Abstract
This study investigates the simple reaction time (SRT) and response time (RT) to a vibrotactile stimulus presented on two body locations at the lower extremity of the foot on different types of surface during walking. We determined RTs while walking on Concrete, Foam, Sand, and gravel surface. Also, for RT, we evaluated two vibrotactile stimulus (VS) locations on the lower extremity: the ankle (AL) and under the foot plantar (FP). A total of 21 young adult participants (n = 21), aged mean 24 ± 2.9 years, took part in a two-session experiment with two main conditions (at rest and while walking on four types of surface). The control session included 2016 repeated measures, with one-way and two-way ANOVA analyses. The findings have consistently revealed slowness of RT to VS, in particular on sand and gravel surface. In addition, we found that body location has a significant effect on RT in certain surfaces. These results showed that RTs increased with environment changes during the performance of dual tasks.
Collapse
|
9
|
Ayena JC, Tremblay LE, Otis MJD, Ménélas BAJ. Comparing auditory, visual and vibrotactile cues in individuals with Parkinson’s disease for reducing risk of falling over different types of soil. Somatosens Mot Res 2018; 34:226-234. [DOI: 10.1080/08990220.2017.1421157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Johannes C. Ayena
- Department of Applied Sciences, University of Quebec at Chicoutimi (UQAC), Chicoutimi, QC, Canada
- Laboratory of Automation and 3D Multimodal Intelligent Interaction, UQAC, Chicoutimi, QC, Canada
| | | | - Martin J.-D. Otis
- Department of Applied Sciences, University of Quebec at Chicoutimi (UQAC), Chicoutimi, QC, Canada
- Laboratory of Automation and 3D Multimodal Intelligent Interaction, UQAC, Chicoutimi, QC, Canada
| | - Bob-Antoine J. Ménélas
- Laboratory of Automation and 3D Multimodal Intelligent Interaction, UQAC, Chicoutimi, QC, Canada
- Department of Mathematics and Computer Science, UQAC, Chicoutimi, QC, Canada
| |
Collapse
|
10
|
Wearable Devices for Classification of Inadequate Posture at Work Using Neural Networks. SENSORS 2017; 17:s17092003. [PMID: 28862665 PMCID: PMC5621084 DOI: 10.3390/s17092003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/20/2017] [Accepted: 08/30/2017] [Indexed: 11/17/2022]
Abstract
Inadequate postures adopted by an operator at work are among the most important risk factors in Work-related Musculoskeletal Disorders (WMSDs). Although several studies have focused on inadequate posture, there is limited information on its identification in a work context. The aim of this study is to automatically differentiate between adequate and inadequate postures using two wearable devices (helmet and instrumented insole) with an inertial measurement unit (IMU) and force sensors. From the force sensors located inside the insole, the center of pressure (COP) is computed since it is considered an important parameter in the analysis of posture. In a first step, a set of 60 features is computed with a direct approach, and later reduced to eight via a hybrid feature selection. A neural network is then employed to classify the current posture of a worker, yielding a recognition rate of 90%. In a second step, an innovative graphic approach is proposed to extract three additional features for the classification. This approach represents the main contribution of this study. Combining both approaches improves the recognition rate to 95%. Our results suggest that neural network could be applied successfully for the classification of adequate and inadequate posture.
Collapse
|