The Head Control Scale: Inter-Rater Reliability among Therapy Students

Research has demonstrated the Head Control Scale to have almost perfect inter-rater reliability when utilized by experienced clinicians. This study examines if further clinical experience or additional training is required to use the scale for assessment of head control in a reliable and effective manner. First and second year physical and occupational therapy students were shown five videotaped subjects of varying ages and abilities in four positions (supine, prone, supported sitting, and pull to sit). Students then utilized each subscale of the HCS to rate every subject on the rating scale in each of the positions. When utilizing the kappa coefficient statistic, the inter-rater reliability among student participants was "almost perfect" on each of the subscales. Thus, the Head Control Scale was found to be reliable with no significant difference in interrater reliability when used by clinicians or students suggesting that additional training or expertise is not required to reliably use this scale in clinical practice.

Effects of Visual Cue Deprivation Balance Training with Head Control on Balance and Gait Function in Stroke Patients

Background and Objectives: Visual cue deprivation is the instability of head control is increased. The purpose of this study is to investigate the effects of visual cue deprivation balance training by applying head control feedback to the balance and gait ability of stroke patients. Materials and Methods: The study was conducted on 41 patients diagnosed with hemiplegia due to stroke. Subjects were randomly assigned to any of the following groups: the experimental group I, the experimental group II or the control group. The randomization method used a simple randomization method. To evaluate changes in balance function, a LOS (Limit of Stability) and a BBS (Berg Balance Scale) were performed. In addition, to evaluate changes in ST (stride time), SL (stride length), and cadence, a LEGSys were performed. Results: A two-way repeated ANOVA was conducted to analyze the differences between groups. There were significant differences between groups in all variables for the balance function. There were significant differences between groups in all variables for the balance function. There were significant differences between groups in SL and cadence for the gait function. Conclusions: Visual cue deprivation balance training applying head control feedback is effective in improving dynamic balance ability and cadence. It is necessary to constantly maintain the head orientation by feedback and to properly control the head movement.

Head control and head-trunk coordination as a function of anticipation in sidestepping

Head reorientation precedes body reorientation during direction change to facilitate gaze realignment, thus enhancing perceptual awareness. Whole body kinematics are dependent on the available planning time. The purpose of this study was to assess the role of anticipation on head control and head-trunk coordination during sidestepping tasks. Fourteen male collegiate athletes performed anticipated and unanticipated sidestepping tasks. Transverse plane head, trunk and heading direction, as well as head-trunk coordination were assessed. During change of direction tasks, we observed greater head orientation towards the new travel direction, followed by heading direction and then trunk direction during both anticipated and unanticipated tasks. With reduced planning time, heading in the preparatory phase and trunk rotation in the preparatory and stance phases were significantly less oriented towards the new travel direction, with no differences in head rotation. During anticipated sidestepping, significantly greater in-phase coordination was observed during the preparatory phase compared to unanticipated sidestepping. Head reorientation facilitates gaze realignment and may be prioritized irrespective of planning time during sidestepping tasks. During anticipated trials, the head and trunk move more synchronously compared to unanticipated sidestepping, highlighting the potential benefits of aligning the degrees of freedom earlier in the change of direction stride and optimizing perceptual awareness.

HeadUp: A Low-Cost Solution for Tracking Head Movement of Children with Cerebral Palsy Using IMU

Cerebral palsy (CP) is a common reason for human motor ability limitations caused before birth, through infancy or early childhood. Poor head control is one of the most important problems in children with level IV CP and level V CP, which can affect many aspects of children’s lives. The current visual assessment method for measuring head control ability and cervical range of motion (CROM) lacks accuracy and reliability. In this paper, a HeadUp system that is based on a low-cost, 9-axis, inertial measurement unit (IMU) is proposed to capture and evaluate the head control ability for children with CP. The proposed system wirelessly measures CROM in frontal, sagittal, and transverse planes during ordinary life activities. The system is designed to provide real-time, bidirectional communication with an Euler-based, sensor fusion algorithm (SFA) to estimate the head orientation and its control ability tracking. The experimental results for the proposed SFA show high accuracy in noise reduction with faster system response. The system is clinically tested on five typically developing children and five children with CP (age range: 2–5 years). The proposed HeadUp system can be implemented as a head control trainer in an entertaining way to motivate the child with CP to keep their head up.

AMiCUS 2.0-System Presentation and Demonstration of Adaptability to Personal Needs by the Example of an Individual with Progressed Multiple Sclerosis

AMiCUS is a human–robot interface that enables tetraplegics to control an assistive robotic arm in real-time using only head motion, allowing them to perform simple manipulation tasks independently. The interface may be used as a standalone system or to provide direct control as part of a semi-autonomous system. Within this work, we present our new gesture-free prototype AMiCUS 2.0, which has been designed with special attention to accessibility and ergonomics. As such, AMiCUS 2.0 addresses the needs of tetraplegics with additional impairments that may come along with multiple sclerosis. In an experimental setup, both AMiCUS 1.0 and 2.0 are compared with each other, showing higher accessibility and usability for AMiCUS 2.0. Moreover, in an activity of daily living, a proof-of-concept is provided that an individual with progressed multiple sclerosis is able to operate the robotic arm in a temporal and functional scope, as would be necessary to perform direct control tasks for use in a commercial semi-autonomous system. The results indicate that AMiCUS 2.0 makes an important step towards closing the gaps of assistive technology, being accessible to those who rely on such technology the most.

Delayed Development of Head Control and Rolling in Infants With Tracheostomies

Objective: Advances in neonatal care lead to an increased survival rate of critically ill babies. Infantile tracheostomies are not uncommon. However, only a few studies have addressed the effect of infant tracheostomy on early motor function. By comparing the scores of the Gross Motor Function Measure-88 (GMFM) on head control and rolling of infants with and without tracheostomies, the authors aimed to evaluate the effect of infant tracheostomy on early motor development. Methods: Medical records and the GMFM of subjects were retrospectively reviewed. Thirty-three infants with tracheostomies and 132 infants without tracheostomies were matched by gestational age, birth weight, and corrected age when the GMFM was performed using propensity score matching. GMFM scores in head control and rolling in different positions were compared by using generalized estimating equation (GEE). Results: Infants with tracheostomy showed lower values for head control in the supine position and in the pull to sit maneuver in multivariate GEE (p = 0.008, 0.004, respectively). However, the results of head control in a prone position and head lift while the examiner held the thorax showed no difference between the groups. Rolling from prone to supine was delayed in the infants with tracheostomy (p = 0.002), while rolling from supine to prone was not delayed compared to the non-tracheostomized group. More than half (54%) of the tracheostomy group scored better in rolling from a prone to supine position than in head control in supine position, which was a higher ratio compared to the non-tracheostomy group (p = 0.00). Conclusions: Tracheostomy seems to influence early motor development in infants. In particular, head control skills related to neck flexor muscle activation and rolling from prone to supine were delayed. Interventions may be required to facilitate these activities.

AMiCUS-A Head Motion-Based Interface for Control of an Assistive Robot

Within this work we present AMiCUS, a Human-Robot Interface that enables tetraplegics to control a multi-degree of freedom robot arm in real-time using solely head motion, empowering them to perform simple manipulation tasks independently. The article describes the hardware, software and signal processing of AMiCUS and presents the results of a volunteer study with 13 able-bodied subjects and 6 tetraplegics with severe head motion limitations. As part of the study, the subjects performed two different pick-and-place tasks. The usability was assessed with a questionnaire. The overall performance and the main control elements were evaluated with objective measures such as completion rate and interaction time. The results show that the mapping of head motion onto robot motion is intuitive and the given feedback is useful, enabling smooth, precise and efficient robot control and resulting in high user-acceptance. Furthermore, it could be demonstrated that the robot did not move unintendedly, giving a positive prognosis for safety requirements in the framework of a certification of a product prototype. On top of that, AMiCUS enabled every subject to control the robot arm, independent of prior experience and degree of head motion limitation, making the system available for a wide range of motion impaired users.