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Albanese GA, Bucchieri A, Podda J, Tacchino A, Buccelli S, De Momi E, Laffranchi M, Mannella K, Holmes MWR, Zenzeri J, De Michieli L, Brichetto G, Barresi G. Robotic systems for upper-limb rehabilitation in multiple sclerosis: a SWOT analysis and the synergies with virtual and augmented environments. Front Robot AI 2024; 11:1335147. [PMID: 38638271 PMCID: PMC11025362 DOI: 10.3389/frobt.2024.1335147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 01/30/2024] [Indexed: 04/20/2024] Open
Abstract
The robotics discipline is exploring precise and versatile solutions for upper-limb rehabilitation in Multiple Sclerosis (MS). People with MS can greatly benefit from robotic systems to help combat the complexities of this disease, which can impair the ability to perform activities of daily living (ADLs). In order to present the potential and the limitations of smart mechatronic devices in the mentioned clinical domain, this review is structured to propose a concise SWOT (Strengths, Weaknesses, Opportunities, and Threats) Analysis of robotic rehabilitation in MS. Through the SWOT Analysis, a method mostly adopted in business management, this paper addresses both internal and external factors that can promote or hinder the adoption of upper-limb rehabilitation robots in MS. Subsequently, it discusses how the synergy with another category of interaction technologies - the systems underlying virtual and augmented environments - may empower Strengths, overcome Weaknesses, expand Opportunities, and handle Threats in rehabilitation robotics for MS. The impactful adaptability of these digital settings (extensively used in rehabilitation for MS, even to approach ADL-like tasks in safe simulated contexts) is the main reason for presenting this approach to face the critical issues of the aforementioned SWOT Analysis. This methodological proposal aims at paving the way for devising further synergistic strategies based on the integration of medical robotic devices with other promising technologies to help upper-limb functional recovery in MS.
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Affiliation(s)
| | - Anna Bucchieri
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Jessica Podda
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Andrea Tacchino
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
| | - Stefano Buccelli
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Matteo Laffranchi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Kailynn Mannella
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | | | | | | | - Giampaolo Brichetto
- Scientific Research Area, Italian Multiple Sclerosis Foundation (FISM), Genoa, Italy
- AISM Rehabilitation Center Liguria, Italian Multiple Sclerosis Society (AISM), Genoa, Italy
| | - Giacinto Barresi
- Rehab Technologies Lab, Istituto Italiano di Tecnologia, Genoa, Italy
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Albanese GA, Zenzeri J, De Santis D. The Effect of Feedback Modality When Learning a Novel Wrist Sensorimotor Transformation Through a Body-Machine Interface. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941291 DOI: 10.1109/icorr58425.2023.10304784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Body-Machine Interfaces (BoMIs) are promising assistive and rehabilitative tools for helping individuals with impaired motor abilities regain independence. When operating a BoMI, the user has to learn a novel sensorimotor transformation between the movement of certain body parts and the output of the device. In this study, we investigated how different feedback modalities impacted learning to operate a BoMI. Forty-seven able-bodied participants learned to control the velocity of a 1D cursor using the 3D rotation of their dominant wrist to reach as many targets as possible in a given amount of time. The map was designed to maximize cursor speed for movements around a predefined axis of wrist rotation. We compared the user's performance and control efficiency under three feedback modalities: i) visual feedback of the cursor position, ii) proprioceptive feedback of the cursor position delivered by a wrist manipulandum, iii) both i) and ii). We found that visual feedback led to a greater number of targets reached than proprioceptive feedback alone. Conversely, proprioceptive feedback yielded greater alignment between the axis of rotation of the wrist and the optimal axis represented by the map. These results suggest that proprioceptive feedback may be preferable over visual feedback when information about intrinsic task components, i.e. joint configurations, is of interest as in rehabilitative interventions aiming to promote more effective learning strategies.
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Albanese GA, Marini F, Morasso P, Campus C, Zenzeri J. μ-band desynchronization in the contralateral central and central-parietal areas predicts proprioceptive acuity. Front Hum Neurosci 2023; 17:1000832. [PMID: 37007684 PMCID: PMC10050694 DOI: 10.3389/fnhum.2023.1000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/28/2023] [Indexed: 03/17/2023] Open
Abstract
IntroductionPosition sense, which belongs to the sensory stream called proprioception, is pivotal for proper movement execution. Its comprehensive understanding is needed to fill existing knowledge gaps in human physiology, motor control, neurorehabilitation, and prosthetics. Although numerous studies have focused on different aspects of proprioception in humans, what has not been fully investigated so far are the neural correlates of proprioceptive acuity at the joints.MethodsHere, we implemented a robot-based position sense test to elucidate the correlation between patterns of neural activity and the degree of accuracy and precision exhibited by the subjects. Eighteen healthy participants performed the test, and their electroencephalographic (EEG) activity was analyzed in its μ band (8–12 Hz), as the frequency band related to voluntary movement and somatosensory stimulation.ResultsWe observed a significant positive correlation between the matching error, representing proprioceptive acuity, and the strength of the activation in contralateral hand motor and sensorimotor areas (left central and central-parietal areas). In absence of visual feedback, these same regions of interest (ROIs) presented a higher activation level compared to the association and visual areas. Remarkably, central and central-parietal activation was still observed when visual feedback was added, although a consistent activation in association and visual areas came up.ConclusionSumming up, this study supports the existence of a specific link between the magnitude of activation of motor and sensorimotor areas related to upper limb proprioceptive processing and the proprioceptive acuity at the joints.
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Affiliation(s)
- Giulia Aurora Albanese
- Department of Robotics, Brain and Cognitive Sciences, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
- *Correspondence: Giulia Aurora Albanese,
| | | | - Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
| | - Claudio Campus
- U-VIP Unit for Visually Impaired People, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Fondazione Istituto Italiano di Tecnologia, Genoa, Italy
- ReWing S.r.l., Milan, Italy
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Cherif A, Zenzeri J, Loram I. What is the contribution of voluntary and reflex processes to sensorimotor control of balance? Front Bioeng Biotechnol 2022; 10:973716. [PMID: 36246368 PMCID: PMC9557221 DOI: 10.3389/fbioe.2022.973716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 08/18/2022] [Indexed: 11/24/2022] Open
Abstract
The contribution to balance of spinal and transcortical processes including the long-latency reflex is well known. The control of balance has been modelled previously as a continuous, state feedback controller representing, long-latency reflexes. However, the contribution of slower, variable delay processes has not been quantified. Compared with fixed delay processes (spinal, transcortical), we hypothesize that variable delay processes provide the largest contribution to balance and are sensitive to historical context as well as current states. Twenty-two healthy participants used a myoelectric control signal from their leg muscles to maintain balance of their own body while strapped to an actuated, inverted pendulum. We study the myoelectric control signal (u) in relation to the independent disturbance (d) comprising paired, discrete perturbations of varying inter-stimulus-interval (ISI). We fit the closed loop response, u from d, using one linear and two non-linear non-parametric (many parameter) models. Model M1 (ARX) is a generalized, high-order linear-time-invariant (LTI) process with fixed delay. Model M1 is equivalent to any parametric, closed-loop, continuous, linear-time-invariant (LTI), state feedback model. Model M2, a single non-linear process (fixed delay, time-varying amplitude), adds an optimized response amplitude to each stimulus. Model M3, two non-linear processes (one fixed delay, one variable delay, each of time-varying amplitude), add a second process of optimized delay and optimized response amplitude to each stimulus. At short ISI, the myoelectric control signals deviated systematically both from the fixed delay LTI process (M1), and also from the fixed delay, time-varying amplitude process (M2) and not from the two-process model (M3). Analysis of M3 (all fixed delay and variable delay response amplitudes) showed the variable (compared with fixed) delay process 1) made the largest contribution to the response, 2) exhibited refractoriness (increased delay related to short ISI) and 3) was sensitive to stimulus history (stimulus direction 2 relative to stimulus 1). For this whole-body balance task and for these impulsive stimuli, non-linear processes at variable delay are central to control of balance. Compared with fixed delay processes (spinal, transcortical), variable delay processes provided the largest contribution to balance and were sensitive to historical context as well as current states.
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Affiliation(s)
- Amel Cherif
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
- *Correspondence: Amel Cherif, ; Ian Loram,
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Ian Loram
- Cognitive Motor Function Research Group, Research Centre for Musculoskeletal Science & Sports Medicine, Dept of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Manchester, United Kingdom
- *Correspondence: Amel Cherif, ; Ian Loram,
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Reece A, Marini F, Mugnosso M, Frost G, Sullivan P, Zabihhosseinian M, Zenzeri J, Holmes MWR. Influence of Neck Pain, Cervical Extensor Muscle Fatigue, and Manual Therapy on Wrist Proprioception. J Manipulative Physiol Ther 2022; 45:216-226. [PMID: 35906104 DOI: 10.1016/j.jmpt.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the effects of submaximal isometric neck muscle fatigue and manual therapy on wrist joint position sense (JPS) within healthy individuals and individuals with subclinical neck pain (SCNP). METHODS Twelve healthy participants and 12 participants with SCNP were recruited. Each group completed 2 sessions, with 48 hours between sessions. On day 1, both groups performed 2 wrist JPS tests using a robotic device. The tests were separated by a submaximal isometric fatigue protocol for the cervical extensor muscles (CEM). On day 2, both groups performed a wrist JPS test, followed by a cervical treatment consisting of manual therapy (SCNP) or neck rest (20 minutes, control group) and another wrist JPS test. Joint position sense was measured as the participant's ability to recreate a previously presented wrist angle. Each wrist JPS test included 12 targets, 6 into wrist flexion and 6 into wrist extension. Kinematic data from the robot established absolute, variability, and constant error. RESULTS Absolute error significantly decreased (P = .01) from baseline to post-fatigue in the SCNP group (baseline = 4.48 ± 1.58°; post-fatigue = 3.90 ± 1.45°) and increased in the control group (baseline = 3.12 ± 0.98°; post-fatigue = 3.81 ± 0.90°). The single session of manual cervical treatment significantly decreased absolute error in participants with SCNP (P = .004). CONCLUSION This study demonstrated that neck pain or fatigue can lead to altered afferent input to the central nervous system and can affect wrist JPS. Our findings demonstrate that acute wrist proprioception may be improved in individuals with SCNP by a single cervical manual therapy session.
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Affiliation(s)
- Ashley Reece
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | | | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Italian Institue of Technology, Genoa, Italy
| | - Gail Frost
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Philip Sullivan
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | | | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Italian Institue of Technology, Genoa, Italy
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.
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Albanese GA, Basile E, Momi ED, Zenzeri J. A new robot-based proprioceptive training algorithm to induce sensorimotor enhancement in the human wrist. IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176156 DOI: 10.1109/icorr55369.2022.9896533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Afferent proprioceptive signals, responsible for body awareness, have a crucial role when planning and executing motor tasks. Increasing evidence suggests that proprioceptive sensory training may improve motor performance. Although this topic had been partially investigated, there was a lack of studies involving the wrist joint. Proprioception at the wrist level is particularly relevant to interact with the environment through actions that require an accurate sense of position and motion, and fine haptic perception. In this study, we implemented and tested a robotic training algorithm of human wrist proprioception. The proposed task was a continuous tracking in the workspace identified by flexion-extension and radial-ulnar deviation movements. Healthy subjects were haptically guided towards the target, without any visual feedback of the position of the end- effector. Our results showed that, after the training, participants improved their motor performance in a different tracking task, completely active and with visual feedback Additionally, the training led them to more efficient use of kinesthetic feedback during haptically-guided reaching tasks. Our findings demonstrated that the proposed training algorithm of wrist proprioception induced a task-specific sensorimotor enhancement. From the perspective of a rehabilitative intervention, this robot-based training has the potential to improve motor functions and the quality of life of subjects with sensorimotor deficits.
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Albanese GA, Falzarano V, Holmes MWR, Morasso P, Zenzeri J. A Dynamic Submaximal Fatigue Protocol Alters Wrist Biomechanical Properties and Proprioception. Front Hum Neurosci 2022; 16:887270. [PMID: 35712530 PMCID: PMC9196583 DOI: 10.3389/fnhum.2022.887270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 05/11/2022] [Indexed: 11/13/2022] Open
Abstract
Fatigue is a temporary condition that arises as a result of intense and/or prolonged use of muscles and can affect skilled human performance. Therefore, the quantitative analysis of these effects is a topic of crucial interest in both ergonomics and clinical settings. This study introduced a novel protocol, based on robotic techniques, to quantitatively assess the effects of fatigue on the human wrist joint. A wrist manipulandum was used for two concurrent purposes: (1) implementing the fatigue task and (2) assessing the functional changes both before and at four time points after the end of the fatigue task. Fourteen participants completed the experimental protocol, which included the fatigue task and assessment sessions over 2 days. Specifically, the assessments performed are related to the following indicators: (1) isometric forces, (2) biomechanical properties of the wrist, (3) position sense, and (4) stretch reflexes of the muscles involved. The proposed fatigue task was a short-term, submaximal and dynamic wrist flexion/extension task designed with a torque opposing wrist flexion. A novel task termination criterion was employed and based on a percentage decrease in the mean frequency of muscles measured using surface electromyography. The muscle fatigue analysis demonstrated a change in mean frequency for both the wrist flexors and extensors, however, only the isometric flexion force decreased 4 min after the end of the task. At the same time point, wrist position sense was significantly improved and stiffness was the lowest. Viscosity presented different behaviors depending on the direction evaluated. At the end of the experiment (about 12 min after the end of the fatigue task), wrist position sense recovered to pre-fatigue values, while biomechanical properties did not return to their pre-fatigue values. Due to the wide variety of fatigue tasks proposed in the literature, it has been difficult to define a complete framework that presents the dynamic of fatigue-related changes in different components associated with wrist function. This work enables us to discuss the possible causes and the mutual relationship of the changes detected after the same task.
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Affiliation(s)
- Giulia A. Albanese
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
- *Correspondence: Giulia A. Albanese,
| | - Valeria Falzarano
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Michael W. R. Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
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Mannella K, Forman GN, Mugnosso M, Zenzeri J, Holmes MWR. The effects of isometric hand grip force on wrist kinematics and forearm muscle activity during radial and ulnar wrist joint perturbations. PeerJ 2022; 10:e13495. [PMID: 35646483 PMCID: PMC9138088 DOI: 10.7717/peerj.13495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/04/2022] [Indexed: 01/17/2023] Open
Abstract
The purpose of this work was to investigate forearm muscle activity and wrist angular displacement during radial and ulnar wrist perturbations across various isometric hand grip demands. Surface electromyography (EMG) was recorded from eight muscles of the upper extremity. A robotic device delivered perturbations to the hand in the radial and ulnar directions across four pre-perturbation grip magnitudes. Angular displacement and time to peak displacement following perturbations were evaluated. Muscle activity was evaluated pre- and post-perturbation. Results showed an inverse relationship between grip force and angular displacement (p ≤ 0.001). Time to peak displacement decreased as grip force increased (p ≤ 0.001). There was an increase in muscle activity with higher grip forces across all muscles both pre-and post-perturbation (p ≤ 0.001) and a greater average muscle activity in ulnar as compared to radial deviation (p = 0.02). This work contributes to the wrist joint stiffness literature by relating wrist angular displacement to grip demands during novel radial/ulnar perturbations and provides insight into neuromuscular control strategies.
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Affiliation(s)
- Kailynn Mannella
- Department of Kinesiology, Brock University, St. Catharines, Canada
| | | | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
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Lombardi G, Zenzeri J, Belgiovine G, Vannucci F, Rea F, Sciutti A, Di Cesare G. The influence of vitality forms on action perception and motor response. Sci Rep 2021; 11:22576. [PMID: 34799623 PMCID: PMC8605011 DOI: 10.1038/s41598-021-01924-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/08/2021] [Indexed: 11/09/2022] Open
Abstract
During the interaction with others, action, speech, and touches can communicate positive, neutral, or negative attitudes. Offering an apple can be gentle or rude, a caress can be kind or rushed. These subtle aspects of social communication have been named vitality forms by Daniel Stern. Although they characterize all human interactions, to date it is not clear whether vitality forms expressed by an agent may affect the action perception and the motor response of the receiver. To this purpose, we carried out a psychophysics study aiming to investigate how perceiving different vitality forms can influence cognitive and motor tasks performed by participants. In particular, participants were stimulated with requests made through a physical contact or vocally and conveying rude or gentle vitality forms, and then they were asked to estimate the end of a passing action observed in a monitor (action estimation task) or to perform an action in front of it (action execution task) with the intention to pass an object to the other person presented in the video. Results of the action estimation task indicated that the perception of a gentle request increased the duration of a rude action subsequently observed, while the perception of a rude request decreased the duration of the same action performed gently. Additionally, during the action execution task, accordingly with the perceived vitality form, participants modulated their motor response.
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Affiliation(s)
- G Lombardi
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy.,Cognitive Architecture for Collaborative Technologies Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - J Zenzeri
- Robotics Brain and Cognitive Sciences Unit, Italian Institute of Technology, Genoa, Italy
| | - G Belgiovine
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy.,Robotics Brain and Cognitive Sciences Unit, Italian Institute of Technology, Genoa, Italy
| | - F Vannucci
- Cognitive Architecture for Collaborative Technologies Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - F Rea
- Robotics Brain and Cognitive Sciences Unit, Italian Institute of Technology, Genoa, Italy
| | - A Sciutti
- Cognitive Architecture for Collaborative Technologies Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - G Di Cesare
- Cognitive Architecture for Collaborative Technologies Unit, Istituto Italiano di Tecnologia, Genoa, Italy.
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Albanese GA, Falzarano V, Holmes MWR, Morasso P, Zenzeri J. Implementing a robust wrist dynamic fatigue task: repeatability and investigation of the features involved. Annu Int Conf IEEE Eng Med Biol Soc 2021; 2021:6487-6490. [PMID: 34892596 DOI: 10.1109/embc46164.2021.9630291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this study, we implemented a protocol for the robotic assessment of the effects of forearm muscle fatigue on wrist dynamics. The potential of robotic devices lies in the possibility to control and measure a wide variety of kinematic and physiological variables, both in repeated sessions over time and during real-time assessments. The implemented fatigue task is tailored to the robotically assessed single-subject maximal force and based on a real-time evaluation of muscle activity. The protocol resulted to be repeatable across sessions evaluated on the same subject and a preliminary step toward a better understanding of which features should be monitored to design a robust and strongly controlled dynamic fatiguing task.
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Falzarano V, Holmes MWR, Masia L, Morasso P, Zenzeri J. Evaluating Viscoelastic Properties of the Wrist Joint During External Perturbations: Influence of Velocity, Grip, and Handedness. Front Hum Neurosci 2021; 15:726841. [PMID: 34671248 PMCID: PMC8520977 DOI: 10.3389/fnhum.2021.726841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 09/13/2021] [Indexed: 11/30/2022] Open
Abstract
In this study, we designed a robot-based method to compute a mechanical impedance model that could extract the viscoelastic properties of the wrist joint. Thirteen subjects participated in the experiment, testing both dominant and nondominant hands. Specifically, the robotic device delivered position-controlled disturbances in the flexion-extension degree of freedom of the wrist. The external perturbations were characterized by small amplitudes and fast velocities, causing rotation at the wrist joint. The viscoelastic characteristics of the mechanical impedance of the joint were evaluated from the wrist kinematics and corresponding torques. Since the protocol used position inputs to determine changes in mean wrist torque, a detailed analysis of wrist joint dynamics could be made. The scientific question was whether and how these mechanical features changed with various grip demands and perturbation velocities. Nine experimental conditions were tested for each hand, given by the combination of three velocity perturbations (fast, medium, and slow) and three hand grip conditions [self-selected grip, medium and high grip force, as percentage of the maximum voluntary contraction (MVC)]. Throughout the experiments, electromyographic signals of the extensor carpi radialis (ECR) and the flexor carpi radialis (FCR) were recorded. The novelty of this work included a custom-made soft grip sensor, wrapped around the robotic handle, to accurately quantify the grip force exerted by the subjects during experimentation. Damping parameters were in the range of measurements from prior studies and consistent among the different experimental conditions. Stiffness was independent of both direction and velocity of perturbations and increased with increasing grip demand. Both damping and stiffness were not different between the dominant and nondominant hands. These results are crucial to improving our knowledge of the mechanical characteristics of the wrist, and how grip demands influence these properties. This study is the foundation for future work on how mechanical characteristics of the wrist are affected in pathological conditions.
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Affiliation(s)
- Valeria Falzarano
- Department of Informatics, Bioengineering, Robotics, and Systems Engineering, University of Genova, Genova, Italy.,Robotics, Brain, and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Lorenzo Masia
- Institut für Technische Informatik, Universität Heidelberg, Heidelberg, Germany
| | - Pietro Morasso
- Robotics, Brain, and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Jacopo Zenzeri
- Robotics, Brain, and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
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Albanese GA, Taglione E, Gasparini C, Grandi S, Pettinelli F, Sardelli C, Catitti P, Sandini G, Masia L, Zenzeri J. Efficacy of wrist robot-aided orthopedic rehabilitation: a randomized controlled trial. J Neuroeng Rehabil 2021; 18:130. [PMID: 34465356 PMCID: PMC8406564 DOI: 10.1186/s12984-021-00925-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 08/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background In recent years, many studies focused on the use of robotic devices for both the assessment and the neuro-motor reeducation of upper limb in subjects after stroke, spinal cord injuries or affected by neurological disorders. Contrarily, it is still hard to find examples of robot-aided assessment and rehabilitation after traumatic injuries in the orthopedic field. However, those benefits related to the use of robotic devices are expected also in orthopedic functional reeducation. Methods After a wrist injury occurred at their workplace, wrist functionality of twenty-three subjects was evaluated through a robot-based assessment and clinical measures (Patient Rated Wrist Evaluation, Jebsen-Taylor and Jamar Test), before and after a 3-week long rehabilitative treatment. Subjects were randomized in two groups: while the control group (n = 13) underwent a traditional rehabilitative protocol, the experimental group (n = 10) was treated replacing traditional exercises with robot-aided ones. Results Functionality, assessed through the function subscale of PRWE scale, improved in both groups (experimental p = 0.016; control p < 0.001) and was comparable between groups, both pre (U = 45.5, p = 0.355) and post (U = 47, p = 0.597) treatment. Additionally, even though groups’ performance during the robotic assessment was comparable before the treatment (U = 36, p = 0.077), after rehabilitation the experimental group presented better results than the control one (U = 26, p = 0.015). Conclusions This work can be considered a starting point for introducing the use of robotic devices in the orthopedic field. The robot-aided rehabilitative treatment was effective and comparable to the traditional one. Preserving efficacy and safety conditions, a systematic use of these devices could lead to decrease human therapists’ effort, increase repeatability and accuracy of assessments, and promote subject’s engagement and voluntary participation. Trial Registration ClinicalTrial.gov ID: NCT04739644. Registered on February 4, 2021—Retrospectively registered, https://www.clinicaltrials.gov/ct2/show/study/NCT04739644.
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Affiliation(s)
- Giulia Aurora Albanese
- Robotics, Brain and Cognitive Sciences (RBCS) Unit, Istituto Italiano di Tecnologia, Genoa, Italy. .,Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy.
| | - Elisa Taglione
- National Institute for Insurance against Accidents at Work (INAIL), Motor Rehabilitation Center, Volterra, Italy
| | - Cecilia Gasparini
- National Institute for Insurance against Accidents at Work (INAIL), Motor Rehabilitation Center, Volterra, Italy
| | - Sara Grandi
- National Institute for Insurance against Accidents at Work (INAIL), Motor Rehabilitation Center, Volterra, Italy
| | - Foebe Pettinelli
- National Institute for Insurance against Accidents at Work (INAIL), Motor Rehabilitation Center, Volterra, Italy
| | - Claudio Sardelli
- National Institute for Insurance against Accidents at Work (INAIL), Motor Rehabilitation Center, Volterra, Italy
| | - Paolo Catitti
- National Institute for Insurance against Accidents at Work (INAIL), Motor Rehabilitation Center, Volterra, Italy
| | - Giulio Sandini
- Robotics, Brain and Cognitive Sciences (RBCS) Unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Lorenzo Masia
- Institut für Technische Informatik (ZITI), Heidelberg University, Heidelberg, Germany
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences (RBCS) Unit, Istituto Italiano di Tecnologia, Genoa, Italy
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13
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Gandolfi M, Valè N, Posteraro F, Morone G, Dell'orco A, Botticelli A, Dimitrova E, Gervasoni E, Goffredo M, Zenzeri J, Antonini A, Daniele C, Benanti P, Boldrini P, Bonaiuti D, Castelli E, Draicchio F, Falabella V, Galeri S, Gimigliano F, Grigioni M, Mazzon S, Molteni F, Petrarca M, Picelli A, Senatore M, Turchetti G, Giansanti D, Mazzoleni S. State of the art and challenges for the classification of studies on electromechanical and robotic devices in neurorehabilitation: a scoping review. Eur J Phys Rehabil Med 2021; 57:831-840. [PMID: 34042413 DOI: 10.23736/s1973-9087.21.06922-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The rapid development of electromechanical and robotic devices has profoundly influenced neurorehabilitation. Growth in the scientific and technological aspects thereof is crucial for increasing the number of newly developed devices, and clinicians have welcomed such growth with enthusiasm. Nevertheless, improving the standard for the reporting clinical, technical, and normative aspects of such electromechanical and robotic devices remains an unmet need in neurorehabilitation. Accordingly, this study aimed to analyse the existing literature on electromechanical and robotic devices used in neurorehabilitation, considering the current clinical, technical, and regulatory classification systems. EVIDENCE ACQUISITION Within the CICERONE Consensus Conference framework, studies on electromechanical and robotic devices used for upper- and lower-limb rehabilitation in persons with neurological disabilities in adulthood and childhood were reviewed. We have conducted a literature search using the following databases: MEDLINE, Cochrane Library, PeDro, Institute of Electrical and Electronics Engineers, Science Direct, and Google Scholar. Clinical, technical, and regulatory classification systems were applied to collect information on the electromechanical and robotic devices. The study designs and populations were investigated. EVIDENCE SYNTHESIS Overall, 316 studies were included in the analysis. More than half (52%) of the studies were randomised controlled trials (RCTs). The population investigated the most suffered from strokes, followed by spinal cord injuries, multiple sclerosis, cerebral palsy, and traumatic brain injuries. In total, 100 devices were described; of these, 19% were certified with the CE mark. Overall, the main type of device was an exoskeleton. However, end-effector devices were primarily used for the upper limbs, whereas exoskeletons were used for the lower limbs (for both children and adults). CONCLUSIONS The current literature on robotic neurorehabilitation lacks detailed information regarding the technical characteristics of the devices used. This affects the understanding of the possible mechanisms underlying recovery. Unfortunately, many electromechanical and robotic devices are not provided with CE marks, strongly hindering the research on the clinical outcomes of rehabilitation treatments based on these devices. A more significant effort is needed to improve the description of the robotic devices used in neurorehabilitation in terms of the technical and functional details, along with high-quality RCT studies.
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Affiliation(s)
- Marialuisa Gandolfi
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy -
| | - Nicola Valè
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Federico Posteraro
- Rehabilitation Department Versilia Hospital, ASL Toscana Nord-Ovest, Italy
| | | | - Antonella Dell'orco
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy
| | - Anita Botticelli
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy
| | - Eleonora Dimitrova
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | | | - Michela Goffredo
- Neurorehabilitation Research Laboratory, Department of Neurological and Rehabilitation Sciences, IRCCS San Raffaele Pisana, Rome, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | | | | | | | - Paolo Boldrini
- Italian Society of Physical Medicine and Rehabilitation (SIMFER), Italy
| | | | - Enrico Castelli
- Pediatric Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | - Francesco Draicchio
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, Rome, Italy
| | - Vincenzo Falabella
- President Italian Federation of Persons with Spinal Cord Injuries (Flip Onlus), Rome, Italy
| | | | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli, " Naples, Italy
| | - Mauro Grigioni
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzon
- ULSS 6 (Unique Sanitary Local Company) Euganea Padova - Distretto IV Alta Padovana, Padova, Italy
| | | | - Maurizio Petrarca
- The Movement Analysis and Robotics Laboratory, Bambino Gesù Children's Hospital, Rome, Italy
| | - Alessandro Picelli
- Department of Neuroscience, Biomedicine, and Movement Sciences, University of Verona, Neurorehabilitation Unit, University Hospital of Verona, Italy
| | | | | | - Daniele Giansanti
- National Center for Innovative Technologies in Public Health, Italian National Institute of Health, Rome, Italy
| | - Stefano Mazzoleni
- Department of Electrical and Information Engineering, Politecnico di Bari, Italy
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Albanese GA, Holmes MWR, Marini F, Morasso P, Zenzeri J. Wrist Position Sense in Two Dimensions: Between-Hand Symmetry and Anisotropic Accuracy Across the Space. Front Hum Neurosci 2021; 15:662768. [PMID: 33967724 PMCID: PMC8100524 DOI: 10.3389/fnhum.2021.662768] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/29/2021] [Indexed: 02/01/2023] Open
Abstract
A deep investigation of proprioceptive processes is necessary to understand the relationship between sensory afferent inputs and motor outcomes. In this work, we investigate whether and how perception of wrist position is influenced by the direction along which the movement occurs. Most previous studies have tested Joint Position Sense (JPS) through 1 degree of freedom (DoF) wrist movements, such as flexion/extension (FE) or radial/ulnar deviation (RUD). However, the wrist joint has 3-DoF and many activities of daily living produce combined movements, requiring at least 2-DoF wrist coordination. For this reason, in this study, target positions involved movement directions that combined wrist flexion or extension with radial or ulnar deviation. The chosen task was a robot-aided Joint Position Matching (JPM), in which blindfolded participants actively reproduced a previously passively assumed target joint configuration. The JPM performance of 20 healthy participants was quantified through measures of accuracy and precision, in terms of both perceived target direction and distance along each direction of movement. Twelve different directions of movement were selected and both hands tested. The left and right hand led to comparable results, both target extents and directions were differently perceived according to the target direction on the FE/RUD space. Moreover, during 2-DoF combined movements, subjects' perception of directions was impaired when compared to 1-DoF target movements. In summary, our results showed that human perception of wrist position on the FE/RUD space is symmetric between hands but not isotropic among movement directions.
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Affiliation(s)
- Giulia A Albanese
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy.,Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | | | - Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
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15
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D'Antonio E, Galofaro E, Zenzeri J, Patané F, Konczak J, Casadio M, Masia L. Robotic Assessment of Wrist Proprioception During Kinaesthetic Perturbations: A Neuroergonomic Approach. Front Neurorobot 2021; 15:640551. [PMID: 33732131 PMCID: PMC7958920 DOI: 10.3389/fnbot.2021.640551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/09/2021] [Indexed: 12/01/2022] Open
Abstract
Position sense refers to an aspect of proprioception crucial for motor control and learning. The onset of neurological diseases can damage such sensory afference, with consequent motor disorders dramatically reducing the associated recovery process. In regular clinical practice, assessment of proprioceptive deficits is run by means of clinical scales which do not provide quantitative measurements. However, existing robotic solutions usually do not involve multi-joint movements but are mostly applied to a single proximal or distal joint. The present work provides a testing paradigm for assessing proprioception during coordinated multi-joint distal movements and in presence of kinaesthetic perturbations: we evaluated healthy subjects' ability to match proprioceptive targets along two of the three wrist's degrees of freedom, flexion/extension and abduction/adduction. By introducing rotations along the pronation/supination axis not involved in the matching task, we tested two experimental conditions, which differed in terms of the temporal imposition of the external perturbation: in the first one, the disturbance was provided after the presentation of the proprioceptive target, while in the second one, the rotation of the pronation/ supination axis was imposed during the proprioceptive target presentation. We investigated if (i) the amplitude of the perturbation along the pronation/supination would lead to proprioceptive miscalibration; (ii) the encoding of proprioceptive target, would be influenced by the presentation sequence between the target itself and the rotational disturbance. Eighteen participants were tested by means of a haptic neuroergonomic wrist device: our findings provided evidence that the order of disturbance presentation does not alter proprioceptive acuity. Yet, a further effect has been noticed: proprioception is highly anisotropic and dependent on perturbation amplitude. Unexpectedly, the configuration of the forearm highly influences sensory feedbacks, and significantly alters subjects' performance in matching the proprioceptive targets, defining portions of the wrist workspace where kinaesthetic and proprioceptive acuity are more sensitive. This finding may suggest solutions and applications in multiple fields: from general haptics where, knowing how wrist configuration influences proprioception, might suggest new neuroergonomic solutions in device design, to clinical evaluation after neurological damage, where accurately assessing proprioceptive deficits can dramatically complement regular therapy for a better prediction of the recovery path.
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Affiliation(s)
- Erika D'Antonio
- Assistive Robotics and Interactive Exosuits (ARIES) Laboratory, Institute of Computer Engineering (ZITI), University of Heidelberg, Heidelberg, Germany
| | - Elisa Galofaro
- Assistive Robotics and Interactive Exosuits (ARIES) Laboratory, Institute of Computer Engineering (ZITI), University of Heidelberg, Heidelberg, Germany.,Department of Informatics, Bioengineering, Robotics, and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain, and Cognitive Sciences Unit, Italian Institute of Technology, Genoa, Italy
| | - Fabrizio Patané
- Mechanical Measurements and Microelectronics (M3Lab) Lab, Engineering Department, University Niccolò Cusano, Rome, Italy
| | - Jürgen Konczak
- Human Sensorimotor Control Laboratory, University of Minnesota, Minneapolis, MN, United States
| | - Maura Casadio
- Department of Informatics, Bioengineering, Robotics, and System Engineering (DIBRIS), University of Genoa, Genoa, Italy
| | - Lorenzo Masia
- Assistive Robotics and Interactive Exosuits (ARIES) Laboratory, Institute of Computer Engineering (ZITI), University of Heidelberg, Heidelberg, Germany.,Faculty of Engineering, The Maersk Mc-Kinney Moller Institute, University of Southern Denmark (SDU), Odense, Denmark
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16
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Kumar RI, Forman GN, Forman DA, Mugnosso M, Zenzeri J, Button DC, Holmes MWR. Dynamic Wrist Flexion and Extension Fatigue Induced via Submaximal Contractions Similarly Impairs Hand Tracking Accuracy in Young Adult Males and Females. Front Sports Act Living 2020; 2:574650. [PMID: 33345137 PMCID: PMC7739657 DOI: 10.3389/fspor.2020.574650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 09/01/2020] [Indexed: 11/22/2022] Open
Abstract
We evaluated the effects of muscle fatigue on hand-tracking performance in young adults. Differences were quantified between wrist flexion and extension fatigability, and between males and females. Participants were evaluated on their ability to trace a pattern using a 3-degrees-of-freedom robotic manipulandum before (baseline) and after (0, 1, 2, 4, 6, 8, and 10 mins) a submaximal-intensity fatigue protocol performed to exhaustion that isolated the wrist flexors or extensors on separate days. Tracking tasks were performed at all time points, while maximal voluntary contractions (MVCs) were performed at baseline, and 2, 6-, and 10-mins post-task termination. We evaluated movement smoothness (jerk ratio, JR), shape reproduction (figural error, FE), and target tracking accuracy (tracking error, TE). MVC force was significantly lower in females (p < 0.05), lower than baseline for all timepoints after task termination (p < 0.05), with no muscle group-dependent differences. JR did not return to baseline until 10-mins post-task termination (most affected), while FE returned at 4-mins post-task termination, and TE at 1-min post-task termination. Males tracked the target with significantly lower JR (p < 0.05), less TE (p < 0.05), and less FE (p < 0.05) than females. No muscle group-dependent changes in hand-tracking performance were observed. Based on this work, hand tracking accuracy is similarly impaired following repetitive submaximal dynamic wrist flexion or extension. The differences between male and female fatigability was independent of the changes in our tracking metrics.
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Affiliation(s)
- Robert I. Kumar
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Garrick N. Forman
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Davis A. Forman
- Faculty of Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Duane C. Button
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michael W. R. Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
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17
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Forman DA, Forman GN, Avila-Mireles EJ, Mugnosso M, Zenzeri J, Murphy B, Holmes MW. Characterizing forearm muscle activity in young adults during dynamic wrist flexion–extension movement using a wrist robot. J Biomech 2020; 108:109908. [DOI: 10.1016/j.jbiomech.2020.109908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 06/11/2020] [Accepted: 06/14/2020] [Indexed: 12/17/2022]
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18
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Forman DA, Forman GN, Avila-Mireles EJ, Mugnosso M, Zenzeri J, Murphy B, Holmes MWR. Characterizing forearm muscle activity in university-aged males during dynamic radial-ulnar deviation of the wrist using a wrist robot. J Biomech 2020; 108:109897. [PMID: 32636008 DOI: 10.1016/j.jbiomech.2020.109897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 05/25/2020] [Accepted: 06/09/2020] [Indexed: 11/16/2022]
Abstract
Functioning as wrist stabilizers, the wrist extensor muscles exhibit higher levels of muscle activity than the flexors in most distal upper-limb tasks. However, this finding has been derived mostly from isometric or wrist flexion-extension protocols, with little consideration for wrist dynamics or radial-ulnar wrist deviations. The purpose of this study was to assess forearm muscle activity during the execution of dynamic wrist radial-ulnar deviation in various forearm orientations (pronation/supination). In 12 healthy university-aged males, surface electromyography (EMG) was recorded from eight muscles of the dominant arm: flexor carpi radialis (FCR), flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), extensor carpi radialis (ECR), extensor carpi ulnaris (ECU), extensor digitorum (ED), biceps brachii (BB) and triceps brachii (TB). While grasping a handle, participants performed dynamic radial-ulnar deviation using a three-degrees-of-freedom wrist manipulandum. The robotic device applied torque to the handle, in either a radial or ulnar direction, and in one of three forearm postures (30° supinated/neutral/30° pronated). Results indicated that forearm posture influenced the muscles acting upon the hand (FDS/ED), whereas movement phase (concentric-eccentric) and torque direction influenced nearly every muscle. The ECR demonstrated the greatest task-dependency of all forearm muscles, which is possibly reflective of forearm muscle lines of action. Co-contraction ratios were much higher in radial trials than ulnar (Radial: 1.20 ± 0.78, Ulnar: 0.28 ± 0.18, P < 0.05), suggesting greater FCU and ECU contribution to wrist joint stability in radial-ulnar movement. These findings highlight a greater complexity of wrist extensor function than has previously been reported in isometric work.
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Affiliation(s)
- Davis A Forman
- Faculty of Science, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Garrick N Forman
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Edwin J Avila-Mireles
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Bernadette Murphy
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada.
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19
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Forman DA, Forman GN, Mugnosso M, Zenzeri J, Murphy B, Holmes MWR. Sustained Isometric Wrist Flexion and Extension Maximal Voluntary Contractions Similarly Impair Hand-Tracking Accuracy in Young Adults Using a Wrist Robot. Front Sports Act Living 2020; 2:53. [PMID: 33345044 PMCID: PMC7739644 DOI: 10.3389/fspor.2020.00053] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/16/2020] [Indexed: 11/13/2022] Open
Abstract
Due to their stabilizing role, the wrist extensor muscles demonstrate an earlier onset of performance fatigability and may impair movement accuracy more than the wrist flexors. However, minimal fatigue research has been conducted at the wrist. Thus, the purpose of this study was to examine how sustained isometric contractions of the wrist extensors/flexors influence hand-tracking accuracy. While gripping the handle of a three-degrees-of-freedom wrist manipulandum, 12 male participants tracked a 2:3 Lissajous curve (±32° wrist flexion/extension; ±18° radial/ulnar deviation). A blue, circular target moved about the trajectory and participants tracked the target with a yellow circle (corresponding to the handle's position). Five baseline tracking trials were performed prior to the fatiguing task. Participants then exerted either maximal wrist extension or flexion force (performed on separate days) against a force transducer until they were unable to maintain 25% of their pre-fatigue maximal voluntary contraction (MVC). Participants then performed 7 tracking trials from immediately post-fatigue to 10 min after. Performance fatigability was assessed using various metrics to account for errors in position-tracking, error tendencies, and movement smoothness. While there were no differences in tracking error between flexion/extension sessions, tracking error significantly increased immediately post-fatigue (Baseline: 1.40 ± 0.54°, Post-fatigue: 2.02 ± 0.51°, P < 0.05). However, error rapidly recovered, with no differences in error from baseline after 1-min post-fatigue. These findings demonstrate that sustained isometric extension/flexion contractions similarly impair tracking accuracy of the hand. This work serves as an important step to future research into workplace health and preventing injuries of the distal upper-limb.
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Affiliation(s)
- Davis A Forman
- Faculty of Science, Ontario Tech University, Oshawa, ON, Canada
| | - Garrick N Forman
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Bernadette Murphy
- Faculty of Health Sciences, Ontario Tech University, Oshawa, ON, Canada
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
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Abstract
Balancing a stick on the fingertip while standing upright is a dual balancing task that requires the integration of two independent control systems. This is a completely novel experimental paradigm for attempting to understand how the brain deals with equilibrium in a general way. Preliminary results are presented and interpreted in the framework of an intermittent control policy extended to include a dual balancing task. In particular the study reveals that the upright standing (the less critical task) is modified in an adaptive way, in order to facilitate the more critical task, i.e. stick balancing.
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21
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Belgiovine G, Morasso P, Zenzeri J. Strategy preference in complex dynamical tasks: preliminary results .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:5104-5107. [PMID: 31947007 DOI: 10.1109/embc.2019.8856519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Many complex activities of daily living are characterized by instabilities. From a motor control point of view, there are two alternative stabilization mechanisms that require to integrate multi-joint coordination aspects: stiffness and positional stabilization strategies. The aim of this work is to understand how the central nervous system can switch between the two control paradigms, depending on the dynamic properties of the environment. This study reports the performance of healthy participants trained to master both strategies and, in particular, it shows how it is possible to quantitatively assess the individual strategy preference when specific environmental factors are introduced.
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22
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Albanese GA, Marini F, Taglione E, Gasparini C, Grandi S, Pettinelli F, Sardelli C, Catitti P, Sandini G, Masia L, Zenzeri J. Assessment of human wrist rigidity and pain in post-traumatic patients .. IEEE Int Conf Rehabil Robot 2020; 2019:89-94. [PMID: 31374612 DOI: 10.1109/icorr.2019.8779508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The aim of this work is to present a novel robot-based method to assess the sources of a lack of functionality in patients with recent traumatic wrist injuries. Post-traumatic patients experience limited range of motion as well as strength and proprioceptive deficits. These dysfunctions are related to different complications that usually follow the injuries: pain, increased rigidity, lack of movement fluency and loss of stability could arise differently, according to the severity, site and kind of lesion. Their quantitative evaluation could be essential to target rehabilitation treatments to the specific problem and to optimize and speed up the functional recovery. The use of robotic devices for assessment not only ensures objectivity and repeatability, but could also help to estimate the goodness of the evaluation itself, in terms of reliability and patient's engagement. Ten subjects with different types of wrist injuries were enrolled in this study and required to perform passive robot-guided reaching movements. Forces and angular positions were used to evaluate subject's range of motion, rigidity and pain that, considered together, allowed a comprehensive characterization of the level of healing and functionality achieved by each subject.
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23
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Avanzino L, Cherif A, Crisafulli O, Carbone F, Zenzeri J, Morasso P, Abbruzzese G, Pelosin E, Konczak J. Tactile and proprioceptive dysfunction differentiates cervical dystonia with and without tremor. Neurology 2020; 94:e639-e650. [DOI: 10.1212/wnl.0000000000008916] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 08/28/2019] [Indexed: 12/13/2022] Open
Abstract
ObjectiveTo determine whether different phenotypes of cervical dystonia (CD) express different types and levels of somatosensory impairment.MethodsWe assessed somatosensory function in patients with CD with and without tremor (n = 12 each) and in healthy age-matched controls (n = 22) by measuring tactile temporal discrimination thresholds of the nondystonic forearm and proprioceptive acuity in both the dystonic (head/neck) and nondystonic body segments (forearm/hand) using a joint position‐matching task. The head or the wrist was passively displaced along different axes to distinct joint positions by the experimenter or through a robotic exoskeleton. Participants actively reproduced the experienced joint position, and the absolute joint position‐matching error between the target and the reproduced positions served as a marker of proprioceptive acuity.ResultsTactile temporal discrimination thresholds were significantly elevated in both CD subgroups compared to controls. Proprioceptive acuity of both the dystonic and nondystonic body segments was elevated in patients with CD and tremor with respect to both healthy controls and patients with CD without tremor. That is, tactile abnormalities were a shared dysfunction of both CD phenotypes, while proprioceptive dysfunction was observed in patients with CD with tremor.ConclusionsOur findings suggest that the pathophysiology in CD can be characterized by 2 abnormal neural processes: a dysfunctional somatosensory gating mechanism involving the basal ganglia that triggers involuntary muscle spasms and abnormal processing of proprioceptive information within a defective corticocerebellar loop, likely affecting the feedback and feedforward control of head positioning. This dysfunction is expressed mainly in CD with tremor.
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Marini F, Zenzeri J, Pippo V, Morasso P, Campus C. Neural correlates of proprioceptive upper limb position matching. Hum Brain Mapp 2019; 40:4813-4826. [PMID: 31348604 PMCID: PMC6865654 DOI: 10.1002/hbm.24739] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 11/06/2022] Open
Abstract
Proprioceptive information allows humans to perform smooth coordinated movements by constantly updating one's mind with knowledge of the position of one's limbs in space. How this information is combined with other sensory modalities and centrally processed to form conscious perceptions of limb position remains relatively unknown. What has proven even more elusive is pinpointing the contribution of proprioception in cortical activity related to motion. This study addresses these gaps by examining electrocortical dynamics while participants performed an upper limb position matching task in two conditions, namely with proprioceptive feedback or with both visual and proprioceptive feedback. Specifically, we evaluated the reduction of the electroencephalographic power (desynchronization) in the μ frequency band (8-12 Hz), which is known to characterize the neural activation associated with motor control and behavior. We observed a stronger desynchronization in the left motor and somatosensory areas, contralateral to the moving limb while, parietal and occipital regions, identifying association and visual areas, respectively, exhibited a similar activation level in the two hemispheres. Pertaining to the influence of the two experimental conditions it affected only movement's offset, and precisely we found that when matching movements are performed relying only on proprioceptive information, a lower cortical activity is entailed. This effect was strongest in the visual and association areas, while there was a minor effect in the hand motor and somatosensory areas.
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Affiliation(s)
- Francesca Marini
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Valentina Pippo
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Pietro Morasso
- Department of Robotics, Brain and Cognitive SciencesIstituto Italiano di TecnologiaGenoaItaly
| | - Claudio Campus
- U‐VIP Unit for Visually Impaired PeopleIstituto Italiano di TecnologiaGenoaItaly
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Mugnosso M, Zenzeri J, Hughes CML, Marini F. Coupling Robot-Aided Assessment and Surface Electromyography (sEMG) to Evaluate the Effect of Muscle Fatigue on Wrist Position Sense in the Flexion-Extension Plane. Front Hum Neurosci 2019; 13:396. [PMID: 31736733 PMCID: PMC6838006 DOI: 10.3389/fnhum.2019.00396] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/22/2019] [Indexed: 11/13/2022] Open
Abstract
Proprioception is a crucial sensory modality involved in the control and regulation of coordinated movements and in motor learning. However, the extent to which proprioceptive acuity is influenced by local muscle fatigue is obscured by methodological differences in proprioceptive and fatiguing protocols. In this study, we used high resolution kinematic measurements provided by a robotic device, as well as both frequency and time domain analysis of signals captured via surface electromyography (sEMG) to examine the effects of local muscle fatigue on wrist proprioceptive acuity in 16 physically and neurologically healthy young adults. To this end, participants performed a flexion/extension ipsilateral joint position matching test (JPM), after which a high-resistive robotic task was used to induce muscle fatigue of the flexor carpi radialis (FCR) muscle. The JPM test was then repeated in order to analyze potential changes in proprioceptive acuity. Results indicated that the fatigue protocol had a significant effect on movements performed in flexion direction, with participants exhibiting a tendency to undershoot the target before the fatigue protocol (−1.218°), but overshooting after the fatigue protocol (0.587°). In contrast, in the extension direction error bias values were similar before and after the fatigue protocol as expected (pre = −1.852°, post = −1.237°) and reflected a tendency to undershoot the target. Moreover, statistical analysis indicated that movement variability was not influenced by the fatigue protocol or movement direction. In sum, results of the present study demonstrate that an individual’s estimation of wrist joint displacement (i.e., error bias), but not precision (i.e., variability), is affected by muscular fatigue in a sample of neurologically and physically healthy adults.
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Affiliation(s)
- Maddalena Mugnosso
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy.,Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy
| | - Jacopo Zenzeri
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Charmayne M L Hughes
- NeuroTech Laboratory, Health Equity Institute, San Francisco State University, San Francisco, CA, United States
| | - Francesca Marini
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
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Marini F, Gordon-Murer C, Sera M, Tanha T, Licudo F, Zenzeri J, Hughes CM. Age-related Declines in Sensorimotor Proficiency are Specific to the Tested Motor Skill Component. IEEE Int Conf Rehabil Robot 2019; 2019:654-659. [PMID: 31374705 DOI: 10.1109/icorr.2019.8779560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This study utilized a 3-degree of freedom robotic device (Wristbot) to examine wrist proprioception and eye-hand coordination in a cross-sectional sample of sixty-three young adults (19-29 years), 20 older young adults (30-49), and 17 older adults (50 years and older). Results indicated differences in the emergence of age-related declines in sensorimotor functioning depending on the tested motor skill component. While young adults exhibited smaller matching error and lower variability compared to older young adults and older adults on the proprioception task, we observed lower times-on-target and higher Linearity indices for participants older than 50 years of age compared to both young adults and older young adults. The present results provide necessary quantitative information on sensorimotor function in adulthood, and have implications for the early diagnosis and effective management of sensorimotor dysfunction in clinical settings using a commercially available robotic device.
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Marini F, Zenzeri J, Pippo V, Morasso P, Campus C. Movement related activity in the μ band of the human EEG during a robot-based proprioceptive task. IEEE Int Conf Rehabil Robot 2019; 2019:1019-1024. [PMID: 31374763 DOI: 10.1109/icorr.2019.8779552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Innovative research in the fields of prosthetic, neurorehabilitation, motor control and human physiology has been focusing on the study of proprioception, the sense through which we perceive the position and movement of our body, and great achievements have been obtained regarding its assessment and characterization. However, how proprioceptive signals are combined with other sensory modalities and processed by the central nervous system to form a conscious body image, is still unknown. Such a crucial question was addressed in this study, which involved 23 healthy subjects, by combining a robot-based proprioceptive test with a specific analysis of electroencephalographic activity (EEG) in the $\mu$ frequency band (8-12 Hz). We observed important activation in the motor area contralateral to the moving hand, and besides, a substantial bias in brain activation and proprioceptive acuity when visual feedback was provided in addition to the proprioceptive information during movement execution. In details, brain activation and proprioceptive acuity were both higher in case of movements performed with visual feedback. Remarkably, we also found a correlation between the level of activation in the brain motor area contralateral to the moving hand and the value of proprioceptive acuity.
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Morasso P, Nomura T, Suzuki Y, Zenzeri J. Stabilization of a Cart Inverted Pendulum: Improving the Intermittent Feedback Strategy to Match the Limits of Human Performance. Front Comput Neurosci 2019; 13:16. [PMID: 31024281 PMCID: PMC6461063 DOI: 10.3389/fncom.2019.00016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/11/2019] [Indexed: 11/13/2022] Open
Abstract
Stabilization of the CIP (Cart Inverted Pendulum) is an analogy to stick balancing on a finger and is an example of unstable tasks that humans face in everyday life. The difficulty of the task grows exponentially with the decrease of the length of the stick and a stick length of 32 cm is considered as a human limit even for well-trained subjects. Moreover, there is a cybernetic limit related to the delay of the multimodal sensory feedback (about 230 ms) that supports a feedback stabilization strategy. We previously demonstrated that an intermittent-feedback control paradigm, originally developed for modeling the stabilization of upright standing, can be applied with success also to the CIP system, but with values of the critical parameters far from the limiting ones (stick length 50 cm and feedback delay 100 ms). The intermittent control paradigm is based on the alternation of on-phases, driven by a proportional/derivative delayed feedback controller, and off-phases, where the feedback is switched off and the motion evolves according to the intrinsic dynamics of the CIP. In its standard formulation, the switching mechanism consists of a simple threshold operator: the feedback control is switched off if the current (delayed) state vector is closer to the stable than to the unstable manifold of the off-phase and is switched on in the opposite case. Although this simple formulation is effective for explaining upright standing as well as CIP balancing, it fails in the most challenging configuration of the CIP. In this work we propose a modification of the standard intermittent control policy that focuses on the explicit selection of switching times and is based on the phase reset of the estimated state vector at each switching time and on the simulation of an approximated internal model of CIP dynamics. We demonstrate, by simulating the modified intermittent control policy, that it can match the limits of human performance, while operating near the edge of instability.
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Affiliation(s)
- Pietro Morasso
- Robotics, Brain and Cognitive Sciences Department, Center for Human Technologies, Italian Institute of Technology, Genoa, Italy
| | - Taishin Nomura
- Mechanical Science and Bioengineering Department, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Yasuyuki Suzuki
- Mechanical Science and Bioengineering Department, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences Department, Center for Human Technologies, Italian Institute of Technology, Genoa, Italy
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Abstract
In the study of balance and postural control the (Single) Inverted Pendulum model (SIP) has been taken for a long time as an acceptable paradigm, with the implicit assumption that only ankle rotations are relevant for describing and explaining sway movements. However, more recent kinematic analysis of quiet standing revealed that hip motion cannot be neglected at all and that ankle-hip oscillatory patterns are characterized by complex in-phase and anti-phase interactions, suggesting that the SIP model should be substituted by a DIP (Double Inverted Pendulum) model. It was also suggested that DIP control could be characterized as a kind of optimal bi-axial active controller whose goal is minimizing the acceleration of the global CoM (Center of Mass). We propose here an alternative where active feedback control is applied in an intermittent manner only to the ankle joint, whereas the hip joint is stabilized by a passive stiffness mechanism. The active control impulses are delivered to the ankle joint as a function of the delayed state vector (tilt rotation angle + tilt rotational speed) of a Virtual Inverted Pendulum (VIP), namely a pendulum that links the ankle to the CoM, embedded in the real DIP. Simulations of such DIP/VIP model, with the hybrid control mechanism, show that it can reproduce the in-phase/anti-phase interaction patterns of the two joints described by several experimental studies. Moreover, the simulations demonstrate that the DIP/VIP model can also reproduce the measured minimization of the CoM acceleration, as an indirect biomechanical consequence of the dynamic interaction between the active control of the ankle joint and the passive control of the hip joint. We suggest that although the SIP model is literally false, because it ignores the ankle-hip coordination, it is functionally correct and practically acceptable for experimental studies that focus on the postural oscillations of the CoM.
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Affiliation(s)
- Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Amel Cherif
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
- Department of Informatics, Bioengineering, Robotics, and System Engineering, University of Genoa, Genoa, Italy
| | - Jacopo Zenzeri
- Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
- * E-mail:
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Abstract
BACKGROUND Several neuromuscular disorders present muscle fatigue as a typical symptom. Therefore, a reliable method of fatigue assessment may be crucial for understanding how specific disease features evolve over time and for developing effective rehabilitation strategies. Unfortunately, despite its importance, a standardized, reliable and objective method for fatigue measurement is lacking in clinical practice and this work investigates a practical solution. METHODS 40 healthy young adults performed a haptic reaching task, while holding a robotic manipulandum. Subjects were required to perform wrist flexion and extension movements in a resistive visco-elastic force field, as many times as possible, until the measured muscles (mainly flexor and extensor carpi radialis) exhibited signs of fatigue. In order to analyze the behavior and the characteristics of the two muscles, subjects were divided into two groups: in the first group, the resistive force was applied by the robot only during flexion movements, whereas, in the second group, the force was applied only during extension movements. Surface electromyographic signals (sEMG) of both flexor and extensor carpi radialis were acquired. A novel indicator to define the Onset of Fatigue (OF) was proposed and evaluated from the Mean Frequency of the sEMG signal. Furthermore, as measure of the subjects' effort throughout the task, the energy consumption was estimated. RESULTS From the beginning to the end of the task, as expected, all the subjects showed a decrement in Mean Frequency of the muscle involved in movements resisting the force. For the OF indicator, subjects were consistent in terms of timing of fatigue; moreover, extensor and flexor muscles presented similar OF times. The metabolic analysis showed a very low level of energy consumption and, from the behavioral point of view, the test was well tolerated by the subjects. CONCLUSION The robot-aided assessment test proposed in this study, proved to be an easy to administer, fast and reliable method for objectively measuring muscular fatigue in a healthy population. This work developed a framework for an evaluation that can be deployed in a clinical practice with patients presenting neuromuscular disorders. Considering the low metabolic demand, the requested effort would likely be well tolerated by clinical populations.
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Affiliation(s)
- Maddalena Mugnosso
- Motor Learning, Assistive and Rehabilitation Robotics Lab, Robotics, Brain and Cognitive Sciences unit, Istituto Italiano di Tecnologia, Genoa, Italy.
- Department of Informatics, Bioengineering, Robotics and Systems Engineering (DIBRIS),University of Genoa, Genoa, Italy.
| | - Francesca Marini
- Motor Learning, Assistive and Rehabilitation Robotics Lab, Robotics, Brain and Cognitive Sciences unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Michael Holmes
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Pietro Morasso
- Motor Learning, Assistive and Rehabilitation Robotics Lab, Robotics, Brain and Cognitive Sciences unit, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Motor Learning, Assistive and Rehabilitation Robotics Lab, Robotics, Brain and Cognitive Sciences unit, Istituto Italiano di Tecnologia, Genoa, Italy
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Marini F, Ferrantino M, Zenzeri J. Proprioceptive identification of joint position versus kinaesthetic movement reproduction. Hum Mov Sci 2018; 62:1-13. [PMID: 30172030 DOI: 10.1016/j.humov.2018.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 08/15/2018] [Accepted: 08/22/2018] [Indexed: 11/15/2022]
Abstract
Regarding our voluntary control of movement, if identification of joint position, that is independent of the starting condition, is stronger than kinaesthetic movement reproduction, that implies knowledge of the starting position and movement's length for accuracy, is still a matter of debate in motor control theories and neuroscience. In the present study, we examined the mechanisms that individuals seem to prefer/adopt when they locate spatial positions and code the amplitude of movements. We implemented a joint position matching task on a wrist robotic device: this task consists in replicating (i.e. matching) a reference joint angle in the absence of vision and the proprioceptive acuity is given by the goodness of such matching. Two experiments were carried out by implementing two different versions of the task and performed by two groups of 15 healthy participants. In the first experiment, blindfolded subjects were asked to perform matching movements towards a fixed target position, experienced with passive movements that started from different positions and had different lengths. In the second experiment, blindfolded subjects were requested to accurately match target positions that had a different location in space but were passively shown through movements of the same length. We found a clear evidence for higher performances in terms of accuracy (0.42±0.011/°) and precision (0.43±0.011/°) in the first experiment, therefore in case of matching positions, rather than in the second where accuracy and precision were lower (0.36±0.011/° and 0.35±0.011/° respectively). These results suggested a preference for proprioceptive identification of joint position rather than kinaesthetic movement reproduction.
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Affiliation(s)
- Francesca Marini
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy.
| | - Martina Ferrantino
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
| | - Jacopo Zenzeri
- Motor Learning, Assistive and Rehabilitation Robotics Laboratory, Department of Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genova, Italy
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De Santis D, Avila Mireles EJ, Squeri V, Morasso P, Zenzeri J. Dealing with instability in bimanual and collaborative tasks. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2015:1417-20. [PMID: 26736535 DOI: 10.1109/embc.2015.7318635] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In the context of unstable tasks, whenever the dynamics of the interaction are unknown, our ability to control an object depends on the predictability of the sensory feedback generated from the physical coupling at the interface with the object. In the case of physical human-human interaction, the haptic sensory feedback plays a primary role in the construction of a shared motor plan, being the channel for the mutual sharing of intentions. The present work addresses the issue of strategy selection in contexts in which instability is arising both from the environment, i.e. controlling a compliant object subject to nonlinear forces, and from the interaction with a partner, i.e. carrying out a bimanual balancing task in the presence of disturbing force-fields.
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Abstract
Proprioceptive signals from cutaneous, joint, tendon and muscle receptors create the basis for bodily perception and are known to be essential for motor control. However, which are the mechanisms underlying the proprioceptive signals and which are the variables that affect them is still a matter of debate. In particular, what is worth to investigate is, namely, the codification of proprioceptive information related to pointing movements of the wrist towards kinesthetic targets. In this work we asked 10 healthy adults to perform with their wrist a robot-aided proprioceptive matching task, in which the starting position of the matching movements was shifted forward or backward, in order to ascertain to which extent such shifts cause target over/under estimation and how important is movement's length on task performance. Results indicate that accuracy and precision of performance are highly correlated with the starting position and targets tended to be undershot when the active matching movements were longer. Moreover, further analysis revealed a consistent decrement of movement speed for shorter movements and conversely, faster displacement in case of backward of starting position.
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Mugnosso M, Marini F, Gillardo M, Morasso P, Zenzeri J. A novel method for muscle fatigue assessment during robot-based tracking tasks. IEEE Int Conf Rehabil Robot 2018; 2017:84-89. [PMID: 28813798 DOI: 10.1109/icorr.2017.8009226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In this work we propose a novel method based on sEMG signals, easy and fast to perform, administered with a robotic device to maximize repeatability and objectivity. Muscle fatigue, which is frequently experienced by healthy subjects, can be a highly debilitating symptom in case of neuromuscular disorders. Its assessment provides crucial information on the progression of the disability itself, on patient's muscular function and on the efficacy of the eventual clinical intervention. Hence, a robust and objective protocol for fatigue assessment is fundamental in rehabilitation practice. Therefore, the aim of this work was twofold. Firstly, we aimed to test the proposed method and highlight its strengths and drawbacks for a future optimization and implementation in a clinical context. Secondly, we meant to identify which are the most sensitive and reliable measures of muscles' performance that can quickly and optimally predict subjects' behavior. sEMG signals were collected from right Extensor and Flexor Carpi Radialis of 9 healthy subjects during a flexion-extension robotic task consisting in a haptic tracking in a viscous field. Three indicators of fatigue (Mean Frequency, Dimitrov Index, Root Mean Square) were obtained and we proposed a novel sensitive parameter which determines the Onset of Fatigue.
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Galofaro E, Morasso P, Zenzeri J. Improving motor skill transfer during dyadic robot training through the modulation of the expert role. IEEE Int Conf Rehabil Robot 2017; 2017:78-83. [PMID: 28813797 DOI: 10.1109/icorr.2017.8009225] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In daily life it is necessary to learn skills that can be applied in different tasks and different contexts. Usually these skills are acquired by observation or by direct physical training with another expert person. The critical point is to know which is the best possible way to achieve this knowledge acquisition. In this work we have proposed a collaborative environment where subjects with different levels of expertise have to interact through the use of a robotic platform. A motor skill learning algorithm has been designed in order to allow the less skilled subjects-naïves-to explore the virtual environment and to exploit the advantages of working with a skilled partner. Results show that the correct trade - off between exploration and exploitation, provided by the implemented algorithm applied during the dyadic training, allows a group of naive subjects to learn the task and generalize better the acquired skills respect to subjects trained without the proposed algorithm.
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Morasso P, Nomura T, Suzuki Y, Zenzeri J. The brain can mix different control strategies in a task-oriented and multi-referential manner: a simulation study. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:9-12. [PMID: 28268268 DOI: 10.1109/embc.2016.7590627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In everyday life the brain must adapt to variable situations that may require a mixture of approaches including anticipatory synergy formation, through an internal body schema, and different control strategies. Unstable tasks are particularly challenging because deteriorate the predictive power of internal models and further enhance the instability potential of delayed sensory feedback. We explore this issue by means of three simulation studies: A) The hybrid control of a double inverted pendulum model, B) The bimanual stabilization of a saddle-like instability, C) Whole-body focal-postural dynamics. The simulation results support the idea that the brain can mix different control strategies in a task-oriented and multi-referential manner.
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Avila Mireles EJ, Zenzeri J, Squeri V, Morasso P, De Santis D. Skill Learning and Skill Transfer Mediated by Cooperative Haptic Interaction. IEEE Trans Neural Syst Rehabil Eng 2017; 25:832-843. [PMID: 28500006 DOI: 10.1109/tnsre.2017.2700839] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
It is known that physical coupling between two subjects may be advantageous in joint tasks. However, little is known about how two people mutually exchange information to exploit the coupling. Therefore, we adopted a reversed, novel perspective to the standard one that focuses on the ability of physically coupled subjects to adapt to cooperative contexts that require negotiating a common plan: we investigated how training in pairs on a novel task affects the development of motor skills of each of the interacting partners. The task involved reaching movements in an unstable dynamic environment using a bilateral non-linear elastic tool that could be used bimanually or dyadically. The main result is that training with an expert leads to the greatest performance in the joint task. However, the performance in the individual test is strongly affected by the initial skill level of the partner. Moreover, practicing with a peer rather than an expert appears to be more advantageous for a naive; and motor skills can be transferred to a bimanual context, after training with an expert, only if the non-expert subject had prior experience of the dynamics of the novel task.
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Loram I, Cunningham R, Zenzeri J, Gollee H. Intermittent control of unstable multivariate systems with uncertain system parameters. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:17-20. [PMID: 28268270 DOI: 10.1109/embc.2016.7590629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Multivariable intermittent control (MIC) combines stability with flexibility in the control of unstable systems. Using an underlying continuous-time optimal control design, MIC uses models of the physical system to generate multivariate open-loop control signals between samples of the observed state. Using accurate model values of physical system parameters, stability of the closed loop system is not dependent upon sample interval. Here we consider the sensitivity of MIC to inaccurate model values of system parameters. The high dimensionality of multiple parameters combined with an unstable open loop system ensures the ratio of hyper-volumes containing good to bad parameter combinations resembles a "needle in a haystack". Is this sensitivity a problem or an asset? Prediction error between open loop and observed states provides the basis for triggering a sampling event but is also sensitive to inaccurate model values. Investigation of the mapping between prediction error and model values of physical parameters illustrates the value of prediction error to identify combinations of parameters giving stable closed loop control with low state error, similar to that provided by accurate values. Sensitivity of prediction error to model inaccuracy is potentially an asset facilitating adaptation and supporting the rationale for MIC to combine control with flexibility.
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Mireles EJA, De Santis D, Morasso P, Zenzeri J. Transferring knowledge during dyadic interaction: The role of the expert in the learning process. Annu Int Conf IEEE Eng Med Biol Soc 2017; 2016:2149-2152. [PMID: 28268757 DOI: 10.1109/embc.2016.7591154] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Physical interaction between man and machines is increasing the interest of the research as well as the industrial community. It is known that physical coupling between active persons can be beneficial and increase the performance of the dyad compared to an individual. However, the factors that may result in performance benefits are still poorly understood. The aim of this work is to investigate how the different initial skill levels of the interacting partners influence the learning of a stabilization task. Twelve subjects, divided in two groups, trained in couples in a joint stabilization task. In the first group the couples were composed of two naive, while in the second a naive was trained together with an expert. Results show that training with an expert results in the greatest performance in the joint task. However, this benefit is not transferred to the individual when performing the same task bimanually.
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Mireles EJA, De Santis D, Squeri V, Morasso P, Zenzeri J. Motor control strategies in the bimanual stabilization of an unstable virtual tool. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:3472-3475. [PMID: 26737040 DOI: 10.1109/embc.2015.7319140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Previous works have shown that, when dealing with instabilities in a bimanual manipulation paradigm, humans modulate the stiffness of the arms according to feedforward or feedback mechanisms as a function of the dynamics of the task. The aim of this work is to complement these results getting insights on how the CNS controls the muscles to achieve the stabilization goal in the two aforementioned control strategies. Surface EMG was recorded from 13 muscles of each arm and trunk while three expert subjects performed bimanual balancing of a virtual underactuated tool immersed in an unstable force-field. Results suggest the existence of an intermittent muscle ensemble recruitment that follows two distinct activation patterns, namely synchronous co-contractions and independent activations. The observed EMG patterns were independent of the motor control strategy applied in the task. These findings therefore suggest the existence of separate control strategies for the tool stabilization and the control of hand movements at the muscular level during a bimanual postural task.
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Morasso P, Casadio M, Mohan V, Rea F, Zenzeri J. Revisiting the body-schema concept in the context of whole-body postural-focal dynamics. Front Hum Neurosci 2015; 9:83. [PMID: 25741274 PMCID: PMC4330890 DOI: 10.3389/fnhum.2015.00083] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 02/02/2015] [Indexed: 12/31/2022] Open
Abstract
The body-schema concept is revisited in the context of embodied cognition, further developing the theory formulated by Marc Jeannerod that the motor system is part of a simulation network related to action, whose function is not only to shape the motor system for preparing an action (either overt or covert) but also to provide the self with information on the feasibility and the meaning of potential actions. The proposed computational formulation is based on a dynamical system approach, which is linked to an extension of the equilibrium-point hypothesis, called Passive Motor Paradigm: this dynamical system generates goal-oriented, spatio-temporal, sensorimotor patterns, integrating a direct and inverse internal model in a multi-referential framework. The purpose of such computational model is to operate at the same time as a general synergy formation machinery for planning whole-body actions in humanoid robots and/or for predicting coordinated sensory-motor patterns in human movements. In order to illustrate the computational approach, the integration of simultaneous, even partially conflicting tasks will be analyzed in some detail with regard to postural-focal dynamics, which can be defined as the fusion of a focal task, namely reaching a target with the whole-body, and a postural task, namely maintaining overall stability.
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Affiliation(s)
- Pietro Morasso
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia , Genoa , Italy ; Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi (DIBRIS), University of Genoa , Genoa , Italy
| | - Maura Casadio
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia , Genoa , Italy ; Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi (DIBRIS), University of Genoa , Genoa , Italy
| | - Vishwanathan Mohan
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia , Genoa , Italy
| | - Francesco Rea
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia , Genoa , Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia , Genoa , Italy
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De Santis D, Zenzeri J, Masia L, Squeri V, Morasso P. Human-human physical interaction in the joint control of an underactuated virtual object. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:4407-10. [PMID: 25570969 DOI: 10.1109/embc.2014.6944601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Human-human physical interaction has proven to be advantageous especially in contexts with high coordination requirements. But under which conditions can haptic communication bring to performance benefits in a challenging cooperative environment? In this work we investigate which are the dynamics that intervene when two subjects are required to switch from a bimanual to a dyadic configuration in order to solve a complex reaching and stabilization task of a virtual tool in the presence of an unstable dynamics. Results show that dyadic cooperation can improve the performance respect to the individual condition, while minimizing the effort. However, in the joint task, when the stiffness of the system becomes harder to manipulate the feedback delays appear to be critical in determining the maximum achievable level of performance.
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De Santis D, Zenzeri J, Casadio M, Masia L, Riva A, Morasso P, Squeri V. Robot-assisted training of the kinesthetic sense: enhancing proprioception after stroke. Front Hum Neurosci 2015; 8:1037. [PMID: 25601833 PMCID: PMC4283673 DOI: 10.3389/fnhum.2014.01037] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/10/2014] [Indexed: 11/13/2022] Open
Abstract
Proprioception has a crucial role in promoting or hindering motor learning. In particular, an intact position sense strongly correlates with the chances of recovery after stroke. A great majority of neurological patients present both motor dysfunctions and impairments in kinesthesia, but traditional robot and virtual reality training techniques focus either in recovering motor functions or in assessing proprioceptive deficits. An open challenge is to implement effective and reliable tests and training protocols for proprioception that go beyond the mere position sense evaluation and exploit the intrinsic bidirectionality of the kinesthetic sense, which refers to both sense of position and sense of movement. Modulated haptic interaction has a leading role in promoting sensorimotor integration, and it is a natural way to enhance volitional effort. Therefore, we designed a preliminary clinical study to test a new proprioception-based motor training technique for augmenting kinesthetic awareness via haptic feedback. The feedback was provided by a robotic manipulandum and the test involved seven chronic hemiparetic subjects over 3 weeks. The protocol included evaluation sessions that consisted of a psychometric estimate of the subject's kinesthetic sensation, and training sessions, in which the subject executed planar reaching movements in the absence of vision and under a minimally assistive haptic guidance made by sequences of graded force pulses. The bidirectional haptic interaction between the subject and the robot was optimally adapted to each participant in order to achieve a uniform task difficulty over the workspace. All the subjects consistently improved in the perceptual scores as a consequence of training. Moreover, they could minimize the level of haptic guidance in time. Results suggest that the proposed method is effective in enhancing kinesthetic acuity, but the level of impairment may affect the ability of subjects to retain their improvement in time.
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Affiliation(s)
- Dalia De Santis
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia , Genova , Italy
| | - Jacopo Zenzeri
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia , Genova , Italy
| | - Maura Casadio
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia , Genova , Italy ; NeuroLab, Department of Informatics, Bioengineering, Robotics and Systems (DIBRIS), University of Genova , Genova , Italy
| | - Lorenzo Masia
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia , Genova , Italy ; Assistive Robotics and Interactive Ergonomic Systems Laboratory, Division of Mechatronics and Design, Robotic Research Center, School of Mechanical and Aerospace Engineering (MAE), Nanyang Technological University (NTU) , Singapore
| | - Assunta Riva
- SI4LIFE - Innovation Hub for Elderly and Disabled People , Genova , Italy
| | - Pietro Morasso
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia , Genova , Italy ; NeuroLab, Department of Informatics, Bioengineering, Robotics and Systems (DIBRIS), University of Genova , Genova , Italy
| | - Valentina Squeri
- Motor Learning and Robotic Rehabilitation Laboratory, Department of Robotics, Brain and Cognitive Sciences (RBCS), Istituto Italiano di Tecnologia , Genova , Italy
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Morasso P, Casadio M, De Santis D, Nomura T, Rea F, Zenzeri J. Stabilization strategies for unstable dynamics. J Electromyogr Kinesiol 2014; 24:803-14. [PMID: 25453479 DOI: 10.1016/j.jelekin.2014.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 09/29/2014] [Accepted: 10/08/2014] [Indexed: 11/29/2022] Open
Abstract
The stabilization of the human standing posture was originally attributed to the stiffness of the ankle muscles but direct measurements of the ankle stiffness ruled out this hypothesis, leaving open the possibility for a feedback stabilization strategy driven by proprioceptive signals. This solution, however, could be implemented with two different kinds of control mechanisms, namely continuous or intermittent feedback. The debate is now settled and the latter solution seems to be the most plausible one. Moreover, stabilization of unstable dynamics is not limited to bipedal standing. Indeed many manipulation tasks can be described in the same framework and thus a very general protocol for addressing this kind of problems is the use of haptic virtual reality where instability is generated by some kind of divergent or saddle-like force field. Several studies demonstrated that human subjects can choose to adopt a stiffness or feedback strategy as a combination of biomechanical and task constraints and can learn to switch from one strategy to the other if it is feasible or to use one or the other is infeasible. Understanding such mechanisms is relevant, for example, for the design of novel ergonomic man-machine interfaces in difficult, unstable tasks.
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Affiliation(s)
- Pietro Morasso
- Istituto Italiano di Tecnologia, Department of Robotics, Brain and Cognitive Sciences, Genoa, Italy.
| | - Maura Casadio
- University of Genoa, Department of Informatics, Bioengineering, Robotics and Systems Engineering, Genoa, Italy.
| | - Dalia De Santis
- Istituto Italiano di Tecnologia, Department of Robotics, Brain and Cognitive Sciences, Genoa, Italy.
| | - Taishin Nomura
- Department of Bioengineering, Graduate School of Engineering Science, Osaka University, Toyonaka, Japan.
| | - Francesco Rea
- Istituto Italiano di Tecnologia, Department of Robotics, Brain and Cognitive Sciences, Genoa, Italy.
| | - Jacopo Zenzeri
- Istituto Italiano di Tecnologia, Department of Robotics, Brain and Cognitive Sciences, Genoa, Italy.
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Abstract
In order to understand mechanisms of strategy switching in the stabilization of unstable dynamics, this work investigates how human subjects learn to become skilled users of an underactuated bimanual tool in an unstable environment. The tool, which consists of a mass and two hand-held non-linear springs, is affected by a saddle-like force-field. The non-linearity of the springs allows the users to determine size and orientation of the tool stiffness ellipse, by using different patterns of bimanual coordination: minimal stiffness occurs when the two spring terminals are aligned and stiffness size grows by stretching them apart. Tool parameters were set such that minimal stiffness is insufficient to provide stable equilibrium whereas asymptotic stability can be achieved with sufficient stretching, although at the expense of greater effort. As a consequence, tool users have two possible strategies for stabilizing the mass in different regions of the workspace: 1) high stiffness feedforward strategy, aiming at asymptotic stability and 2) low stiffness positional feedback strategy aiming at bounded stability. The tool was simulated by a bimanual haptic robot with direct torque control of the motors. In a previous study we analyzed the behavior of naïve users and we found that they spontaneously clustered into two groups of approximately equal size. In this study we trained subjects to become expert users of both strategies in a discrete reaching task. Then we tested generalization capabilities and mechanism of strategy-switching by means of stabilization tasks which consist of tracking moving targets in the workspace. The uniqueness of the experimental setup is that it addresses the general problem of strategy-switching in an unstable environment, suggesting that complex behaviors cannot be explained in terms of a global optimization criterion but rather require the ability to switch between different sub-optimal mechanisms.
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Affiliation(s)
- Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
- * E-mail:
| | - Dalia De Santis
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Pietro Morasso
- Robotics, Brain and Cognitive Sciences Department, Istituto Italiano di Tecnologia, Genoa, Italy
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De Santis D, Masia L, Morasso P, Squeri V, Zenzeri J, Casadio M, Riva A. Pulsed assistance: a new paradigm of robot training. IEEE Int Conf Rehabil Robot 2013; 2013:6650504. [PMID: 24187319 DOI: 10.1109/icorr.2013.6650504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
In this preliminary study we compare continuous with pulsed robot assistance in five chronic stroke survivors with a mild degree of spasticity, with the aim of promoting volitional effort and reducing assistance during a reaching task. The protocol consists of one familiarization session and a single training session during which a manipulandum provides subjects with pulsed or continuous assistance in random order. The basic level of assistive force is calibrated for each subject and is the same for both modalities; however, the average force during continuous assistance is about twice the average force in pulsed assistance. In spite of this, the results show that pulsed assistance allows subjects to reach similar performance levels as compared to continuous assistance after a single training session. Moreover, we introduce a novel kinematic-based measure to assess voluntary participation of subjects during the rehabilitation task, which is only applicable with pulsed assistance.
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Squeri V, Zenzeri J, Morasso P, Basteris A. Integrating proprioceptive assessment with proprioceptive training of stroke patients. IEEE Int Conf Rehabil Robot 2012; 2011:5975500. [PMID: 22275696 DOI: 10.1109/icorr.2011.5975500] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Although proprioceptive impairment is likely to affect in a significant manner the capacity of stroke patients to recover functionality of the upper limb, clinical assessment methods in current use are rather crude, with a low level of reliability and a limited capacity to discriminate the relevant features of the deficits. In this paper we describe a new technique based on robot technology, with the goal of providing a reliable, accurate, quantitative evaluation of the position sense in peri-personal space. The proposed technique uses a bimanual, planar robot manipuladum (BdF device), whose handles are grasped by the blindfolded patient: the paretic hand is passively placed in one of 17 positions and the subject is asked to actively match the paretic hand position in space with the other hand. The position sense of the paretic arm and the corresponding deficit of space representation are characterized by means of 7 indicators: 1) positional error; 2) holding force; 3) medio/lateral shift; 4) antero/posterior shift; 5) medio/lateral skew; 6) antero/posterior skew; 7) shrink coefficient. We also show how the same experimental setup can be used for "proprioceptive training", i.e. for providing robot assistance to the paretic arm that may improve the position sense of the patient. A preliminary, feasibility test has been carried out with one patient and three controls.
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Zenzeri J, Morasso P, Saha DJ. Expert strategy switching in the control of a bimanual manipulandum with an unstable task. Annu Int Conf IEEE Eng Med Biol Soc 2011; 2011:3115-3118. [PMID: 22254999 DOI: 10.1109/iembs.2011.6090850] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The goal of this study is to better understand how the central nervous system switches between alternative stabilization strategies when presented with an unstable task. A haptic, bimanual manipulandum has been used to emulate an unstable task, which requires subjects to stabilize a virtual mass under the action of a saddle force field with two nonlinear springs, whose stiffness increases with the amount of stretch. Subjects learn to position the mass at various target points by adjusting the rest length, and thus the stiffness of the two springs. From a previous study we know that subjects can stabilize the mass by either 1) applying large forces to stretch the springs and increase the mechanical stiffness of the system beyond a critical level or by 2) applying small force impulses that intermittently adjust the position of the mass. In this study we report the performance of a subject who was trained extensively to use one strategy or the other in order to characterize the mechanism of target switching, from the high-stiffness to the low-stiffness regime and back.
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Affiliation(s)
- Jacopo Zenzeri
- Italian Institute of Technology, Dept of Robotics, Brain and Cognitive Sciences, 16163 Genoa, Italy.
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Morasso P, Casadio M, Mohan V, Zenzeri J. A neural mechanism of synergy formation for whole body reaching. Biol Cybern 2010; 102:45-55. [PMID: 19937068 DOI: 10.1007/s00422-009-0349-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2009] [Accepted: 11/02/2009] [Indexed: 05/28/2023]
Abstract
The present study proposes a computational model for the formation of whole body reaching synergy, i.e., coordinated movements of lower and upper limbs, characterized by a focal component (the hand must reach a target) and a postural component (the center of mass must remain inside the support base). The model is based on an extension of the equilibrium point hypothesis that has been called Passive Motion Paradigm (PMP), modified in order to achieve terminal attractor features and allow the integration of multiple constraints. The model is a network with terminal attractor dynamics. By simulating it in various conditions it was possible to show that it exhibits many of the spatio-temporal features found in experimental data. In particular, the motion of the center of mass appears to be synchronized with the motion of the hand and with proportional amplitude. Moreover, the joint rotation patterns can be accounted for by a single functional degree of freedom, as shown by principal component analysis. It is also suggested that recent findings in motor imagery support the idea that the PMP network may represent the motor cognitive part of synergy formation, uncontaminated by the effect of execution.
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Affiliation(s)
- Pietro Morasso
- Department of Robotics, Brain and Cognitive Sciences, Italian Institute of Technology, Genoa, Italy.
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