Definición e implementación de métricas objetivas para la evaluación funcional del miembro superior: aplicación a población con lesión medular cervical

En personas que padecen una Lesión Medular cervical, la función de los miembros superiores se ve afectada en mayor o menor medida, dependiendo fundamentalmente del nivel de la lesión y de la severidad de la misma. El déficit en la función del miembro superior hace que la autonomía e independencia de las personas se vea reducida en la ejecución de Actividades de la Vida Diaria. En el entorno clínico, la valoración de la función del miembro superior se realiza principalmente con escalas clínicas. Algunas de ellas valoran el nivel de dependencia o independencia en la ejecución de Actividades de la Vida Diaria, como, por ejemplo, el índice de Barthel y la escala FIM (Medida de la Independencia Funcional). Otras escalas, como Jebsen-Taylor Hand Function, miden la función del miembro superior valorando la destreza y la habilidad en la ejecución de determinadas tareas funcionales. Estas escalas son generales, es decir, se pueden aplicar a distintas poblaciones de sujetos y a la presencia de distintas patologías. Sin embargo, existen otras escalas desarrolladas específicamente para valorar una patología concreta, con el objetivo de hacer las evaluaciones funcionales más sensibles a cambios. Un ejemplo es la escala Spinal Cord Independence Measure (SCIM), desarrollada para valorar Lesión Medular. Las escalas clínicas son instrumentos de medida estandarizados, válidos para su uso en el entorno clínico porque se han validado en muestras grandes de pacientes. No obstante, suelen poseer una elevada componente de subjetividad que depende principalmente de la persona que puntúa el test. Otro aspecto a tener en cuenta, es que la sensibilidad de las escalas es alta, fundamentalmente, a cambios groseros en el estado de salud o en la función del miembro superior, de forma que cambios sutiles en el sujeto pueden no ser detectados. Además, en ocasiones, poseen saturaciones en el sistema de puntuación, de forma que mejorías que se puedan producir por encima de un determinado umbral no son detectadas. En definitiva, estas limitaciones hacen que las escalas clínicas no sean suficientes, por sí mismas, para evaluar estrategias motoras del miembro superior durante la ejecución de movimientos funcionales, siendo necesaria la búsqueda de instrumentos de medida que aporten objetividad, complementen las valoraciones y, al mismo tiempo, intenten solventar las limitaciones que poseen las escalas. Los estudios biomecánicos son ejemplos de métodos objetivos, en los que diversas tecnologías se pueden utilizar para recoger información de los sujetos. Una concreción de estos estudios son los estudios cinemáticos. Mediante tecnología optoelectrónica, inercial o electromagnética, estos estudios proporcionan información objetiva acerca del movimiento realizado por los sujetos, durante la ejecución de tareas concretas. Estos sistemas de medida proporcionan grandes cantidades de datos que carecen de una interpretación inmediata. Estos datos necesariamente deben ser tratados y reducidos a un conjunto de variables que, a priori, posean una interpretación más sencilla para ser utilizados en la práctica clínica. Estas han sido las principales motivaciones de esta investigación. El objetivo principal fue proponer un conjunto de índices cinemáticos que, de forma objetiva, valoren la función del miembro superior; y validar los índices propuestos en poblaciones con Lesión Medular, para su uso como instrumentos de valoración en el entorno clínico. Esta tesis se enmarca dentro de un proyecto de investigación: HYPER (Hybrid Neuroprosthetic and Neurorobotic Devices for Functional Compensation and Rehabilitation of Motor Disorders, referencia CSD2009-00067 CONSOLIDER INGENIO 2010). Dentro de este proyecto se lleva a cabo investigación en el desarrollo de modelos, para determinar los requisitos biomecánicos y los patrones de movimiento de los miembros superiores en sujetos sanos y personas con lesión medular. Además, se realiza investigación en la propuesta de nuevos instrumentos de evaluación funcional en el campo de la rehabilitación de los miembros superiores. ABSTRACT In people who have suffered a cervical Spinal Cord Injury, upper limbs function is affected to a greater or lesser extent, depending primarily on the level of the injury and the severity of it. The deficit in the upper limb function reduces the autonomy and independence of persons in the execution of Activities of Daily Living. In the clinical setting, assessment of upper limb function is mainly performed based on clinical scales. Some value the level of dependence or independence in performing activities of daily living, such as the Barthel Index and the FIM scale (Functional Independence Measure). Other scales, such as the Jebsen-Taylor Hand Function, measure upper limb function in terms of the skill and ability to perform specific functional tasks. These scales are general, so can be applied to different populations of subjects and the presence of different pathologies. However, there are other scales developed for a specific injury, in order to make the functional assessments more sensitive to changes. An example is the Spinal Cord Independence Measure (SCIM), developed for people with Spinal Cord Injury. The clinical scales are standardized instruments measure, valid for use in the clinical setting because they have been validated in large patient samples. However, they usually have a high level of subjectivity which mainly depends on the person who scores the test. Another aspect to take into account is the high sensitivity of the scales mainly to gross changes in the health status or upper limb function, so that subtle changes in the subject may not be detected. Moreover, sometimes, have saturations in the scoring system, so that improvements which may occur above a certain threshold are not detected. For these reasons, clinical scales are not enough, by themselves, to assess motor strategies used during movements. So, it’s necessary to find measure instruments that provide objectivity, supplement the assessments and, at the same time, solving the limitations that scales have. Biomechanical studies are examples of objective methods, in which several technologies can be used to collect information from the subjects. One kind of these studies is the kinematic movement analysis. By means of optoelectronics, inertial and electromagnetic technology, these studies provide objective information about the movement performed by the subjects during the execution of specific tasks. These systems provide large quantities of data without easy and intuitive interpretation. These data must necessarily be treated and reduced to a set of variables that, a priori, having a simpler interpretation for their use in the clinical practice. These were the main motivations of this research. The main objective was to propose a set of kinematic indices, or metrics that, objectively, assess the upper limb function and validate the proposed rates in populations with Spinal Cord Injury, for use as assessment tools in the clinical setting. This dissertation is framed within a research project: HYPER (Neurorobotic Devices for Functional Compensation and Rehabilitation of Motor Disorders, grant CSD2009- 00067 CONSOLIDER INGENIO 2010). Within this research project, research is conducted in relation to the biomechanical models development for determining the biomechanical requirements and movement patterns of the upper limb in healthy and people with Spinal Cord Injury. Moreover, research is conducted with respect to the proposed of new functional assessment instruments in the field of upper limb rehabilitation.

Modelling Crowd Load for Floor Vibration Analysis

The dynamic floor loads induced by crowds in gymnasium or stadium structures are commonly modelled by superposition of the individual contributions using reduction factors for the different Fourier coefficients. These Fourier coefficients and the reduction factors are calculated using full scale measurements. Generally the testing is performed on platforms or structures that can be considered rigid, such that the natural frequencies are higher than the frequencies of the spectator movement. In this paper we shall present the testing done on a structure that used to be a gymnasium as well as the procedure used to identify its dynamic properties and a first evaluation of the socalled “group effect”.

Automatic motion compensation of free breathing acquired myocardial perfusion data by using independent component analysis

Images acquired during free breathing using first-pass gadolinium-enhanced myocardial perfusion magnetic resonance imaging (MRI) exhibit a quasiperiodic motion pattern that needs to be compensated for if a further automatic analysis of the perfusion is to be executed. In this work, we present a method to compensate this movement by combining independent component analysis (ICA) and image registration: First, we use ICA and a time?frequency analysis to identify the motion and separate it from the intensity change induced by the contrast agent. Then, synthetic reference images are created by recombining all the independent components but the one related to the motion. Therefore, the resulting image series does not exhibit motion and its images have intensities similar to those of their original counterparts. Motion compensation is then achieved by using a multi-pass image registration procedure. We tested our method on 39 image series acquired from 13 patients, covering the basal, mid and apical areas of the left heart ventricle and consisting of 58 perfusion images each. We validated our method by comparing manually tracked intensity profiles of the myocardial sections to automatically generated ones before and after registration of 13 patient data sets (39 distinct slices). We compared linear, non-linear, and combined ICA based registration approaches and previously published motion compensation schemes. Considering run-time and accuracy, a two-step ICA based motion compensation scheme that first optimizes a translation and then for non-linear transformation performed best and achieves registration of the whole series in 32 ± 12 s on a recent workstation. The proposed scheme improves the Pearsons correlation coefficient between manually and automatically obtained time?intensity curves from .84 ± .19 before registration to .96 ± .06 after registration

Lithologic Control on the Scaling Properties of the First-Order Streams of Drainage Networks: A Monofractal Analysis

The movement of water through the landscape can be investigated at different scales. This study dealt with the interrelation between bedrock lithology and the geometry of the overlying drainage systems. Parameters of fractal analysis, such as fractal dimension and lacunarity, were used to measure and quantify this relationship. The interrelation between bedrock lithology and the geometry of the drainage systems has been widely studied in the last decades. The quantification of this linkage has not yet been clearly established. Several studies have selected river basins or regularly shaped areas as study units, assuming them to be lithologically homogeneous. This study considered irregular distributions of rock types, establishing areas of the soil map (1:25,000) with the same lithologic information as study units. The tectonic stability and the low climatic variability of the study region allowed effective investigation of the lithologic controls on the drainage networks developed on the plutonic rocks, the metamorphic rocks, and the sedimentary materials existing in the study area. To exclude the effect of multiple in- and outflows in the lithologically homogeneous units, we focused this study on the first-order streams of the drainage networks. The geometry of the hydrologic features was quantified through traditional metrics of fluvial geomorphology and scaling parameters of fractal analysis, such as the fractal dimension, the reference density, and the lacunarity. The results demonstrate the scale invariance of both the drainage networks and the set of first-order streams at the study scale and a relationship between scaling in the lithology and the drainage network.

Analysis and Modelling of the Structural Components of the Elbow Joint

A recent application of computer simulation is its use for the human body, which resembles a mechanism that is complemented by torques in the joints that are caused by the action of muscles and tendons. Among others, the application can be used to provide training in surgical procedures or to learn how the body works. Some of the other applications are to make a biped walk upright, to build robots that are designed on the human body or to make prostheses or robot arms to perform specific tasks. One of the uses of simulation is to optimise the movement of the human body by examining which muscles are activated and which should or should not be activated in order to improve a person?s movements. This work presents a model of the elbow joint, and by analysing the constraint equations using classic methods we go on to model the bones, muscles and tendons as well as the logic linked to the force developed by them when faced with a specific movement. To do this, we analyse the reference bibliography and the software available to perform the validation.

A comparative analysis of visual strategy in elite and amateur handball goalkeepers

The aim of the present study was to analyze the visual strategies prior to a throw from 7 metres in elite and amateur handball goalkeepers. To this end we analyzed the visual fixations in number and order of 10 goalkeepers (29.7±5.4 years; 14.7±8.6 years of experience), 3 elite and 7 amateurs, during the life size projection of 14 different throws, made by different players. During each throw the movement of the eyeballs, the dilation of the pupil (pupillometry) and the subject?s blinking were recorded thanks to a technological system which permitted eye tracking with high speed cameras, and the subsequent presentation of the visual data for each action studied. The elite goalkeepers performed a greater number of visual fixations than the amateur goalkeepers, revealing large and significant differences. Equally the priority zones observed were differed, with the amateur goalkeepers fixating more on the thrower?s face, and the elite goalkeepers paying more attention to the area of the arm/ball. It can therefore be inferred that elite goalkeepers have a greater perceptive capacity and also use different visual strategies from the amateur goalkeepers.

Aerodynamic Analysis of Cup Anemometers Performance: The Stationary Harmonic Response

The effect of cup anemometer shape parameters, such as the cups’ shape, their size, and their center rotation radius, was experimentally analyzed.This analysis was based on both the calibration constants of the transfer function and the most important harmonic termof the rotor’smovement,which due to the cup anemometer design is the third one.This harmonic analysis represents a new approach to study cup anemometer performances. The results clearly showed a good correlation between the average rotational speed of the anemometer’s rotor and the mentioned third harmonic term of its movement.

Development of a human movement monitoring system based on wearable devices

It is essential to remotely and continuously monitor the movements of individuals in many social areas, for example, taking care of aging people, physical therapy, athletic training etc. Many methods have been used, such as video record, motion analysis or sensor-based methods. Due to the limitations in remote communication, power consumption, portability and so on, most of them are not able to fulfill the requirements. The development of wearable technology and cloud computing provides a new efficient way to achieve this goal. This paper presents an intelligent human movement monitoring system based on a smartwatch, an Android smartphone and a distributed data management engine. This system includes advantages of wide adaptability, remote and long-term monitoring capacity, high portability and flexibility. The structure of the system and its principle are introduced. Four experiments are designed to prove the feasibility of the system. The results of the experiments demonstrate the system is able to detect different actions of individuals with adequate accuracy.

Analysis and optimization for a hexapod walking robot for planetary missions

La tecnología de las máquinas móviles autónomas ha sido objeto de una gran investigación y desarrollo en las últimas décadas. En muchas actividades y entornos, los robots pueden realizar operaciones que son duras, peligrosas o simplemente imposibles para los humanos. La exploración planetaria es un buen ejemplo de un entorno donde los robots son necesarios para realizar las tareas requeridas por los científicos. La reciente exploración de Marte con robots autónomos nos ha mostrado la capacidad de las nuevas tecnologías. Desde la invención de la rueda, que esta acertadamente considerado como el mayor invento en la historia del transporte humano, casi todos los vehículos para exploración planetaria han empleado las ruedas para su desplazamiento. Las nuevas misiones planetarias demandan maquinas cada vez mas complejas. En esta Tesis se propone un nuevo diseño de un robot con patas o maquina andante que ofrecerá claras ventajas en entornos extremos. Se demostrara que puede desplazarse en los terrenos donde los robots con ruedas son ineficientes, convirtiéndolo en una elección perfecta para misiones planetarias. Se presenta una reseña histórica de los principales misiones espaciales, en particular aquellos dirigidos a la exploración planetaria. A través de este estudio será posible analizar las desventajas de los robots con ruedas utilizados en misiones anteriores. El diseño propuesto de robot con patas será presentado como una alternativa para aquellas misiones donde los robots con ruedas puedan no ser la mejor opción. En esta tesis se presenta el diseño mecánico de un robot de seis patas capaz de soportar las grandes fuerzas y momentos derivadas del movimiento de avance. Una vez concluido el diseño mecánico es necesario realizar un análisis que permita entender el movimiento y comportamiento de una maquina de esta complejidad. Las ecuaciones de movimiento del robot serán validadas por dos métodos: cinemático y dinámico. Dos códigos Matlab® han sido desarrollados para resolver dichos sistemas de ecuaciones y han sido verificados por un tercer método, un modelo de elementos finitos, que también verifica el diseño mecánico. El robot con patas presentado, ha sido diseñado para la exploración planetaria en Marte. El comportamiento del robot durante sus desplazamientos será probado mediante un código de Matlab®, desarrollado para esta tesis, que permite modificar las trayectorias, el tipo de terreno, y el número y altura de los obstáculos. Estos terrenos y requisitos iniciales no han sido elegidos de forma aleatoria, si no que están basados en mi experiencia como miembro del equipo de MSL-NASA que opera un instrumento a bordo del rover Curiosity en Marte. El robot con patas desarrollado y fabricado por el Centro de Astrobiología (INTA-CSIC), esta basado en el diseño mecánico y análisis presentados en esta tesis. ABSTRACT The autonomous machines technology has undergone a major research and development during the last decades. In many activities and environments, robots can perform operations that are tought, dangerous or simply imposible to humans. Planetary exploration is a good example of such environment where robots are needed to perform the tasks required by the scientits. Recent Mars exploration based on autonomous vehicles has shown us the capacity of the new technologies. From the invention of the wheel, which is rightly regarded as the greatest invention in the history of human transportation, nearly all-planetary vehicles are based in wheeled locomotion, but new missions demand new types of machines due to the complex tasks needed to be performed. It will be proposed in this thesis a new design of a legged robot or walking machine, which may offer clear advantages in tough environments. This Thesis will show that the proposed walking machine can travel, were terrain difficulties make wheeled vehicles ineffective, making it a perfect choice for planetary mission. A historical background of the main space missions, in particular those aimed at planetary exploration will be presented. From this study the disadvantages found in the existing wheel rovers will be analysed. The legged robot designed will be introduced as an alternative were wheeled rovers could be no longer the best option for planetary exploration. This thesis introduces the mechanical design of a six-leg robot capable of withstanding high forces and moments due to the walking motion. Once the mechanical design is concluded, and in order to analyse a machine of this complexity an understanding of its movement and behaviour is mandatory. This movement equation will be validated by two methods: kinematics and dynamics. Two Matlab® codes have been developed to solve the systems of equations and validated by a third method, a finite element model, which also verifies the mechanical design. The legged robot presented has been designed for a Mars planetary exploration. The movement behaviour of the robot will be tested in a Matlab® code developed that allows to modify the trajectories, the type of terrain, number and height of obstacles. These terrains and initial requirements have not been chosen randomly, those are based on my experience as a member of the MSL NASA team, which operates an instrument on-board of the Curiosity rover in Mars. The walking robot developed and manufactured by the Center of Astrobiology (CAB) is based in the mechanical design and analysis that will be presented in this thesis.