ENABLE: a wrist worn device with integrated accessible services to support old people living independently and safely at home

This RTD project, 2007-2009, is partly funded by the European Commission, in Framework Programme 6. It aims to assist elderly people for living well, independently and at case. ENABLE will provide a number of services for elderly people based on the new technology provided by mobile phones. The project is developing a Wrist unit with both integrated and external sensors, and with a radio frequency link to a mobile phone. Dedicated ENABLE software running on the wrist unit and mobile phone makes these services fully accessible for the elderly users. This paper outlines the fundamental motivation and the approach which currently is undertaken in order to collect the more detailed user needs and requirements. The general architecture and the design of the ENABLE system are outlined.

Marker placement to describe the wrist movements during activities of daily living in cyclical tasks

Objective. To describe the wrist kinematics during movement through free range of motion and activities of daily living using a cyclical task. Design. The wrist angles were initially calculated in a calibration trial and then in two selected activities of daily living (jar opening and carton pouring). Background. Existing studies which describe the wrist movement do not address the specific application of daily activities. Moreover, the data presented from subject to subject may differ simply because of the non-cyclical nature of the upper limbs movements. Methods. The coordinates of external markers attached to bone references on the forearm and dorsal side of the hand were obtained using an optical motion capture system. The wrist angles were derived from free motion trials and successively calculated in four healthy subjects for two specific cyclical daily activities (opening a jar and pouring from a carton). Results. The free motions trial highlighted the interaction between the wrist angles. Both the jar opening and the carton pouring activity showed a repetitive pattern for the three angles within the cycle length. In the jar-opening task, the standard deviation for the whole population was 10.8degrees for flexion-extension, 5.3degrees for radial-ulnar deviation and 10.4degrees for pronation-supination. In the carton-pouring task, the standard deviation for the whole population was 16.0degrees for flexion-extension, 3.4degrees for radial-ulnar deviation and 10.7degrees for pro nation-supination. Conclusion. Wrist kinematics in healthy subjects can be successfully described by the rotations about the axes of marker-defined coordinates systems during free range of motion and daily activities using cyclical tasks.

Preliminary observations on the presence of sustained tendon strain and eccentric contractions of the wrist extensors during a common manual task: implications for lateral epicondylitis

Lateral epicondylitis (LE) is hypothesized to occur as a result of repetitive, strenuous and abnormal postural activities of the elbow and wrist. There is still a lack of understanding of how wrist and forearm positions contribute to this condition during common manual tasks. In this study the wrist kinematics and the wrist extensors’ musculotendon patterns were investigated during a manual task believed to elicit LE symptoms in susceptible subjects. A 42-year-old right-handed male, with no history of LE, performed a repetitive movement involving pushing and turning a spring-loaded mechanism. Motion capture data were acquired for the upper limb and an inverse kinematic and dynamic analysis was subsequently carried out. Results illustrated the presence of eccentric contractions sustained by the extensor carpi radialis longus (ECRL), together with an almost constant level of tendon strain of both extensor carpi radialis brevis (ECRB) and extensor digitorum communis lateral (EDCL) branch. It is believed that these factors may partly contribute to the onset of LE as they are both responsible for the creation of microtears at the tendons’ origins. The methodology of this study can be used to explore muscle actions during movements that might cause or exacerbate LE.

Cortical activation during executed, imagined, observed, and passive wrist movements in healthy volunteers and stroke patients

Motor imagery, passive movement, and movement observation have been suggested to activate the sensorimotor system without overt movement. The present study investigated these three covert movement modes together with overt movement in a within-subject design to allow for a fine-grained comparison of their abilities in activating the sensorimotor system, i.e. premotor, primary motor, and somatosensory cortices. For this, 21 healthy volunteers underwent functional magnetic resonance imaging (fMRI). In addition we explored the abilities of the different covert movement modes in activating the sensorimotor system in a pilot study of 5 stroke patients suffering from chronic severe hemiparesis. Results demonstrated that while all covert movement modes activated sensorimotor areas, there were profound differences between modes and between healthy volunteers and patients. In healthy volunteers, the pattern of neural activation in overt execution was best resembled by passive movement, followed by motor imagery, and lastly by movement observation. In patients, attempted overt execution was best resembled by motor imagery, followed by passive movement, and lastly by movement observation. Our results indicate that for severely hemiparetic stroke patients motor imagery may be the preferred way to activate the sensorimotor system without overt behavior. In addition, the clear differences between the covert movement modes point to the need for within-subject comparisons.

Latitude and longitude vertical disparities

The literature on vertical disparity is complicated by the fact that several different definitions of the term “vertical disparity” are in common use, often without a clear statement about which is intended or a widespread appreciation of the properties of the different definitions. Here, we examine two definitions of retinal vertical disparity: elevation-latitude and elevation-longitude disparities. Near the fixation point, these definitions become equivalent, but in general, they have quite different dependences on object distance and binocular eye posture, which have not previously been spelt out. We present analytical approximations for each type of vertical disparity, valid for more general conditions than previous derivations in the literature: we do not restrict ourselves to objects near the fixation point or near the plane of regard, and we allow for non-zero torsion, cyclovergence, and vertical misalignments of the eyes. We use these expressions to derive estimates of the latitude and longitude vertical disparities expected at each point in the visual field, averaged over all natural viewing. Finally, we present analytical expressions showing how binocular eye position—gaze direction, convergence, torsion, cyclovergence, and vertical misalignment—can be derived from the vertical disparity field and its derivatives at the fovea.

Optokinetic stimulation induces illusory movement of both out-of-the-body and on-the-body hand-held visual objects

The coding of body part location may depend upon both visual and proprioceptive information, and allows targets to be localized with respect to the body. The present study investigates the interaction between visual and proprioceptive localization systems under conditions of multisensory conflict induced by optokinetic stimulation (OKS). Healthy subjects were asked to estimate the apparent motion speed of a visual target (LED) that could be located either in the extrapersonal space (visual encoding only, V), or at the same distance, but stuck on the subject's right index finger-tip (visual and proprioceptive encoding, V-P). Additionally, the multisensory condition was performed with the index finger kept in position both passively (V-P passive) and actively (V-P active). Results showed that the visual stimulus was always perceived to move, irrespective of its out- or on-the-body location. Moreover, this apparent motion speed varied consistently with the speed of the moving OKS background in all conditions. Surprisingly, no differences were found between V-P active and V-P passive conditions in the speed of apparent motion. The persistence of the visual illusion during the active posture maintenance reveals a novel condition in which vision totally dominates over proprioceptive information, suggesting that the hand-held visual stimulus was perceived as a purely visual, external object despite its contact with the hand.

Disruption of sitting balance after stroke: influence of spoken output

Objectives: To identify the extent of dual task interference between cognitive and motor tasks, (cognitive motor interference (CMI)) in sitting balance during recovery from stroke; to compare CMI in sitting balance between stroke and non-stroke groups; and to record any changes to CMI during sitting that correlate with functional recovery. Method: 36 patients from stroke rehabilitation settings in three NHS trusts. Healthy control group: 21 older volunteers. Measures of seated postural sway were taken in unsupported sitting positions, alone, or concurrently with either a repetitive utterance task or an oral word category generation task. Outcome measures were variability of sway area, path length of sway, and the number of valid words generated. Results: Stroke patients were generally less stable than controls during unsupported sitting tasks. They showed greater sway during repetitive speech compared with quiet sitting, but did not show increased instability to posture between repetitive speech and word category generation. When compared with controls, stroke patients experienced greater dual task interferences during repetitive utterance but not during word generation. Sway during repetitive speech was negatively correlated with concurrent function on the Barthel ADL index. Conclusions: The stroke patients showed postural instability and poor word generation skills. The results of this study show that the effort of verbal utterances alone was sufficient to disturb postural control early after stroke, and the extent of this instability correlated with concomitant Barthel ADL function.

Cooperative transport of extended payloads

In this paper we present experimental results for the dual robot transport of an extended payload. Two robotic rovers that were designed specifically for the extended payload transport task are described. Each rover incorporates a 4-DOF robot arm incorporating three active joints (one of which is a gripper), a passive wrist, and a mobile base which employs a rocker-bogie design. A set of behaviours has been developed to support the performance of the task, integrating simple sensing with controls. We describe the behaviours and their integration within the overall task structure. The experimental results presented focus on the manipulation elements of the task, but incorporate a complete cycle of pick-up, traversal, and putdown.

ENABLE - a view on user's needs

The ENABLE project, which is partly funded by the European Commission, aims to assist elderly people to live well, independently and at case. In this project a wrist unit with both integrated and external sensors, and with a radio frequency link to a mobile phone. will be developed. ENABLE will provide a number of services for elderly people. among them also a remote control service for the home environment. This paper briefly describes the project in general and then focuses on the initial user needs investigation which was carried Out in early 2007 in six different European countries. The provisional findings are discussed and an outlook on the ongoing and future project work is given. A special focus of this paper is on the environmental control service.

A classification system for delirium subtyping with the use of a commercial mobility monitor

The usefulness of motor subtypes of delirium is unclear due to inconsistency in subtyping methods and a lack of validation with objective measures of activity. The activity of 40 patients was measured over 24 h with a commercial accelerometer-based activity monitor. Accelerometry data from patients with DSM-IV delirium that were readily divided into hyperactive, hypoactive and mixed motor subtypes, were used to create classification trees that were Subsequently applied to the remaining cohort to define motoric subtypes. The classification trees used the periods of sitting/lying, standing, stepping and number of postural transitions as measured by the activity monitor as determining factors from which to classify the delirious cohort. The use of a classification system shows how delirium subtypes can be categorised in relation to overall activity and postural changes, which was one of the most discriminating measures examined. The classification system was also implemented to successfully define other patient motoric subtypes. Motor subtypes of delirium defined by observed ward behaviour differ in electronically measured activity levels. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved.

Development and experimental identification of a biomechanical model of the trunk for functional electrical stimulation control in paraplegia

Objectives. Theoretic modeling and experimental studies suggest that functional electrical stimulation (FES) can improve trunk balance in spinal cord injured subjects. This can have a positive impact on daily life, increasing the volume of bimanual workspace, improving sitting posture, and wheelchair propulsion. A closed loop controller for the stimulation is desirable, as it can potentially decrease muscle fatigue and offer better rejection to disturbances. This paper proposes a biomechanical model of the human trunk, and a procedure for its identification, to be used for the future development of FES controllers. The advantage over previous models resides in the simplicity of the solution proposed, which makes it possible to identify the model just before a stimulation session ( taking into account the variability of the muscle response to the FES). Materials and Methods. The structure of the model is based on previous research on FES and muscle physiology. Some details could not be inferred from previous studies, and were determined from experimental data. Experiments with a paraplegic volunteer were conducted in order to measure the moments exerted by the trunk-passive tissues and artificially stimulated muscles. Data for model identification and validation also were collected. Results. Using the proposed structure and identification procedure, the model could adequately reproduce the moments exerted during the experiments. The study reveals that the stimulated trunk extensors can exert maximal moment when the trunk is in the upright position. In contrast, previous studies show that able-bodied subjects can exert maximal trunk extension when flexed forward. Conclusions. The proposed model and identification procedure are a successful first step toward the development of a model-based controller for trunk FES. The model also gives information on the trunk in unique conditions, normally not observable in able-bodied subjects (ie, subject only to extensor muscles contraction).

H∞ robust control design for unsupported paraplegic standing: experimental evaluation

This paper is concerned with the design of robust feedback H~-control systems for the control of the upright posture of paraplegic persons standing. While the subject stands in a special apparatus, stabilising torque at the ankle joint is generated by electrical stimulation of the paralyzed calf muscles. Since the muscles acting as actuators in this setup show a significant degree of nonlinearity, a robust H~-control design is used. The design approach is implemented in experiments with a paraplegic subject. The results demonstrate good performance and closed loop stability over the whole range of operation.

Modelling human dynamics in-situ for rehabilitation and therapy robots

This paper outlines some rehabilitation applications of manipulators and identifies that new approaches demand that the robot make an intimate contact with the user. Design of new generations of manipulators with programmable compliance along with higher level controllers that can set the compliance appropriately for the task, are both feasible propositions. We must thus gain a greater insight into the way in which a person interacts with a machine, particularly given that the interaction may be non-passive. We are primarily interested in the change in wrist and arm dynamics as the person co-contracts his/her muscles. It is observed that this leads to a change in stiffness that can push an actuated interface into a limit cycle. We use both experimental results gathered from a PHANToM haptic interface and a mathematical model to observe this effect. Results are relevant to the fields of rehabilitation and therapy robots, haptic interfaces, and telerobotics