Tele-Supervised FES-Assisted Exercise for Hemiplegic Upper Limb

Stroke survivors often have upper limb (UL) hemiparesis, limiting their ability to perform activities of daily life (ADLs). Intensive, task-oriented exercise therapy (ET) can improve UL function, but motivation to perform sufficient ET is difficult to maintain. Here we report on a trial in which a workstation was deployed in the homes of chronic stroke survivors to enable tele-coaching of ET in the guise of computer games. Participants performed 6 weeks of 1 hour/day, 5 days/week ET. Hand opening and grasp were assisted with functional electrical stimulation (FES). The primary outcome measure was the Action Research Arm Test (ARAT). Secondary outcome measures included a quantitative test of UL function performed on the workstation, grasp force measurements and transcranial magnetic stimulation (TMS). Improvements were seen in the functional tests, but surprisingly, not in the TMS responses. An important finding was that participants commencing with intermediate functional scores improved the most.

CONCLUSIONS: 1) Daily, tele-supervised FES-ET in chronic stroke survivors is feasible with commercially-available technology. 2) The intervention can significantly improve UL function, particularly in people who start with an intermediate level of function. 3) Significant improvements in UL function can occur in the absence of changes in TMS responses.

Robotic object grasping in context of human grasping and manipulation

This paper presents experimental and deductive findings that shed new light on grasp force estimation, which improves robot’s chances to grasp and manipulate the object close to optimum conditions on the first attempt, which in turn improves robot’s object manipulation dexterity.
This paper proposes that object slippage detection in the human hand is not detected based purely on microvibrations sensed by the human skin during incipient slippage but also on load sensing at each finger and movement of fingers relative to each other while holding an object.

Optimal sensing requirement for slippage prevention in robotic grasping

This paper presents a new theoretical development and modelling related to the requirement of the minimum number of sensors necessary for slippage prevention in robotic grasping. A fundamental experimental investigation has been conducted to support the newly developed postulate. A series of basic experiments proved that it is possible to evaluate the contributions of various sensors to slippage prevention and control in robotic grasping. The use of three discrete physical sensors, one for each of the three sensing functions (normal, tangential and slippage), has been proven to be the most reliable combination for slippage prevention in robotic grasping. It was also proven that the best performance from a two-sensor combination can be achieved when normal grasp force and tangential force are both monitored in the grasping process.

Object slippage prevention using different control strategies

This paper presents experimental results obtained using a friction-based slippage and tangential force sensing device that has been developed for the purpose of reliable object slippage prevention during robotic manipulation. The experimental results obtained demonstrate that the developed slippage sensing strategy is rugged and reliable even in its current “rough prototype” state of development. This work has the potential to yield a low cost and highly customisable slippage and tangential force sensing device for a variety of robotic object grasping and manipulation applications. It is envisaged that the work presented here will be beneficial to researchers in the area of object slippage prevention.

Multiple grasp-specific representations of tool dynamics mediate skillful manipulation.

Skillful tool use requires knowledge of the dynamic properties of tools in order to specify the mapping between applied force and tool motion. Importantly, this mapping depends on the orientation of the tool in the hand. Here we investigate the representation of dynamics during skillful manipulation of a tool that can be grasped at different orientations. We ask whether the motor system uses a single general representation of dynamics for all grasp contexts or whether it uses multiple grasp-specific representations. Using a novel robotic interface, subjects rotated a virtual tool whose orientation relative to the hand could be varied. Subjects could immediately anticipate the force direction for each orientation of the tool based on its visual geometry, and, with experience, they learned to parameterize the force magnitude. Surprisingly, this parameterization of force magnitude showed limited generalization when the orientation of the tool changed. Had subjects parameterized a single general representation, full generalization would be expected. Thus, our results suggest that object dynamics are captured by multiple representations, each of which encodes the mapping associated with a specific grasp context. We suggest that the concept of grasp-specific representations may provide a unifying framework for interpreting previous results related to dynamics learning.

The Synthesis of Stable Force-Closure Grasps

This thesis addresses the problem of synthesizing grasps that are force-closure and stable. The synthesis of force-closure grasps constructs independent regions of contact for the fingertips, such that the motion of the grasped object is totally constrained. The synthesis of stable grasps constructs virtual springs at the contacts, such that the grasped object is stable, and has a desired stiffness matrix about its stable equilibrium. A grasp on an object is force-closure if and only if we can exert, through the set of contacts, arbitrary forces and moments on the object. So force-closure implies equilibrium exists because zero forces and moment is spanned. In the reverse direction, we prove that a non-marginal equilibrium grasp is also a force-closure grasp, if it has at least two point contacts with friction in 2D, or two soft-finger contacts or three hard-finger contacts in 3D. Next, we prove that all force-closure grasps can be made stable, by using either active or passive springs at the contacts. The thesis develops a simple relation between the stability and stiffness of the grasp and the spatial configuration of the virtual springs at the contacts. The stiffness of the grasp depends also on whether the points of contact stick, or slide without friction on straight or curved surfaces of the object. The thesis presents fast and simple algorithms for directly constructing stable fore-closure grasps based on the shape of the grasped object. The formal framework of force-closure and stable grasps provides a partial explanation to why we stably grasp objects to easily, and to why our fingers are better soft than hard.

Perceptual cues for orientation in a two finger haptic grasp task

Single point interaction haptic devices do not provide the natural grasp and manipulations found in the real world, as afforded by multi-fingered haptics. The present study investigates a two-fingered grasp manipulation involving rotation with and without force feedback. There were three visual cue conditions: monocular, binocular and projective lighting. Performance metrics of time and positional accuracy were assessed. The results indicate that adding haptics to an object manipulation task increases the positional accuracy but slightly increases the overall time taken.

Design, development, and evaluation of a pinch-grasp haptic interface

Interaction with virtual or teleoperated environments requires contact with objects on a multipoint level. We describe the design of a pinch--grasp hand interface device for use as a grasping mechanism to complement haptic interfaces. To preserve a suitable level of transparency for human--computer interaction, this novel interface is designed for high-resolution contact forces, while centered around a lightweight structure. This functionality renders the device scalable and adaptable to a wide range of haptic interface structures and force level requirements. We present an optimal configuration for a pinch--grasp interface, which produces bidirectional forces to an operator's fingers and a rotational force to the wrist through a cable drive system. The device is characterized for use on a commercial haptic interface through demonstration of sustained peak performance and also workspace utilization. The dynamic performance of the pinch--grasp interface is experimentally determined, and the frequency response is identified to illustrate its contact force resolution.

A new method for extending the range of conductive polymer sensors for contact force

This paper describes a technique for extending the force range of thin conductive polymer force sensors used for measuring contact force. These sensors are conventionally used for measuring force by changing electrical resistance when they are compressed. The new method involves measuring change in electrical resistance when the flexible sensor, which is sensitive to both compression and bending, is sandwiched between two layers of spring steel, and the structure is supported on a thin metal ring. When external force is applied, the stiffened sensor inside the spring steel is deformed within the annular center of the ring, causing the sensor to bend in proportion to the applied force. This method effectively increases the usable force range, while adding little in the way of thickness and weight. Average error for loads between 10 N and 100 N was 2.2 N (SD = 1.7) for a conventional conductive polymer sensor, and 0.9 N (SD = 0.4) using the new approach. Although this method permits measurement of greater loads with an error less than 1 N, it is limited since the modified sensor is insensitive to loads less than 5 N. These modified sensors are nevertheless useful for directly measuring normal force applied against handles and tools and other situations involving forceful manual work activities, such as grasp, push, pull, or press that could not otherwise be measured in actual work situations.

Visuomotor processing and hand force coordination in dyslexic children during a visually guided manipulation task

Developmental Dyslexia negatively affects children's reading and writing ability and, in most cases, performance in sensorimotor tasks. These deficits have been associated with structural and functional alterations in the cerebellum and the posterior parietal cortex (PPC). Both neural structures are active during visually guided force control and in the coordination of load force (LF) and grip force (GF) during manipulation tasks. Surprisingly, both phenomena have not been investigated in dyslexic children. Therefore, the aim of this study was to compare dyslexic and non-dyslexic children regarding their visuomotor processing ability and GF-LF coordination during a static manipulation task. Thirteen dyslexic (8-14YO) and 13 age- and sex-matched non-dyslexic (control) children participated in the study. They were asked to grasp a fixed instrumented handle using the tip of all digits and pull the handle upward exerting isometric force to match a ramp-and-hold force profile displayed in a computer monitor. Task performance (i.e., visuomotor coordination) was assessed by RMSE calculated in both ramp and hold phases. GF-LF coordination was assessed by the ratio between GF and LF (GF/LF) calculated at both phases and the maximum value of a cross-correlation function (r(max)) and its respective time lag calculated at ramp phase. The results revealed that the RMSE at both phases was larger in dyslexic than in control children. However, we found that GF/LF, rmax, and time lags were similar between groups. Those findings indicate that dyslexic children have a mild deficit in visuomotor processing but preserved GF-LF coordination. Altogether, these findings suggested that dyslexic children could present mild structural and functional alterations in specific PPC or cerebellum areas that are directly related to visuomotor processing. (C) 2014 Elsevier Ltd. All rights reserved.

Biomechanical force displacement analysis of strength of fixation of tracker holding devices to bone in computer aided joint replacement

Computer aided joint replacement surgery has become very popular during recent years and is being done in increasing numbers all over the world. The accuracy of the system depends to a major extent, on accurate registration and immobility of the tracker attachment devices to the bone. This study was designed to asses the forces needed to displace the tracker attachment devices in the bone simulators. Bone simulators were used to maintain the uniformity of the bone structure during the study. The fixation devices tested were 3mm diameter self drilling, self tapping threaded pin, 4mm diameter self tapping cortical threaded pin, 5mm diameter self tapping cancellous threaded pin and a triplanar fixation device ‘ortholock’ used with three 3mm pins. All the devices were tested for pull out, translational and rotational forces in unicortical and bicortical fixation modes. Also tested was the normal bang strength and forces generated by leaning on the devices. The forces required to produce translation increased with the increasing diameter of the pins. These were 105N, 185N, and 225N for the unicortical fixations and 130N, 200N, 225N for the bicortical fixations for 3mm, 4mm and 5mm diameter pins respectively. The forces required to pull out the pins were 1475N, 1650N, 2050N for the unicortical, 1020N, 3044N and 3042N for the bicortical fixated 3mm, 4mm and 5mm diameter pins. The ortholock translational and pull out strength was tested to 900N and 920N respectively and still it did not fail. Rotatory forces required to displace the tracker on pins was to the magnitude of 30N before failure. The ortholock device had rotational forces applied up to 135N and still did not fail. The manual leaning forces and the sudden bang forces generated were of the magnitude of 210N and 150N respectively. The strength of the fixation pins increases with increasing diameter from three to five mm for the translational forces. There is no significant difference in pull out forces of four mm and five mm diameter pins though it is more that the three mm diameter pins. This is because of the failure of material at that stage rather than the fixation device. The rotatory forces required to displace the tracker are very small and much less that that can be produced by the surgeon or assistants in single pins. Although the ortholock device was tested to 135N in rotation without failing, one has to be very careful not to put any forces during the operation on the tracker devices to ensure the accuracy of the procedure.

(-)-CGP12177 increases contractile force through beta1l-adrenoceptors but not through beta3-adrenoceptors in human right atrial myocardium

(-)-CGP12177 is a non-conventional partial agonist that causes modest and transient increases of contractile force in human atrial trabeculae (Kaumann and Molenaar, 2008). These effects are markedly increased and maintained by inhibition of phosphodiesterase PDE3. As verified with recombinant receptors, the cardiostimulant effect of (-)-CGP12177 is mediated through a site at the beta1-adrenoceptor with lower affinity (beta1LAR) compared to the site through which (-)-CGP12177 antagonizes the effects of catecholamines (beta1HAR). However, in a recent report it was proposed that the positive inotropic effects of CGP12177 are mediated through beta3-adrenoceptors (Skeberdis et al 2008). We therefore investigated whether the effects of (-)-CGP12177 on human atrial trabeculae are antagonized by the beta3-adrenoceptor-selective antagonist L-748,337 (1 microM). (-)-CGP12177 (200 nM) caused a stable increase in force which was significantly reduced by the addition of (-)-bupranolol (1 microM), P = 0.002, (basal 4.45 ± 0.78 mN, IBMX (PDE inhibitor) 5.47 ± 1.01 mN, (-)-CGP12177 9.34 ± 1.33 mN, (-)-bupranolol 5.79 ± 1.08 mN, n = 6) but not affected by the addition of L-748,337 (1 microM), P = 0.12, (basal 4.48 ± 1.32 mN, IBMX 7.15 ± 2.28 mN, (-)-CGP12177 12.51 ± 3.71 mN, L-748,337 10.90 ± 3.49 mN, n = 6). Cumulative concentration-effect curves for (-)-CGP12177 were not shifted to the right by L-748,337 (1 microM). The –logEC50M values of (-)-CGP12177 in the absence and presence of L-748,337 were 7.21±0.09 and 7.41±0.13, respectively (data from 25 trabeculae from 8 patients, P=0.2) The positive inotropic effects of (-)-CGP12177 (IBMX present) were not antagonized by L-748,337 but were blunted by (-)-bupranolol (1 microM). The results rule out an involvement of beta3-adrenoceptors in the positive inotropic effects (-)-CGP12177 in human right atrial myocardium and are consistent with mediation through beta1LAR. Kaumann A and Molenaar P (2008) Pharmacol Ther 118, 303-336 Skeberdis VA et al (2008) J Clin Invest, 118, 3219-3227