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Can Startle Elicit Sequential Movements in Highly Trained Individuals?

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Most daily living tasks consist of pairing a series of sequential movements, e.g., reaching to a cup, grabbing the cup, lifting and returning the cup to your mouth. The process by which we control and mediate the smooth progression of

Most daily living tasks consist of pairing a series of sequential movements, e.g., reaching to a cup, grabbing the cup, lifting and returning the cup to your mouth. The process by which we control and mediate the smooth progression of these tasks is not well understood. One method which we can use to further evaluate these motions is known as Startle Evoked Movements (SEM). SEM is an established technique to probe the motor learning and planning processes by detecting muscle activation of the sternocleidomastoid muscles of the neck prior to 120ms after a startling stimulus is presented. If activation of these muscles was detected following a stimulus in the 120ms window, the movement is classified as Startle+ whereas if no sternocleidomastoid activation is detected after a stimulus in the allotted time the movement is considered Startle-. For a movement to be considered SEM, the activation of movements for Startle+ trials must be faster than the activation of Startle- trials. The objective of this study was to evaluate the effect that expertise has on sequential movements as well as determining if startle can distinguish when the consolidation of actions, known as chunking, has occurred. We hypothesized that SEM could distinguish words that were solidified or chunked. Specifically, SEM would be present when expert typists were asked to type a common word but not during uncommon letter combinations. The results from this study indicated that the only word that was susceptible to SEM, where Startle+ trials were initiated faster than Startle-, was an uncommon task "HET" while the common words "AND" and "THE" were not. Additionally, the evaluation of the differences between each keystroke for common and uncommon words showed that Startle was unable to distinguish differences in motor chunking between Startle+ and Startle- trials. Explanations into why these results were observed could be related to hand dominance in expert typists. No proper research has been conducted to evaluate the susceptibility of the non-dominant hand's fingers to SEM, and the results of future studies into this as well as the results from this study can impact our understanding of sequential movements.

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2018-05

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Startle can evoke individuated movements of the fingers; implications for neural control

Description

Startle-evoked-movement (SEM), the involuntary release of a planned movement via a startling stimulus, has gained significant attention recently for its ability to probe motor planning as well as enhance movement of the upper extremity following stroke. We recently showed that

Startle-evoked-movement (SEM), the involuntary release of a planned movement via a startling stimulus, has gained significant attention recently for its ability to probe motor planning as well as enhance movement of the upper extremity following stroke. We recently showed that hand movements are susceptible to SEM. Interestingly, only coordinated movements of the hand (grasp) but not individuated movements of the finger (finger abduction) were susceptible. It was suggested that this resulted from different neural mechanisms involved in each task; however it is possible this was the result of task familiarity. The objective of this study was to evaluate a more familiar individuated finger movement, typing, to determine if this task was susceptible to SEM. We hypothesized that typing movements will be susceptible to SEM in all fingers. These results indicate that individuated movements of the fingers are susceptible to SEM when the task involves a more familiar task, since the electromyogram (EMG) latency is faster in SCM+ trials compared to SCM- trials. However, the middle finger does not show a difference in terms of the keystroke voltage signal, suggesting the middle finger is less susceptible to SEM. Given that SEM is thought to be mediated by the brainstem, specifically the reticulospinal tract, this suggest that the brainstem may play a role in movements of the distal limb when those movements are very familiar, and the independence of each finger might also have a significant on the effect of SEM. Further research includes understanding SEM in fingers in the stroke population. The implications of this research can impact the way upper extremity rehabilitation is delivered.

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2016-12

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The role of tactile information in transfer of learned manipulation following changes in degrees of freedom

Description

Humans are capable of transferring learning for anticipatory control of dexterous object manipulation despite changes in degrees-of-freedom (DoF), i.e., switching from lifting an object with two fingers to lifting the same object with three fingers. However, the role that tactile

Humans are capable of transferring learning for anticipatory control of dexterous object manipulation despite changes in degrees-of-freedom (DoF), i.e., switching from lifting an object with two fingers to lifting the same object with three fingers. However, the role that tactile information plays in this transfer of learning is unknown. In this study, subjects lifted an L-shaped object with two fingers (2-DoF), and then lifted the object with three fingers (3-DoF). The subjects were divided into two groups--one group performed the task wearing a glove (to reduce tactile sensibility) upon the switch to 3-DoF (glove group), while the other group did not wear the glove (control group). Compensatory moment (torque) was used as a measure to determine how well the subject could minimize the tilt of the object following the switch from 2-DoF to 3-DoF. Upon the switch to 3-DoF, subjects wearing the glove generated a compensatory moment (Mcom) that had a significantly higher error than the average of the last five trials at the end of the 3-DoF block (p = 0.012), while the control subjects did not demonstrate a significant difference in Mcom. Additional effects of the reduction in tactile sensibility were: (1) the grip force for the group of subjects wearing the glove was significantly higher in the 3-DoF trials compared to the 2-DoF trials (p = 0.014), while the grip force of the control subjects was not significantly different; (2) the difference in centers of pressure between the thumb and fingers (ΔCoP) significantly increased in the 3-DoF block for the group of subjects wearing the glove, while the ΔCoP of the control subjects was not significantly different; (3) lastly, the control subjects demonstrated a greater increase in lift force than the group of subjects wearing the glove (though results were not significant). Combined together, these results suggest different force modulation strategies are used depending on the amount of tactile feedback that is available to the subject. Therefore, reduction of tactile sensibility has important effects on subjects' ability to transfer learned manipulation across different DoF contexts.

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Date Created
2014

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Smart glove: an assistive device to enhance recovery of hand function during motor rehabilitation

Description

Stroke accounts for high rates of mortality and disability in the United States. It levies great economic burden on the affected subjects, their family and the society at large. Motor impairments after stroke mainly manifest themselves as hemiplegia or hemiparesis

Stroke accounts for high rates of mortality and disability in the United States. It levies great economic burden on the affected subjects, their family and the society at large. Motor impairments after stroke mainly manifest themselves as hemiplegia or hemiparesis in the upper and lower limbs. Motor recovery is highly variable but can be enhanced through motor rehabilitation with sufficient movement repetition and intensity. Cost effective assistive devices that can augment therapy by increasing movement repetition both at home and in the clinic may facilitate recovery. This thesis aims to develop a Smart Glove that can enhance motor recovery by providing feedback to both the therapist and the patient on the number of hand movements (wrist and finger extensions) performed during therapy. The design implements resistive flex sensors for detecting the extensions and processes the information using the Lightblue bean microcontroller mounted on the wrist. Communication between the processing unit and display module is wireless and executes Bluetooth 4.0 communication protocol. The capacity for the glove to measure and record hand movements was tested on three stroke and one traumatic brain injured patient while performing a box and blocks test. During testing many design flaws were noted and several were adapted during testing to improve the function of the glove. Results of the testing showed that the glove could detect wrist and finger extensions but that the sensitivity had to be calibrated for each patient. It also allowed both the therapist and patient to know whether the patient was actually performing the task in the manner requested by the therapist. Further work will reveal whether this feedback can enhance recovery of hand function in neurologically impaired patients.

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Date Created
2015

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Somatic ABC's: a theoretical framework for designing, developing and evaluating the building blocks of touch-based information delivery

Description

Situations of sensory overload are steadily becoming more frequent as the ubiquity of technology approaches reality--particularly with the advent of socio-communicative smartphone applications, and pervasive, high speed wireless networks. Although the ease of accessing information has improved our communication effectiveness

Situations of sensory overload are steadily becoming more frequent as the ubiquity of technology approaches reality--particularly with the advent of socio-communicative smartphone applications, and pervasive, high speed wireless networks. Although the ease of accessing information has improved our communication effectiveness and efficiency, our visual and auditory modalities--those modalities that today's computerized devices and displays largely engage--have become overloaded, creating possibilities for distractions, delays and high cognitive load; which in turn can lead to a loss of situational awareness, increasing chances for life threatening situations such as texting while driving. Surprisingly, alternative modalities for information delivery have seen little exploration. Touch, in particular, is a promising candidate given that it is our largest sensory organ with impressive spatial and temporal acuity. Although some approaches have been proposed for touch-based information delivery, they are not without limitations including high learning curves, limited applicability and/or limited expression. This is largely due to the lack of a versatile, comprehensive design theory--specifically, a theory that addresses the design of touch-based building blocks for expandable, efficient, rich and robust touch languages that are easy to learn and use. Moreover, beyond design, there is a lack of implementation and evaluation theories for such languages. To overcome these limitations, a unified, theoretical framework, inspired by natural, spoken language, is proposed called Somatic ABC's for Articulating (designing), Building (developing) and Confirming (evaluating) touch-based languages. To evaluate the usefulness of Somatic ABC's, its design, implementation and evaluation theories were applied to create communication languages for two very unique application areas: audio described movies and motor learning. These applications were chosen as they presented opportunities for complementing communication by offloading information, typically conveyed visually and/or aurally, to the skin. For both studies, it was found that Somatic ABC's aided the design, development and evaluation of rich somatic languages with distinct and natural communication units.

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Date Created
2012

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Startle-evoked movement in multi-jointed, two-dimensional reaching tasks

Description

Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown

Previous research has shown that a loud acoustic stimulus can trigger an individual's prepared movement plan. This movement response is referred to as a startle-evoked movement (SEM). SEM has been observed in the stroke survivor population where results have shown that SEM enhances single joint movements that are usually performed with difficulty. While the presence of SEM in the stroke survivor population advances scientific understanding of movement capabilities following a stroke, published studies using the SEM phenomenon only examined one joint. The ability of SEM to generate multi-jointed movements is understudied and consequently limits SEM as a potential therapy tool. In order to apply SEM as a therapy tool however, the biomechanics of the arm in multi-jointed movement planning and execution must be better understood. Thus, the objective of our study was to evaluate if SEM could elicit multi-joint reaching movements that were accurate in an unrestrained, two-dimensional workspace. Data was collected from ten subjects with no previous neck, arm, or brain injury. Each subject performed a reaching task to five Targets that were equally spaced in a semi-circle to create a two-dimensional workspace. The subject reached to each Target following a sequence of two non-startling acoustic stimuli cues: "Get Ready" and "Go". A loud acoustic stimuli was randomly substituted for the "Go" cue. We hypothesized that SEM is accessible and accurate for unrestricted multi-jointed reaching tasks in a functional workspace and is therefore independent of movement direction. Our results found that SEM is possible in all five Target directions. The probability of evoking SEM and the movement kinematics (i.e. total movement time, linear deviation, average velocity) to each Target are not statistically different. Thus, we conclude that SEM is possible in a functional workspace and is not dependent on where arm stability is maximized. Moreover, coordinated preparation and storage of a multi-jointed movement is indeed possible.

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Date Created
2016-12

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The Design and Characterization of a Soft Haptic Interface for Rehabilitation of Impaired Hand Function

Description

The human hand comprises complex sensorimotor functions that can be impaired by neurological diseases and traumatic injuries. Effective rehabilitation can bring the impaired hand back to a functional state because of the plasticity of the central nervous system to relearn

The human hand comprises complex sensorimotor functions that can be impaired by neurological diseases and traumatic injuries. Effective rehabilitation can bring the impaired hand back to a functional state because of the plasticity of the central nervous system to relearn and remodel the lost synapses in the brain. Current rehabilitation therapies focus on strengthening motor skills, such as grasping, employ multiple objects of varying stiffness and devices that are bulky, costly, and have limited range of stiffness due to the rigid mechanisms employed in their variable stiffness actuators. This research project presents a portable cost-effective soft robotic haptic device with a broad stiffness range that is adjustable and can be utilized in both clinical and home settings. The device eliminates the need for multiple objects by employing a pneumatic soft structure made with highly compliant materials that act as the actuator as well as the structure of the haptic interface. It is made with interchangeable soft elastomeric sleeves that can be customized to include materials of varying stiffness to increase or decrease the stiffness range. The device is fabricated using existing 3D printing technologies, and polymer molding and casting techniques, thus keeping the cost low and throughput high. The haptic interface is linked to either an open-loop system that allows for an increased pressure during usage or closed-loop system that provides pressure regulation in accordance with the stiffness the user specifies. A preliminary evaluation is performed to characterize the effective controllable region of variance in stiffness. Results indicate that the region of controllable stiffness was in the center of the device, where the stiffness appeared to plateau with each increase in pressure. The two control systems are tested to derive relationships between internal pressure, grasping force exertion on the surface, and displacement using multiple probing points on the haptic device. Additional quantitative evaluation is performed with study participants and juxtaposed to a qualitative analysis to ensure adequate perception in compliance variance. Finally, a qualitative evaluation showed that greater than 60% of the trials resulted in the correct perception of stiffness in the haptic device.

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Date Created
2018

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On the effect of walking surface stiffness on inter-leg coordination during human walking: a unique perspective to robot-assisted gait rehabilitation

Description

Millions of individuals suffer from gait impairments due to stroke or other neurological disorders. A primary goal of patients is to walk independently, but most patients only achieve a poor functional outcome five years after injury. Despite the

Millions of individuals suffer from gait impairments due to stroke or other neurological disorders. A primary goal of patients is to walk independently, but most patients only achieve a poor functional outcome five years after injury. Despite the growing interest in using robotic devices for rehabilitation of sensorimotor function, state-of-the-art robotic interventions in gait therapy have not resulted in improved outcomes when compared to traditional treadmill-based therapy. Because bipedal walking requires neural coupling and dynamic interactions between the legs, a fundamental understanding of the sensorimotor mechanisms of inter-leg coordination during walking is needed to inform robotic interventions in gait therapy. This dissertation presents a systematic exploration of sensorimotor mechanisms of inter-leg coordination by studying the effect of unilateral perturbations of the walking surface stiffness on contralateral muscle activation in healthy populations. An analysis of the contribution of several sensory modalities to the muscle activation of the opposite leg provides new insight into the sensorimotor control mechanisms utilized in human walking, including the role of supra-spinal neural circuits in inter-leg coordination. Based on these insights, a model is created which relates the unilateral deflection of the walking surface to the resulting neuromuscular activation in the opposite leg. Additionally, case studies with hemiplegic walkers indicate the existence of the observed mechanism in neurologically impaired walkers. The results of this dissertation suggest a novel approach to gait therapy for hemiplegic patients in which desired muscle activity is evoked in the impaired leg by only interacting with the healthy leg. One of the most significant advantages of this approach over current rehabilitation protocols is the safety of the patient since there is no direct manipulation of the impaired leg. Therefore, the methods and results presented in this dissertation represent a potential paradigm shift in robot-assisted gait therapy.

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Date Created
2017

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Impact of Total Knee Arthroplasty on Dynamic Fall Response

Description

Falls are the leading cause of fatal and non-fatal injuries in the older adult population with more than 27,000 fall related deaths reported every year[1]. Adults suffering from lower extremity arthritis have more than twice the likelihood of experiencing multiple

Falls are the leading cause of fatal and non-fatal injuries in the older adult population with more than 27,000 fall related deaths reported every year[1]. Adults suffering from lower extremity arthritis have more than twice the likelihood of experiencing multiple falls resulting in increased fall-related injuries compared to healthy adults. People with lower extremity end-stage osteoarthritis(KOA), experience a number of fall risk factors such as knee instability, poor mobility, and knee pain/stiffness. At end-stage knee OA, the space between the bones in the joint of the knee is significantly reduced, resulting in bone to bone frictional wearing causing bone deformation. In addition, an impaired stepping response during a postural perturbation is seen in people with OA related knee instability. The most common treatment for end-stage knee osteoarthritis is a surgical procedure called, total knee replacement (TKR). It is known that TKR significantly reduces pain, knee stiffness, and restores musculoskeletal functions such as range of motion. Despite studies concluding that knee OA increases fall-risk, it remains unknown if standard treatments, such as TKR, can effectively decrease fall-risk. Analyzing the compensatory step response during a fall is a significant indicator of whether a fall or a recovery will occur in the event of a postural disturbance and is key to determining fall risk among people. Studies have shown reduced trunk stability and step length, as well as increased trunk velocities, correspond to an impaired compensatory step. This study looks at these populations to determine whether TKR significantly enhances compensatory stepping response by analyzing trunk velocities and flexions among other kinematic/kinetic variable analysis during treadmill induced perturbations and clinical assessments.

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Date Created
2019