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Description
A cerebral aneurysm is a bulging of a blood vessel in the brain. Aneurysmal rupture affects 25,000 people each year and is associated with a 45% mortality rate. Therefore, it is critically important to treat cerebral aneurysms effectively before they rupture. Endovascular coiling is the most effective treatment for cerebral

A cerebral aneurysm is a bulging of a blood vessel in the brain. Aneurysmal rupture affects 25,000 people each year and is associated with a 45% mortality rate. Therefore, it is critically important to treat cerebral aneurysms effectively before they rupture. Endovascular coiling is the most effective treatment for cerebral aneurysms. During coiling process, series of metallic coils are deployed into the aneurysmal sack with the intent of reaching a sufficient packing density (PD). Coils packing can facilitate thrombus formation and help seal off the aneurysm from circulation over time. While coiling is effective, high rates of treatment failure have been associated with basilar tip aneurysms (BTAs). Treatment failure may be related to geometrical features of the aneurysm. The purpose of this study was to investigate the influence of dome size, parent vessel (PV) angle, and PD on post-treatment aneurysmal hemodynamics using both computational fluid dynamics (CFD) and particle image velocimetry (PIV). Flows in four idealized BTA models with a combination of dome sizes and two different PV angles were simulated using CFD and then validated against PIV data. Percent reductions in post-treatment aneurysmal velocity and cross-neck (CN) flow as well as percent coverage of low wall shear stress (WSS) area were analyzed. In all models, aneurysmal velocity and CN flow decreased after coiling, while low WSS area increased. However, with increasing PD, further reductions were observed in aneurysmal velocity and CN flow, but minimal changes were observed in low WSS area. Overall, coil PD had the greatest impact while dome size has greater impact than PV angle on aneurysmal hemodynamics. These findings lead to a conclusion that combinations of treatment goals and geometric factor may play key roles in coil embolization treatment outcomes, and support that different treatment timing may be a critical factor in treatment optimization.
ContributorsIndahlastari, Aprinda (Author) / Frakes, David (Thesis advisor) / Chong, Brian (Committee member) / Muthuswamy, Jitendran (Committee member) / Arizona State University (Publisher)
Created2013
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Description
While wearable soft robots have successfully addressed many inherent design limitations faced by wearable rigid robots, they possess a unique set of challenges due to their soft and compliant nature. Some of these challenges are present in the sensing, modeling, control and evaluation of wearable soft robots. Machine learning algorithms

While wearable soft robots have successfully addressed many inherent design limitations faced by wearable rigid robots, they possess a unique set of challenges due to their soft and compliant nature. Some of these challenges are present in the sensing, modeling, control and evaluation of wearable soft robots. Machine learning algorithms have shown promising results for sensor fusion with wearable robots, however, they require extensive data to train models for different users and experimental conditions. Modeling soft sensors and actuators require characterizing non-linearity and hysteresis, which complicates deriving an analytical model. Experimental characterization can capture the characteristics of non-linearity and hysteresis but requires developing a synthesized model for real-time control. Controllers for wearable soft robots must be robust to compensate for unknown disturbances that arise from the soft robot and its interaction with the user. Since developing dynamic models for soft robots is complex, inaccuracies that arise from the unmodeled dynamics lead to significant disturbances that the controller needs to compensate for. In addition, obtaining a physical model of the human-robot interaction is complex due to unknown human dynamics during walking. Finally, the performance of soft robots for wearable applications requires extensive experimental evaluation to analyze the benefits for the user. To address these challenges, this dissertation focuses on the sensing, modeling, control and evaluation of soft robots for wearable applications. A model-based sensor fusion algorithm is proposed to improve the estimation of human joint kinematics, with a soft flexible robot that requires compact and lightweight sensors. To overcome limitations with rigid sensors, an inflatable soft haptic sensor is developed to enable gait sensing and haptic feedback. Through experimental characterization, a mathematical model is derived to quantify the user's ground reaction forces and the delivered haptic force. Lastly, the performance of a wearable soft exosuit in assisting human users during lifting tasks is evaluated, and the benefits obtained from the soft robot assistance are analyzed.
ContributorsQuiñones Yumbla, Emiliano (Author) / Zhang, Wenlong (Thesis advisor) / Berman, Spring (Committee member) / Lee, Hyunglae (Committee member) / Marvi, Hamid (Committee member) / Sugar, Thomas (Committee member) / Arizona State University (Publisher)
Created2023
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Description
One of the long-standing issues that has arisen in the sports medicine field is identifying the ideal methodology to optimize recovery following anterior cruciate ligament reconstruction (ACLR). The perioperative period for ACLR is notoriously heterogeneous in nature as it consists of many variables that can impact surgical outcomes. While there

One of the long-standing issues that has arisen in the sports medicine field is identifying the ideal methodology to optimize recovery following anterior cruciate ligament reconstruction (ACLR). The perioperative period for ACLR is notoriously heterogeneous in nature as it consists of many variables that can impact surgical outcomes. While there has been extensive literature published regarding the efficacy of various recovery and rehabilitation topics, it has been widely acknowledged that certain modalities within the field of ACLR rehabilitation need further high-quality evidence to support their use in clinical practice, such as blood flow restriction (BFR) training. BFR training involves the application of a tourniquet-like cuff to the proximal aspect of a limb prior to exercise; the cuff is inflated so that it occludes venous flow but allows arterial inflow. BFR is usually combined with low-intensity (LI) resistance training, with resistance as low as 20% of one-repetition maximum (1RM). LI-BFR has been used as an emerging clinical modality to combat postoperative atrophy of the quadriceps muscles for those who have undergone ACLR, as these individuals cannot safely tolerate high muscular tension exercise after surgery. Impairments of the quadriceps are the major cause of poor functional status of patients following an otherwise successful ACLR procedure; however, these impairments can be mitigated with preoperative rehabilitation done before surgery. It was hypothesized that the use of a preoperative LI-BFR training protocol could help improve postoperative outcomes following ACLR; primarily, strength and hypertrophy of the quadriceps. When compared with a SHAM control group, subjects who were randomized to a BFR intervention group made greater preoperative strength gains in the quadriceps and recovered quadriceps mass at an earlier timepoint than that of the SHAM group aftersurgery; however, the gains made in strength were not able to be maintained in the 8-week postoperative period. While these results do not support the use of LI-BFR from the short-term perspective after ACLR, follow-up data will be used to investigate trends in re-injury and return to sport rates to evaluate the efficacy of the use of LI-BFR from a long-term perspective.
ContributorsGlattke, Kaycee Elizabeth (Author) / Lockhart, Thurmon (Thesis advisor) / McDaniel, Troy (Committee member) / Banks, Scott (Committee member) / Peterson, Daniel (Committee member) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2022
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Description
The Soft Robotic Hip Exosuit (SR-HExo) was designed, fabricated, and tested in treadmill walking experiments with healthy participants to gauge effectivity of the suit in assisting locomotion and in expanding the basin of entrainment as a method of rehabilitation. The SR-HExo consists of modular, compliant materials to move freely with

The Soft Robotic Hip Exosuit (SR-HExo) was designed, fabricated, and tested in treadmill walking experiments with healthy participants to gauge effectivity of the suit in assisting locomotion and in expanding the basin of entrainment as a method of rehabilitation. The SR-HExo consists of modular, compliant materials to move freely with a user’s range of motion and is actuated with X-oriented flat fabric pneumatic artificial muscles (X-ff-PAM) that contract when pressurized and can generate 190N of force at 200kPa in a 0.3 sec window. For use in gait assistance experiments, X-ff-PAM actuators were placed anterior and posterior to the right hip joint. Extension assistance and flexion assistance was provided in 10-45% and 50-90% of the gait cycle, respectively. Device effectivity was determined through range of motion (ROM) preservation and hip flexor and extensor muscular activity reduction. While the active suit reduced average hip ROM by 4o from the target 30o, all monitored muscles experienced significant reductions in electrical activity. The gluteus maximus and biceps femoris experienced electrical activity reduction of 13.1% and 6.6% respectively and the iliacus and rectus femoris experienced 10.7% and 27.7% respectively. To test suit rehabilitative potential, the actuators were programmed to apply periodic torque perturbations to induce locomotor entrainment. An X-ff-PAM was contracted at the subject’s preferred gait frequency and, in randomly ordered increments of 3%, increased up to 15% beyond. Perturbations located anterior and posterior to the hip were tested separately to assess impact of location on entrainment characteristics. All 11 healthy participants achieved entrainment in all 12 experimental conditions in both suit orientations. Phase-locking consistently occurred around toe-off phase of the gait cycle (GC). Extension perturbations synchronized earlier in the gait cycle (before 60% GC where peak hip extension occurs) than flexion perturbations (just after 60% GC at the transition from full hip extension to hip flexion), across group averaged results. The study demonstrated the suit can significantly extend the basin of entrainment and improve transient response compared to previously reported results and confirms that a single stable attractor exists during gait entrainment to unidirectional hip perturbations.
ContributorsBaye-Wallace, Lily (Author) / Lee, Hyunglae (Thesis advisor) / Marvi, Hamidreza (Committee member) / Berman, Spring (Committee member) / Arizona State University (Publisher)
Created2021
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Description
This thesis work presents two separate studies:The first study assesses standing balance under various 2-dimensional (2D) compliant environments simulated using a dual-axis robotic platform and vision conditions. Directional virtual time-to-contact (VTC) measures were introduced to better characterize postural balance from both temporal and spatial aspects, and enable prediction of fall-relevant

This thesis work presents two separate studies:The first study assesses standing balance under various 2-dimensional (2D) compliant environments simulated using a dual-axis robotic platform and vision conditions. Directional virtual time-to-contact (VTC) measures were introduced to better characterize postural balance from both temporal and spatial aspects, and enable prediction of fall-relevant directions. Twenty healthy young adults were recruited to perform quiet standing tasks on the platform. Conventional stability measures, namely center-of-pressure (COP) path length and COP area, were also adopted for further comparisons with the proposed VTC. The results indicated that postural balance was adversely impacted, evidenced by significant decreases in VTC and increases in COP path length/area measures, as the ground compliance increased and/or in the absence of vision (ps < 0.001). Interaction effects between environment and vision were observed in VTC and COP path length measures (ps ≤ 0.05), but not COP area (p = 0.103). The estimated likelihood of falls in anterior-posterior (AP) and medio-lateral (ML) directions converged to nearly 50% (almost independent of the foot setting) as the experimental condition became significantly challenging. The second study introduces a deep learning approach using convolutional neural network (CNN) for predicting environments based on instant observations of sway during balance tasks. COP data were collected from fourteen subjects while standing on the 2D compliant environments. Different window sizes for data segmentation were examined to identify its minimal length for reliable prediction. Commonly-used machine learning models were also tested to compare their effectiveness with that of the presented CNN model. The CNN achieved above 94.5% in the overall prediction accuracy even with 2.5-second length data, which cannot be achieved by traditional machine learning models (ps < 0.05). Increasing data length beyond 2.5 seconds slightly improved the accuracy of CNN but substantially increased training time (60% longer). Importantly, averaged normalized confusion matrices revealed that CNN is much more capable of differentiating the mid-level environmental condition. These two studies provide new perspectives in human postural balance, which cannot be interpreted by conventional stability analyses. Outcomes of these studies contribute to the advancement of human interactive robots/devices for fall prevention and rehabilitation.
ContributorsPhan, Vu Nguyen (Author) / Lee, Hyunglae (Thesis advisor) / Peterson, Daniel (Committee member) / Marvi, Hamidreza (Committee member) / Arizona State University (Publisher)
Created2021
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Description
Low back pain (LBP) is the most common symptom leading to hospitalization and medical assistance. In the US, LBP is the fifth most prevalent case for visiting hospitals. Approximately 2.06 million LBP incidents were reported during the timeline between 2004 and 2008. Globally, LBP occurrence increased by almost 200 million

Low back pain (LBP) is the most common symptom leading to hospitalization and medical assistance. In the US, LBP is the fifth most prevalent case for visiting hospitals. Approximately 2.06 million LBP incidents were reported during the timeline between 2004 and 2008. Globally, LBP occurrence increased by almost 200 million from 1990 to 2017. This problem is further implicated by physical and financial constraints that impact the individual’s quality of life. The medical cost exceeded $87.6 billion, and the lifetime prevalence was 84%. This indicates that the majority of people in the US will experience this symptom. Also, LBP limits Activities of Daily Living (ADL) and possibly affects the gait and postural stability. Prior studies indicated that LBP patients have slower gait speed and postural instability. To alleviate this symptom, the epidural injection is prescribed to treat pain and improve mobility function. To evaluate the effectiveness of LBP epidural injection intervention, gait and posture stability was investigated before and after the injection. While these factors are the fundamental indicator of LBP improvement, ADL is an element that needs to be significantly considered. The physical activity level depicts a person’s dynamic movement during the day, it is essential to gather activity level that supports monitoring chronic conditions, such as LBP, osteoporosis, and falls. The objective of this study was to assess the effects of Epidural Steroid Injection (ESI) on LBP and related gait and postural stability in the pre and post-intervention status. As such, the second objective was to assess the influence of ESI on LBP, and how it influences the participant’s ADL physical activity level. The results indicated that post-ESI intervention has significantly improved LBP patient’s gait and posture stability, however, there was insufficient evidence to determine the significant disparity in the physical activity levels. In conclusion, ESI depicts significant positive effects on LBP patients’ gait and postural parameters, however, more verification is required to indicate a significant effect on ADL physical activity levels.
ContributorsMoon, Seong Hyun (Author) / Lockhart, Thurmon (Thesis advisor) / Honeycutt, Claire (Committee member) / Peterson, Daniel (Committee member) / Lee, Hyunglae (Committee member) / Soangra, Rahul (Committee member) / Arizona State University (Publisher)
Created2023
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Description
Locomotion is of prime importance in enabling human beings to effectively respond

in space and time to meet different needs. Approximately 2 million Americans live

with an amputation with most of those amputations being of the lower limbs. To

advance current state-of-the-art lower limb prosthetic devices, it is necessary to adapt

performance at a

Locomotion is of prime importance in enabling human beings to effectively respond

in space and time to meet different needs. Approximately 2 million Americans live

with an amputation with most of those amputations being of the lower limbs. To

advance current state-of-the-art lower limb prosthetic devices, it is necessary to adapt

performance at a level of intelligence seen in human walking. As such, this thesis

focuses on the mechanisms involved during human walking, while transitioning from

rigid to compliant surfaces such as from pavement to sand, grass or granular media.

Utilizing a unique tool, the Variable Stiffness Treadmill (VST), as the platform for

human walking, rigid to compliant surface transitions are simulated. The analysis of

muscular activation during the transition from rigid to different compliant surfaces

reveals specific anticipatory muscle activation that precedes stepping on a compliant

surface. There is also an indication of varying responses for different surface stiffness

levels. This response is observed across subjects. Results obtained are novel and

useful in establishing a framework for implementing control algorithm parameters to

improve powered ankle prosthesis. With this, it is possible for the prosthesis to adapt

to a new surface and therefore resulting in a more robust smart powered lower limb

prosthesis.
ContributorsObeng, Ruby Afriyie (Author) / Artemiadis, Panagiotis (Thesis advisor) / Santello, Marco (Thesis advisor) / Lee, Hyunglae (Committee member) / Arizona State University (Publisher)
Created2019
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Description
Human walking has been a highly studied topic in research communities because of its extreme importance to human functionality and mobility. A complex system of interconnected gait mechanisms in humans is responsible for generating robust and consistent walking motion over unpredictable ground and through challenging obstacles. One interesting aspect of

Human walking has been a highly studied topic in research communities because of its extreme importance to human functionality and mobility. A complex system of interconnected gait mechanisms in humans is responsible for generating robust and consistent walking motion over unpredictable ground and through challenging obstacles. One interesting aspect of human gait is the ability to adjust in order to accommodate varying surface grades. Typical approaches to investigating this gait function focus on incline and decline surface angles, but most experiments fail to address the effects of surface grades that cause ankle inversion and eversion. There have been several studies of ankle angle perturbation over wider ranges of grade orientations in static conditions; however, these studies do not account for effects during the gait cycle. Furthermore, contemporary studies on this topic neglect critical sources of unnatural stimulus in the design of investigative technology. It is hypothesized that the investigation of ankle angle perturbations in the frontal plane, particularly in the context of inter-leg coordination mechanisms, results in a more complete characterization of the effects of surface grade on human gait mechanisms. This greater understanding could potentially lead to significant applications in gait rehabilitation, especially for individuals who suffer from impairment as a result of stroke. A wearable pneumatic device was designed to impose inversion and eversion perturbations on the ankle through simulated surface grade changes. This prototype device was fabricated, characterized, and tested in order to assess its effectiveness. After testing and characterizing this device, it was used in a series of experiments on human subjects while data was gathered on muscular activation and gait kinematics. The results of the characterization show success in imposing inversion and eversion angle perturbations of approximately 9° with a response time of 0.5 s. Preliminary experiments focusing on inter-leg coordination with healthy human subjects show that one-sided inversion and eversion perturbations have virtually no effect on gait kinematics. However, changes in muscular activation from one-sided perturbations show statistical significance in key lower limb muscles. Thus, the prototype device demonstrates novelty in the context of human gait research for potential applications in rehabilitation.
ContributorsBarkan, Andrew (Author) / Artemiadis, Panagiotis (Thesis advisor) / Lee, Hyunglae (Committee member) / Marvi, Hamidreza (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Cerebral aneurysms are pathological balloonings of blood vessels in the brain, commonly found in the arterial network at the base of the brain. Cerebral aneurysm rupture can lead to a dangerous medical condition, subarachnoid hemorrhage, that is associated with high rates of morbidity and mortality. Effective evaluation and management of

Cerebral aneurysms are pathological balloonings of blood vessels in the brain, commonly found in the arterial network at the base of the brain. Cerebral aneurysm rupture can lead to a dangerous medical condition, subarachnoid hemorrhage, that is associated with high rates of morbidity and mortality. Effective evaluation and management of cerebral aneurysms is therefore essential to public health. The goal of treating an aneurysm is to isolate the aneurysm from its surrounding circulation, thereby preventing further growth and rupture. Endovascular treatment for cerebral aneurysms has gained popularity over traditional surgical techniques due to its minimally invasive nature and shorter associated recovery time. The hemodynamic modifications that the treatment effects can promote thrombus formation within the aneurysm leading to eventual isolation. However, different treatment devices can effect very different hemodynamic outcomes in aneurysms with different geometries.

Currently, cerebral aneurysm risk evaluation and treatment planning in clinical practice is largely based on geometric features of the aneurysm including the dome size, dome-to-neck ratio, and parent vessel geometry. Hemodynamics, on the other hand, although known to be deeply involved in cerebral aneurysm initiation and progression, are considered to a lesser degree. Previous work in the field of biofluid mechanics has demonstrated that geometry is a driving factor behind aneurysmal hemodynamics.

The goal of this research is to develop a more combined geometric/hemodynamic basis for informing clinical decisions. Geometric main effects were analyzed to quantify contributions made by geometric factors that describe cerebral aneurysms (i.e., dome size, dome-to-neck ratio, and inflow angle) to clinically relevant hemodynamic responses (i.e., wall shear stress, root mean square velocity magnitude and cross-neck flow). Computational templates of idealized bifurcation and sidewall aneurysms were created to satisfy a two-level full factorial design, and examined using computational fluid dynamics. A subset of the computational bifurcation templates was also translated into physical models for experimental validation using particle image velocimetry. The effects of geometry on treatment were analyzed by virtually treating the aneurysm templates with endovascular devices. The statistical relationships between geometry, treatment, and flow that emerged have the potential to play a valuable role in clinical practice.
ContributorsNair, Priya (Author) / Frakes, David (Thesis advisor) / Vernon, Brent (Committee member) / Chong, Brian (Committee member) / Pizziconi, Vincent (Committee member) / Adrian, Ronald (Committee member) / Arizona State University (Publisher)
Created2016
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Description
Fall accident is a significant problem associated with our society both in terms of economic losses and human suffering [1]. In 2016, more than 800,000 people were hospitalized and over 33,000 deaths resulted from falling. Health costs associated with falling in 2016 yielded at 33% of total medical expenses in

Fall accident is a significant problem associated with our society both in terms of economic losses and human suffering [1]. In 2016, more than 800,000 people were hospitalized and over 33,000 deaths resulted from falling. Health costs associated with falling in 2016 yielded at 33% of total medical expenses in the US- mounting to approximately $31 billion per year. As such, it is imperative to find intervention strategies to mitigate deaths and injuries associated with fall accidents. In order for this goal to be realized, it is necessary to understand the mechanisms associated with fall accidents and more specifically, the movement profiles that may represent the cogent behavior of the locomotor system that may be amendable to rehabilitation and intervention strategies. In this light, this Thesis is focused on better understanding the factors influencing dynamic stability measure (as measured by Lyapunov exponents) during over-ground ambulation utilizing wireless Inertial Measurement Unit (IMU).

Four pilot studies were conducted: the First study was carried out to verify if IMU system was sophisticated enough to determine different load-carrying conditions. Second, to test the effects of walking inclinations, three incline levels on gait dynamic stability were examined. Third, tested whether different sections from the total gait cycle can be stitched together to assess LDS using the laboratory collected data. Finally, the fourth study examines the effect of “stitching” the data on dynamic stability measure from a longitudinally assessed (3-day continuous data collection) data to assess the effects of free-range data on assessment of dynamic stability.

Results indicated that load carrying significantly influenced dynamic stability measure but not for the floor inclination levels – indicating that future use of such measure should further implicate normalization of dynamic stability measures associated with different activities and terrain conditions. Additionally, stitching method was successful in obtaining dynamic stability measure utilizing free-living IMU data.
ContributorsMoon, Seong Hyun (Author) / Lockhart, Thurmon Eddy (Thesis advisor) / Lee, Hyunglae (Committee member) / Honeycutt, Claire (Committee member) / Arizona State University (Publisher)
Created2017