1
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Krishnakumar S, van Beijnum BJF, Baten CTM, Veltink PH, Buurke JH. Estimation of Kinetics Using IMUs to Monitor and Aid in Clinical Decision-Making during ACL Rehabilitation: A Systematic Review. Sensors (Basel) 2024; 24:2163. [PMID: 38610374 PMCID: PMC11014074 DOI: 10.3390/s24072163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/18/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024]
Abstract
After an ACL injury, rehabilitation consists of multiple phases, and progress between these phases is guided by subjective visual assessments of activities such as running, hopping, jump landing, etc. Estimation of objective kinetic measures like knee joint moments and GRF during assessment can help physiotherapists gain insights on knee loading and tailor rehabilitation protocols. Conventional methods deployed to estimate kinetics require complex, expensive systems and are limited to laboratory settings. Alternatively, multiple algorithms have been proposed in the literature to estimate kinetics from kinematics measured using only IMUs. However, the knowledge about their accuracy and generalizability for patient populations is still limited. Therefore, this article aims to identify the available algorithms for the estimation of kinetic parameters using kinematics measured only from IMUs and to evaluate their applicability in ACL rehabilitation through a comprehensive systematic review. The papers identified through the search were categorized based on the modelling techniques and kinetic parameters of interest, and subsequently compared based on the accuracies achieved and applicability for ACL patients during rehabilitation. IMUs have exhibited potential in estimating kinetic parameters with good accuracy, particularly for sagittal movements in healthy cohorts. However, several shortcomings were identified and future directions for improvement have been proposed, including extension of proposed algorithms to accommodate multiplanar movements and validation of the proposed techniques in diverse patient populations and in particular the ACL population.
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Affiliation(s)
- Sanchana Krishnakumar
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
| | - Bert-Jan F. van Beijnum
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
| | - Chris T. M. Baten
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands;
| | - Peter H. Veltink
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
| | - Jaap H. Buurke
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.); (J.H.B.)
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands;
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2
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Braem CIR, Yavuz US, Hermens HJ, Veltink PH. Missing Data Statistics Provide Causal Insights into Data Loss in Diabetes Health Monitoring by Wearable Sensors. Sensors (Basel) 2024; 24:1526. [PMID: 38475061 DOI: 10.3390/s24051526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/14/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Data loss in wearable sensors is an inevitable problem that leads to misrepresentation during diabetes health monitoring. We systematically investigated missing wearable sensors data to get causal insight into the mechanisms leading to missing data. METHODS Two-week-long data from a continuous glucose monitor and a Fitbit activity tracker recording heart rate (HR) and step count in free-living patients with type 2 diabetes mellitus were used. The gap size distribution was fitted with a Planck distribution to test for missing not at random (MNAR) and a difference between distributions was tested with a Chi-squared test. Significant missing data dispersion over time was tested with the Kruskal-Wallis test and Dunn post hoc analysis. RESULTS Data from 77 subjects resulted in 73 cleaned glucose, 70 HR and 68 step count recordings. The glucose gap sizes followed a Planck distribution. HR and step count gap frequency differed significantly (p < 0.001), and the missing data were therefore MNAR. In glucose, more missing data were found in the night (23:00-01:00), and in step count, more at measurement days 6 and 7 (p < 0.001). In both cases, missing data were caused by insufficient frequency of data synchronization. CONCLUSIONS Our novel approach of investigating missing data statistics revealed the mechanisms for missing data in Fitbit and CGM data.
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Affiliation(s)
- Carlijn I R Braem
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Utku S Yavuz
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Hermie J Hermens
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
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3
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Zhang J, van Mierlo M, Veltink PH, van Asseldonk EHF. Estimation of sagittal-plane whole-body angular momentum during perturbed and unperturbed gait using simplified body models. Hum Mov Sci 2024; 93:103179. [PMID: 38244350 DOI: 10.1016/j.humov.2024.103179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 12/31/2023] [Accepted: 01/10/2024] [Indexed: 01/22/2024]
Abstract
Human whole-body angular momentum (WBAM) during walking typically follows a consistent pattern, making it a valuable indicator of the state of balance. However, calculating WBAM is labor-intensive, where the kinematic data for all body segments is needed, that is, based on a full-body model. In this study, we focused on selecting appropriate segments for estimating sagittal-plane WBAM during both unperturbed and perturbed gaits, which were segments with significant angular momentum contributions. Those major segments were constructed as a simplified model, and the sagittal-plane WBAM based on a simplified model was calculated by combining the angular momenta of the selected segments. We found that the WBAM estimated by seven-segment models, incorporating the head & torso (HT) and all lower limb segments, provided an average correlation coefficient of 0.99 and relative angular momentum percentage of 96.8% and exhibited the most similar sensitivity to external perturbations compared to the full-body model-based WBAM. Additionally, our findings revealed that the rotational angular momenta (RAM) of lower limb segments were much smaller than their translational angular momenta (TAM). The pair-wise comparisons between simplified models with and without RAMs of lower body segments were observed with no significant difference, indicating that RAMs of lower body segments are neglectable. This may further simplify the WBAM estimation based on the seven-segment model, eliminating the need to estimate the angular velocities of lower limb segments. These findings have practical implications for future studies of using inertial measurement units (IMUs) for estimating WBAM, as our results can help reduce the number of required sensors and simplify kinematics measurement.
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Affiliation(s)
- J Zhang
- Department of Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands.
| | - M van Mierlo
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
| | - P H Veltink
- Department of Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands
| | - E H F van Asseldonk
- Department of Biomechanical Engineering, University of Twente, Enschede, the Netherlands
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4
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Yogesh V, Buurke JH, Veltink PH, Baten CTM. Integrated UWB/MIMU Sensor System for Position Estimation towards an Accurate Analysis of Human Movement: A Technical Review. Sensors (Basel) 2023; 23:7277. [PMID: 37631813 PMCID: PMC10458750 DOI: 10.3390/s23167277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Integrated Ultra-wideband (UWB) and Magnetic Inertial Measurement Unit (MIMU) sensor systems have been gaining popularity for pedestrian tracking and indoor localization applications, mainly due to their complementary error characteristics that can be exploited to achieve higher accuracies via a data fusion approach. These integrated sensor systems have the potential for improving the ambulatory 3D analysis of human movement (estimating 3D kinematics of body segments and joints) over systems using only on-body MIMUs. For this, high accuracy is required in the estimation of the relative positions of all on-body integrated UWB/MIMU sensor modules. So far, these integrated UWB/MIMU sensors have not been reported to have been applied for full-body ambulatory 3D analysis of human movement. Also, no review articles have been found that have analyzed and summarized the methods integrating UWB and MIMU sensors for on-body applications. Therefore, a comprehensive analysis of this technology is essential to identify its potential for application in 3D analysis of human movement. This article thus aims to provide such a comprehensive analysis through a structured technical review of the methods integrating UWB and MIMU sensors for accurate position estimation in the context of the application for 3D analysis of human movement. The methods used for integration are all summarized along with the accuracies that are reported in the reviewed articles. In addition, the gaps that are required to be addressed for making this system applicable for the 3D analysis of human movement are discussed.
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Affiliation(s)
- Vinish Yogesh
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands; (J.H.B.); (C.T.M.B.)
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands;
| | - Jaap H. Buurke
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands; (J.H.B.); (C.T.M.B.)
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands;
| | - Peter H. Veltink
- Department of Biomedical Signals and System, University of Twente, Drienerlolaan 5, 7522 NB Enschede, The Netherlands;
| | - Chris T. M. Baten
- Roessingh Research and Development, Roessinghsbleekweg 33B, 7522 AH Enschede, The Netherlands; (J.H.B.); (C.T.M.B.)
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Mohamed Refai MI, van Beijnum BJF, Buurke JH, Shull PB, Veltink PH. Editorial: Wearable sensing of movement quality after neurological disorders. Front Physiol 2023; 14:1156520. [PMID: 36846338 PMCID: PMC9950730 DOI: 10.3389/fphys.2023.1156520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/12/2023] Open
Affiliation(s)
- Mohamed Irfan Mohamed Refai
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands,Biomechanical Engineering, University of Twente, Enschede, Netherlands,*Correspondence: Mohamed Irfan Mohamed Refai,
| | | | - Jaap H. Buurke
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands,Roessingh Research and Development, Enschede, Netherlands
| | - Peter B. Shull
- Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Peter H. Veltink
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
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6
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Zandbergen MA, Ter Wengel XJ, van Middelaar RP, Buurke JH, Veltink PH, Reenalda J. Peak tibial acceleration should not be used as indicator of tibial bone loading during running. Sports Biomech 2023:1-18. [PMID: 36645012 DOI: 10.1080/14763141.2022.2164345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/27/2022] [Indexed: 01/17/2023]
Abstract
Peak tibial acceleration (PTA) is a widely used indicator of tibial bone loading. Indirect bone loading measures are of interest to reduce the risk of stress fractures during running. However, tibial compressive forces are caused by both internal muscle forces and external ground reaction forces. PTA might reflect forces from outside the body, but likely not the compressive force from muscles on the tibial bone. Hence, the strength of the relationship between PTA and maximum tibial compression forces in rearfoot-striking runners was investigated. Twelve runners ran on an instrumented treadmill while tibial acceleration was captured with accelerometers. Force plate and inertial measurement unit data were spatially aligned with a novel method based on the centre of pressure crossing a virtual toe marker. The correlation coefficient between maximum tibial compression forces and PTA was 0.04 ± 0.14 with a range of -0.15 to +0.28. This study showed a very weak and non-significant correlation between PTA and maximum tibial compression forces while running on a level treadmill at a single speed. Hence, PTA as an indicator for tibial bone loading should be reconsidered, as PTA does not provide a complete picture of both internal and external compressive forces on the tibial bone. .
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Affiliation(s)
- Marit A Zandbergen
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
- Department of Rehabilitation Technology, Roessingh Research and Development, Enschede, The Netherlands
| | - Xanthe J Ter Wengel
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
| | - Robbert P van Middelaar
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
| | - Jaap H Buurke
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
- Department of Rehabilitation Technology, Roessingh Research and Development, Enschede, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
| | - Jasper Reenalda
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, Enschede, The Netherlands
- Department of Rehabilitation Technology, Roessingh Research and Development, Enschede, The Netherlands
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7
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Zandbergen MA, Buurke JH, Veltink PH, Reenalda J. Quantifying and correcting for speed and stride frequency effects on running mechanics in fatiguing outdoor running. Front Sports Act Living 2023; 5:1085513. [PMID: 37139307 PMCID: PMC10150107 DOI: 10.3389/fspor.2023.1085513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 02/23/2023] [Indexed: 05/05/2023] Open
Abstract
Measuring impact-related quantities in running is of interest to improve the running technique. Many quantities are typically measured in a controlled laboratory setting, even though most runners run in uncontrolled outdoor environments. While monitoring running mechanics in an uncontrolled environment, a decrease in speed or stride frequency can mask fatigue-related changes in running mechanics. Hence, this study aimed to quantify and correct the subject-specific effects of running speed and stride frequency on changes in impact-related running mechanics during a fatiguing outdoor run. Seven runners ran a competitive marathon while peak tibial acceleration and knee angles were measured with inertial measurement units. Running speed was measured through sports watches. Median values over segments of 25 strides throughout the marathon were computed and used to create subject-specific multiple linear regression models. These models predicted peak tibial acceleration, knee angles at initial contact, and maximum stance phase knee flexion based on running speed and stride frequency. Data were corrected for individual speed and stride frequency effects during the marathon. The speed and stride frequency corrected and uncorrected data were divided into ten stages to investigate the effect of marathon stage on mechanical quantities. This study showed that running speed and stride frequency explained, on average, 20%-30% of the variance in peak tibial acceleration, knee angles at initial contact, and maximum stance phase knee angles while running in an uncontrolled setting. Regression coefficients for speed and stride frequency varied strongly between subjects. Speed and stride frequency corrected peak tibial acceleration, and maximum stance phase knee flexion increased throughout the marathon. At the same time, uncorrected maximum stance phase knee angles showed no significant differences between marathon stages due to a decrease in running speed. Hence, subject-specific effects of changes in speed and stride frequency influence the interpretation of running mechanics and are relevant when monitoring, or comparing the gait pattern between runs in uncontrolled environments.
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Affiliation(s)
- Marit A. Zandbergen
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
- Department of Rehabilitation Technology, Roessingh Research and Development, Enschede, Netherlands
- Correspondence: Marit A. Zandbergen
| | - Jaap H. Buurke
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
- Department of Rehabilitation Technology, Roessingh Research and Development, Enschede, Netherlands
| | - Peter H. Veltink
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
| | - Jasper Reenalda
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands
- Department of Rehabilitation Technology, Roessingh Research and Development, Enschede, Netherlands
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8
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Zandbergen MA, Marotta L, Bulthuis R, Buurke JH, Veltink PH, Reenalda J. Effects of level running-induced fatigue on running kinematics: A systematic review and meta-analysis. Gait Posture 2023; 99:60-75. [PMID: 36332318 DOI: 10.1016/j.gaitpost.2022.09.089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 07/15/2022] [Accepted: 09/19/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Runners have a high risk of acquiring a running-related injury. Understanding the mechanisms of impact force attenuation into the body when a runner fatigues might give insight into the role of running kinematics on the aetiology of overuse injuries. RESEARCH QUESTIONS How do running kinematics change due to running-induced fatigue? And what is the influence of experience level on changes in running kinematics due to fatigue? METHODS Three electronic databases were searched: PubMed, Web of Science, and Scopus. This resulted in 33 articles and 19 kinematic quantities being included in this review. A quality assessment was performed on all included articles and meta-analyses were performed for 18 kinematic quantities. RESULTS AND SIGNIFICANCE Main findings included an increase in peak acceleration at the tibia and a decrease in leg stiffness after a fatiguing protocol. Additionally, level running-induced fatigue increased knee flexion at initial contact and maximum knee flexion during swing. An increase in vertical centre of mass displacement was found in novice but not in experienced runners with fatigue. Overall, runners changed their gait pattern due to fatigue by moving to a smoother gait pattern (i.e. more knee flexion at initial contact and during swing, decreased leg stiffness). However, these changes were not sufficient to prevent an increase in peak accelerations at the tibia after a fatigue protocol. Large inter-individual differences in responses to fatigue were reported. Hence, it is recommended to investigate changes in running kinematics as a result of fatigue on a subject-specific level since group-level analysis might mask individual responses.
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Affiliation(s)
- Marit A Zandbergen
- Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands; Rehabilitation Technology, Roessingh Research and Development, Enschede, the Netherlands.
| | - Luca Marotta
- Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands; Rehabilitation Technology, Roessingh Research and Development, Enschede, the Netherlands
| | - Roos Bulthuis
- Rehabilitation Technology, Roessingh Research and Development, Enschede, the Netherlands
| | - Jaap H Buurke
- Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands; Rehabilitation Technology, Roessingh Research and Development, Enschede, the Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands
| | - Jasper Reenalda
- Biomedical Signals and Systems, University of Twente, Enschede, the Netherlands; Rehabilitation Technology, Roessingh Research and Development, Enschede, the Netherlands
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Schwarz A, Bhagubai MMC, Nies SHG, Held JPO, Veltink PH, Buurke JH, Luft AR. Correction to: Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures. J Neuroeng Rehabil 2022; 19:70. [PMID: 35820923 PMCID: PMC9277818 DOI: 10.1186/s12984-022-01048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Affiliation(s)
- Anne Schwarz
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. .,Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands.
| | - Miguel M C Bhagubai
- Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands
| | - Saskia H G Nies
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Jeremia P O Held
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Peter H Veltink
- Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands
| | - Jaap H Buurke
- Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands.,Roessingh Research and Development B.V., Enschede, The Netherlands
| | - Andreas R Luft
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
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Refai MIM, Van Beijnum BJF, Buurke JH, Veltink PH. Centroidal Moment Pivot for ambulatory estimation of relative feet and CoM movement post stroke: Portable Gait Lab . IEEE Int Conf Rehabil Robot 2022; 2022:1-6. [PMID: 36176085 DOI: 10.1109/icorr55369.2022.9896526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Measuring gait and balance recovery is necessary post stroke. In an earlier study, we developed a minimal three Inertial Measurement Units (IMUs) system called Portable Gait Lab (PGL). The PGL used the Centroidal Moment Pivot (CMP) assumption to estimate relative foot and centre of mass (CoM) positions, and thereby estimate gait parameters in healthy participants. In this study, we validate the feasibility of the PGL to track foot and CoM trajectory during gait in four persons with chronic stroke. Spatiotemporal gait and balance measures were estimated from the foot and CoM trajectories, and compared with the reference ForceShoes™. Each participant made at least 20 steps, and the PGL was able to track foot and CoM trajectories with a root mean square of the differences with the reference of 2.9 ± 0.2 cm and 4.6 ± 3.6 cm. The distances between either foot at the end of the walking task, and step lengths were estimated by PGL with an average error with the reference of 1.98 ± 2.2 cm and 7.8 ± 0.1 cm respectively across participants. We show that our approach was able to estimate spatiotemporal and balance parameters related to gait quality in a clinically useful manner. We recommend conducting further studies to study the feasibility of using the PGL system for variable gait patterns measured post stroke.
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Saes M, Mohamed Refai MI, van Beijnum BJF, Bussmann JBJ, Jansma EP, Veltink PH, Buurke JH, van Wegen EEH, Meskers CGM, Krakauer JW, Kwakkel G. Quantifying Quality of Reaching Movements Longitudinally Post-Stroke: A Systematic Review. Neurorehabil Neural Repair 2022; 36:183-207. [PMID: 35100897 PMCID: PMC8902693 DOI: 10.1177/15459683211062890] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Background Disambiguation of behavioral restitution from compensation is important to better understand recovery of upper limb motor control post-stroke and subsequently design better interventions. Measuring quality of movement (QoM) during standardized performance assays and functional tasks using kinematic and kinetic metrics potentially allows for this disambiguation. Objectives To identify longitudinal studies that used kinematic and/or kinetic metrics to investigate post-stroke recovery of reaching and assess whether these studies distinguish behavioral restitution from compensation. Methods A systematic literature search was conducted using the databases PubMed, Embase, Scopus, and Wiley/Cochrane Library up to July 1st, 2020. Studies were identified if they performed longitudinal kinematic and/or kinetic measurements during reaching, starting within the first 6 months post-stroke. Results Thirty-two longitudinal studies were identified, which reported a total of forty-six different kinematic metrics. Although the majority investigated improvements in kinetics or kinematics to quantify recovery of QoM, none of these studies explicitly addressed the distinction between behavioral restitution and compensation. One study obtained kinematic metrics for both performance assays and a functional task. Conclusions Despite the growing number of kinematic and kinetic studies on post-stroke recovery, longitudinal studies that explicitly seek to delineate between behavioral restitution and compensation are still lacking in the literature. To rectify this situation, future studies should measure kinematics and/or kinetics during performance assays to isolate restitution and during a standardized functional task to determine the contributions of restitution and compensation.
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Affiliation(s)
- M Saes
- Department of Rehabilitation Medicine, 1209Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - M I Mohamed Refai
- Department of Biomedical Signals & Systems, Technical Medical Centre, 214825University of Twente, Enschede, Netherlands
| | - B J F van Beijnum
- Department of Biomedical Signals & Systems, Technical Medical Centre, 214825University of Twente, Enschede, Netherlands
| | - J B J Bussmann
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, Netherlands
| | - E P Jansma
- Medical Library, 1190Vrije Universiteit Amsterdam, Amsterdam, Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, Location VUmcAmsterdam, The Netherlands
| | - P H Veltink
- Department of Biomedical Signals & Systems, Technical Medical Centre, 214825University of Twente, Enschede, Netherlands
| | - J H Buurke
- Department of Biomedical Signals & Systems, Technical Medical Centre, 214825University of Twente, Enschede, Netherlands.,Rehabilitation Technology, Roessingh Research and Development, Enschede, Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, Il, USA
| | - E E H van Wegen
- Department of Rehabilitation Medicine, 1209Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - C G M Meskers
- Department of Rehabilitation Medicine, 1209Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, Il, USA
| | - J W Krakauer
- Departments of Neurology, Neuroscience and Physical Medicine and Rehabilitation, 1500Johns Hopkins University, Baltimore, MD, United States
| | - G Kwakkel
- Department of Rehabilitation Medicine, 1209Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, Amsterdam, Netherlands.,Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, 12244Northwestern University, Chicago, Il, USA.,Department of Neurorehabilitation, 522567Amsterdam Rehabilitation Research Centre, Amsterdam, Netherlands
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12
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Zandbergen MA, Reenalda J, van Middelaar RP, Ferla RI, Buurke JH, Veltink PH. Drift-Free 3D Orientation and Displacement Estimation for Quasi-Cyclical Movements Using One Inertial Measurement Unit: Application to Running. Sensors (Basel) 2022; 22:s22030956. [PMID: 35161701 PMCID: PMC8838725 DOI: 10.3390/s22030956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/14/2022] [Accepted: 01/19/2022] [Indexed: 12/04/2022]
Abstract
A Drift-Free 3D Orientation and Displacement estimation method (DFOD) based on a single inertial measurement unit (IMU) is proposed and validated. Typically, body segment orientation and displacement methods rely on a constant- or zero-velocity point to correct for drift. Therefore, they are not easily applicable to more proximal segments than the foot. DFOD uses an alternative single sensor drift reduction strategy based on the quasi-cyclical nature of many human movements. DFOD assumes that the quasi-cyclical movement occurs in a quasi-2D plane and with an approximately constant cycle average velocity. DFOD is independent of a constant- or zero-velocity point, a biomechanical model, Kalman filtering or a magnetometer. DFOD reduces orientation drift by assuming a cyclical movement, and by defining a functional coordinate system with two functional axes. These axes are based on the mean acceleration and rotation axes over multiple complete gait cycles. Using this drift-free orientation estimate, the displacement of the sensor is computed by again assuming a cyclical movement. Drift in displacement is reduced by subtracting the mean value over five gait cycle from the free acceleration, velocity, and displacement. Estimated 3D sensor orientation and displacement for an IMU on the lower leg were validated with an optical motion capture system (OMCS) in four runners during constant velocity treadmill running. Root mean square errors for sensor orientation differences between DFOD and OMCS were 3.1 ± 0.4° (sagittal plane), 5.3 ± 1.1° (frontal plane), and 5.0 ± 2.1° (transversal plane). Sensor displacement differences had a root mean square error of 1.6 ± 0.2 cm (forward axis), 1.7 ± 0.6 cm (mediolateral axis), and 1.6 ± 0.2 cm (vertical axis). Hence, DFOD is a promising 3D drift-free orientation and displacement estimation method based on a single IMU in quasi-cyclical movements with many advantages over current methods.
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Affiliation(s)
- Marit A. Zandbergen
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, 7522 NB Enschede, The Netherlands; (J.R.); (R.P.v.M.); (R.I.F.); (J.H.B.); (P.H.V.)
- Roessingh Research and Development, 7522 AH Enschede, The Netherlands
- Correspondence:
| | - Jasper Reenalda
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, 7522 NB Enschede, The Netherlands; (J.R.); (R.P.v.M.); (R.I.F.); (J.H.B.); (P.H.V.)
- Roessingh Research and Development, 7522 AH Enschede, The Netherlands
| | - Robbert P. van Middelaar
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, 7522 NB Enschede, The Netherlands; (J.R.); (R.P.v.M.); (R.I.F.); (J.H.B.); (P.H.V.)
| | - Romano I. Ferla
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, 7522 NB Enschede, The Netherlands; (J.R.); (R.P.v.M.); (R.I.F.); (J.H.B.); (P.H.V.)
| | - Jaap H. Buurke
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, 7522 NB Enschede, The Netherlands; (J.R.); (R.P.v.M.); (R.I.F.); (J.H.B.); (P.H.V.)
- Roessingh Research and Development, 7522 AH Enschede, The Netherlands
| | - Peter H. Veltink
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science (EEMCS), University of Twente, 7522 NB Enschede, The Netherlands; (J.R.); (R.P.v.M.); (R.I.F.); (J.H.B.); (P.H.V.)
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13
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Schwarz A, Bhagubai MMC, Nies SHG, Held JPO, Veltink PH, Buurke JH, Luft AR. Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures. J Neuroeng Rehabil 2022; 19:2. [PMID: 35016694 PMCID: PMC8753836 DOI: 10.1186/s12984-021-00979-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
Background Upper limb kinematic assessments provide quantifiable information on qualitative movement behavior and limitations after stroke. A comprehensive characterization of spatiotemporal kinematics of stroke subjects during upper limb daily living activities is lacking. Herein, kinematic expressions were investigated with respect to different movement types and impairment levels for the entire task as well as for motion subphases. Method Chronic stroke subjects with upper limb movement impairments and healthy subjects performed a set of daily living activities including gesture and grasp movements. Kinematic measures of trunk displacement, shoulder flexion/extension, shoulder abduction/adduction, elbow flexion/extension, forearm pronation/supination, wrist flexion/extension, movement time, hand peak velocity, number of velocity peaks (NVP), and spectral arc length (SPARC) were extracted for the whole movement as well as the subphases of reaching distally and proximally. The effects of the factors gesture versus grasp movements, and the impairment level on the kinematics of the whole task were tested. Similarities considering the metrics expressions and relations were investigated for the subphases of reaching proximally and distally between tasks and subgroups. Results Data of 26 stroke and 5 healthy subjects were included. Gesture and grasp movements were differently expressed across subjects. Gestures were performed with larger shoulder motions besides higher peak velocity. Grasp movements were expressed by larger trunk, forearm, and wrist motions. Trunk displacement, movement time, and NVP increased and shoulder flexion/extension decreased significantly with increased impairment level. Across tasks, phases of reaching distally were comparable in terms of trunk displacement, shoulder motions and peak velocity, while reaching proximally showed comparable expressions in trunk motions. Consistent metric relations during reaching distally were found between shoulder flexion/extension, elbow flexion/extension, peak velocity, and between movement time, NVP, and SPARC. Reaching proximally revealed reproducible correlations between forearm pronation/supination and wrist flexion/extension, movement time and NVP. Conclusion Spatiotemporal differences between gestures versus grasp movements and between different impairment levels were confirmed. The consistencies of metric expressions during movement subphases across tasks can be useful for linking kinematic assessment standards and daily living measures in future research and performing task and study comparisons. Trial registration: ClinicalTrials.gov Identifier NCT03135093. Registered 26 April 2017, https://clinicaltrials.gov/ct2/show/NCT03135093.
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Affiliation(s)
- Anne Schwarz
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland. .,Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands.
| | - Miguel M C Bhagubai
- Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands
| | - Saskia H G Nies
- Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Jeremia P O Held
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Peter H Veltink
- Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands
| | - Jaap H Buurke
- Biomedical Signals and Systems (BSS), University of Twente, Enschede, The Netherlands.,Roessingh Research and Development B.V., Enschede, The Netherlands
| | - Andreas R Luft
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
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14
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Frankemolle-Gilbert AM, Howell B, Bower KL, Veltink PH, Heida T, McIntyre CC. Comparison of methodologies for modeling directional deep brain stimulation electrodes. PLoS One 2021; 16:e0260162. [PMID: 34910744 PMCID: PMC8673613 DOI: 10.1371/journal.pone.0260162] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 11/03/2021] [Indexed: 11/18/2022] Open
Abstract
Deep brain stimulation (DBS) is an established clinical therapy, and directional DBS electrode designs are now commonly used in clinical practice. Directional DBS leads have the ability to increase the therapeutic window of stimulation, but they also increase the complexity of clinical programming. Therefore, computational models of DBS have become available in clinical software tools that are designed to assist in the identification of therapeutic settings. However, the details of how the DBS model is implemented can influence the predictions of the software. The goal of this study was to compare different methods for representing directional DBS electrodes within finite element volume conductor (VC) models. We evaluated 15 different DBS VC model variants and quantified how their differences influenced estimates on the spatial extent of axonal activation from DBS. Each DBS VC model included the same representation of the brain and head, but the details of the current source and electrode contact were different for each model variant. The more complex VC models explicitly represented the DBS electrode contacts, while the more simple VC models used boundary condition approximations. The more complex VC models required 2-3 times longer to mesh, build, and solve for the DBS voltage distribution than the more simple VC models. Differences in individual axonal activation thresholds across the VC model variants were substantial (-24% to +47%). However, when comparing total activation of an axon population, or estimates of an activation volume, the differences between model variants decreased (-7% to +8%). Nonetheless, the technical details of how the electrode contact and current source are represented in the DBS VC model can directly affect estimates of the voltage distribution and electric field in the brain tissue.
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Affiliation(s)
- Anneke M. Frankemolle-Gilbert
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Bryan Howell
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America
| | - Kelsey L. Bower
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America
| | - Peter H. Veltink
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Tjitske Heida
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente, Enschede, The Netherlands
| | - Cameron C. McIntyre
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States of America
- * E-mail:
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15
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Saes M, Mohamed Refai MI, van Kordelaar J, Scheltinga BL, van Beijnum BJF, Bussmann JBJ, Buurke JH, Veltink PH, Meskers CGM, van Wegen EEH, Kwakkel G. Smoothness metric during reach-to-grasp after stroke: part 2. longitudinal association with motor impairment. J Neuroeng Rehabil 2021; 18:144. [PMID: 34560898 PMCID: PMC8461930 DOI: 10.1186/s12984-021-00937-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 09/08/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The cause of smoothness deficits as a proxy for quality of movement post stroke is currently unclear. Previous simulation analyses showed that spectral arc length (SPARC) is a valid metric for investigating smoothness during a multi-joint goal-directed reaching task. The goal of this observational study was to investigate how SPARC values change over time, and whether SPARC is longitudinally associated with the recovery from motor impairments reflected by the Fugl-Meyer motor assessment of the upper extremity (FM-UE) in the first 6 months after stroke. METHODS Forty patients who suffered a first-ever unilateral ischemic stroke (22 males, aged 58.6 ± 12.5 years) with upper extremity paresis underwent kinematic and clinical measurements in weeks 1, 2, 3, 4, 5, 8, 12, and 26 post stroke. Clinical measures included amongst others FM-UE. SPARC was obtained by three-dimensional kinematic measurements using an electromagnetic motion tracking system during a reach-to-grasp movement. Kinematic assessments of 12 healthy, age-matched individuals served as reference. Longitudinal linear mixed model analyses were performed to determine SPARC change over time, compare smoothness in patients with reference values of healthy individuals, and establish the longitudinal association between SPARC and FM-UE scores. RESULTS SPARC showed a significant positive longitudinal association with FM-UE (B: 31.73, 95%-CI: [27.27 36.20], P < 0.001), which encompassed significant within- and between-subject effects (B: 30.85, 95%-CI: [26.28 35.41], P < 0.001 and B: 50.59, 95%-CI: [29.97 71.21], P < 0.001, respectively). Until 5 weeks post stroke, progress of time contributed significantly to the increase in SPARC and FM-UE scores (P < 0.05), whereafter they levelled off. At group level, smoothness was lower in patients who suffered a stroke compared to healthy subjects at all time points (P < 0.05). CONCLUSIONS The present findings show that, after stroke, recovery of smoothness in a multi-joint reaching task and recovery from motor impairments are longitudinally associated and follow a similar time course. This suggests that the reduction of smoothness deficits quantified by SPARC is a proper objective reflection of recovery from motor impairment, as reflected by FM-UE, probably driven by a common underlying process of spontaneous neurological recovery early post stroke.
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Affiliation(s)
- Mique Saes
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, de Boelelaan 1117, Location VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Mohamed Irfan Mohamed Refai
- Department of Biomedical Signals & Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Joost van Kordelaar
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, de Boelelaan 1117, Location VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Bouke L Scheltinga
- Department of Biomedical Signals & Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Bert-Jan F van Beijnum
- Department of Biomedical Signals & Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Johannes B J Bussmann
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Jaap H Buurke
- Department of Biomedical Signals & Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Il, USA
- Rehabilitation Technology, Roessingh Research and Development, Enschede, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals & Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Carel G M Meskers
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, de Boelelaan 1117, Location VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Il, USA
| | - Erwin E H van Wegen
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, de Boelelaan 1117, Location VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Gert Kwakkel
- Department of Rehabilitation Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam Neuroscience, de Boelelaan 1117, Location VUmc, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Il, USA.
- Department of Neurorehabilitation, Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, The Netherlands.
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16
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Halfwerk FR, van Haaren JHL, Klaassen R, van Delden RW, Veltink PH, Grandjean JG. Objective Quantification of In-Hospital Patient Mobilization after Cardiac Surgery Using Accelerometers: Selection, Use, and Analysis. Sensors (Basel) 2021; 21:s21061979. [PMID: 33799717 PMCID: PMC7999757 DOI: 10.3390/s21061979] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 03/03/2021] [Accepted: 03/07/2021] [Indexed: 01/06/2023]
Abstract
Cardiac surgery patients infrequently mobilize during their hospital stay. It is unclear for patients why mobilization is important, and exact progress of mobilization activities is not available. The aim of this study was to select and evaluate accelerometers for objective qualification of in-hospital mobilization after cardiac surgery. Six static and dynamic patient activities were defined to measure patient mobilization during the postoperative hospital stay. Device requirements were formulated, and the available devices reviewed. A triaxial accelerometer (AX3, Axivity) was selected for a clinical pilot in a heart surgery ward and placed on both the upper arm and upper leg. An artificial neural network algorithm was applied to classify lying in bed, sitting in a chair, standing, walking, cycling on an exercise bike, and walking the stairs. The primary endpoint was the daily amount of each activity performed between 7 a.m. and 11 p.m. The secondary endpoints were length of intensive care unit stay and surgical ward stay. A subgroup analysis for male and female patients was planned. In total, 29 patients were classified after cardiac surgery with an intensive care unit stay of 1 (1 to 2) night and surgical ward stay of 5 (3 to 6) nights. Patients spent 41 (20 to 62) min less time in bed for each consecutive hospital day, as determined by a mixed-model analysis (p < 0.001). Standing, walking, and walking the stairs increased during the hospital stay. No differences between men (n = 22) and women (n = 7) were observed for all endpoints in this study. The approach presented in this study is applicable for measuring all six activities and for monitoring postoperative recovery of cardiac surgery patients. A next step is to provide feedback to patients and healthcare professionals, to speed up recovery.
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Affiliation(s)
- Frank R. Halfwerk
- Thoraxcentrum Twente, Medisch Spectrum Twente, P.O. Box 50 000, 7500 KA Enschede, The Netherlands; (J.H.L.v.H.); (J.G.G.)
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
- Correspondence:
| | - Jeroen H. L. van Haaren
- Thoraxcentrum Twente, Medisch Spectrum Twente, P.O. Box 50 000, 7500 KA Enschede, The Netherlands; (J.H.L.v.H.); (J.G.G.)
| | - Randy Klaassen
- Human Media Interaction Lab, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (R.K.); (R.W.v.D.)
| | - Robby W. van Delden
- Human Media Interaction Lab, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands; (R.K.); (R.W.v.D.)
| | - Peter H. Veltink
- Department of Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands;
| | - Jan G. Grandjean
- Thoraxcentrum Twente, Medisch Spectrum Twente, P.O. Box 50 000, 7500 KA Enschede, The Netherlands; (J.H.L.v.H.); (J.G.G.)
- Department of Biomechanical Engineering, TechMed Centre, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
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17
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Wouda FJ, Jaspar SLJO, Harlaar J, van Beijnum BJF, Veltink PH. Foot progression angle estimation using a single foot-worn inertial sensor. J Neuroeng Rehabil 2021; 18:37. [PMID: 33596942 PMCID: PMC7888122 DOI: 10.1186/s12984-021-00816-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 01/12/2021] [Indexed: 11/16/2022] Open
Abstract
Background The foot progression angle is an important measure used to help patients reduce their knee adduction moment. Current measurement systems are either lab-bounded or do not function in all environments (e.g., magnetically distorted). This work proposes a novel approach to estimate foot progression angle using a single foot-worn inertial sensor (accelerometer and gyroscope). Methods The approach uses a dynamic step frame that is recalculated for the stance phase of each step to calculate the foot trajectory relative to that frame, to minimize effects of drift and to eliminate the need for a magnetometer. The foot progression angle (FPA) is then calculated as the angle between walking direction and the dynamic step frame. This approach was validated by gait measurements with five subjects walking with three gait types (normal, toe-in and toe-out). Results The FPA was estimated with a maximum mean error of ~ 2.6° over all gait conditions. Additionally, the proposed inertial approach can significantly differentiate between the three different gait types. Conclusion The proposed approach can effectively estimate differences in FPA without requiring a heading reference (magnetometer). This work enables feedback applications on FPA for patients with gait disorders that function in any environment, i.e. outside of a gait lab or in magnetically distorted environments.
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Affiliation(s)
- Frank J Wouda
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands.
| | - Stephan L J O Jaspar
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Bert-Jan F van Beijnum
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Peter H Veltink
- Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
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18
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Bhagubai MMC, Wolterink G, Schwarz A, Held JPO, Van Beijnum BJF, Veltink PH. Quantifying Pathological Synergies in the Upper Extremity of Stroke Subjects With the Use of Inertial Measurement Units: A Pilot Study. IEEE J Transl Eng Health Med 2020; 9:2100211. [PMID: 33344099 PMCID: PMC7742824 DOI: 10.1109/jtehm.2020.3042931] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/06/2020] [Accepted: 11/24/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Stroke is one of the main causes of disability in the world, causing loss of motor function on mainly one side of the body. A proper assessment of motor function is required to help to direct and evaluate therapy. Assessment is currently performed by therapists using observer-based standardized clinical assessment protocols. Sensor-based technologies can be used to objectively quantify the presence and severity of motor impairments in stroke patients. METHODS In this work, a minimally obstructive distributed inertial sensing system, intended to measure kinematics of the upper extremity, was developed and tested in a pilot study, where 10 chronic stroke subjects performed the arm-related tasks from the Fugl-Meyer Assessment protocol with the affected and non-affected side. RESULTS The pilot study showed that the developed distributed measurement system was adequately sensitive to show significant differences in stroke subjects' arm postures between the affected and non-affected side. The presence of pathological synergies can be analysed using the measured joint angles of the upper limb segments, that describe the movement patterns of the subject. CONCLUSION Features measured by the system vary from the assessed FMA-UE sub-score showing its potential to provide more detailed clinical information.
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Affiliation(s)
- Miguel M C Bhagubai
- Biomedical Signals and Systems~(BSS) Research GroupUniversity of Twente7522LWEnschedeThe Netherlands
| | - Gerjan Wolterink
- Biomedical Signals and Systems~(BSS) Research GroupUniversity of Twente7522LWEnschedeThe Netherlands.,Robotics and Mechatronics GroupUniversity of Twente7522NHEnschedeThe Netherlands
| | - Anne Schwarz
- Biomedical Signals and Systems~(BSS) Research GroupUniversity of Twente7522LWEnschedeThe Netherlands.,Division of Vascular Neurology and NeurorehabilitationDepartment of NeurologyUniversity Hospital Zürich, University of Zürich8091ZürichSwitzerland
| | - Jeremia P O Held
- Division of Vascular Neurology and NeurorehabilitationDepartment of NeurologyUniversity Hospital Zürich, University of Zürich8091ZürichSwitzerland
| | - Bert-Jan F Van Beijnum
- Biomedical Signals and Systems~(BSS) Research GroupUniversity of Twente7522LWEnschedeThe Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems~(BSS) Research GroupUniversity of Twente7522LWEnschedeThe Netherlands
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19
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van Loon LM, van der Hoeven H, Veltink PH, Lemson J. The inspiration hold maneuver is a reliable method to assess mean systemic filling pressure but its clinical value remains unclear. Ann Transl Med 2020; 8:1390. [PMID: 33313135 PMCID: PMC7723632 DOI: 10.21037/atm-20-3540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background The upstream pressure for venous return (VR) is considered to be a combined conceptual blood pressure of the systemic vessels: the mean systemic filling pressure (MSFP). The relevance of estimating the MSFP during dynamic changes of the circulation at the bedside is controversial. Herein, we studied the effect of high ventilatory pressures on the relationship between VR and central venous pressure (CVP). Methods In 9 healthy pigs under anaesthesia and mechanically ventilated, MSFP was estimated from extrapolated VR versus CVP relationships during inspiratory hold maneuvers (IHMs) with different levels of ventilatory pressure (Pvent). MSFP was measure 3 times per animal during euvolemia and hypovolemia. Hypovolemia was induced by bleeding with 10 mL/kg. The estimated MSFP values were compared to the blood pressure recording after induced ventricle fibrillation (i.e., mean circulatory filling pressure). Results Our results revealed a strong linear correlation between VR and CVP [R2 of 0.92 (range, 0.67–0.99)], during IHMs with different levels of Pvent. Volume status significantly alters the resulting MSFP, 20±1 and 16±2 mmHg for euvolemia and hypovolemia respectively. This estimation of the MSFP was strongly correlated—but not interchangeable—to the blood pressure recording after induced ventricle fibrillation (R2=0.8 and P=0.045). Conclusions In conclusion, we showed a strong linear correlation between VR and CVP—when applying IHMs with high levels of Pvent—however the clinical applicability of this method to guide volume therapy in its current form is improbable.
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Affiliation(s)
- Lex M van Loon
- Cardiovascular and Respiratory Physiology Group, Faculty of Science and Technology, Technical Medical Centre, University of Twente, Enschede, The Netherlands.,Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, The Netherlands
| | - Hans van der Hoeven
- Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, The Netherlands.,Radboud Center for Infectious Diseases, Nijmegen, The Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Joris Lemson
- Department of Intensive Care Medicine, Radboud university medical center, Nijmegen, The Netherlands
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20
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Jonkman AH, Frenzel T, McCaughey EJ, McLachlan AJ, Boswell-Ruys CL, Collins DW, Gandevia SC, Girbes ARJ, Hoiting O, Kox M, Oppersma E, Peters M, Pickkers P, Roesthuis LH, Schouten J, Shi ZH, Veltink PH, de Vries HJ, Shannon Weickert C, Wiedenbach C, Zhang Y, Tuinman PR, de Man AME, Butler JE, Heunks LMA. Breath-synchronized electrical stimulation of the expiratory muscles in mechanically ventilated patients: a randomized controlled feasibility study and pooled analysis. Crit Care 2020; 24:628. [PMID: 33126902 PMCID: PMC7596623 DOI: 10.1186/s13054-020-03352-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/16/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Expiratory muscle weakness leads to difficult ventilator weaning. Maintaining their activity with functional electrical stimulation (FES) may improve outcome. We studied feasibility of breath-synchronized expiratory population muscle FES in a mixed ICU population ("Holland study") and pooled data with our previous work ("Australian study") to estimate potential clinical effects in a larger group. METHODS Holland: Patients with a contractile response to FES received active or sham expiratory muscle FES (30 min, twice daily, 5 days/week until weaned). Main endpoints were feasibility (e.g., patient recruitment, treatment compliance, stimulation intensity) and safety. Pooled: Data on respiratory muscle thickness and ventilation duration from the Holland and Australian studies were combined (N = 40) in order to estimate potential effect size. Plasma cytokines (day 0, 3) were analyzed to study the effects of FES on systemic inflammation. RESULTS Holland: A total of 272 sessions were performed (active/sham: 169/103) in 20 patients (N = active/sham: 10/10) with a total treatment compliance rate of 91.1%. No FES-related serious adverse events were reported. Pooled: On day 3, there was a between-group difference (N = active/sham: 7/12) in total abdominal expiratory muscle thickness favoring the active group [treatment difference (95% confidence interval); 2.25 (0.34, 4.16) mm, P = 0.02] but not on day 5. Plasma cytokine levels indicated that early FES did not induce systemic inflammation. Using a survival analysis approach for the total study population, median ventilation duration and ICU length of stay were 10 versus 52 (P = 0.07), and 12 versus 54 (P = 0.03) days for the active versus sham group. Median ventilation duration of patients that were successfully extubated was 8.5 [5.6-12.2] versus 10.5 [5.3-25.6] days (P = 0.60) for the active (N = 16) versus sham (N = 10) group, and median ICU length of stay was 10.5 [8.0-14.5] versus 14.0 [9.0-19.5] days (P = 0.36) for those active (N = 16) versus sham (N = 8) patients that were extubated and discharged alive from the ICU. During ICU stay, 3/20 patients died in the active group versus 8/20 in the sham group (P = 0.16). CONCLUSION Expiratory muscle FES is feasible in selected ICU patients and might be a promising technique within a respiratory muscle-protective ventilation strategy. The next step is to study the effects on weaning and ventilator liberation outcome. TRIAL REGISTRATION ClinicalTrials.gov, ID NCT03453944. Registered 05 March 2018-Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03453944 .
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Affiliation(s)
- Annemijn H Jonkman
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Tim Frenzel
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Euan J McCaughey
- Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, 2052, Australia
| | | | - Claire L Boswell-Ruys
- Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, 2052, Australia
| | | | - Simon C Gandevia
- Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Armand R J Girbes
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Oscar Hoiting
- Department of Intensive Care Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Matthijs Kox
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eline Oppersma
- Cardiovascular and Respiratory Physiology Group, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Marco Peters
- Department of Intensive Care Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Peter Pickkers
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lisanne H Roesthuis
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen Schouten
- Department of Intensive Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Zhong-Hua Shi
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, Technical Medical Centre, University of Twente, Enschede, The Netherlands
| | - Heder J de Vries
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Cyndi Shannon Weickert
- Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.,School of Psychiatry, University of New South Wales, Kensington, NSW, 2052, Australia.,Department of Neuroscience and Physiology, Upstate Medical University, New York, 13210, USA
| | - Carsten Wiedenbach
- Department of Intensive Care Medicine, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
| | - Yingrui Zhang
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands
| | - Pieter R Tuinman
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Angélique M E de Man
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands.,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jane E Butler
- Neuroscience Research Australia, 139 Barker Street, Randwick, NSW, 2031, Australia.,School of Medical Sciences, University of New South Wales, Kensington, NSW, 2052, Australia
| | - Leo M A Heunks
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, location VUmc, Postbox 7505, 1007 MB, Amsterdam, The Netherlands. .,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam UMC, Amsterdam, The Netherlands.
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21
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Schwarz A, Bhagubai MMC, Wolterink G, Held JPO, Luft AR, Veltink PH. Assessment of Upper Limb Movement Impairments after Stroke Using Wearable Inertial Sensing. Sensors (Basel) 2020; 20:s20174770. [PMID: 32846958 PMCID: PMC7506737 DOI: 10.3390/s20174770] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/13/2020] [Accepted: 08/20/2020] [Indexed: 11/23/2022]
Abstract
Precise and objective assessments of upper limb movement quality after strokes in functional task conditions are an important prerequisite to improve understanding of the pathophysiology of movement deficits and to prove the effectiveness of interventions. Herein, a wearable inertial sensing system was used to capture movements from the fingers to the trunk in 10 chronic stroke subjects when performing reach-to-grasp activities with the affected and non-affected upper limb. It was investigated whether the factors, tested arm, object weight, and target height, affect the expressions of range of motion in trunk compensation and flexion-extension of the elbow, wrist, and finger during object displacement. The relationship between these metrics and clinically measured impairment was explored. Nine subjects were included in the analysis, as one had to be excluded due to defective data. The tested arm and target height showed strong effects on all metrics, while an increased object weight showed effects on trunk compensation. High inter- and intrasubject variability was found in all metrics without clear relationships to clinical measures. Relating all metrics to each other resulted in significant negative correlations between trunk compensation and elbow flexion-extension in the affected arm. The findings support the clinical usability of sensor-based motion analysis.
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Affiliation(s)
- Anne Schwarz
- Biomedical Signals and Systems (BSS), University of Twente, 7500 AE Enschede, The Netherlands; (M.M.C.B.); (G.W.); (P.H.V.)
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.P.O.H.); (A.R.L.)
- Correspondence:
| | - Miguel M. C. Bhagubai
- Biomedical Signals and Systems (BSS), University of Twente, 7500 AE Enschede, The Netherlands; (M.M.C.B.); (G.W.); (P.H.V.)
| | - Gerjan Wolterink
- Biomedical Signals and Systems (BSS), University of Twente, 7500 AE Enschede, The Netherlands; (M.M.C.B.); (G.W.); (P.H.V.)
- Robotics and Mechatronics group, University of Twente, 7500 AE Enschede, The Netherlands
| | - Jeremia P. O. Held
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.P.O.H.); (A.R.L.)
| | - Andreas R. Luft
- Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland; (J.P.O.H.); (A.R.L.)
- Cereneo, Center for Neurology and Rehabilitation, 6354 Vitznau, Switzerland
| | - Peter H. Veltink
- Biomedical Signals and Systems (BSS), University of Twente, 7500 AE Enschede, The Netherlands; (M.M.C.B.); (G.W.); (P.H.V.)
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22
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Mohamed Refai MI, van Beijnum BJF, Buurke JH, Veltink PH. Portable Gait Lab: Tracking Relative Distances of Feet and CoM Using Three IMUs. IEEE Trans Neural Syst Rehabil Eng 2020; 28:2255-2264. [PMID: 32816676 DOI: 10.1109/tnsre.2020.3018158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ambulatory estimation of gait and balance parameters requires knowledge of relative feet and centre of mass (CoM) positions. Inertial measurement units (IMU) placed on each foot, and on the pelvis are useful in tracking these segments over time, but cannot track the relative distances between these segments. Further, drift due to strapdown inertial navigation results in erroneous relative estimates of feet and CoM positions after a few steps. In this study, we track the relative distances using the assumptions of the Centroidal Moment Pivot (CMP) theory. An Extended Kalman filter approach was used to fuse information from different sources: strapdown inertial navigation, commonly used constraints such as zero velocity updates, and relative segment distances from the CMP assumption; to eventually track relative feet and CoM positions. These estimates were expressed in a reference frame defined by the heading of each step. The validity of this approach was tested on variable gait. The step lengths and step widths were estimated with an average absolute error of 4.6±1.5 cm and 3.8±1.5 cm respectively when compared against the reference VICON©. Additionally, we validated the relative distances of the feet and the CoM, and further, show that the approach proves useful in identifying asymmetric gait patterns. We conclude that a three IMU approach is feasible as a portable gait lab for ambulatory measurement of foot and CoM positions in daily life.
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23
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Yang Z, van Beijnum BJF, Li B, Yan S, Veltink PH. Estimation of Relative Hand-Finger Orientation Using a Small IMU Configuration. Sensors (Basel) 2020; 20:s20144008. [PMID: 32707635 PMCID: PMC7412023 DOI: 10.3390/s20144008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/14/2020] [Accepted: 07/17/2020] [Indexed: 06/11/2023]
Abstract
Relative orientation estimation between the hand and its fingers is important in many applications, such as virtual reality (VR), augmented reality (AR) and rehabilitation. It is still quite a big challenge to do the estimation by only exploiting inertial measurement units (IMUs) because of the integration drift that occurs in most approaches. When the hand is functionally used, there are many instances in which hand and finger tips move together, experiencing almost the same angular velocities, and in some of these cases, almost the same accelerations are measured in different 3D coordinate systems. Therefore, we hypothesize that relative orientations between the hand and the finger tips can be adequately estimated using 3D IMUs during such designated events (DEs) and in between these events. We fused this extra information from the DEs and IMU data with an extended Kalman filter (EKF). Our results show that errors in relative orientation can be smaller than five degrees if DEs are constantly present and the linear and angular movements of the whole hand are adequately rich. When the DEs are partially available in a functional water-drinking task, the orientation error is smaller than 10 degrees.
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Affiliation(s)
- Zhicheng Yang
- Department of Biomedical Signals Systems, Technical Medical Centre, University of Twente, 7500 AE Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.)
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi’an 710072, China; (B.L.); (S.Y.)
| | - Bert-Jan F. van Beijnum
- Department of Biomedical Signals Systems, Technical Medical Centre, University of Twente, 7500 AE Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.)
| | - Bin Li
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi’an 710072, China; (B.L.); (S.Y.)
| | - Shenggang Yan
- School of Marine Science and Technology, Northwestern Polytechnical University, Xi’an 710072, China; (B.L.); (S.Y.)
| | - Peter H. Veltink
- Department of Biomedical Signals Systems, Technical Medical Centre, University of Twente, 7500 AE Enschede, The Netherlands; (B.-J.F.v.B.); (P.H.V.)
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24
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Zandbergen MA, Buurke JH, Veltink PH, Reenalda J. Changes In Peak Accelerations And Shock Attenuation Over The Course Of A Marathon. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000684324.28968.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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25
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Refai MIM, van Beijnum BJF, Buurke JH, Veltink PH. Portable Gait Lab: Estimating 3D GRF Using a Pelvis IMU in a Foot IMU Defined Frame. IEEE Trans Neural Syst Rehabil Eng 2020; 28:1308-1316. [PMID: 32310775 DOI: 10.1109/tnsre.2020.2984809] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Ground Reaction Forces (GRF) during gait are measured using expensive laboratory setups such as in-floor or treadmill force plates. Ambulatory measurement of GRF using wearables enables remote monitoring of gait and balance. Here, we propose using an Inertial Measurement Unit (IMU) mounted on the pelvis to estimate the GRF during gait in daily life. Calibration procedures and an Error State Extended Kalman filter (EEKF) were used to transform the accelerations at the center of mass (CoM) to the 3D GRF. The instantaneous 3D GRF was estimated for different overground walking patterns and compared with the 3D GRF measured using the reference ForceShoe™ system. Furthermore, we introduce a changing reference frame called the current step frame that followed the direction of each step made. The frame was defined using movement of the feet, and the estimated GRF were expressed in this new frame. This allowed direct comparison and validation with the reference. The mean and standard deviation of error between the estimated instantaneous 3D GRF and the reference, normalized against the range of the reference, was 12.1 ± 3.3% across all walking tasks, in the horizontal plane. The error margins show that a single pelvis IMU could be a minimal and ambulatory sensing alternative for estimating the instantaneous 3D components of GRF during overground gait.
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26
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Luft F, Sharifi S, Mugge W, Schouten AC, Bour LJ, van Rootselaar AF, Veltink PH, Heida T. Distinct cortical activity patterns in Parkinson's disease and essential tremor during a bimanual tapping task. J Neuroeng Rehabil 2020; 17:45. [PMID: 32183867 PMCID: PMC7079392 DOI: 10.1186/s12984-020-00670-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 02/27/2020] [Indexed: 11/13/2022] Open
Abstract
Background Parkinson’s disease (PD) and essential tremor (ET) are neurodegenerative diseases characterized by movement deficits. Especially in PD, maintaining cyclic movement can be significantly disturbed due to pathological changes in the basal ganglia and the cerebellum. Providing external cues improves timing of these movements in PD and also affects ET. The aim of this study is to determine differences in cortical activation patterns in PD and ET patients during externally and internally cued movements. Methods Eleven PD patients, twelve ET patients, OFF tremor suppressing medication, and nineteen age-matched healthy controls (HC) were included and asked to perform a bimanual tapping task at two predefined cue frequencies. The auditory cue, a metronome sound presented at 2 or 4 Hz, was alternately switched on and off every 30 s. Tapping at two different frequencies were used since it is expected that different brain networks are involved at different frequencies as has been shown in previous studies. Cortical activity was recorded using a 64-channel EEG cap. To establish the cortical activation pattern in each group, the task related power (TRP) was calculated for each subject. For inter-groups analysis, EEG electrodes for divided into 5 different areas. Results Inter-group analysis revealed significant differences in areas responsible for motor planning, organization and regulation and involved in initiation, maintenance, coordination and planning of complex sequences of movements. Within the area of the primary motor cortex the ET group showed a significantly lower TRP than the HC group. In the area responsible for combining somatosensory, auditory and visual information both patient groups had a higher TRP than the HC group. Conclusions Different neurological networks are involved during cued and non-cued movements in ET, PD and HC. Distinct cortical activation patterns were revealed using task related power calculations. Different activation patterns were revealed during the 2 and 4 Hz tapping task indicating different strategies to execute movements at these rates. The results suggest that a including a cued/non-cued tapping task during clinical decision making could be a valuable tool in an objective diagnostic protocol.
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Affiliation(s)
- Frauke Luft
- Department of Biomedical Signals and Systems, Faculty EEMCS, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands.
| | - Sarvi Sharifi
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Winfred Mugge
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, Netherlands
| | - Alfred C Schouten
- Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, Netherlands.,Department of Biomechanical Engineering, University of Twente, Enschede, The Netherlands
| | - Lo J Bour
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Anne Fleur van Rootselaar
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, Faculty EEMCS, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands
| | - Tijtske Heida
- Department of Biomedical Signals and Systems, Faculty EEMCS, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands
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27
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Oppersma E, Doorduin J, Roesthuis LH, van der Hoeven JG, Veltink PH, Heunks LM. Patient-Ventilator Interaction During Noninvasive Ventilation in Subjects With Exacerbation of COPD: Effect of Support Level and Ventilator Mode. Respir Care 2020; 65:1315-1322. [PMID: 32156788 DOI: 10.4187/respcare.07159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Patient-ventilator synchrony in patients with COPD is at risk during noninvasive ventilation (NIV). NIV in neurally-adjusted ventilatory assist (NAVA) mode improves synchrony compared to pressure support ventilation (PSV). The current study investigated patient-ventilator interaction at 2 levels of NAVA and PSV mode in subjects with COPD exacerbation. METHODS NIV was randomly applied at 2 levels (5 and 15 cm H2O) of PSV and NAVA. Patient-ventilator interaction was evaluated by comparing airway pressure and electrical activity of the diaphragm waveforms with automated computer algorithms. RESULTS 8 subjects were included. Trigger delay was longer in PSV high (268 ± 112 ms) than in PSV low (161 ± 118 ms, P = .043), and trigger delay during NAVA was shorter than PSV for both low support (49 ± 24 ms for NAVA, P = .035) and high support (79 ± 276 ms for NAVA, P = .003). No difference in cycling error for low and high levels of PSV (PSV low -100 ± 114 ms and PSV high 56 ± 315 ms) or NAVA (NAVA low -5 ± 18 ms, NAVA high 12 ± 36 ms) and no difference between PSV and NAVA was found. CONCLUSIONS Increasing PSV levels during NIV caused a progressive mismatch between neural effort and pneumatic timing. Patient-ventilator interaction during NAVA was more synchronous than during PSV, independent of inspiratory support level. (ClinicalTrials.gov registration NCT01791335.).
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Affiliation(s)
- Eline Oppersma
- Cardiovascular and Respiratory Physiology, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands. .,Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands.,Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jonne Doorduin
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Neurology, Donders Institute for Brain Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Lisanne H Roesthuis
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Peter H Veltink
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, The Netherlands
| | - Leo Ma Heunks
- Department of Intensive Care, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Intensive Care Medicine, Amsterdam UMC, Amsterdam, The Netherlands
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28
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Mohamed Refai MI, van Beijnum BJF, Buurke JH, Saes M, Bussmann JBJ, Meskers CG, Wegen EV, Kwakkel G, Veltink PH. Portable Gait Lab: Zero Moment Point for Minimal Sensing of Gait. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:2077-2081. [PMID: 31946310 DOI: 10.1109/embc.2019.8857314] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Ambulatory sensing of gait kinematics using inertial measurement units (IMUs) usually uses sensor fusion filters. These algorithms require measurement updates to reduce drift between segments. A full body IMU suit can use biomechanical relations between body segments to solve this. However, when minimising the sensor set, we lose a lot of this information. In this study, we explore the assumptions of zero moment point (ZMP) as a possible source of measurement updates for the sensor fusion filters. ZMP is otherwise utilised for humanoid gait in robots. In this study, first, the relation between the ZMP and centre of pressure (CoP) is studied using a GRAIL system, consisting of opto-kinetic measurements. We find that the mean distance over the gait cycle between ZMP and CoP is 10.5±1.2% of the foot length. Following this, we show how these results could be used to improve measurements in a minimal IMU based sensing setup.
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van Loon LM, Rongen GA, van der Hoeven JG, Veltink PH, Lemson J. β-Blockade attenuates renal blood flow in experimental endotoxic shock by reducing perfusion pressure. Physiol Rep 2019; 7:e14301. [PMID: 31814327 PMCID: PMC6900489 DOI: 10.14814/phy2.14301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Clinical data suggests that heart rate (HR) control with selective β1-blockers may improve cardiac function during septic shock. However, it seems counterintuitive to start β-blocker infusion in a shock state when organ blood flow is already low or insufficient. Therefore, we studied the effects of HR control with esmolol, an ultrashort- acting β1-selective adrenoceptor antagonist, on renal blood flow (RBF) and renal autoregulation during early septic shock. In 10 healthy sheep, sepsis was induced by continuous i.v. administration of lipopolysaccharide, while maintained under anesthesia and mechanically ventilated. After successful resuscitation of the septic shock with fluids and vasoactive drugs, esmolol was infused to reduce HR with 30% and was stopped 30-min after reaching this target. Arterial and venous pressures, and RBF were recorded continuously. Renal autoregulation was evaluated by the response in RBF to renal perfusion pressure (RPP) in both the time domain and frequency domain. During septic shock, β-blockade with esmolol significantly increased the pressure dependency of RBF to RPP. Stopping esmolol showed the reversibility of the impaired renal autoregulation. Showing that clinical diligence and caution are necessary when treating septic shock with esmolol in the acute phase since esmolol reduced RPP to critical values thereby significantly reducing RBF.
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Affiliation(s)
- Lex M. van Loon
- Cardiovascular and Respiratory Physiology GroupFaculty of Science and TechnologyUniversity of TwenteEnschedeThe Netherlands
- Department of Intensive Care MedicineRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
| | - Gerard A. Rongen
- Department of Pharmacology and ToxicologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Johannes G. van der Hoeven
- Department of Intensive Care MedicineRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
- Radboud Center for Infectious diseasesNijmegenThe Netherlands
| | - Peter H. Veltink
- Biomedical Signals and SystemsFaculty of Electrical Engineering, Mathematics and Computer ScienceTechnical Medical CentreUniversity of TwenteEnschedeThe Netherlands
| | - Joris Lemson
- Department of Intensive Care MedicineRadboud University Medical CenterRadboud Institute for Health SciencesNijmegenThe Netherlands
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30
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Luft F, Sharifi S, Mugge W, Schouten AC, Bour LJ, van Rootselaar AF, Veltink PH, Heida T. A Power Spectral Density-Based Method to Detect Tremor and Tremor Intermittency in Movement Disorders. Sensors (Basel) 2019; 19:s19194301. [PMID: 31590227 PMCID: PMC6806079 DOI: 10.3390/s19194301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/05/2019] [Accepted: 09/30/2019] [Indexed: 12/24/2022]
Abstract
There is no objective gold standard to detect tremors. This concerns not only the choice of the algorithm and sensors, but methods are often designed to detect tremors in one specific group of patients during the performance of a specific task. Therefore, the aim of this study is twofold. First, an objective quantitative method to detect tremor windows (TWs) in accelerometer and electromyography recordings is introduced. Second, the tremor stability index (TSI) is determined to indicate the advantage of detecting TWs prior to analysis. Ten Parkinson’s disease (PD) patients, ten essential tremor (ET) patients, and ten healthy controls (HC) performed a resting, postural and movement task. Data was split into 3-s windows, and the power spectral density was calculated for each window. The relative power around the peak frequency with respect to the power in the tremor band was used to classify the windows as either tremor or non-tremor. The method yielded a specificity of 96.45%, sensitivity of 84.84%, and accuracy of 90.80% of tremor detection. During tremors, significant differences were found between groups in all three parameters. The results suggest that the introduced method could be used to determine under which conditions and to which extent undiagnosed patients exhibit tremors.
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Affiliation(s)
- Frauke Luft
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands.
| | - Sarvi Sharifi
- Amsterdam Neuroscience, Amsterdam UMC, Department of Neurology, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Winfred Mugge
- Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2600 AA Delft, The Netherlands
| | - Alfred C Schouten
- Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, 2600 AA Delft, The Netherlands
- Department of Biomechanical Engineering, University of Twente, 7522 NB Enschede, The Netherland
| | - Lo J Bour
- Amsterdam Neuroscience, Amsterdam UMC, Department of Neurology, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Anne-Fleur van Rootselaar
- Amsterdam Neuroscience, Amsterdam UMC, Department of Neurology, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
| | - Tijtske Heida
- Department of Biomedical Signals and Systems, University of Twente, 7522 NB Enschede, The Netherlands
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Luft F, Sharifi S, Mugge W, Schouten AC, Bour LJ, van Rootselaar AF, Veltink PH, Heida T. Deficits in tapping accuracy and variability in tremor patients. J Neuroeng Rehabil 2019; 16:54. [PMID: 31064378 PMCID: PMC6505201 DOI: 10.1186/s12984-019-0528-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 04/30/2019] [Indexed: 12/02/2022] Open
Abstract
Background The basal ganglia and cerebellum are brain structures involved in movement initiation, execution and termination. They are thought to be involved in the tremor generation and movement deficits in Parkinson’s disease (PD) and essential tremor (ET). Especially in PD, maintaining cyclic movement, such as walking or tapping can be significantly disturbed. Providing external cues improves timing of these movements in PD but its effect on ET has not yet been studied in depth. The aim of this study is to evaluate the usefulness of a bimanual tapping task as a tool during clinical decision making. Method Hand movements and tremor was recorded using accelerometers and EMG (m. extensor carpi ulnaris) from PD and ET patients and healthy controls during a bimanual tapping task as a way to distinguish PD from ET. All subjects performed the tapping task at two different frequencies, 2 Hz and 4 Hz, with and without the presence of auditory cues. Results No significant intra-group differences were found in the patient groups. Acceleration data revealed significantly less accurate tapping and more variable tapping in PD than in ET and healthy controls. ET subjects tapped less accurate and with a greater variability than healthy controls during the 4 Hz tapping task. Most interestingly the tapping accuracy improved in PD patients when kinetic tremor was recorded with EMG during the task. Conclusion Providing ET and PD patients with an external cue results in different tapping performances between patient groups and healthy controls. Furthermore, the findings suggest that kinetic tremor in PD enables patients to perform the task with a greater accuracy. So far this has not been shown in other studies.
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Affiliation(s)
- Frauke Luft
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands.
| | - Sarvi Sharifi
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Winfred Mugge
- Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Alfred C Schouten
- Department of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Lo J Bour
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Anne-Fleur van Rootselaar
- Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands
| | - Tijtske Heida
- Department of Biomedical Signals and Systems, University of Twente, Enschede, The Netherlands
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Karatsidis A, Jung M, Schepers HM, Bellusci G, de Zee M, Veltink PH, Andersen MS. Musculoskeletal model-based inverse dynamic analysis under ambulatory conditions using inertial motion capture. Med Eng Phys 2019; 65:68-77. [DOI: 10.1016/j.medengphy.2018.12.021] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 09/26/2018] [Accepted: 12/16/2018] [Indexed: 12/01/2022]
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Mohamed Refai MI, van Beijnum BJF, Buurke JH, Veltink PH. Gait and Dynamic Balance Sensing Using Wearable Foot Sensors. IEEE Trans Neural Syst Rehabil Eng 2018; 27:218-227. [PMID: 30582548 DOI: 10.1109/tnsre.2018.2885309] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Remote monitoring of gait performance offers possibilities for objective evaluation and tackling impairment in motor ability, gait, and balance in populations, such as elderly, stroke, multiple sclerosis, and Parkinson's. This requires a wearable and unobtrusive system capable of estimating ambulatory gait and balance measures, such as the extrapolated center of mass (XCoM) and dynamicmargin of stability. These estimations require the knowledge of 3-D forces and moments (F&M) and accurate foot positions. Though an existing ambulatory gait and balance system (AGBS) consisting of 3-D F&M sensors and inertial measurement units can be used for the purpose, it is bulky and conspicuous. Resistive pressure sensorswere investigated as an alternative to the onboard 3-D F&M sensors. Subject-specific regression models were built to estimate 3-D F&M from 1-D plantar pressures. The model was applicable for different walking speeds. Different pressure sensor configurations were studied to optimize the system complexity and accuracy. Using resistive sensors only under the toe and heel, we were able to estimate the XCoM with a mean absolute rms error of 2.2 ±0.3 cm in the walking direction while walking at a preferred speed, when compared to the AGBS. For the same case, the XCoM was classified as ahead or behind the base of support correctly at 97.7±1.7%. In conclusion, this paper shows that pressure sensors, minimally under the heel and toe, offer a lightweight and inconspicuous alternative for F&M sensing, toward estimating ambulatory gait and dynamic balance.
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van Ommeren AL, Smulders LC, Prange-Lasonder GB, Buurke JH, Veltink PH, Rietman JS. Assistive Technology for the Upper Extremities After Stroke: Systematic Review of Users' Needs. JMIR Rehabil Assist Technol 2018; 5:e10510. [PMID: 30497993 PMCID: PMC6293243 DOI: 10.2196/10510] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 07/24/2018] [Accepted: 10/01/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Technical innovations have the potential to compensate for loss of upper-limb motor functions after stroke. However, majority of the designs do not completely meet the needs and preferences of the end users. User-centered design methods have shown that the attention to user perspectives during development of assistive technology leads to devices that better suit the needs of the users. OBJECTIVE To get more insight into the factors that can bring the design of assistive technology to higher levels of satisfaction and acceptance, studies about user perspectives on assistive technology for the upper limb after stroke are systematically reviewed. METHODS A database search was conducted in PubMed, EMBASE, CINAHL, PsycINFO, and Scopus from inception to August 2017, supplemented with a search of reference lists. Methodological quality of the included studies was appraised. User perspectives of stroke survivors, carers, and health care professionals were extracted. A total of 35 descriptive themes were identified, from which 5 overarching themes were derived. RESULTS In total, 9 studies with information gathered from focus groups, questionnaires, and interviews were included. Barriers and enablers influencing the adoption of assistive technology for the upper limb after stroke emerged within 5 overarching but highly interdependent themes: (1) promoting hand and arm performance; (2) attitude toward technology; (3) decision process; (4) usability; and (5) practical applicability. CONCLUSIONS Expected use of an assistive technology is facilitated when it has a clear therapeutic base (expected benefit in enhancing function), its users (patients and health care professionals) have a positive attitude toward technology, sufficient information about the assistive technology is available, and usability and practical applicability have been addressed successfully in its design. The interdependency of the identified themes implies that all aspects influencing user perspectives of assistive technology need to be considered when developing assistive technology to enhance its chance of acceptance. The importance of each factor may vary depending on personal factors and the use context, either at home as an assistive aid or for rehabilitation at a clinic.
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Affiliation(s)
- Anne L van Ommeren
- Roessingh Research and Development, Enschede, Netherlands.,Biomechanical Engineering, University of Twente, Enschede, Netherlands
| | | | - Gerdienke B Prange-Lasonder
- Roessingh Research and Development, Enschede, Netherlands.,Biomechanical Engineering, University of Twente, Enschede, Netherlands
| | - Jaap H Buurke
- Roessingh Research and Development, Enschede, Netherlands.,Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems, University of Twente, Enschede, Netherlands
| | - Johan S Rietman
- Roessingh Research and Development, Enschede, Netherlands.,Biomechanical Engineering, University of Twente, Enschede, Netherlands
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van Loon LM, van der Hoeven JG, Veltink PH, Lemson J. The influence of esmolol on right ventricular function in early experimental endotoxic shock. Physiol Rep 2018; 6:e13882. [PMID: 30318855 PMCID: PMC6186817 DOI: 10.14814/phy2.13882] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 11/24/2022] Open
Abstract
The mechanism by which heart rate (HR) control with esmolol improves hemodynamics during septic shock remains unclear. Improved right ventricular (RV) function, thereby reducing venous congestion, may play a role. We assessed the effect of HR control with esmolol during sepsis on RV function, macrocirculation, microcirculation, end-organ-perfusion, and ventricular-arterial coupling. Sepsis was induced in 10 healthy anesthetized and mechanically ventilated sheep by continuous IV administration of lipopolysaccharide (LPS). Esmolol was infused after successful resuscitation of the septic shock, to reduce HR and stopped 30-min after reaching targeted HR reduction of 30%. Venous and arterial blood gases were sampled and the small intestines' microcirculation was assessed by using a hand-held video microscope (CytoCam-IDF). Arterial and venous pressures, and cardiac output (CO) were recorded continuously. An intraventricular micromanometer was used to assess the RV function. Ventricular-arterial coupling ratio (VACR) was estimated by catheterization-derived single beat estimation. The targeted HR reduction of >30% by esmolol infusion, after controlled resuscitation of the LPS induced septic shock, led to a deteriorated RV-function and macrocirculation, while the microcirculation remained depressed. Esmolol improved VACR by decreasing the RV end-systolic pressure. Stopping esmolol showed the reversibility of these effects on the RV and the macrocirculation. In this animal model of acute severe endotoxic septic shock, early administration of esmolol decreased RV-function resulting in venous congestion and an unimproved poor microcirculation despite improved cardiac mechanical efficiency.
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Affiliation(s)
- Lex M. van Loon
- Biomedical Signals and SystemsFaculty of Electrical Engineering, Mathematics and Computer ScienceTechnical Medical CentreUniversity of TwenteEnschedethe Netherlands
- Department of Critical Care Medicine (707)Radboud university medical centerNijmegenthe Netherlands
| | | | - Peter H. Veltink
- Biomedical Signals and SystemsFaculty of Electrical Engineering, Mathematics and Computer ScienceTechnical Medical CentreUniversity of TwenteEnschedethe Netherlands
| | - Joris Lemson
- Department of Critical Care Medicine (707)Radboud university medical centerNijmegenthe Netherlands
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36
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Karatsidis A, Richards RE, Konrath JM, van den Noort JC, Schepers HM, Bellusci G, Harlaar J, Veltink PH. Validation of wearable visual feedback for retraining foot progression angle using inertial sensors and an augmented reality headset. J Neuroeng Rehabil 2018; 15:78. [PMID: 30111337 PMCID: PMC6094564 DOI: 10.1186/s12984-018-0419-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/30/2018] [Indexed: 11/22/2022] Open
Abstract
Background Gait retraining interventions using real-time biofeedback have been proposed to alter the loading across the knee joint in patients with knee osteoarthritis. Despite the demonstrated benefits of these conservative treatments, their clinical adoption is currently obstructed by the high complexity, spatial demands, and cost of optical motion capture systems. In this study we propose and evaluate a wearable visual feedback system for gait retraining of the foot progression angle (FPA). Methods The primary components of the system are inertial measurement units, which track the human movement without spatial limitations, and an augmented reality headset used to project the visual feedback in the visual field. The adapted gait protocol contained five different target angles ranging from 15 degrees toe-out to 5 degrees toe-in. Eleven healthy participants walked on an instrumented treadmill, and the protocol was performed using both an established laboratory visual feedback driven by optical motion capture, and the proposed wearable system. Results and conclusions The wearable system tracked FPA with an accuracy of 2.4 degrees RMS and ICC=0.94 across all target angles and subjects, when compared to an optical motion capture reference. In addition, the effectiveness of the biofeedback, reflected by the number of steps with FPA value ±2 degrees from the target, was found to be around 50% in both wearable and laboratory approaches. These findings demonstrate that retraining of the FPA using wearable inertial sensing and visual feedback is feasible with effectiveness matching closely an established laboratory method. The proposed wearable setup may reduce the complexity of gait retraining applications and facilitate their transfer to routine clinical practice.
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Affiliation(s)
- Angelos Karatsidis
- Xsens Technologies B.V, Pantheon 6, Enschede, 7521 PR, The Netherlands. .,Department of Biomedical Signals and Systems (BSS), Technical Medical Centre, University of Twente, Enschede, The Netherlands.
| | - Rosie E Richards
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands
| | - Jason M Konrath
- Xsens Technologies B.V, Pantheon 6, Enschede, 7521 PR, The Netherlands
| | - Josien C van den Noort
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands.,Academic Medical Center, Musculoskeletal Imaging Quantification Center (MIQC), Department of Radiology and Nuclear Medicine, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - H Martin Schepers
- Xsens Technologies B.V, Pantheon 6, Enschede, 7521 PR, The Netherlands
| | - Giovanni Bellusci
- Xsens Technologies B.V, Pantheon 6, Enschede, 7521 PR, The Netherlands
| | - Jaap Harlaar
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, VU University Medical Center, Amsterdam, The Netherlands.,Department of Biomechanical Engineering, Delft University of Technology, Delft, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems (BSS), Technical Medical Centre, University of Twente, Enschede, The Netherlands
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Oppersma E, Doorduin J, Gooskens PJ, Roesthuis LH, van der Heijden EHFM, van der Hoeven JG, Veltink PH, Heunks LMA. Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. Respir Physiol Neurobiol 2018; 259:53-57. [PMID: 30026086 DOI: 10.1016/j.resp.2018.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/13/2018] [Accepted: 07/16/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Non-invasive ventilation (NIV) provides ventilatory support for patients with respiratory failure. However, the glottis can act as a closing valve, limiting effectiveness of NIV. This study investigates the patency of the glottis during NIV in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD). METHODS Electrical activity of the diaphragm, flow, pressure and videolaryngoscopy were acquired. NIV was randomly applied in pressure support (PSV) and neurally adjusted ventilatory assist (NAVA) mode with two levels of support. The angle formed by the vocal cords represented glottis patency. RESULTS Eight COPD patients with acute exacerbation requiring NIV were included. No differences were found in median glottis angle during inspiration or peak inspiratory effort between PSV and NAVA at low and high support levels. CONCLUSIONS The present study showed that glottis patency during inspiration in patients with an acute exacerbation of COPD is not affected by mode (PSV or NAVA) or level of assist (5 or 15 cm H2O) during NIV.
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Affiliation(s)
- Eline Oppersma
- Cardiovascular and Respiratory Physiology, Faculty of Science and Technology, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands; Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands; Department of Intensive Care Medicine, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Jonne Doorduin
- Department of Intensive Care Medicine, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands; Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Petra J Gooskens
- Cardiovascular and Respiratory Physiology, Faculty of Science and Technology, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands; Department of Intensive Care Medicine, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Lisanne H Roesthuis
- Department of Intensive Care Medicine, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Erik H F M van der Heijden
- Department of Pulmonology, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Johannes G van der Hoeven
- Department of Intensive Care Medicine, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Peter H Veltink
- Biomedical Signals and Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Postbox 217, 7500 AE, Enschede, The Netherlands.
| | - Leo M A Heunks
- Department of Intensive Care Medicine, Radboud University Medical Center, Postbox 9101, 6500 HB, Nijmegen, The Netherlands; Department of Intensive Care Medicine, Amsterdam UMC, Location VUmc, Postbox 7057, 1007MB, Amsterdam, The Netherlands.
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Held JPO, Klaassen B, Eenhoorn A, van Beijnum BJF, Buurke JH, Veltink PH, Luft AR. Inertial Sensor Measurements of Upper-Limb Kinematics in Stroke Patients in Clinic and Home Environment. Front Bioeng Biotechnol 2018; 6:27. [PMID: 29707537 PMCID: PMC5906540 DOI: 10.3389/fbioe.2018.00027] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 03/06/2018] [Indexed: 01/13/2023] Open
Abstract
Background Upper-limb impairments in stroke patients are usually measured in clinical setting using standard clinical assessment. In addition, kinematic analysis using opto-electronic systems has been used in the laboratory setting to map arm recovery. Such kinematic measurements cannot capture the actual function of the upper extremity in daily life. The aim of this study is to longitudinally explore the complementarity of post-stroke upper-limb recovery measured by standard clinical assessments and daily-life recorded kinematics. Methods The study was designed as an observational, single-group study to evaluate rehabilitation progress in a clinical and home environment, with a full-body sensor system in stroke patients. Kinematic data were recorded with a full-body motion capture suit during clinical assessment and self-directed activities of daily living. The measurements were performed at three time points for 3 h: (1) 2 weeks before discharge of the rehabilitation clinic, (2) right after discharge, and (3) 4 weeks after discharge. The kinematic analysis of reaching movements uses the position and orientation of each body segment to derive the joint angles. Newly developed metrics for classifying activity and quality of upper extremity movement were applied. Results The data of four stroke patients (three mildly impaired, one sever impaired) were included in this study. The arm motor function assessment improved during the inpatient rehabilitation, but declined in the first 4 weeks after discharge. A change in the data (kinematics and new metrics) from the daily-life recording was seen in in all patients. Despite this worsening patients increased the number of reaches they performed during daily life in their home environment. Conclusion It is feasible to measure arm kinematics using Inertial Measurement Unit sensors during daily life in stroke patients at the different stages of rehabilitation. Our results from the daily-life recordings complemented the data from the clinical assessments and illustrate the potential to identify stroke patient characteristics, based on kinematics, reaching counts, and work area. Clinical Trial Registration https://clinicaltrials.gov, identifier NCT02118363.
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Affiliation(s)
- Jeremia P O Held
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, Zurich, Switzerland.,Biomedical Signals and Systems, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Bart Klaassen
- Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Albert Eenhoorn
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, Zurich, Switzerland
| | - Bert-Jan F van Beijnum
- Biomedical Signals and Systems, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Jaap H Buurke
- Biomedical Signals and Systems, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Roessingh Research and Development B.V., Enschede, Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems, MIRA-Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Andreas R Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, Zurich, Switzerland.,cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
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Wouda FJ, Giuberti M, Bellusci G, Maartens E, Reenalda J, van Beijnum BJF, Veltink PH. Estimation of Vertical Ground Reaction Forces and Sagittal Knee Kinematics During Running Using Three Inertial Sensors. Front Physiol 2018; 9:218. [PMID: 29623042 PMCID: PMC5874328 DOI: 10.3389/fphys.2018.00218] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/26/2018] [Indexed: 11/18/2022] Open
Abstract
Analysis of running mechanics has traditionally been limited to a gait laboratory using either force plates or an instrumented treadmill in combination with a full-body optical motion capture system. With the introduction of inertial motion capture systems, it becomes possible to measure kinematics in any environment. However, kinetic information could not be provided with such technology. Furthermore, numerous body-worn sensors are required for a full-body motion analysis. The aim of this study is to examine the validity of a method to estimate sagittal knee joint angles and vertical ground reaction forces during running using an ambulatory minimal body-worn sensor setup. Two concatenated artificial neural networks were trained (using data from eight healthy subjects) to estimate the kinematics and kinetics of the runners. The first artificial neural network maps the information (orientation and acceleration) of three inertial sensors (placed at the lower legs and pelvis) to lower-body joint angles. The estimated joint angles in combination with measured vertical accelerations are input to a second artificial neural network that estimates vertical ground reaction forces. To validate our approach, estimated joint angles were compared to both inertial and optical references, while kinetic output was compared to measured vertical ground reaction forces from an instrumented treadmill. Performance was evaluated using two scenarios: training and evaluating on a single subject and training on multiple subjects and evaluating on a different subject. The estimated kinematics and kinetics of most subjects show excellent agreement (ρ>0.99) with the reference, for single subject training. Knee flexion/extension angles are estimated with a mean RMSE <5°. Ground reaction forces are estimated with a mean RMSE < 0.27 BW. Additionaly, peak vertical ground reaction force, loading rate and maximal knee flexion during stance were compared, however, no significant differences were found. With multiple subject training the accuracy of estimating discrete and continuous outcomes decreases, however, good agreement (ρ > 0.9) is still achieved for seven of the eight different evaluated subjects. The performance of multiple subject learning depends on the diversity in the training dataset, as differences in accuracy were found for the different evaluated subjects.
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Affiliation(s)
- Frank J Wouda
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, Netherlands
| | | | | | - Erik Maartens
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, Netherlands.,Roessingh Research and Development, Roessingh Rehabilitation Hospital, Enschede, Netherlands
| | - Jasper Reenalda
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, Netherlands.,Roessingh Research and Development, Roessingh Rehabilitation Hospital, Enschede, Netherlands
| | - Bert-Jan F van Beijnum
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, Netherlands.,Centre for Telematics and Information Technology, University of Twente, Enschede, Netherlands
| | - Peter H Veltink
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede, Netherlands
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40
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Oppersma E, Doorduin J, van der Hoeven JG, Veltink PH, van Hees HWH, Heunks LMA. The effect of metabolic alkalosis on the ventilatory response in healthy subjects. Respir Physiol Neurobiol 2018; 249:47-53. [PMID: 29307724 DOI: 10.1016/j.resp.2018.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/07/2017] [Accepted: 01/03/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Patients with acute respiratory failure may develop respiratory acidosis. Metabolic compensation by bicarbonate production or retention results in posthypercapnic alkalosis with an increased arterial bicarbonate concentration. The hypothesis of this study was that elevated plasma bicarbonate levels decrease respiratory drive and minute ventilation. METHODS In an intervention study in 10 healthy subjects the ventilatory response using a hypercapnic ventilatory response (HCVR) test was assessed, before and after administration of high dose sodium bicarbonate. Total dose of sodiumbicarbonate was 1000 ml 8.4% in 3 days. RESULTS Plasma bicarbonate increased from 25.2 ± 2.2 to 29.2 ± 1.9 mmol/L. With increasing inspiratory CO2 pressure during the HCVR test, RR, Vt, Pdi, EAdi and VE increased. The clinical ratio ΔVE/ΔPetCO2 remained unchanged, but Pdi, EAdi and VE were significantly lower after bicarbonate administration for similar levels of inspired CO2. CONCLUSION This study demonstrates that in healthy subjects metabolic alkalosis decreases the neural respiratory drive and minute ventilation, as a response to inspiratory CO2.
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Affiliation(s)
- E Oppersma
- MIRA - Institute for Biomedical Technology & Technical Medicine, University of Twente, Enschede, The Netherlands; Department of Critical Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J Doorduin
- Department of Critical Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - J G van der Hoeven
- Department of Critical Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - P H Veltink
- MIRA - Institute for Biomedical Technology & Technical Medicine, University of Twente, Enschede, The Netherlands
| | - H W H van Hees
- Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - L M A Heunks
- Department of Critical Care Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Intensive Care Medicine, VU University Medical Center, Amsterdam, The Netherlands.
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de Vries JC, van Ommeren AL, Prange-Lasonder GP, Rietman JS, Veltink PH. Detection of the intention to grasp during reach movements. J Rehabil Assist Technol Eng 2018; 5:2055668317752850. [PMID: 31191924 PMCID: PMC6453090 DOI: 10.1177/2055668317752850] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/15/2017] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Soft-robotic gloves have been developed to enhance grip to support stroke patients during daily life tasks. Studies showed that users perform tasks faster without the glove as compared to with the glove. It was investigated whether it is possible to detect grasp intention earlier than using force sensors to enhance the performance of the glove. METHODS This was studied by distinguishing reach-to-grasp movements from reach movements without the intention to grasp, using minimal inertial sensing and machine learning. Both single-user and multi-user support vector machine classifiers were investigated. Data were gathered during an experiment with healthy subjects, in which they were asked to perform grasp and reach movements. RESULTS Experimental results show a mean accuracy of 98.2% for single-user and of 91.4% for multi-user classification, both using only two sensors: one on the hand and one on the middle finger. Furthermore, it was found that using only 40% of the trial length, an accuracy of 85.3% was achieved, which would allow for an earlier prediction of grasp during the reach movement by 1200 ms. CONCLUSIONS Based on these promising results, further research will be done to investigate the possibility to use classification of the movements in stroke patients.
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Affiliation(s)
- JC de Vries
- Department of Biomedical Signals and
Systems, University of Twente, Enschede, the Netherlands
| | - AL van Ommeren
- Roessingh Research and Development,
Enschede, the Netherlands
- Department of Biomechanical Engineering,
University of Twente, Enschede, the Netherlands
| | - GP Prange-Lasonder
- Roessingh Research and Development,
Enschede, the Netherlands
- Department of Biomechanical Engineering,
University of Twente, Enschede, the Netherlands
| | - JS Rietman
- Roessingh Research and Development,
Enschede, the Netherlands
- Department of Biomechanical Engineering,
University of Twente, Enschede, the Netherlands
| | - PH Veltink
- Department of Biomedical Signals and
Systems, University of Twente, Enschede, the Netherlands
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van Dijk KJ, Verhagen R, Bour LJ, Heida C, Veltink PH. Avoiding Internal Capsule Stimulation With a New Eight-Channel Steering Deep Brain Stimulation Lead. Neuromodulation 2017; 21:553-561. [DOI: 10.1111/ner.12702] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/22/2017] [Accepted: 08/25/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Kees J. van Dijk
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente; Enschede NL The Netherlands
| | - Rens Verhagen
- Department of Neurology/Clinical Neurophysiology; Academic Medical Center; Amsterdam NL The Netherlands
| | - Lo J. Bour
- Department of Neurology/Clinical Neurophysiology; Academic Medical Center; Amsterdam NL The Netherlands
| | - Ciska Heida
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente; Enschede NL The Netherlands
| | - Peter H. Veltink
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente; Enschede NL The Netherlands
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Abstract
Reduction of the number of sensors needed to evaluate arm movements, makes a system for the assessment of human body movements more suitable for clinical practice and daily life assessments. In this study, we propose an algorithm to reconstruct lower arm orientation, velocity and position, based on a sensing system which consists of only one inertial measurement unit (IMU) to the forearm. Lower arm movements were reconstructed using a single IMU and assuming that within a measurement there are moments without arm movements. The proposed algorithm, together with a single IMU attached to the forearm, may be used to evaluate lower arm movements during clinical assessments or functional tasks. In this pilot study, reconstructed quantities were compared with an optical reference system. The limits of agreement in the magnitude of the orientation vector and the norm of the velocity vectors are respectively 4.2 deg (normalized, 5.2 percent) and 7.1 cm/s (normalized, 5.8 percent). The limit of agreement of the difference between the reconstructed positions of both sensing systems were relatively greater 7.7 cm (normalized, 16.8 percent).
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van den Noort JC, Verhagen R, van Dijk KJ, Veltink PH, Vos MCPM, de Bie RMA, Bour LJ, Heida CT. Quantification of Hand Motor Symptoms in Parkinson's Disease: A Proof-of-Principle Study Using Inertial and Force Sensors. Ann Biomed Eng 2017; 45:2423-2436. [PMID: 28726022 PMCID: PMC5622175 DOI: 10.1007/s10439-017-1881-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 07/05/2017] [Indexed: 01/19/2023]
Abstract
This proof-of-principle study describes the methodology and explores and demonstrates the applicability of a system, existing of miniature inertial sensors on the hand and a separate force sensor, to objectively quantify hand motor symptoms in patients with Parkinson’s disease (PD) in a clinical setting (off- and on-medication condition). Four PD patients were measured in off- and on- dopaminergic medication condition. Finger tapping, rapid hand opening/closing, hand pro/supination, tremor during rest, mental task and kinetic task, and wrist rigidity movements were measured with the system (called the PowerGlove). To demonstrate applicability, various outcome parameters of measured hand motor symptoms of the patients in off- vs. on-medication condition are presented. The methodology described and results presented show applicability of the PowerGlove in a clinical research setting, to objectively quantify hand bradykinesia, tremor and rigidity in PD patients, using a single system. The PowerGlove measured a difference in off- vs. on-medication condition in all tasks in the presented patients with most of its outcome parameters. Further study into the validity and reliability of the outcome parameters is required in a larger cohort of patients, to arrive at an optimal set of parameters that can assist in clinical evaluation and decision-making.
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Affiliation(s)
- Josien C van den Noort
- Biomedical Signals and Systems Group, MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands.
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
- Department of Radiology and Nuclear Medicine, Musculoskeletal Imaging Quantification Center, Academic Medical Center, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
| | - Rens Verhagen
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Kees J van Dijk
- Biomedical Signals and Systems Group, MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems Group, MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Michelle C P M Vos
- Biomedical Signals and Systems Group, MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
| | - Rob M A de Bie
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Lo J Bour
- Department of Neurology and Clinical Neurophysiology, Academic Medical Center, Amsterdam, The Netherlands
| | - Ciska T Heida
- Biomedical Signals and Systems Group, MIRA Research Institute for Biomedical Technology and Technical Medicine, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands
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Lobo-Prat J, Nizamis K, Janssen MMHP, Keemink AQL, Veltink PH, Koopman BFJM, Stienen AHA. Comparison between sEMG and force as control interfaces to support planar arm movements in adults with Duchenne: a feasibility study. J Neuroeng Rehabil 2017; 14:73. [PMID: 28701169 PMCID: PMC5508565 DOI: 10.1186/s12984-017-0282-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 06/26/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Adults with Duchenne muscular dystrophy (DMD) can benefit from devices that actively support their arm function. A critical component of such devices is the control interface as it is responsible for the human-machine interaction. Our previous work indicated that surface electromyography (sEMG) and force-based control with active gravity and joint-stiffness compensation were feasible solutions for the support of elbow movements (one degree of freedom). In this paper, we extend the evaluation of sEMG- and force-based control interfaces to simultaneous and proportional control of planar arm movements (two degrees of freedom). METHODS Three men with DMD (18-23 years-old) with different levels of arm function (i.e. Brooke scores of 4, 5 and 6) performed a series of line-tracing tasks over a tabletop surface using an experimental active arm support. The arm movements were controlled using three control methods: sEMG-based control, force-based control with stiffness compensation (FSC), and force-based control with no compensation (FNC). The movement performance was evaluated in terms of percentage of task completion, tracing error, smoothness and speed. RESULTS For subject S1 (Brooke 4) FNC was the preferred method and performed better than FSC and sEMG. FNC was not usable for subject S2 (Brooke 5) and S3 (Brooke 6). Subject S2 presented significantly lower movement speed with sEMG than with FSC, yet he preferred sEMG since FSC was perceived to be too fatiguing. Subject S3 could not successfully use neither of the two force-based control methods, while with sEMG he could reach almost his entire workspace. CONCLUSIONS Movement performance and subjective preference of the three control methods differed with the level of arm function of the participants. Our results indicate that all three control methods have to be considered in real applications, as they present complementary advantages and disadvantages. The fact that the two weaker subjects (S2 and S3) experienced the force-based control interfaces as fatiguing suggests that sEMG-based control interfaces could be a better solution for adults with DMD. Yet force-based control interfaces can be a better alternative for those cases in which voluntary forces are higher than the stiffness forces of the arms.
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Affiliation(s)
- Joan Lobo-Prat
- Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, Enschede, 7522, NB, The Netherlands.
| | - Kostas Nizamis
- Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, Enschede, 7522, NB, The Netherlands
| | - Mariska M H P Janssen
- Department of Rehabilitation, Radboud University Medical Center, Reinier Postlaan 4, Nijmegen, 6500, HB, The Netherlands
| | - Arvid Q L Keemink
- Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, Enschede, 7522, NB, The Netherlands
| | - Peter H Veltink
- Department of Biomedical Signals and Systems, University of Twente, Drienerlolaan 5, Enschede, 7500, AE, The Netherlands
| | - Bart F J M Koopman
- Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, Enschede, 7522, NB, The Netherlands
| | - Arno H A Stienen
- Department of Biomechanical Engineering, University of Twente, Drienerlolaan 5, Enschede, 7522, NB, The Netherlands
- Department of Physical Therapy and Human Movement Sciences, Northwestern University, 645 N Michigan Ave Suite 1100, Chicago (IL), 60611, USA
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Klaassen B, van Beijnum BJF, Held JP, Reenalda J, van Meulen FB, Veltink PH, Hermens HJ. Usability Evaluations of a Wearable Inertial Sensing System and Quality of Movement Metrics for Stroke Survivors by Care Professionals. Front Bioeng Biotechnol 2017; 5:20. [PMID: 28421180 PMCID: PMC5377936 DOI: 10.3389/fbioe.2017.00020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 03/15/2017] [Indexed: 11/13/2022] Open
Abstract
Background Inertial motion capture systems are used in many applications such as measuring the movement quality in stroke survivors. The absence of clinical effectiveness and usability evidence in these assistive technologies into rehabilitation has delayed the transition of research into clinical practice. Recently, a new inertial motion capture system was developed in a project, called INTERACTION, to objectively measure the quality of movement (QoM) in stroke survivors during daily-life activity. With INTERACTION, we are to be able to investigate into what happens with patients after discharge from the hospital. Resulting QoM metrics, where a metric is defined as a measure of some property, are subsequently presented to care professionals. Metrics include for example: reaching distance, walking speed, and hand distribution plots. The latter shows a density plot of the hand position in the transversal plane. The objective of this study is to investigate the opinions of care professionals in using these metrics obtained from INTERACTION and its usability. Methods By means of a semi-structured interview, guided by a presentation, presenting two patient reports. Each report includes several QoM metric (like reaching distance, hand position density plots, shoulder abduction) results obtained during daily-life measurements and in clinic and were evaluated by care professionals not related to the project. The results were compared with care professionals involved within the INTERACTION project. Furthermore, two questionnaires (5-point Likert and open questionnaire) were handed over to rate the usability of the metrics and to investigate if they would like such a system in their clinic. Results Eleven interviews were conducted, where each interview included either two or three care professionals as a group, in Switzerland and The Netherlands. Evaluation of the case reports (CRs) by participants and INTERACTION members showed a high correlation for both lower and upper extremity metrics. Participants were most in favor of hand distribution plots during daily-life activities. All participants mentioned that visualizing QoM of stroke survivors over time during daily-life activities has more possibilities compared to current clinical assessments. They also mentioned that these metrics could be important for self-evaluation of stroke survivors. Discussion The results showed that most participants were able to understand the metrics presented in the CRs. For a few metrics, it remained difficult to assess the underlying cause of the QoM. Hence, a combination of metrics is needed to get a better insight of the patient. Furthermore, it remains important to report the state (e.g., how the patient feels), its surroundings (outside, inside the house, on a slippery surface), and detail of specific activities (does the patient grasps a piece of paper or a heavy cooking pan but also dual tasks). Altogether, it remains a questions how to determine what the patient is doing and where the patient is doing his or her activities.
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Affiliation(s)
- Bart Klaassen
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Centre for Telematics and Information Technology, University of Twente, Enschede, Netherlands
| | - Bert-Jan F van Beijnum
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Centre for Telematics and Information Technology, University of Twente, Enschede, Netherlands
| | - Jeremia P Held
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, Zurich, Switzerland.,Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Jasper Reenalda
- Roessingh Research and Development, Roessingh Rehabilitation Hospital, Enschede, Netherlands.,Biomechanical Engineering, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Fokke B van Meulen
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Peter H Veltink
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands
| | - Hermie J Hermens
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands.,Centre for Telematics and Information Technology, University of Twente, Enschede, Netherlands.,Roessingh Research and Development, Roessingh Rehabilitation Hospital, Enschede, Netherlands
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Held JP, Klaassen B, van Beijnum BJF, Luft AR, Veltink PH. Usability Evaluation of a VibroTactile Feedback System in Stroke Subjects. Front Bioeng Biotechnol 2017; 4:98. [PMID: 28180128 PMCID: PMC5263126 DOI: 10.3389/fbioe.2016.00098] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 12/19/2016] [Indexed: 11/30/2022] Open
Abstract
Background To increase the functional capabilities of stroke subjects during activities of daily living, patients receive rehabilitative training to recover adequate motor control. With the goal to motivate self-training by use of the arm in daily life tasks, a sensor system (Arm Usage Coach, AUC) was developed that provides VibroTactile (VT) feedback if the patient does not move the affected arm above a certain threshold level. The objective of this study is to investigate the usability of this system in stroke subjects. Method The study was designed as a usability and user acceptance study of feedback modalities. Stroke subjects with mild to moderate arm impairments were enrolled. The subjects wore two AUC devices one on each wrist. VT feedback was given by the device on the affected arm. A semi-structured interview was performed before and after a measurement session with the AUC. In addition, the System Usability Scale (SUS) questionnaire was given. Results Ten ischemic chronic stroke patients (39 ± 38 months after stroke) were recruited. Four out of 10 subjects have worn the VT feedback on their dominant, affected arm. In the pre-measurement interview, eight participants indicated a preference for acoustic or visual over VT feedback. In the post evaluation interview, nine of 10 participants preferred VT over visual and acoustic feedback. On average, the AUC gave VT feedback six times during the measurement session. All participants, with the exception of one, used their dominant arm more then the non-dominant. For the SUS, eight participants responded above 80%, one between 70 and 80%, and one participant responded below 50%. Discussion More patients accepted and valued VT feedback after the test period, hence VT is a feasible feedback modality. The AUC can be used as a telerehabilitation device to train and maintain upper extremity use in daily life tasks.
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Affiliation(s)
- Jeremia P Held
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands; Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, Zurich, Switzerland; Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Bart Klaassen
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands; Centre for Telematics and Information Technology, University of Twente, Enschede, Netherlands
| | - Bert-Jan F van Beijnum
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, Netherlands; Centre for Telematics and Information Technology, University of Twente, Enschede, Netherlands
| | - Andreas R Luft
- Division of Vascular Neurology and Neurorehabilitation, Department of Neurology, University Hospital of Zurich, Zurich, Switzerland; Cereneo, Center for Neurology and Rehabilitation, Vitznau, Switzerland
| | - Peter H Veltink
- Biomedical Signals and Systems, MIRA - Institute for Biomedical Technology and Technical Medicine, University of Twente , Enschede , Netherlands
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Karatsidis A, Bellusci G, Schepers HM, de Zee M, Andersen MS, Veltink PH. Estimation of Ground Reaction Forces and Moments During Gait Using Only Inertial Motion Capture. Sensors (Basel) 2016; 17:s17010075. [PMID: 28042857 PMCID: PMC5298648 DOI: 10.3390/s17010075] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/21/2016] [Accepted: 12/28/2016] [Indexed: 11/24/2022]
Abstract
Ground reaction forces and moments (GRF&M) are important measures used as input in biomechanical analysis to estimate joint kinetics, which often are used to infer information for many musculoskeletal diseases. Their assessment is conventionally achieved using laboratory-based equipment that cannot be applied in daily life monitoring. In this study, we propose a method to predict GRF&M during walking, using exclusively kinematic information from fully-ambulatory inertial motion capture (IMC). From the equations of motion, we derive the total external forces and moments. Then, we solve the indeterminacy problem during double stance using a distribution algorithm based on a smooth transition assumption. The agreement between the IMC-predicted and reference GRF&M was categorized over normal walking speed as excellent for the vertical (ρ = 0.992, rRMSE = 5.3%), anterior (ρ = 0.965, rRMSE = 9.4%) and sagittal (ρ = 0.933, rRMSE = 12.4%) GRF&M components and as strong for the lateral (ρ = 0.862, rRMSE = 13.1%), frontal (ρ = 0.710, rRMSE = 29.6%), and transverse GRF&M (ρ = 0.826, rRMSE = 18.2%). Sensitivity analysis was performed on the effect of the cut-off frequency used in the filtering of the input kinematics, as well as the threshold velocities for the gait event detection algorithm. This study was the first to use only inertial motion capture to estimate 3D GRF&M during gait, providing comparable accuracy with optical motion capture prediction. This approach enables applications that require estimation of the kinetics during walking outside the gait laboratory.
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Affiliation(s)
- Angelos Karatsidis
- Xsens Technologies B.V., Enschede 7521 PR, The Netherlands.
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede 7500 AE, The Netherlands.
| | | | | | - Mark de Zee
- Department of Health Science and Technology, Aalborg University, Aalborg 9220, Denmark.
| | - Michael S Andersen
- Department of Mechanical and Manufacturing Engineering, Aalborg University, Aalborg 9220, Denmark.
| | - Peter H Veltink
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, Enschede 7500 AE, The Netherlands.
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van den Noort JC, van Beek N, van der Kraan T, Veeger DHEJ, Stegeman DF, Veltink PH, Maas H. Variable and Asymmetric Range of Enslaving: Fingers Can Act Independently over Small Range of Flexion. PLoS One 2016; 11:e0168636. [PMID: 27992598 PMCID: PMC5167409 DOI: 10.1371/journal.pone.0168636] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/05/2016] [Indexed: 12/25/2022] Open
Abstract
The variability in the numerous tasks in which we use our hands is very large. However, independent movement control of individual fingers is limited. To assess the extent of finger independency during full-range finger flexion including all finger joints, we studied enslaving (movement in non-instructed fingers) and range of independent finger movement through the whole finger flexion trajectory in single and multi-finger movement tasks. Thirteen young healthy subjects performed single- and multi-finger movement tasks under two conditions: active flexion through the full range of movement with all fingers free to move and active flexion while the non-instructed finger(s) were restrained. Finger kinematics were measured using inertial sensors (PowerGlove), to assess enslaving and range of independent finger movement. Although all fingers showed enslaving movement to some extent, highest enslaving was found in adjacent fingers. Enslaving effects in ring and little finger were increased with movement of additional, non-adjacent fingers. The middle finger was the only finger affected by restriction in movement of non-instructed fingers. Each finger showed a range of independent movement before the non-instructed fingers started to move, which was largest for the index finger. The start of enslaving was asymmetrical for adjacent fingers. Little finger enslaving movement was affected by multi-finger movement. We conclude that no finger can move independently through the full range of finger flexion, although some degree of full independence is present for smaller movements. This range of independent movement is asymmetric and variable between fingers and between subjects. The presented results provide insight into the role of finger independency for different types of tasks and populations.
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Affiliation(s)
- Josien C. van den Noort
- Biomedical Signals and Systems, MIRA Institute, University of Twente, Enschede, the Netherlands
- Department of Rehabilitation medicine, VU University medical center, MOVE Research Institute Amsterdam, the Netherlands
- * E-mail:
| | - Nathalie van Beek
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
| | - Thomas van der Kraan
- Donders Institute, Department of Neurology and Clinical Neurophysiology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - DirkJan H. E. J. Veeger
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
| | - Dick F. Stegeman
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
- Donders Institute, Department of Neurology and Clinical Neurophysiology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Peter H. Veltink
- Biomedical Signals and Systems, MIRA Institute, University of Twente, Enschede, the Netherlands
| | - Huub Maas
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, MOVE Research Institute Amsterdam, The Netherlands
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50
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Kortier HG, Schepers HM, Veltink PH. Identification of Object Dynamics Using Hand Worn Motion and Force Sensors. Sensors (Basel) 2016; 16:s16122005. [PMID: 27898040 PMCID: PMC5190986 DOI: 10.3390/s16122005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 11/16/2016] [Accepted: 11/21/2016] [Indexed: 11/16/2022]
Abstract
Emerging microelectromechanical system (MEMS)-based sensors become much more applicable for on-body measurement purposes lately. Especially, the development of a finger tip-sized tri-axial force sensor gives the opportunity to measure interaction forces between the human hand and environmental objects. We have developed a new prototype device that allows simultaneous 3D force and movement measurements at the finger and thumb tips. The combination of interaction forces and movements makes it possible to identify the dynamical characteristics of the object being handled by the hand. With this device attached to the hand, a subject manipulated mass and spring objects under varying conditions. We were able to identify and estimate the weight of two physical mass objects (0.44 kg: 29.3%±18.9% and 0.28 kg: 19.7%±10.6%) and the spring constant of a physical spring object (16.3%±12.6%). The system is a first attempt to quantify the interactions of the hand with the environment and has many potential applications in rehabilitation, ergonomics and sports.
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Affiliation(s)
- Henk G Kortier
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
| | | | - Peter H Veltink
- Institute for Biomedical Technology and Technical Medicine (MIRA), University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands.
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