Benedetta Cesqui

Catching a Ball at the Right Time and Place: Individual Factors Matter

Intercepting a moving object requires accurate spatio-temporal control. Several studies have investigated how the CNS copes with such a challenging task, focusing on the nature of the information used to extract target motion parameters and on the identification of general control strategies. In the present study we provide evidence that the right time and place of the collision is not univocally specified by the CNS for a given target motion; instead, different but equally successful solutions can be adopted by different subjects when task constraints are loose. We characterized arm kinematics of fourteen subjects and performed a detailed analysis on a subset of six subjects who showed comparable success rates when asked to catch a flying ball in three dimensional space. Balls were projected by an actuated launching apparatus in order to obtain different arrival flight time and height conditions. Inter-individual variability was observed in several kinematic parameters, such as wrist trajectory, wrist velocity profile, timing and spatial distribution of the impact point, upper limb posture, trunk motion, and submovement decomposition. Individual idiosyncratic behaviors were consistent across different ball flight time conditions and across two experimental sessions carried out at one year distance. These results highlight the importance of a systematic characterization of individual factors in the study of interceptive tasks.

Robot-mediated therapy for paretic upper limb of chronic patients following neurological injury

OBJECTIVE To evaluate the effectiveness of robot-mediated therapy targeted at the motor recovery of the upper limb in chronic patients following neurological injury. DESIGN Pre-post treatment study. SUBJECTS Twenty patients were enrolled in the study. METHODS Robot-mediated therapy was provided to chronic hemiparetic patients (acute event had occurred at least one year prior to the study), 3 times a week, for 6 weeks. The therapy consisted of goal-directed, planar reaching tasks that exercised the hemiparetic shoulder and elbow. The items for the shoulder and elbow of Motor Status Score, Modified Ashworth Scale and range of motion were used as outcome measures. RESULTS Statistically significant improvements before and after treatment were found in each outcome measure. A 3-month follow-up evaluation indicated that patients maintained the improvements. CONCLUSION The results confirm that robot-mediated therapy, through short-term, but intensive, repetitive and goal-directed trials, contributes to a decrease in the upper limbs motor disability in people with a chronic neurological injury by reducing motor impairment and shoulder pain. The treatment was well accepted and tolerated by patients. No adverse events occurred.

Upper Limb Spasticity Reduction Following Active Training: A Robot-Mediated Study In Patients With Chronic Hemiparesis

OBJECTIVE To compare the effects on spasticity of 2 robot-mediated therapies in patients with chronic hemiparesis. DESIGN Groups comparison. SUBJECTS Thirty-four patients, divided into 2 homogeneous groups. METHODS Outcome measures were: motor status score, Modified Ashworth scale, and range of motion. A pattern of reaching exercises was implemented, in which the direction and length of the movements were modified with the aim of reducing activity of the flexor muscles and improving extension of the arm. A 3-month follow-up was performed. RESULTS Statistically significant improvements were found in both groups after treatment. Some differences were found in elbow motor improvement between the 2 groups. CONCLUSION Comparison between groups confirms that active movement training does not result in increased hypertonia, but results in spasticity reduction in antagonist muscles by activating the reciprocal inhibition mechanism. Furthermore, robot-mediated therapy contributes to a decrease in motor impairment of the upper limbs in subjects with chronic hemiparesis, resulting in a reduction in shoulder pain.

On the use of divergent force fields in robot-mediated neurorehabilitation

The present study is aimed at developing new rehabilitation protocols to be used in post-stroke robotic-aided therapy. In the recent past, it has been suggested that the use of robotic training forces that enhance error instead of reducing it, could stimulate new learning and feedback strategies at the base of an effective motor recovery. Starting from these findings, in this work two different robotic-aided therapies were compared: the first was based on the constraint induced movement therapy, the second employed an unstable training force field increasing path errors performed by the subjects. The results shows that the use of the unstable divergent force field can increase the recovery, especially in people with mild level of impairment.

Characterization of age-related modifications of upper limb motor control strategies in a new dynamic environment

BackgroundIn the past, several research groups have shown that when a velocity dependent force field is applied during upper limb movements subjects are able to deal with this external perturbation after some training. This adaptation is achieved by creating a new internal model which is included in the normal unperturbed motor commands to achieve good performance. The efficiency of this motor control mechanism can be compromised by pathological disorders or by muscular-skeletal modifications such as the ones due to the natural aging process. In this respect, the present study aimed at identifying the age-related modifications of upper limb motor control strategies during adaptation and de-adaptation processes in velocity dependent force fields.MethodsEight young and eight elderly healthy subjects were included in the experiment. Subjects were instructed to perform pointing movements in the horizontal plane both in a null field and in a velocity dependent force field. The evolution of smoothness and hand path were used to characterize the performance of the subjects. Furthermore, the ability of modulating the interactive torque has been used as a paradigm to explain the observed discoordinated patterns during the adaptation process.ResultsThe evolution of the kinematics during the experiments highlights important behavioural differences between the two groups during the adaptation and de-adaptation processes. In young subjects the improvement of movement smoothness was in accordance with the expected learning trend related to the consolidation of the internal model. On the contrary, elders did not show a coherent learning process. The kinetic analysis pointed out the presence of different strategies for the compensation of the external perturbation: older people required an increased involvement of the shoulder with a different modulation of joint torque components during the evolution of the experiments.ConclusionThe results obtained with the present study seem to confirm the presence of different adaptation mechanisms in young and senior subjects. The strategy adopted by young subjects was to first minimize hand path errors with a secondary process that is consistent with the optimization of the effort. Elderly subjects instead, seemed to shift the importance of the two processes involved in the control loop slowing the mechanism optimizing kinematic performance and enabling more the dynamic adaptation mechanism.

Gaze Behavior in One-Handed Catching and Its Relation with Interceptive Performance: What the Eyes Can't Tell

In ball sports, it is usually acknowledged that expert athletes track the ball more accurately than novices. However, there is also evidence that keeping the eyes on the ball is not always necessary for interception. Here we aimed at gaining new insights on the extent to which ocular pursuit performance is related to catching performance. To this end, we analyzed eye and head movements of nine subjects catching a ball projected by an actuated launching apparatus. Four different ball flight durations and two different ball arrival heights were tested and the quality of ocular pursuit was characterized by means of several timing and accuracy parameters. Catching performance differed across subjects and depended on ball flight characteristics. All subjects showed a similar sequence of eye movement events and a similar modulation of the timing of these events in relation to the characteristics of the ball trajectory. On a trial-by-trial basis there was a significant relationship only between pursuit duration and catching performance, confirming that keeping the eyes on the ball longer increases catching success probability. Ocular pursuit parameters values and their dependence on flight conditions as well as the eye and head contributions to gaze shift differed across subjects. However, the observed average individual ocular behavior and the eye-head coordination patterns were not directly related to the individual catching performance. These results suggest that several oculomotor strategies may be used to gather information on ball motion, and that factors unrelated to eye movements may underlie the observed differences in interceptive performance.

A novel method for measuring gaze orientation in space in unrestrained head conditions

Investigation of eye movement strategies often requires the measurement of gaze orientation without restraining the head. However, most commercial eye-trackers have low tolerance for head movements. Here we present a novel geometry-based method to estimate gaze orientation in space in unrestricted head conditions. The method combines the measurement of eye-in-head orientation-provided by a head-mounted video-based eye-tracker-and head-in-space position and orientation-provided by a motion capture system. The method does not rely on specific assumptions on the configuration of the eye-tracker camera with respect to the eye and uses a central projection to estimate the pupil position from the camera image, thus improving upon previously proposed geometry-based procedures. The geometrical parameters for the mapping between pupil image and gaze orientation are derived with a calibration procedure based on nonlinear constrained optimization. Additionally, the method includes a procedure to correct for possible slippages of the tracker helmet based on a geometrical representation of the pupil-to-gaze mapping. We tested and validated our method on seven subjects in the context of a one-handed catching experiment. We obtained accuracy better than 0.8° and precision better than 0.5° in the measurement of gaze orientation. Our method can be used with any video-based eye-tracking system to investigate eye movement strategies in a broad range of naturalistic experimental scenarios.

Identifying Muscle Synergies from EMG Decomposition: Approaches, Evidence, and Potential Application to Neurorehabilitation

Muscle synergies may simplify healthy motor control by allowing the generation of appropriate motor commands with a small number of parameters. Muscle synergies have been recently identified as basic control modules by decomposing electromyographic (EMG) signals. Here we present two EMG decomposition approaches, we review some of the experimental evidence for muscle synergies deriving from them, and we propose a potential application to neurorehabilitation.

Effects of the Alternate Combination of “Error-Enhancing” and “Active Assistive” Robot-Mediated Treatments on Stroke Patients

This paper aimed at investigating the effects of a novel robotic-aided rehabilitation treatment for the recovery of the upper limb related capabilities in chronic post stroke patients. Eighteen post-stroke patients were enrolled in a six-week therapy program and divided into two groups. They were all required to perform horizontal pointing movements both in the presence of a robot-generated divergent force field (DF) that pushed their hands proportional to the trajectory error and perpendicular to the direction of motion, and according to the typical active assistive (AA) approach used in robotic therapy. We used a crossover experimental paradigm where the two groups switched from one therapy treatment to the other. The hypothesis underlying this paper was that the use of the destabilizing scenario forced the patient to keep the end-point position as close as possible to the ideal path, hence requiring a more active control of the arm with respect to the AA approach. Our findings confirmed this hypothesis. In addition, when the DF treatment was provided in the first therapy cycle, patients also showed straighter and smoother paths during the subsequent AA therapy cycle, while this was not true in the opposite case. In conclusion, the results herein reported provide evidence that the use of an unstable DF field can lead to better recovery outcomes, and therefore it potentially more effective than solely active assistance therapy alone.

Sound-evoked vestibular stimulation affects the anticipation of gravity effects during visual self-motion

Abstract Humans anticipate the effects of gravity during visually simulated self-motion in the vertical direction. Here we report that an artificial vestibular stimulation consisting of short-tone bursts (STB) suppresses this anticipation. Participants pressed a button upon entering a tunnel during virtual-reality roller coaster rides in downward or forward directions. In different trials, we delivered STB, pulsed white noise (WN), or no sound (NO). In the control conditions (WN, NO), participants responded earlier during downward than forward motion irrespective of true kinematics, consistent with the a priori expectation that downward but not forward motion is accelerated by gravity. STB canceled the difference in response timing between the two directions, without affecting overall task performance. Thus, we argue that vestibular signals play a role in the anticipation of visible gravity effects during self-motion.