Camilo Cortés

Upper Limb Posture Estimation in Robotic and Virtual Reality-Based Rehabilitation

New motor rehabilitation therapies include virtual reality (VR) and robotic technologies. In limb rehabilitation, limb posture is required to (1) provide a limb realistic representation in VR games and (2) assess the patient improvement. When exoskeleton devices are used in the therapy, the measurements of their joint angles cannot be directly used to represent the posture of the patient limb, since the human and exoskeleton kinematic models differ. In response to this shortcoming, we propose a method to estimate the posture of the human limb attached to the exoskeleton. We use the exoskeleton joint angles measurements and the constraints of the exoskeleton on the limb to estimate the human limb joints angles. This paper presents (a) the mathematical formulation and solution to the problem, (b) the implementation of the proposed solution on a commercial exoskeleton system for the upper limb rehabilitation, (c) its integration into a rehabilitation VR game platform, and (d) the quantitative assessment of the method during elbow and wrist analytic training. Results show that this method properly estimates the limb posture to (i) animate avatars that represent the patient in VR games and (ii) obtain kinematic data for the patient assessment during elbow and wrist analytic rehabilitation.

Introduction to Low-Cost Motion-Tracking for Virtual Rehabilitation

Low-cost motion sensors have seen tremendous increase in popularity in the past few years. Accelerometers, gyroscopes or cameras can be found in most available smart phones and gaming controllers. The Apple® iPhone, Nintendo® Wii™ and the PlayStatio® EyeToy™ are just a few examples where such technology is used to provide a more natural interaction for the user. Depth-sensing cameras by companies such as Microsoft, PrimeSense and Asus can enhance the user experience even further by enabling full-body interaction. This chapter will specifically discuss the use of the Microsoft® Kinect™ depth-sensing camera (Kinect) for rehabilitation of patients with motor disabilities. In addition, examples will be provided of how the Kinect can be used with off-the-shelf computer games or utilized in conjunction with modern game development tools such as the game engine Unity. The examples will outline concepts and required resources in order to enable the reader to use low-cost depth-sensing cameras for rehabilitation.

Ultrasound Image Dataset for Image Analysis Algorithms Evaluation

The use of ultrasound (US) imaging as an alternative for real-time computer assisted interventions is increasing. Growing usage of US occurs despite of US lower imaging quality compared to other techniques and its difficulty to be used with image analysis algorithms. On the other hand, it is still difficult to find sufficient data to develop and assess solutions for navigation, registration and reconstruction at medical research level. At present, manually acquired available datasets present significant usability obstacles due to their lack of control of acquisition conditions, which hinders the study and correction of algorithm design parameters. To address these limitations, we present a database of robotically acquired sequences of US images from medical phantoms, ensuring the trajectory, pose and force control of the probe. The acquired dataset is publicly available, and it is specially useful for designing and testing registration and volume reconstruction algorithms.

Optical Enhancement of Exoskeleton-Based Estimation of Glenohumeral Angles

In Robot-Assisted Rehabilitation (RAR) the accurate estimation of the patient limb joint angles is critical for assessing therapy efficacy. In RAR, the use of classic motion capture systems (MOCAPs) (e.g., optical and electromagnetic) to estimate the Glenohumeral (GH) joint angles is hindered by the exoskeleton body, which causes occlusions and magnetic disturbances. Moreover, the exoskeleton posture does not accurately reflect limb posture, as their kinematic models differ. To address the said limitations in posture estimation, we propose installing the cameras of an optical marker-based MOCAP in the rehabilitation exoskeleton. Then, the GH joint angles are estimated by combining the estimated marker poses and exoskeleton Forward Kinematics. Such hybrid system prevents problems related to marker occlusions, reduced camera detection volume, and imprecise joint angle estimation due to the kinematic mismatch of the patient and exoskeleton models. This paper presents the formulation, simulation, and accuracy quantification of the proposed method with simulated human movements. In addition, a sensitivity analysis of the method accuracy to marker position estimation errors, due to system calibration errors and marker drifts, has been carried out. The results show that, even with significant errors in the marker position estimation, method accuracy is adequate for RAR.

Intraoperative Navigation System for Image Guided Surgery

Surgery is a field in which Human-Computer Interaction design and technical development is a critical success factor. Patient safety and surgical accuracy can take great advantages from a carefully designed user interface technology. The medical world needs easy and fast sharing of information. Prior to the use of any interface, an accurate analysis is required in order to understand if it meets medical needs. Normally, if the innovative concepts proposed relay on the use of existing medical devices it is more probable that new technology is successful. We present the initial development of software for the navigation in different types of stereo tactic surgeries. In this research, conventional medical interfaces for intra-operative visualization purposes are augmented with three-dimensional information provided to the surgeon in order to minimize mistakes.

Inverse Kinematics for Upper Limb Compound Movement Estimation in Exoskeleton-Assisted Rehabilitation.

Robot-Assisted Rehabilitation (RAR) is relevant for treating patients affected by nervous system injuries (e.g., stroke and spinal cord injury). The accurate estimation of the joint angles of the patient limbs in RAR is critical to assess the patient improvement. The economical prevalent method to estimate the patient posture in Exoskeleton-based RAR is to approximate the limb joint angles with the ones of the Exoskeleton. This approximation is rough since their kinematic structures differ. Motion capture systems (MOCAPs) can improve the estimations, at the expenses of a considerable overload of the therapy setup. Alternatively, the Extended Inverse Kinematics Posture Estimation (EIKPE) computational method models the limb and Exoskeleton as differing parallel kinematic chains. EIKPE has been tested with single DOF movements of the wrist and elbow joints. This paper presents the assessment of EIKPE with elbow-shoulder compound movements (i.e., object prehension). Ground-truth for estimation assessment is obtained from an optical MOCAP (not intended for the treatment stage). The assessment shows EIKPE rendering a good numerical approximation of the actual posture during the compound movement execution, especially for the shoulder joint angles. This work opens the horizon for clinical studies with patient groups, Exoskeleton models, and movements types.

Robust CT to US 3D-3D Registration by Using Principal Component Analysis and Kalman Filtering

Algorithms based on the unscented Kalman filter (UKF) have been proposed as an alternative for registration of point clouds obtained from vertebral ultrasound (US) and computerised tomography (CT) scans, effectively handling the US limited depth and low signal-to-noise ratio. Previously proposed methods are accurate, but their convergence rate is considerably reduced with initial misalignments of the datasets greater than \(30^\circ \) or 30 mm. We propose a novel method which increases robustness by adding a coarse alignment of the datasets’ principal components and batch-based point inclusions for the UKF. Experiments with simulated scans with full coverage of a single vertebra show the method’s capability and accuracy to correct misalignments as large as \(180^\circ \) and 90 mm. Furthermore, the method registers datasets with varying degrees of missing data and datasets with outlier points coming from adjacent vertebrae.

ROBOTIC RESEARCH PLATFORM FOR IMAGE-GUIDED SURGERY ASSISTANCE

In the context of surgery, it is very common to face challenging scenarios during the preoperative plan implementation. The surgical technique’s complexity, the human anatomical variability and the occurrence of unexpected situations generate issues for the intervention’s goals achievement. To support the surgeon, robotic systems are being integrated to the operating room. However, current commercial solutions are specialized for a particular technique or medical application, being difficult to integrate with other systems. Thus, versatile and modular systems are needed to conduct several procedures and to help solving the problems that surgeons face. This article aims to describe the implementation of a robotic research platform prototype that allows novel applications in the field of image-guided surgery. In particular, this research is focused on the topics of medical image acquisition during surgery, patient registration and surgical/medical equipment operation. In this paper, we address the implementation of the general purpose teleoperation and path following modes of the platform, which constitute the base of future developments. Also, we discuss relevant aspects of the system, as well as future directions and application fields to investigate.

Experience-based SEEG planning: from retrospective data to automated electrode trajectories suggestions

StereoElectroEncephaloGraphy (SEEG) is a minimally invasive technique that consists of the insertion of multiple intracranial electrodes to precisely identify the epileptogenic focus. The planning of electrode trajectories is a cumbersome and time-consuming task. Current approaches to support the planning focus on electrode trajectory optimisation based on geometrical constraints but are not helpful to produce an initial electrode set to begin with the planning procedure. In this work, the authors propose a methodology that analyses retrospective planning data and builds a set of average trajectories, representing the practice of a clinical centre, which can be mapped to a new patient to initialise planning procedure. They collected and analysed the data from 75 anonymised patients, obtaining 30 exploratory patterns and 61 mean trajectories in an average brain space. A preliminary validation on a test set showed that they were able to correctly map 90% of those trajectories and, after optimisation, they have comparable or better values than manual trajectories in terms of distance from vessels and insertion angle. Finally, by detecting and analysing similar plans, they were able to identify eight planning strategies, which represent the main tailored sets of trajectories that neurosurgeons used to deal with the different patient cases.

A Subject-Specific Kinematic Model to Predict Human Motion in Exoskeleton-Assisted Gait

The relative motion between human and exoskeleton is a crucial factor that has remarkable consequences on the efficiency, reliability and safety of human-robot interaction. Unfortunately, its quantitative assessment has been largely overlooked in the literature. Here, we present a methodology that allows predicting the motion of the human joints from the knowledge of the angular motion of the exoskeleton frame. Our method combines a subject-specific skeletal model with a kinematic model of a lower limb exoskeleton (H2, Technaid), imposing specific kinematic constraints between them. To calibrate the model and validate its ability to predict the relative motion in a subject-specific way, we performed experiments on seven healthy subjects during treadmill walking tasks. We demonstrate a prediction accuracy lower than 3.5° globally, and around 1.5° at the hip level, which represent an improvement up to 66% compared to the traditional approach assuming no relative motion between the user and the exoskeleton.