Gyoosuk Kim

Evaluation of physical and emotional responses to vibrotactile stimulation of the forearm in young adults, the elderly, and transradial amputees

Vibrotactile stimulation (VS) is widely used in the biomedical and biomechanics fields. Most studies have attempted to verify the effects and/or function of VS, but few studies have evaluated emotional response (ER) to VS, although emotions play a critical role in human behavior. This study aimed to evaluate the subjective response (SR) to VS in young, elderly, and amputee adults and to verify whether VS on the forearm evokes displeasure. Twenty-four young adults (YM: male 13, YF: female 11), 31 elderly subjects (EM: male 15, EF: female 16), and 19 transradial amputees (AM: male 11, AF: female 8) participated. Eight equally spaced vibration motors were attached around the circumference of the forearm (channels 1-4 on the lateral site and channels 5-8 on the medial site) and were located 25% of the proximal forearm. Vibration stimuli with frequencies ranging from 37Hz to 258Hz were applied. An SR 10-level test and ER (displeasure or not) test were performed. In all 3 groups, SRs to the lateral site were higher than those to the medial site (YM group, p<0.001; YF group, p=0.002; EM group, p<0.001; EF group, p=0.031; AM group, p<0.001; AF group, p=0.021). Additionally, SRs were saturated at certain frequencies (YM group, 149Hz; YF and EM groups, 198Hz; EF and AM groups, 120Hz; AF group, 176Hz). Several subjects (YM group, 7; YF group, 4; EM group, 2; EF group, 6; AM group, 3; AF group, 1) expressed displeasure, and ERs were different according to sex, age, or amputation. As a result, the lateral site was more sensitive to VS than the medial site, regardless of sex, age, or amputation. Furthermore, VS may evoke displeasure.

Linear- and Nonlinear-Electromyographic Analysis of Supracutaneous Vibration Stimuli of the Forearm Using Diverse Frequencies and Considering Skin Physiological Properties

Numerous studies have reported the efficacy of vibration in sensory feedback or substitution devices for users of myoelectric hand prostheses. Although most myoelectric hand prostheses are presently manipulated by a surface electromyogram (sEMG), only a few studies have been conducted on the effect of vibration on an sEMG. This study aimed to determine whether vibration stimulation affects the linear and nonlinear properties of surface electromyography (sEMG) considering the skin properties. The vibration stimuli, with frequencies ranging from 37 to 258 Hz, were applied to the proximal part of the arms of the eight female and seven male subjects. The skinfold thickness, hardness, and vibration threshold at the stimuli loci were measured. The root mean square (rms) and fractal dimension (DF) of the sEMG were measured at a distance of 1 cm in the upward direction from the stimuli loci. Above 223 Hz there were no differences between the rms of the genders in between the vibration stimuli (p > 0.05). Moreover, no differences were observed between the DF of the genders for any frequency (p > 0.05). Above 149 Hz, there were correlations between the rms and the skin hardness in the females. Otherwise, no correlations were observed between the rms and DF and the skin properties in both genders for most of the frequencies (all p > 0.05). These results suggest that vibration stimuli affect the linear properties of the sEMG, but not the nonlinear properties.

The Measurement of the Magnitude of Sensory Perception and Displeasure to the Vibration Stimuli applied on Forearm in upper Limb Amputees

Research involving discomfort or pain related to haptic vibratory stimulation the for prosthesis users of myoelectrical hand is very lacking. Our objective of this study was to evaluate the displeasure and sensitivity of areas in forearm using vibration stimulation system between upper limb amputees and non-amputees. Twenty transradial amputees and forty non-amputees (20 youth, 20 elderly) were involved. We set up custom-made vibration stimulation system including eight actuators (4 medial parts and 4 lateral parts) and GUI-based acquisition system, to investigate changes of residual somatosensory sensibility and displeasure at proximal 25% of forearm. Eight vibration actuators were attached to the circumference of proximal 25% point of forearm at regular intervals. Sensitivity tests were used to stimulate the 120Hz and discomfort experiment was used to 37 ~ 223Hz. The subjective responses were evaluated by 10 point scale. The results showed that both groups were similar in sensitive areas. Response at around of radius was most sensitive than other areas in all subjects. Elderly group do not appear discomfort of vibrotactile; however, youth group and amputee presented discomfort of vibrotactile. Prosthesis with a vibrotactile feedback system should be developed considering the sensitivity. Furthermore, Future studies should investigate the scope of application of that principle.

The Effect of Negative Damping at the Hip Joint During Level Walking: A Preliminary Testing

Walking is a fundamental but important activity for independent daily life. We designed an intuitive controller (called negative damping controller) for the elderly to walk more efficiently. The controller behaves as a negative damping for the hip joint to eliminate natural energy dissipation terms and is capable of mimicking the biological torque profile. The primary objective of this study is to evaluate the effects of the controller on the biomechanical and physiological aspects of gait. As a first step, we measured gait parameters and muscle activation levels for a subject during overground walking with and without exoskeleton at self-selected speed. The experimental results show that the negative damping controller has the potential to enable the wearer to walk overground with larger hip range of motion and lower muscle activation: the hip range of motion increased about 21.9% and the average muscle activation levels decreased about 18.0% in rectus femoris and about 23.7% in bicep femoris.

Between-day reliability of MyotonPRO for the non-invasive measurement of muscle material properties in the lower extremities of patients with a chronic spinal cord injury

Measuring the muscle properties of patients with spinal cord injuries (SCIs) is important to better understand their biomechanical features. In this study, we sought to evaluate the between-day reliability of MyotonPRO, a handheld device that can measure muscle mechanical properties, and assess whether it is reliable to measure muscle properties over time in patients with SCI. Thirteen men with complete SCIs (age 53.9 ± 6.3 years, height 171.0 ± 5.2 cm, weight 66.1 ± 5.8 kg), and injury levels ranging from L1 to T12, were enrolled. Oscillation frequency; logarithmic decrement; dynamic stiffness; mechanical stress relaxation time; and creep of the biceps femoris, medial and lateral gastrocnemius, rectus femoris, tibialis anterior, and Achilles tendon were measured on consecutive days using MyotonPRO. The intraclass coefficient for most muscles and the Achilles tendon ranged from 0.53 to 0.99 for all parameters. The percentage standard error of the measurement for many parameters in most muscles and the Achilles tendon was less than 10%. Bland-Altman analysis showed a high agreement for all mechanical properties. No significant differences were observed in any muscle or Achilles tendon properties between days (all p > 0.05). These results indicate that the MyotonPRO is reliable for between-day measurements of the mechanical properties of lower limb muscles and Achilles tendon in patients with SCI.

Effects of knee sleeves on coordination of lower-limb segments in healthy adults during level walking and one-leg hopping

The evaluation of multisegment coordination is important in gaining a better understanding of the gait and physical activities in humans. Therefore, this study aims to verify whether the use of knee sleeves affects the coordination of lower-limb segments during level walking and one-leg hopping. Eleven healthy male adults participated in this study. They were asked to walk 10 m on a level ground and perform one-leg hops with and without a knee sleeve. The segment angles and the response velocities of the thigh, shank, and foot were measured and calculated by using a motion analysis system. The phases between the segment angle and the velocity were then calculated. Moreover, the continuous relative phase (CRP) was calculated as the phase of the distal segment subtracted from the phase of the proximal segment and denoted as CRPTS (thigh–shank), CRPSF (shank–foot), and CRPTF (thigh–foot). The root mean square (RMS) values were used to evaluate the in-phase or out-of-phase states, while the standard deviation (SD) values were utilized to evaluate the variability in the stance and swing phases during level walking and in the preflight, flight, and landing phases during one-leg hopping. The walking velocity and the flight time improved when the knee sleeve was worn (p < 0.05). The segment angles of the thigh and shank also changed when the knee sleeve was worn during level walking and one-leg hopping. The RMS values of CRPTS and CRPSF in the stance phase and the RMS values of CRPSF in the preflight and landing phases changed (p < 0.05 in all cases). Moreover, the SD values of CRPTS in the landing phase and the SD values of CRPSF in the preflight and landing phases increased (p < 0.05 in all cases). These results indicated that wearing a knee sleeve caused changes in segment kinematics and coordination.

Correlations between Biomechanical Characteristics, Physical Characteristics, and the Ability to Maintain Dynamic Sitting Balance on an Unstable Surface in the Disabled with Spinal Cord Injury

Objective: This study aims to analyze the factors that affect the ability to maintain dynamic sitting balance (DSB), biomechanical characteristics, and physical characteristics in spinal cord injuries (SCI) patients. Background: Virtual ski training systems, ski equipment, and training protocols for disabled skiers are being studied to spread awareness. However, few studies have been reported on the sitting balance ability associated with chair mono skiing. Method: A dynamic sitting balance border system was built to investigate the ability to maintain dynamic sitting balance in SCI patients. Trunk muscle activity was evaluated by electromyogram while conducting dynamic sitting balance tests. The trunk muscle strength was tested with a portable handheld dynamometer. Physical activity scores were measured with the physical activity recall assessment. Results: There were high levels of correlation between the ability to maintain DSB and trunk flexor strength, extensor strength, rotator strength, and physical activity score. However, height, weight, and injury level in SCI patients were not correlated with the ability to maintain DSB. Additionally, strong negative correlations were found between muscle activities of the external oblique and lumbar erector spinae muscles and the ability to perform the backward tilt test. Trunk extensor muscle activity during the ball lifting test was significantly higher than in other tests. Conclusion: The results indicate that improving trunk muscle strength and physical activity can increase the ability to maintain DSB. Application: The findings of a close relationship between trunk strength, physical activity, and the ability to maintain DSB need to be reflected in the chair mono ski training program.

Assessment of forearm and plantar foot load in the elderly using a four-wheeled walker with armrest and the effect of armrest height

Background Patients with hand and/or wrist pathology are recommended to have a four-wheeled walker with an arm rest (FWW-AR) rather than a standard walker or a standard four-wheeled walker (FWW). However, only a few quantitative studies have been performed to compare upper and lower extremity weight bearing. The aim of this study was to evaluate forearm and foot weight bearing using a FWW-AR and the effect of the armrest height. Methods Eleven elderly women (mean age 80.1±5.3 years; mean height 148.5±4.0 cm; mean weight 51.2±9.0 kg) were enrolled. The subjects walked with an FWW-AR, with the elbow in either 90 degree (D90) or 130 degree (D130) flexion, for a distance of 10 m. Surface electromyographic signals were recorded for the upper, middle, and lower trapezius, anterior deltoid, and erector spinae muscles; walking velocity was measured with the subjects weight bearing on their feet and forearms while walking. Simultaneously, the maximum plantar and forearm loads during walking with an FWW-AR were measured. Results The normalized foot plantar loads were lower at D90 than at D130, while the normalized forearm load was higher at D90 than at D130 (all P<0.05; left foot, 7.9±0.1 N/kg versus 8.8±0.1 N/kg; right foot, 8.6±0.2 N/kg versus. 9.6±0.1 N/kg; left forearm, 1.8±0.5 N/kg versus 0.8±0.2 N/kg; and right forearm, 2.0±0.5 N/kg versus 1.0±0.2 N/kg, respectively). The surface electromyographic activity of the muscles involved in shoulder elevation and the walking velocity were both lower with the elbow at D90 than at D130 (all P<0.05; left upper trapezius, 98.7%±19.5% versus 132.6%±16.9%; right upper trapezius, 83.4%±10.6% versus 108.1%±10.5%; left anterior deltoid, 94.1%±12.8% versus 158.6%±40.4%; right anterior deltoid, 99.1%±15.0% versus 151.9%±19.4%; and velocity, 0.6±0.1 m/sec versus 0.7±0.1 m/sec, respectively). Conclusion Weight bearing on the lower extremities is significantly reduced when the upper extremities are supported during walking with an FWW-AR. Furthermore, the weight bearing profile is dependent on the armrest height.