Josep R. Medina

Upper limb portable motion analysis system based on inertial technology for neurorehabilitation purposes.

Here an inertial sensor-based monitoring system for measuring and analyzing upper limb movements is presented. The final goal is the integration of this motion-tracking device within a portable rehabilitation system for brain injury patients. A set of four inertial sensors mounted on a special garment worn by the patient provides the quaternions representing the patient upper limb’s orientation in space. A kinematic model is built to estimate 3D upper limb motion for accurate therapeutic evaluation. The human upper limb is represented as a kinematic chain of rigid bodies with three joints and six degrees of freedom. Validation of the system has been performed by co-registration of movements with a commercial optoelectronic tracking system. Successful results are shown that exhibit a high correlation among signals provided by both devices and obtained at the Institut Guttmann Neurorehabilitation Hospital.

A review of the analyses of ocean wave groups

Abstract The most common parameters and functions used to characterize wave groups in linear seas are reviewed and interrelated in a unified manner. A three-axes representation of run lengths is used to characterize wave groups using exponential and Markov chain approximations. A relationship between four parameters ( Q p , Q e , κ 2 , and ρ 2 ) and the correlation coefficient between consecutive wave heights [ r HH (1)] is demonstrated. The wave-height function method is reviewed in some detail in order to relate the run length theory with envelope theories. The theoretical estimates used to demonstrate the relationships between the various parameters must be considered as only first-order trends to parameter estimates computed from real wave data due to the statistical variability in these estimates when computed from real wave data.

A co-adaptive brain-computer interface for end users with severe motor impairment.

Co-adaptive training paradigms for event-related desynchronization (ERD) based brain-computer interfaces (BCI) have proven effective for healthy users. As of yet, it is not clear whether co-adaptive training paradigms can also benefit users with severe motor impairment. The primary goal of our paper was to evaluate a novel cue-guided, co-adaptive BCI training paradigm with severely impaired volunteers. The co-adaptive BCI supports a non-control state, which is an important step toward intuitive, self-paced control. A secondary aim was to have the same participants operate a specifically designed self-paced BCI training paradigm based on the auto-calibrated classifier. The co-adaptive BCI analyzed the electroencephalogram from three bipolar derivations (C3, Cz, and C4) online, while the 22 end users alternately performed right hand movement imagery (MI), left hand MI and relax with eyes open (non-control state). After less than five minutes, the BCI auto-calibrated and proceeded to provide visual feedback for the MI task that could be classified better against the non-control state. The BCI continued to regularly recalibrate. In every calibration step, the system performed trial-based outlier rejection and trained a linear discriminant analysis classifier based on one auto-selected logarithmic band-power feature. In 24 minutes of training, the co-adaptive BCI worked significantly (p = 0.01) better than chance for 18 of 22 end users. The self-paced BCI training paradigm worked significantly (p = 0.01) better than chance in 11 of 20 end users. The presented co-adaptive BCI complements existing approaches in that it supports a non-control state, requires very little setup time, requires no BCI expert and works online based on only two electrodes. The preliminary results from the self-paced BCI paradigm compare favorably to previous studies and the collected data will allow to further improve self-paced BCI systems for disabled users.

An observational report of intensive robotic and manual gait training in sub-acute stroke

BackgroundThe use of automated electromechanical devices for gait training in neurological patients is increasing, yet the functional outcomes of well-defined training programs using these devices and the characteristics of patients that would most benefit are seldom reported in the literature. In an observational study of functional outcomes, we aimed to provide a benchmark for expected change in gait function in early stroke patients, from an intensive inpatient rehabilitation program including both robotic and manual gait training.MethodsWe followed 103 sub-acute stroke patients who met the clinical inclusion criteria for Body Weight Supported Robotic Gait Training (BWSRGT). Patients completed an intensive 8-week gait-training program comprising robotic gait training (weeks 0-4) followed by manual gait training (weeks 4-8). A change in clinical function was determined by the following assessments taken at 0, 4 and 8 weeks (baseline, mid-point and end-point respectively): Functional Ambulatory Categories (FAC), 10 m Walking Test (10 MWT), and Tinetti Gait and Balance Scales.ResultsOver half of the patients made a clinically meaningful improvement on the Tinetti Gait Scale (> 3 points) and Tinetti Balance Scale (> 5 points), while over 80% of the patients increased at least 1 point on the FAC scale (0-5) and improved walking speed by more than 0.2 m/s. Patients responded positively in gait function regardless of variables gender, age, aetiology (hemorrhagic/ischemic), and affected hemisphere. The most robust and significant change was observed for patients in the FAC categories two and three. The therapy was well tolerated and no patients withdrew for factors related to the type or intensity of training.ConclusionsEight-weeks of intensive rehabilitation including robotic and manual gait training was well tolerated by early stroke patients, and was associated with significant gains in function. Patients with mid-level gait dysfunction showed the most robust improvement following robotic training.

Non-motor tasks improve adaptive brain-computer interface performance in users with severe motor impairment.

Individuals with severe motor impairment can use event-related desynchronization (ERD) based BCIs as assistive technology. Auto-calibrating and adaptive ERD-based BCIs that users control with motor imagery tasks (“SMR-AdBCI”) have proven effective for healthy users. We aim to find an improved configuration of such an adaptive ERD-based BCI for individuals with severe motor impairment as a result of spinal cord injury (SCI) or stroke. We hypothesized that an adaptive ERD-based BCI, that automatically selects a user specific class-combination from motor-related and non motor-related mental tasks during initial auto-calibration (“Auto-AdBCI”) could allow for higher control performance than a conventional SMR-AdBCI. To answer this question we performed offline analyses on two sessions (21 data sets total) of cue-guided, five-class electroencephalography (EEG) data recorded from individuals with SCI or stroke. On data from the twelve individuals in Session 1, we first identified three bipolar derivations for the SMR-AdBCI. In a similar way, we determined three bipolar derivations and four mental tasks for the Auto-AdBCI. We then simulated both, the SMR-AdBCI and the Auto-AdBCI configuration on the unseen data from the nine participants in Session 2 and compared the results. On the unseen data of Session 2 from individuals with SCI or stroke, we found that automatically selecting a user specific class-combination from motor-related and non motor-related mental tasks during initial auto-calibration (Auto-AdBCI) significantly (p < 0.01) improved classification performance compared to an adaptive ERD-based BCI that only used motor imagery tasks (SMR-AdBCI; average accuracy of 75.7 vs. 66.3%).

WAVE GROUP ANALYSIS BY THE HILBERT TRANSFORM

The Labrador Sea Extreme Waves Experiment (LEWEX), is an international basic research programme concerned with full-scale measurements, analysis, modelling and simulation in test basins of 3-dimensional seas. The research is carried out in order to assess the significance of 3-dimensional sea states in engineering applications. The first phase of the programme full scale wave measurements in the North Atlantic Ocean was performed at a site and time that had a high probability of encountering severe sea states. The present publication shows examples of measured bi-modal directional sea spectra obtained with the WAVESCAN buoy and directional sea spectra measured with an airborne Synthetic Aperture Radar (SAR). Directional spectra of gravity waves are obtained with the SAR both in open waters and below an ice cover. Further work is needed in order to verify SAR-measurements with in-situ observations. In-situ measured directional spectra are also compared with hindcast spectra from the 3G-WAM model. Hindcast significant wave heights were found to be lower than the in-situ measurements.The littoral drift model developed at DHI and ISVA, see Deigaard et al. (1986b) has been extended to include the effects of the irregularity of the waves, of a coastal current and a wind acting on the surf zone. Further, a mathematical model to simulate the near-shore current pattern along a barred coast with rip channels has been developed. The influence on the littoral drift of the irregularity of waves, wind, coastal current, and rip channels is discussed. It is concluded that irregularity of waves and presence of rip channels must be considered while coastal current and wind action are of minor importance.At present, the Prodhoe Bay oil field in Alaska contributes a substantial amount of the domestic oil production of the United States. Oil is also expected to be present on the continental shelf of Alaska, and it is estimated that approximatedly 28 percent of the total U. S. reserve is located beneath the shallow ice covered seas of the Alaskan continental shelf. To expolre and to exploit these oil rich resources, engineers are confronted with hostile oceanographic conditions such as high tides, waves, strong currents and sea ice. The same area is also rich in fishery resources. Being one of the most productive fishing grounds in the nothern Pacific, the potential ecological impact due to an oil spill is of a major concern. This paper describes the methologies used for the development of a modeling system for the oil risk analysis. The system is designed with generality in mind so it can be used for other coastal areas. The development of three dimensional models used in the modeling system described here have been published in the earlier International Coastal Engineering Conferences (Liu and Leendertse, 1982, 1984, 1986) and a report published recently by RAND (Liu and Leendertse, 1987). In the oil-spill risk analysis, these three dimensional hydrodynamic models are coupled to a two-dimensional stochastic weather model and an oil weathering model.The two projects (LUBIATOWO 79 and LUBIATOWO 86) were aimed at study pore pressure behaviour in natural sand bed in the coastal zone of the Baltic sea under the action of storm waves. During both projects, the wave induced pore pressures at the various levels in the sea bed were measured. The collected data were used to verify the applicability of the various theoretical approaches. In the conclusion, the range of the application of the particular analytical method is given.The rapid recession of the shingle bank of Hurst Beach (up to 3.5m/yr) makes it an excellent natural laboratory for the study of the factors which influence the stability of shingle beaches. Studies have included: the significance of long period, high energy, swell waves the classification and quantification of overwash processes run-up and seepage characteristics the effect of settlement of the underlying strata and the implications for practices in shingle nourishment. The studies have revealed the distinctive character of shingle beaches as compared with the more fully researched sand beaches. More detailed research on shingle beaches is justified particularly in relation to (i) the run-up characteristics including its interaction with swash cusps and (ii) the influence of the subsidiary sand fraction on the beach characteristics.Environmental assessment, engineering studies and designs were completed for a new 26.5 m3/s seawater intake system in the Persian Gulf. The original intake facility consisted of a curved, 60m breakwater with one end attached to the shoreline, a settling basin immediately adjacent to the shoreline and dredged to a maximum depth of approximately 5m, and a pumphouse structure located on shore such that the seaward wall formed one side of the settling basin. The facility located on an island in the Gulf, which served multiple seawater uses, had experienced both structural and operational problems, the latter consisting principally of excessive ingestion of sediment and seaweed. These factors plus the requirement for additional demands for seawater beyond plant capacity caused the owner to initiate a study of alternative intake systems, produce a design for the most effective solution and construct the new intake system.A two-dimensional wave prediction model suitable for use on personal computers is described. The model requires the twodimensional time-dependent wind field as input. Output consists of wave height, wave period, and wave direction estimates at all grid points on a computational grid representing an enclosed or semi-closed basin. Model predictions compare favorably with observations from a wave research tower in Lake Erie. A formula is provided to estimate how long a model simulation would take on a personal computer given the surface area of the computational domain, the grid size, and the computer clock speed.Cullera Bay is a neritic ecosystem placed on the Spanish Mediterranean Littoral largely influenced by the Jucar River, that brings about lower salinities than surrounding waters, and broad variations of its values. An extensive research, with 9 samplings throughout the year, was carried out, measuring both physical and chemical parameters, and the planktonic communities. The trophic status of the ecosystem, the spatial and temporal variations of the nutrients and the planktonic communities were studied, evaluating the influence of the river loads and the littoral dynamics. Some essential basis to allow a suitable emplacement of waste waters disposals along the Valencian littoral are set up in order to minimize the gradual eutrophication of this coast.In the last two years a whole of studies was realized in order to determine precise solutions to the regeneration of Villajoyosas beach, in the Spanish mediterranean coast. Investigations were carried out to the surrounding coastal areas based in field investigations and laboratory analyses of the beaches materials.

Heterogeneous Packing and Hydraulic Stability of Cube and Cubipod Armor Units

AbstractThis paper describes the heterogeneous packing (HEP) failure mode of breakwater armor. HEP reduces packing density in the armor layer near and above the mean water level and increases packing density below it. With HEP, armor units may move in the armor layer, although they are not actually extracted from it. Thus, when HEP occurs, armor-layer porosity is not constant, and measurements obtained with conventional methods may underestimate armor damage. In this paper, the Virtual Net method is proposed to calculate armor damage considering both armor-unit extraction and HEP. The Cubipod concrete armor unit is then described as a solution to the effects of HEP on conventional cubic block armor. The hydraulic stability of cube and Cubipod armor units was compared in two-dimensional laboratory experiments. Cube and Cubipod armor layers were tested in two wave flumes under nonbreaking and non-overtopping conditions. The hydraulic stability was higher for double-layer Cubipod armor than for single-layer ...

Anticipatory assistance-as-needed control algorithm for a multijoint upper limb robotic orthosis in physical neurorehabilitation

Robotic devices are becoming a popular alternative to the traditional physical therapy as a mean to enhance functional recovery after stroke; they offer more intensive practice opportunities without increasing time spent on supervision by the treating therapist. An ideal behavior for these systems would consist in emulating real therapists by providing anticipated force feedback to the patients in order to encourage and modulate neural plasticity. However, nowadays there are no systems able to work in an anticipatory fashion. For this reason, the authors propose an anticipatory assistance-as-needed control algorithm for a multijoint robotic orthosis to be used in physical ABI neurorehabilitation. This control algorithm, based on a dysfunctional-adapted biomechanical prediction subsystem, is able to avoid patient trajectory deviations by providing them with anticipatory force-feedback. The system has been validated by means of a robotic simulator. Obtained results demonstrate through simulations that the proposed assistance-as-needed control algorithm is able to provide anticipatory actuation to the patients, avoiding trajectory deviations and tending to minimize the degree of actuation. Thus, the main novelty and contribution of this work is the anticipatory nature of the proposed assistance-as-needed control algorithm, that breaks with the current robotic control strategies by not waiting for the trajectory deviations to take place. This new actuation paradigm avoids patient slacking and increases both participation and muscle activity in such a way that neural plasticity is encouraged and modulated to reinforce motor recovery.

Recovery of assisted overground stepping in a patient with chronic motor complete spinal cord injury: A case report

BACKGROUND Clinical studies have shown that after incomplete spinal cord lesions at the thoracic level, patients can develop functional gait patterns through gait training. To date, however, training has been ineffective in producing gait in patients with clinically motor complete spinal cord lesions. OBJECTIVE Here we report a patient with chronic motor complete spinal cord injury who regained locomotor function with assistance after intensive gait rehabilitation treatment. METHODS A fifteen year old female patient had sustained motor complete spinal cord injury (T6, AIS B) 2 years earlier, with severe bilateral extensor spasticity, and ineffective previous gait training with robotic systems. The therapy consisted of two months of gait training with a robotic system combined with bilateral functional electrical stimulation (FES) of the peroneal nerve, and one month of gait training with a special walker and FES of the left leg and occasionally on the right leg, due to flexor reflex could sometimes be initiated by the patient in the right leg without electrical stimulation. Neurophysiological studies and ten metres test were done. RESULTS At the end of training, the patient was able to cover a distance of 200 metres without FES with a walker and assistance from a physiotherapist, who pulled the walker with each step to help her to accomplish effective overground stepping. Motor and somatosensory evoked potentials were absent in the lower limbs. CONCLUSION Even after a motor complete lesion with some preservation of sensory pathways, the spinal cord may be able to retain some of its locomotor function through intensive gait rehabilitation.

Accuracy of a P300 speller for people with motor impairments

A Brain-Computer Interface (BCI) provides a completely new output pathway and so an additional possible way a person can express himself if he/she suffers disorders like amyotrophic lateral sclerosis (ALS), brainstem stroke, brain or spinal cord injury or other diseases which impair the function of the common output pathways which are responsible for the control of muscles or impair the muscles. Although most BCIs are thought to help people with disabilities, they are mainly tested on healthy, young subjects who may achieve better results than people with impairments. In this study we compare measurements, performed on 10 physically disabled people to the results of a previous study, taken of 100 healthy persons. We prove that, under certain constraints most patients are able to control a P300-based spelling device with almost the same accuracy than the healthy ones. Tuning parameters are discussed as well as criteria for people who are not able to use this device.