Werner L. Popp

Physical Student–Robot Interaction With the ETHZ Haptic Paddle

Haptic paddles-low-cost one-degree-of-freedom force feedback devices-have been used with great success at several universities throughout the US to teach the basic concepts of dynamic systems and physical human-robot interaction (pHRI) to students. The ETHZ haptic paddle was developed for a new pHRI course offered in the undergraduate Mechatronics Focus track of the Mechanical Engineering curriculum at ETH Zurich, Switzerland. Twenty students engaged in this 2-h weekly lecture over the 14 weeks of the Autumn 2011 semester, complemented by a weekly 2-h laboratory session with the ETHZ haptic paddle. In pairs, students worked through three common sets of experiments before embarking on a specialization project that investigated one of several advanced topics such as impedance control with force feedback, admittance control, the effect of velocity estimation on stability, or electromyographic control. For these projects, students received additional hardware, including force sensors, electrooptical encoders or high-performance data acquisition cards. The learning objectives were developed in the context of an accompanying faculty development program at ETH Zurich; a set of interactive sequences and the oral exam were explicitly aligned to these learning objectives. The outcomes of the specialization project presentations and oral exams, and a student evaluation of the course, demonstrated that the ETHZ haptic paddle is a valuable tool that allows students to quite literally grasp abstract principles such as mechanical impedance, passivity, and human factors and helps students create a tangible link between theory and practice in the highly interdisciplinary field of pHRI.

Reliable and Rapid Robotic Assessment of Wrist Proprioception Using a Gauge Position Matching Paradigm

Quantitative assessments of position sense are essential for the investigation of proprioception, as well as for diagnosis, prognosis and treatment planning for patients with somatosensory deficits. Despite the development and use of various paradigms and robotic tools, their clinimetric properties are often poorly evaluated and reported. A proper evaluation of the latter is essential to compare results between different studies and to identify the influence of possible confounds on outcome measures. The aim of the present study was to perform a comprehensive evaluation of a rapid robotic assessment of wrist proprioception using a passive gauge position matching task. Thirty-two healthy subjects undertook six test-retests of proprioception of the right wrist on two different days. The constant error (CE) was 0.87°, the absolute error (AE) was 5.87°, the variable error (VE) was 4.59° and the total variability (E) was 6.83° in average for the angles presented in the range from 10° to 30°. The intraclass correlation analysis provided an excellent reliability for CE (0.75), good reliability for AE (0.68) and E (0.68), and fair reliability for VE (0.54). Tripling the assessment length had negligible effects on the reliabilities. Additional analysis revealed significant trends of larger overestimation (constant errors), as well as larger absolute and variable errors with increased flexion angles. No proprioceptive learning occurred, despite increased familiarity with the task, which was reflected in significantly decreased assessment duration by 30%. In conclusion, the proposed automated assessment can provide sensitive and reliable information on proprioceptive function of the wrist with an administration time of around 2.5 min, demonstrating the potential for its application in research or clinical settings. Moreover, this study highlights the importance of reporting the complete set of errors (CE, AE, VE, and E) in a matching experiment for the identification of trends and subsequent interpretation of results.

Experimental Validation of a Rapid, Adaptive Robotic Assessment of the MCP Joint Angle Difference Threshold

This paper presents an experimental evaluation of a rapid, adaptive assessment of the difference threshold (DL) of passive metacarpophalangeal index finger joint flexion using a robotic device. Parameter Estimation by Sequential Testing (PEST) is compared to the method of constant stimuli (MOCS) using a two-alternative forced-choice paradigm. The pilot study with \(13\) healthy subjects provided DLs within similar ranges for MOCS and PEST, averaging at \(2.15^{\circ }\pm 0.77^{\circ }\) and \(1.73^{\circ }\pm 0.78^{\circ }\), respectively, in accordance with the literature. However, no significant correlation was found between the two methods (\(r(11) = 0.09\), \(p = 0.762\)). The average number of trials required for PEST to converge was \(58.7\pm 17.6\), and significantly lower compared to \(120\) trials for MOCS (\(p < 0.001\)), leading to an assessment time of under \(15\) min. These results suggest that rapid, adaptive methods, such as PEST, could be successfully implemented in novel robotic tools for clinical assessment of sensory deficits.

Multi-Day Recordings of Wearable Sensors Are Valid and Sensitive Measures of Function and Independence in Human Spinal Cord Injury

Wearable sensor assessment tools have proven to be reliable in measuring function in normal and impaired movement disorders during well-defined assessment protocols. While such assessments can provide valid and sensitive measures of upper limb activity in spinal cord injury (SCI), no assessment tool has yet been introduced into unsupervised daily recordings to complement clinical assessments during rehabilitation. The objective of this study was to measure the overall amount of upper-limb activity in subjects with acute SCI using wearable sensors and relate this to lesion characteristics, independence, and function. The overall amount of upper extremity activity counts, measures of wheeling (speed and distance), and limb-use laterality were measured in 30 in-patients with an acute cervical or thoracic SCI three months after injury. The findings were related to the international standards for neurological classification of SCI, the spinal cord independence measure, and the upper extremity motor scores of the Graded and Redefined Assessment of Strength, Sensibility, and Prehension. Overall upper extremity activity counts were successfully recorded in all patients and correlated with the neurological level of injury and independence. Clinical measures of proximal muscle strength were related to overall activity count and peak velocity of wheeling. Compared with paraplegics, tetraplegics showed significantly lower activity counts and increased limb-use laterality. This is the first cross-sectional study showing the feasibility and clinical value of sensor recordings during unsupervised daily activities in rehabilitation. The strong relationship between sensor-based measures and clinical outcomes supports the application of such technology to assess and track changes in function during rehabilitation and in clinical trials.

Design and Evaluation of a Fiber-Optic Grip Force Sensor with Compliant 3D-Printable Structure for (f)MRI Applications

Grip force sensors compatible with magnetic resonance imaging (MRI) are used in human motor control and decision-making research, providing objective and sensitive behavioral outcome measures. Commercial sensors are expensive, cover limited force ranges, rely on pneumatic force transmission that cannot detect fast force changes, or are electrically active, which increases the risk of electromagnetic interference. We present the design and evaluation of a low-cost, 3D-printed, inherently MRI-compatible grip force sensor based on a commercial intensity-based fiber-optic sensor. A compliant monobloc structure with flexible hinges transduces grip force to a linear displacement captured by the fiber-optic sensor. The structure can easily be adapted for different force ranges by changing the hinge thickness. A prototype designed for forces up to 800 N was manufactured and showed a highly linear behavior (nonlinearity of 2.37%) and an accuracy of 1.57% in a range between zero and 500 N. It can be printed and assembled within one day and for less than

Algorithm for improving psychophysical threshold estimates by detecting sustained inattention in experiments using PEST

300. Accurate performance was confirmed, both inside and outside a 3 T MRI scanner within a pilot study. Given its simple design allowing for customization of sensing properties and ergonomics for different applications and requirements, the proposed grip force handle offers researchers a valuable scientific tool.

Monitoring Upper Limb Recovery after Cervical Spinal Cord Injury: Insights beyond Assessment Scores

Psychophysical procedures are applied in various fields to assess sensory thresholds. During experiments, sampled psychometric functions are usually assumed to be stationary. However, perception can be altered, for example by loss of attention to the presentation of stimuli, leading to biased data, which results in poor threshold estimates. The few existing approaches attempting to identify non-stationarities either detect only whether there was a change in perception, or are not suitable for experiments with a relatively small number of trials (e.g., <

Method for Improving Psychophysical Threshold Estimates by Detecting Sustained Inattention

<

Physical therapy is targeted and adjusted over time for the rehabilitation of locomotor function in acute spinal cord injury interventions in physical and sports therapy

300). We present a method to detect inattention periods on a trial-by-trial basis with the aim of improving threshold estimates in psychophysical experiments using the adaptive sampling procedure Parameter Estimation by Sequential Testing (PEST). The performance of the algorithm was evaluated in computer simulations modeling inattention, and tested in a behavioral experiment on proprioceptive difference threshold assessment in 20 stroke patients, a population where attention deficits are likely to be present. Simulations showed that estimation errors could be reduced by up to 77% for inattentive subjects, even in sequences with less than 100 trials. In the behavioral data, inattention was detected in 14% of assessments, and applying the proposed algorithm resulted in reduced test–retest variability in 73% of these corrected assessments pairs. The novel algorithm complements existing approaches and, besides being applicable post hoc, could also be used online to prevent collection of biased data. This could have important implications in assessment practice by shortening experiments and improving estimates, especially for clinical settings.

Estimation of energy expenditure in wheelchair-bound spinal cord injured individuals using inertial measurement units

Background Preclinical investigations in animal models demonstrate that enhanced upper limb (UL) activity during rehabilitation promotes motor recovery following spinal cord injury (SCI). Despite this, following SCI in humans, no commonly applied training protocols exist, and therefore, activity-based rehabilitative therapies (ABRT) vary in frequency, duration, and intensity. Quantification of UL recovery is limited to subjective questionnaires or scattered measures of muscle function and movement tasks. Objective To objectively measure changes in UL activity during acute SCI rehabilitation and to assess the value of wearable sensors as novel measurement tools that are complimentary to standard clinical assessments tools. Methods The overall amount of UL activity and kinematics of wheeling were measured longitudinally with wearable sensors in 12 thoracic and 19 cervical acute SCI patients (complete and incomplete). The measurements were performed for up to seven consecutive days, and simultaneously, SCI-specific assessments were made during rehabilitation sessions 1, 3, and 6 months after injury. Changes in UL activity and function over time were analyzed using linear mixed models. Results During acute rehabilitation, the overall amount of UL activity and the active distance wheeled significantly increased in tetraplegic patients, but remained constant in paraplegic patients. The same tendency was shown in clinical scores with the exception of those for independence, which showed improvements at the beginning of the rehabilitation period, even in paraplegic subjects. In the later stages of acute rehabilitation, the quantity of UL activity in tetraplegic individuals matched that of their paraplegic counterparts, despite their greater motor impairments. Both subject groups showed higher UL activity during therapy time compared to the time outside of therapy time. Conclusion Tracking day-to-day UL activity is necessary to gain insights into the real impact of a patient’s impairments on their UL movements during therapy and during their leisure time. In the future, this novel methodology may be used to reliably control and adjust ABRT and to evaluate the progress of UL rehabilitation in clinical trials.