[Abstract + References] eConHand: A Wearable Brain-Computer Interface System for Stroke Rehabilitation


Brain-Computer Interface (BCI) combined with assistive robots has been developed as a promising method for stroke rehabilitation. However, most of the current studies are based on complex system setup, expensive and bulky devices. In this work, we designed a wearable Electroencephalography(EEG)-based BCI system for hand function rehabilitation of the stroke. The system consists of a customized EEG cap, a small-sized commercial amplifer and a lightweight hand exoskeleton. In addition, visualized interface was designed for easy use. Six healthy subjects and two stroke patients were recruited to validate the safety and effectiveness of our proposed system. Up to 79.38% averaged online BCI classification accuracy was achieved. This study is a proof of concept, suggesting potential clinical applications in outpatient environments.

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[Abstract + References] Self-paced movement intention recognition from EEG signals during upper limb robot-assisted rehabilitation


Currently, one of the challenges in EEG-based brain-computer interfaces (BCI) for neurorehabilitation is the recognition of the intention to perform different movements from same limb. This would allow finer control of neurorehabilitation and motor recovery devices by end-users [1]. To address this issue, we assess the feasibility of recognizing two self-paced movement intentions of the right upper limb plus a rest state from EEG signals recorded during robot-assisted rehabilitation therapy. In addition, the work proposes the use of Multi-CSP features and deep learning classifiers to recognize movement intentions of the same limb. The results showed performance peaked greater at (80%) using a novel classification models implemented in a multiclass classification scenario. On the basis of these results, the decoding of the movement intention could potentially be used to develop more natural and intuitive robot assisted neurorehabilitation therapies
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2. P. Ofner , A. Schwarz , J. Pereira , and G. R. Müller-Putz , “Upper limb movements can be decoded from the time-domain of low-frequency EEG,” PLoS One, vol. 12, no. 8, p. e0182578, Aug 2017, poNE-D- 17-04785[PII].

3. F. Shiman , E. Lopez-Larraz , A. Sarasola-Sanz , N. Irastorza-Landa , M. Spler , N. Birbaumer , and A. Ramos-Murguialday , “Classification of different reaching movements from the same limb using EEG,” Journal of Neural Engineering, vol. 14, no. 4, p. 046018, 2017.

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[Abstract] The SonicHand Protocol for Rehabilitation of Hand Motor Function: a validation and feasibility study


Musical sonification therapy is a new technique that can reinforce conventional rehabilitation treatments by increasing therapy intensity and engagement through challenging and motivating exercises. Aim of this study is to evaluate the feasibility and validity of the SonicHand protocol, a new training and assessment method for the rehabilitation of hand function. The study was conducted in 15 healthy individuals and 15 stroke patients. The feasibility of implementation of the training protocol was tested in stroke patients only, who practiced a series of exercises concurrently to music sequences produced by specific movements. The assessment protocol evaluated hand motor performance during pronation/supination, wrist horizontal flexion/extension and hand grasp without sonification. From hand position data, 15 quantitative parameters were computed evaluating mean velocity, movement smoothness and angular excursions of hand/fingers. We validated this assessment in terms of its ability to discriminate between patients and healthy subjects, test-retest reliability and concurrent validity with the upper limb section of the Fugl-Meyer scale (FM), the Functional Independence Measure (FIM) and the Box & Block Test (BBT). All patients showed good understanding of the assigned tasks and were able to correctly execute the proposed training protocol, confirming its feasibility. A moderate-to-excellent intraclass correlation coefficient was found in 8/15 computed parameters. Moderate-to-strong correlation was found between the measured parameters and the clinical scales. The SonicHand training protocol is feasible and the assessment protocol showed good to excellent between-group discrimination ability, reliability and concurrent validity, thus enabling the implementation of new personalized and motivating training programs employing sonification for the rehabilitation of hand function.

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[Abstract] A Greedy Assist-as-Needed Controller for Upper Limb Rehabilitation


Previous studies on robotic rehabilitation have shown that subjects’ active participation and effort involved in rehabilitation training can promote the performance of therapies. In order to improve the voluntary effort of participants during the rehabilitation training, assist-as-needed (AAN) control strategies regulating the robotic assistance according to subjects’ performance and conditions have been developed. Unfortunately, the heterogeneity of patients’ motor function capability in task space is not taken into account during the implementation of these controllers. In this paper, a new scheme called greedy AAN (GAAN) controller is designed for the upper limb rehabilitation training of neurologically impaired subjects. The proposed GAAN control paradigm includes a baseline controller and a Gaussian RBF network that is utilized to model the functional capability of subjects and to provide corresponding a task challenge for them. In order to avoid subjects’ slacking and encourage their active engagement, the weight vectors of RBF networks evaluating subjects’ impairment level are updated based on a greedy strategy that makes the networks progressively learn the maximum forces over time provided by subjects. Simultaneously, a challenge level modification algorithm is employed to adjust the task challenge according to the task performance of subjects. Experiments on 12 subjects with neurological impairment are conducted to validate the performance and feasibility of the GAAN controller. The results show that the proposed GAAN controller has significant potential to promote the subjects’ voluntary engagement during training exercises.

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[Abstract + References] Synergy-Based FES for Post-Stroke Rehabilitation of Upper-Limb Motor Functions


Functional electrical stimulation (FES) is capable of activating muscles that are under-recruited in neurological diseases, such as stroke. Therefore, FES provides a promising technology for assisting upper-limb motor functions in rehabilitation following stroke. However, the full benefits of FES may be limited due to lack of a systematic approach to formulate the pattern of stimulation. Our preliminary work demonstrated that it is feasible to use muscle synergy to guide the generation of FES patterns.In this paper, we present a methodology of formulating FES patterns based on muscle synergies of a normal subject using a programmable multi-channel FES device. The effectiveness of the synergy-based FES was tested in two sets of experiments. In experiment one, the instantaneous effects of FES to improve movement kinematics were tested in three patients post ischemic stroke. Patients performed frontal reaching and lateral reaching tasks, which involved coordinated movements in the elbow and shoulder joints. The FES pattern was adjusted in amplitude and time profile for each subject in each task. In experiment two, a 5-day session of intervention using synergy-based FES was delivered to another three patients, in which patients performed task-oriented training in the same reaching movements in one-hour-per-day dose. The outcome of the short-term intervention was measured by changes in Fugl–Meyer scores and movement kinematics. Results on instantaneous effects showed that FES assistance was effective to increase the peak hand velocity in both or one of the tasks. In short-term intervention, evaluations prior to and post intervention showed improvements in both Fugl–Meyer scores and movement kinematics. The muscle synergy of patients also tended to evolve towards that of the normal subject. These results provide promising evidence of benefits using synergy-based FES for upper-limb rehabilitation following stroke. This is the first step towards a clinical protocol of applying FES as therapeutic intervention in stroke rehabilitation.

I. Introduction

Muscle activation during movement is commonly disrupted due to neural injuries from stroke. A major challenge for stroke rehabilitation is to re-establish the normal ways of muscle activation through a general restoration of motor control, otherwise impairments may be compensated by the motor system through a substitution strategy of task control [1]. In post-stroke intervention, new technologies such as neuromuscular electrical stimulation (NMES) or functional electrical stimulation (FES) offer advantages for non-invasively targeting specific groups of muscles [2]–[4] to restore the pattern of muscle activation. Nevertheless, their effectiveness is limited by lack of a systematic methodology to optimize the stimulation pattern, to implement the optimal strategy in clinical settings, and to design a protocol of training towards the goal of restoring motor functions. This pioneer study addresses these issues in clinical application with a non-invasive FES technology.

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[Abstract] A Virtual Reality based Training and Assessment System for Hand Rehabilitation – IEEE Conference Publication


Virtual reality is widely applied in rehabilitation robot to help post-stoke patients complete rehabilitation training for the body function recovery. Most of virtual rehabilitation training systems lack scientific assessment standards and doctors don’t usually use quantitative examinations but qualitative observation and conversation with patients to evaluate the motor function of limb. Based on this situation, a virtual rehabilitation training and assessment system is designed, which contains two rehabilitation training games and one assessment system. The virtual system can attract patient attention and decrease the boredom of rehabilitation training and assessment. Compared with the existing rehabilitation assessment methods, the proposed virtual assessment system can give the assessment results similar to Fugl-Meyer Assessment, which is more quantitative, interesting and convenient. Five volunteers participate in the study of assessment system and the experimental results confirm the effectiveness of assessment system.

I. Introduction

In recent years, according to American Heart Association, stroke is the leading cause of serious long-term disability in the US and about 795,000 people suffer from a stroke each year [1]. China is also facing the same problem. The stroke is the first leading cause of death. Every year, 2.4 million people suffer from stroke [2]. Fortunately, about 60-75 percent of those can survive. However, about 65 percent of them still remain severely handicapped because of the neurological damage caused by stroke, for example, movement disorders, hemiparesis and so on [3], [4]. Those sequelae have an effect on body movement function, especially arm and hand function [4], [5]. The lost of hand movement function will affect the Activities of Daily Living (ADLs), which will decrease the quality of life [6].[…]

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[Abstract] EMG Feature Extractions for Upper-Limb Functional Movement During Rehabilitation


Rehabilitation is important treatment for post stroke patient to regain their muscle strength and motor coordination as well as to retrain their nervous system. Electromyography (EMG) has been used by researcher to enhance conventional rehabilitation method as a tool to monitor muscle electrical activity however EMG signal is very stochastic in nature and contains some noise. Special technique is yet to be researched in processing EMG signal to make it useful and effective both to researcher and to patient in general. Feature extraction is among the signal processing technique involved and the best method for specific EMG study needs to be applied. In this works, nine feature extractions techniques are applied to EMG signals recorder from subjects performing upper limb rehabilitation activity based on suggested movement sequence pattern. Three healthy subjects perform the experiment with three trials each and EMG data were recorded from their bicep and deltoid muscle. The applied features for every trials of each subject were analyzed statistically using student T-Test their significant of p-value. The results were then totaled up and compared between the nine features applied and Auto Regressive coefficient (AR) present the best result and consistent with each subjects’ data. This feature will be used later in our future research work of Upper-limb Virtual Reality Rehabilitation.

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[Abstract + References] Novel Assessment Measures of Upper-Limb Function in Pre and Poststroke Rehabilitation: A Pilot Study – IEEE Conference Publication


Hand function assessment is essential for upper limb rehabilitation of stroke survivors. Conventional acquisition devices have inherent and restrictive difficulties for their clinical usage. Data gloves are limited for applications outside the medical environment, and motion tracking systems setup are time and personnel demanding. We propose a novel instrument designed as a replica of a glass, equipped with an omnidirectional vision system to capture hand images and an inertial measurement unit for movements kinematic data acquisition. Four stroke survivors were invited as volunteers in pre and post-treatment experiments for its evaluating. The exercise of drinking water from a glass was elected for the trails. Before treatment, subjects used their contralesional and ipsilateral hands to perform them. Two main functional features were found in the data analysis. There were differences between limbs in the grasping hand postures, mainly in the index and thumb abduction angle, and in the task timing. After treatment, two volunteers repeated the protocol with their contralesional hands. Changes in the features were observed, index and thumb abduction angles were greater in both cases, and tasks timing were altered in distinct ways. These preliminary results suggest the instrument can be used both in evaluation of hand functional deficit and rehabilitation progress. Improvements and future work are also presented.
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14. A. C. P. Rocha, E. Tudella, L. M. Pedro, V. C. R. Appel, L. G. P. da Silva, G. A. d. P. Caurin, “A novel device for grasping assessment during functional tasks: preliminary results”, Frontiers in bioengineering and biotechnology, vol. 4, pp. 16, 2016.

15. E. Taub, G. Uswatte, “Constraint-induced movement therapy: bridging from the primate laboratory to the stroke rehabilitation laboratory”, Journal of Rehabilitation Medicine-Supplements, vol. 41, pp. 34-40, 2003.

16. R. d. N. B. Marques, A. C. Magesto, R. E. Garcia, C. B. d. Oliveira, G. d. S. Matuti, “Efeitos da terapia por contensão induzida nas lesões encefálicas adquiridas”, Fisioterapia Brasil, vol. 17, no. 1, pp. f-30, 2016.

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18. E. E. Butler, A. L. Ladd, S. A. Louie, L. E. LaMont, W. Wong, J. Rose, “Three-dimensional kinematics of the upper limb during a reach and grasp cycle for children”, Gait & posture, vol. 32, no. 1, pp. 72-77, 2010.

19. L. Gauthier, Structural brain changes produced by different motor therapies after stroke, 2011.

20. L. M. Pedro, G. A. de Paula Caurin, “Kinect evaluation for human body movement analysis”, Biomedical Robotics and Biomechatronics (BioRob) 2012 4th IEEE RAS & EMBS International Conference on, pp. 1856-1861, 2012.

21. A. Hussain, S. Balasubramanian, N. Roach, J. Klein, N. Jarrassé, M. Mace, A. David, S. Guy, E. Burdet, “Sitar: a system for independent task-oriented assessment and rehabilitation”, Journal of Rehabilitation and Assistive Technologies Engineering, vol. 4, pp. 2055668317729637, 2017.

22. L. R. L. Cardoso, M. N. Martelleto, P. M. Aguiar, E. Burdet, G. A. P. Caurin, L. M. Pedro, “Upper limb rehabilitation through bicycle controlling”, 24th International Congress of Mechanical Engineering, 2017.

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[Abstract + References] Patient Evaluation of an Upper-Limb Rehabilitation Robotic Device for Home Use – IEEE Conference Publication


The paper presents a user study to compare the performance of two rehabilitation robotic systems, called HomeRehab and PupArm. The first one is a novel tele-rehabilitation system for delivering therapy to stroke patients at home and the second one has been designed and developed to provide rehabilitation therapy to patients in clinical settings. Nine patients with different neurological disorders participated in the study. The patients performed 16 movements with each robotic platform and after that they filled a usability survey. Moreover, to evaluate the patient’s performance with each robotic device, 8 movement parameters were computed from each trial and for the two robotic devices. Based on the analysis of subjective assessments of usability and the data acquired objectively by the robotic devices, we can conclude that the performance and user experience with both systems are very similar. This finding will be the base of more extensive studies to demonstrate that home-therapy with HomeRehab could be as efficient as therapy in clinical settings assisted by PupArm robot.


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[Abstract] Hand Rehabilitation via Gesture Recognition Using Leap Motion Controller – Conference Paper

I. Introduction

Nowadays, a stroke is the fourth leading cause of death in the United States. In fact, every 40 seconds, someone in the US is having a stroke. Moreover, around 50% of stroke survivors suffer damage to the upper extremity [1]–[3]. Many actions of treating and recovering from a stroke have been developed over the years, but recent studies show that combining the recovery process with the existing rehabilitation plan provides better results and a raise in the patients quality of life [4]–[6]. Part of the stroke recovery process is a rehabilitation plan [7]. The process can be difficult, intensive and long depending on how adverse the stroke and which parts of the brain were damaged. These processes usually involve working with a team of health care providers in a full extensive rehabilitation plan, which includes hospital care and home exercises.


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2. J. E. Pompeu, T. H. Alonso, I. B. Masson, S. M. A. A. Pompeu, C. Torriani-Pasin, “The effects of virtual reality on stroke rehabilitation: a systematic review”, Motricidade, vol. 10, no. 4, pp. 111-122, 2014.

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7. C. J. Winstein, J. Stein, R. Arena, B. Bates, L. R. Cherney, S. C. Cramer, F. Deruyter, J. J. Eng, B. Fisher, R. L. Harvey et al., “Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the american heart association/american stroke association”, Stroke, vol. 47, no. 6, pp. e98-e169, 2016.

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13. K. R. Anderson, M. L. Woodbury, K. Phillips, L. V. Gauthier, “Virtual reality video games to promote movement recovery in stroke rehabilitation: a guide for clinicians”, Archives of physical medicine and rehabilitation, vol. 96, no. 5, pp. 973-976, 2015.

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17. W.-J. Li, C.-Y. Hsieh, L.-F. Lin, W.-C. Chu, “Hand gesture recognition for post-stroke rehabilitation using leap motion”, Applied System Innovation (ICASI) 2017 International Conference on, pp. 386-388, 2017.

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