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1. Human-Human Hand Interactions Aid Balance During Walking by Haptic Communication

   https://doi.org/10.3389/frobt.2021.735575  

   Wu, Mengnan ; Drnach, Luke ; Bong, Sistania M. ; Song, Yun Seong ; Ting, Lena H. ( November 2021 , Frontiers in Robotics and AI)

   Principles from human-human physical interaction may be necessary to design more intuitive and seamless robotic devices to aid human movement. Previous studies have shown that light touch can aid balance and that haptic communication can improve performance of physical tasks, but the effects of touch between two humans on walking balance has not been previously characterized. This study examines physical interaction between two persons when one person aids another in performing a beam-walking task. 12 pairs of healthy young adults held a force sensor with one hand while one person walked on a narrow balance beam (2 cm wide x 3.7 m long) and the other person walked overground by their side. We compare balance performance during partnered vs. solo beam-walking to examine the effects of haptic interaction, and we compare hand interaction mechanics during partnered beam-walking vs. overground walking to examine how the interaction aided balance. While holding the hand of a partner, participants were able to walk further on the beam without falling, reduce lateral sway, and decrease angular momentum in the frontal plane. We measured small hand force magnitudes (mean of 2.2 N laterally and 3.4 N vertically) that created opposing torque components about the beam axis and calculated the interactionmore »torque, the overlapping opposing torque that does not contribute to motion of the beam-walker’s body. We found higher interaction torque magnitudes during partnered beam-walking vs . partnered overground walking, and correlation between interaction torque magnitude and reductions in lateral sway. To gain insight into feasible controller designs to emulate human-human physical interactions for aiding walking balance, we modeled the relationship between each torque component and motion of the beam-walker’s body as a mass-spring-damper system. Our model results show opposite types of mechanical elements (active vs . passive) for the two torque components. Our results demonstrate that hand interactions aid balance during partnered beam-walking by creating opposing torques that primarily serve haptic communication, and our model of the torques suggest control parameters for implementing human-human balance aid in human-robot interactions.« less
2. Navigating the FDA Medical Device Regulatory Pathways for Pediatric Lower Limb Exoskeleton Devices

   https://doi.org/10.1109/JSYST.2020.3025111  

   Eguren, David ; Contreras-Vidal, Jose Luis ( October 2020 , IEEE Systems Journal)

   There have been significant advances in the technologies for robot-assisted lower-limb rehabilitation in the last decade. However, the development of similar systems for children has been slow despite the fact that children with conditions such as cerebral palsy (CP), spina bifida (SB) and spinal cord injury (SCI) can benefit greatly from these technologies. Robotic assisted gait therapy (RAGT) has emerged as a way to increase gait training duration and intensity while decreasing the risk of injury to therapists. Robotic walking devices can be coupled with motion sensing, electromyography (EMG), scalp electroencephalography (EEG) or other noninvasive methods of acquiring information about the user’s intent to design Brain-Computer Interfaces (BCI) for neuromuscular rehabilitation and control of powered exoskeletons. For users with SCI, BCIs could provide a method of overground mobility closer to the natural process of the brain controlling the body’s movement during walking than mobility by wheelchair. For adults there are currently four FDA approved lower-limb exoskeletons that could be incorporated into such a BCI system, but there are no similar devices specifically designed for children, who present additional physical, neurological and cognitive developmental challenges. The current state of the art for pediatric RAGT relies on large clinical devices with highmore »costs that limit accessibility. This can reduce the amount of therapy a child receives and slow rehabilitation progress. In many cases, lack of gait training can result in a reduction in the mobility, independence and overall quality of life for children with lower-limb disabilities. Thus, it is imperative to facilitate and accelerate the development of pediatric technologies for gait rehabilitation, including their regulatory path. In this paper an overview of the U.S. Food and Drug Administration (FDA) clearance/approval process is presented. An example device has been used to navigate important questions facing device developers focused on providing lower limb rehabilitation to children in home-based or other settings beyond the clinic.« less
3. An Objective System for Quantifying the Effect of Cognitive Load on Movement in Individuals with Autism Spectrum Disorder

   https://doi.org/10.1109/NER.2019.8717022  

   Simmons, Trent L. ; Snider, Joseph ; Amit, Moran ; Ng, Tse Nga ; Townsend, Jeanne ; Chukoskie, Leanne ( March 2019 , IEEE/EMBS Conference on Neural Engineering)

   For someone with Autism Spectrum Disorder, performance on tasks that require coordinated motor and cognitive activities, such as walking while talking (or texting) on our phones, can take substantially more effort to accomplish. While it is more common to isolate and examine motor and cognitive skill in separate experiments, we propose a dual task experiment to allow us to examine performance in people with autism more realistically. We designed a system composed of three task types and accompanying hardware to simultaneously quantify balance, fine motor skill, and cognitive ability. We hypothesized that the additional demands of the balance and speeded finger-tapping tasks would degrade motor performance in the simultaneous conditions, but not impact cognitive (N-Back task) performance. Movement data were evaluated by comparing the change of each group across 3 levels of cognitive load (0-, 1-, and 2-back). We tested the task on a small sample of young adults with autism spectrum disorder (ASD; n=4) and matched controls (n=4). We observed a trend largely consistent with our hypotheses. The system's temporal precision and modular design also allow for the incorporation of other sensors as needed, like EEG or heart rate variability. We propose that a version of this system bemore »tested as a putative outcome measure for interventions involving attention, cognitive load or certain types of motor skill training.« less
4. Using Augmented Reality with Older Adults in the Community to Select Design Features for an Age-Friendly Park: A Pilot Study

   https://doi.org/10.1155/2020/8341034  

   Vieira, Edgar R. ; Civitella, Fernanda ; Carreno, Jorge ; Junior, Miburge G. ; Amorim, Cesar F. ; D’Souza, Newton ; Ozer, Ebru ; Ortega, Francisco ; Estrázulas, Jansen A. ( September 2020 , Journal of Aging Research)

   Sedentary behavior is prevalent in older adults. Older adults often underutilize public parks for exercising because the parks do not support their needs and preferences. Engaging older adults on the redesign of parks may help promote active lifestyles. The objectives of this pilot study were to evaluate (1) the effects of wearing augmented reality (AR) and virtual reality (VR) glasses on balance; (2) the effects of different virtual walls separating the walking trail from the roadway on older adults’ gait, and (3) the preferences of the participants regarding wall design and other features. The participants were ten older adults (68 ± 5 years) who lived within two miles from the park. Balance and gait were assessed using a force plate and an instrumented mat. It was feasible to use AR with older adults in the park to evaluate features for redesign. Motion sickness was not an issue when using AR glasses, but balance was affected when wearing VR goggles. The area of postural sway increased approximately 25% when wearing AR glasses, and it increased by close to 70% when wearing VR goggles compared to no glasses. This difference is clinically relevant; however, we did not have enough power to identify the differencesmore »as statistically significant because of the small sample size and large variability. Different walls did not significantly affect the participants’ gait either because they did not alter the way they walked or because the holograms were insufficiently realistic to cause changes. The participants preferred a transparent wall rather than tall or short solid walls to separate the park from the roadway.« less
5. Prediction of fall risk among community-dwelling older adults using a wearable system

   https://doi.org/10.1038/s41598-021-00458-5  

   Lockhart, Thurmon E. ; Soangra, Rahul ; Yoon, Hyunsoo ; Wu, Teresa ; Frames, Christopher W. ; Weaver, Raven ; Roberto, Karen A. ( December 2021 , Scientific Reports)

   Abstract Falls are among the most common cause of decreased mobility and independence in older adults and rank as one of the most severe public health problems with frequent fatal consequences. In the present study, gait characteristics from 171 community-dwelling older adults were evaluated to determine their predictive ability for future falls using a wearable system. Participants wore a wearable sensor (inertial measurement unit, IMU) affixed to the sternum and performed a 10-m walking test. Measures of gait variability, complexity, and smoothness were extracted from each participant, and prospective fall incidence was evaluated over the following 6-months. Gait parameters were refined to better represent features for a random forest classifier for the fall-risk classification utilizing three experiments. The results show that the best-trained model for faller classification used both linear and nonlinear gait parameters and achieved an overall 81.6 ± 0.7% accuracy, 86.7 ± 0.5% sensitivity, 80.3 ± 0.2% specificity in the blind test. These findings augment the wearable sensor's potential as an ambulatory fall risk identification tool in community-dwelling settings. Furthermore, they highlight the importance of gait features that rely less on event detection methods, and more on time series analysis techniques. Fall prevention is a critical component in older individuals’ healthcare, and simple modelsmore »based on gait-related tasks and a wearable IMU sensor can determine the risk of future falls.« less