A Case Study With Symbihand: An sEMG-Controlled Electrohydraulic Hand Orthosis for Individuals With Duchenne Muscular Dystrophy

Bos, Ronald A.; Nizamis, Kostas; Koopman, Bart; Herder, Just L.; Sartori, Massimo; Plettenburg, Dick H.

doi:10.1109/tnsre.2019.2952470

Cited by 29 publications

(28 citation statements)

References 39 publications

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“…Lastly, an analysis of the homogeneity of activations needs to be carried out using HD-sEMG, as it is known that different joint positions and contraction strength and duration may cause muscles to activate in a non-homogeneous manner (21). The results of this study together with the future studies will be further used for the development of myocontrol algorithms for the robust control of an active hand exoskeleton (29,62), developed within the Symbionics project (63) for individuals with DMD.…”

Section: Discussionmentioning

confidence: 97%

“…The signals were subsequently rectified and filtered with a low-pass filter (thirdorder Butterworth, 2 Hz). Our choice for the cutoff frequency was motivated by the low-frequency dynamic tasks involved in this study (28) and our previous study on real-time sEMG control of a hand exoskeleton (29). The resulting envelopes were visually inspected segmented, according to the acquisition protocol, to 10 contractions and periods (each lasting approximately 3 s) and normalized.…”

Section: Signal Processing and Analysismentioning

confidence: 99%

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Characterization of Forearm Muscle Activation in Duchenne Muscular Dystrophy via High-Density Electromyography: A Case Study on the Implications for Myoelectric Control

et al. 2020

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Duchenne muscular dystrophy (DMD) is a genetic disorder that results in progressive muscular degeneration. Although medical advances increased their life expectancy, DMD individuals are still highly dependent on caregivers. Hand/wrist function is central for providing independence, and robotic exoskeletons are good candidates for effectively compensating for deteriorating functionality. Robotic hand exoskeletons require the accurate decoding of motor intention typically via surface electromyography (sEMG). Traditional low-density sEMG was used in the past to explore the muscular activations of individuals with DMD; however, it cannot provide high spatial resolution. This study characterized, for the first time, the forearm high-density (HD) electromyograms of three individuals with DMD while performing seven hand/wrist-related tasks and compared them to eight healthy individuals (all data available online). We looked into the spatial distribution of HD-sEMG patterns by using principal component analysis (PCA) and also assessed the repeatability and the amplitude distributions of muscle activity. Additionally, we used a machine learning approach to assess DMD individuals' potentials for myocontrol. Our analysis showed that although participants with DMD were able to repeat similar HD-sEMG patterns across gestures (similarly to healthy participants), a fewer number of electrodes was activated during their gestures compared to the healthy participants. Additionally, participants with DMD activated their muscles close to maximal contraction level (0.63 ± 0.23), whereas healthy participants had lower normalized activations (0.26 ± 0.2). Lastly, participants with DMD showed on average fewer PCs (3), explaining 90% of the complete gesture space than the healthy (5). However, the ability of the DMD participants to produce repeatable HD-sEMG patterns was unexpectedly comparable to that of healthy participants, and the same holds true for their offline myocontrol performance, disproving our hypothesis and suggesting a clear potential for the myocontrol of wearable exoskeletons. Our findings present evidence for the first

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Section: Discussionmentioning

confidence: 97%

Section: Signal Processing and Analysismentioning

confidence: 99%

Characterization of Forearm Muscle Activation in Duchenne Muscular Dystrophy via High-Density Electromyography: A Case Study on the Implications for Myoelectric Control

et al. 2020

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“…Additionally, individuals with DMD need robotic devices for daily assistance and for a significant amount of time [81]. In recent years robotic devices to support the arm [82], the trunk [83,84], and the hand [85,86] of people with DMD were developed and tested with promising results. Novel sensors were used [84,85] in integration with novel robotic designs [83,86] to achieve robust interfacing between the user and the robotic device.…”

Section: Duchenne Muscular Dystrophy (Dmd)mentioning

confidence: 99%

Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges

Nizamis

Athanasiou

Almpani

et al. 2021

Sensors

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Recent advances in the field of neural rehabilitation, facilitated through technological innovation and improved neurophysiological knowledge of impaired motor control, have opened up new research directions. Such advances increase the relevance of existing interventions, as well as allow novel methodologies and technological synergies. New approaches attempt to partially overcome long-term disability caused by spinal cord injury, using either invasive bridging technologies or noninvasive human–machine interfaces. Muscular dystrophies benefit from electromyography and novel sensors that shed light on underlying neuromotor mechanisms in people with Duchenne. Novel wearable robotics devices are being tailored to specific patient populations, such as traumatic brain injury, stroke, and amputated individuals. In addition, developments in robot-assisted rehabilitation may enhance motor learning and generate movement repetitions by decoding the brain activity of patients during therapy. This is further facilitated by artificial intelligence algorithms coupled with faster electronics. The practical impact of integrating such technologies with neural rehabilitation treatment can be substantial. They can potentially empower nontechnically trained individuals—namely, family members and professional carers—to alter the programming of neural rehabilitation robotic setups, to actively get involved and intervene promptly at the point of care. This narrative review considers existing and emerging neural rehabilitation technologies through the perspective of replacing or restoring functions, enhancing, or improving natural neural output, as well as promoting or recruiting dormant neuroplasticity. Upon conclusion, we discuss the future directions for neural rehabilitation research, diagnosis, and treatment based on the discussed technologies and their major roadblocks. This future may eventually become possible through technological evolution and convergence of mutually beneficial technologies to create hybrid solutions.

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“…Other research shows promising advances in hand orthoses, for therapy or daily assistance, which are increasingly simplified and less cumbersome [28]. These advancements enhance hand function and reduce fatigue while grasping and are particularly relevant for individuals with muscular dystrophy [29]. Such health-care advances can prolong the life expectancy of several populations with impairments, in that complete or partial restoration of physical abilities contributes to a persons' ability to engage in daily life activities and to their self-esteem, both of which can be of vital importance to the psychological and physical well-being of a person and hence to his or her ability to flourish.…”

Section: Exoskeletons: a Question Of Accessmentioning

confidence: 99%

Promoting inclusiveness in exoskeleton robotics: Addressing challenges for pediatric access

Fosch‐Villaronga

Čartolovni

Pierce

2020

Paladyn, Journal of Behavioral Robotics

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Pediatric access to exoskeletons lags far behind that of adults. In this article, we promote inclusiveness in exoskeleton robotics by identifying and addressing challenges and barriers to pediatric access to this potentially life-changing technology. We first present available exoskeleton solutions for upper and lower limbs and note the variability in the absence of these. Next, we query the possible reasons for this variability in access, explicitly focusing on children, who constitute a categorically vulnerable population, and also stand to benefit significantly from the use of this technology at this critical point in their physical and emotional growth. We propose the use of a life-based design approach as a way to address some of the design challenges and offer insights toward a resolution regarding market viability and implementation challenges. We conclude that the development of pediatric exoskeletons that allow for and ensure access to health-enhancing technology is a crucial aspect of the responsible provision of health care to all members of society. For children, the stakes are particularly high, given that this technology, when used at a critical phase of a child’s development, not only holds out the possibility of improving the quality of life but also can improve the long-term health prospects.

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A Case Study With Symbihand: An sEMG-Controlled Electrohydraulic Hand Orthosis for Individuals With Duchenne Muscular Dystrophy

Cited by 29 publications

References 39 publications

Characterization of Forearm Muscle Activation in Duchenne Muscular Dystrophy via High-Density Electromyography: A Case Study on the Implications for Myoelectric Control

Characterization of Forearm Muscle Activation in Duchenne Muscular Dystrophy via High-Density Electromyography: A Case Study on the Implications for Myoelectric Control

Converging Robotic Technologies in Targeted Neural Rehabilitation: A Review of Emerging Solutions and Challenges

Promoting inclusiveness in exoskeleton robotics: Addressing challenges for pediatric access

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