Neurorehabilitation Engineering
Editor's Note
Currently, neurorehabilitation engineering is one of the international research hotspots in the fields of neuroscience, biomedical engineering and rehabilitation engineering. The articles included in this thematic issue reported recent research progress in motor nerve function reconstruction, neural information decoding and a multifunctional myoelectrical prostheses control system, motor function rehabilitation robots of neuro-machine interface technology, interaction between patients and rehabilitation environment, motor function rehabilitation technology based on functional electrical stimulation, electromyographic information evaluation on swallowing function, and advances in hearing and pronunciation function assessment.
Guest Editor
Guanglin Li, Professor
Director, Institute of Advanced Integration Technology, Shenzhen Institutes of Advanced Technology (SIAT), Chinese Academy of Sciences, Shenzhen, China; Director, the CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems at SIAT and the Guangdong-Hong Kong-Macau Joint Laboratory of Human-Machine Intelligence-Synergy Systems.
Prof. Li’s research focuses on neurorehabilitation engineering, medical equipment and intelligent rehabilitation robots, and human-machine intelligence enhancement and interaction.
Article List
2013, 2(4):3-7.
DOI: 10.12146/j.issn.2095-3135.201307001
Abstract:
Targeted muscle reinnervation (TMR) can improve amputees’ movement ability by providing simultaneous and intuitive control of artificial limbs. However, little is known about whether TMR can relieve the phantom limb pain and how intramuscular nerve branches are distributed in the targeted muscle after the operation. The purpose of this study is to investigate the effects of TMR on phantom limb pain and to explore the possibility of post-operative neuranagenesis in rats. The rat model was established by sciatic nerves transaction (SNT group) and the proximal ends of these nerves were grafted into targeted muscles (TMR group). The degree of the phantom limb pain was measured by observing the autotomy behaviors of rats. The pilot results show that rats in the sham group have no autotomy behaviors, while rats in SNT group and TMR group show typical autotomy behaviors two days after the operations and the behaviors become worse gradually. However, the TMR group show obviously less pain than the SNT group. Meanwhile, some small new branches rising from the transferred nerves could be observed in targeted muscle with the aid of Sihler’s nerve staining technique. The experimental results suggest that TMR can possibly alleviate the phantom limb pain and the transferred nerve can regenerate to innervate with the targeted muscle.
Targeted muscle reinnervation (TMR) can improve amputees’ movement ability by providing simultaneous and intuitive control of artificial limbs. However, little is known about whether TMR can relieve the phantom limb pain and how intramuscular nerve branches are distributed in the targeted muscle after the operation. The purpose of this study is to investigate the effects of TMR on phantom limb pain and to explore the possibility of post-operative neuranagenesis in rats. The rat model was established by sciatic nerves transaction (SNT group) and the proximal ends of these nerves were grafted into targeted muscles (TMR group). The degree of the phantom limb pain was measured by observing the autotomy behaviors of rats. The pilot results show that rats in the sham group have no autotomy behaviors, while rats in SNT group and TMR group show typical autotomy behaviors two days after the operations and the behaviors become worse gradually. However, the TMR group show obviously less pain than the SNT group. Meanwhile, some small new branches rising from the transferred nerves could be observed in targeted muscle with the aid of Sihler’s nerve staining technique. The experimental results suggest that TMR can possibly alleviate the phantom limb pain and the transferred nerve can regenerate to innervate with the targeted muscle.
2013, 2(4):8-13.
DOI: 10.12146/j.issn.2095-3135.201307002
Abstract:
In this paper, a signal acquisition system was designed and developed for the movements of upper limbs of nonhuman primates. The system included a behavior-training unit of upper limbs and a myoelectric signal-acquisition unit. Two daily behaviors of feeding and drinking were employed to stimulate the motions of animals’ upper limbs for the convenience of the behavior training and signal acquisition. The feasibility of the training system was confirmed by the preliminary experiments on monkeys. Compared with the traditional systems, the system proposed in this study was more convenient for the signal acquisition of the arms of animals, and more suitable for nonhuman primates with different sizes.
In this paper, a signal acquisition system was designed and developed for the movements of upper limbs of nonhuman primates. The system included a behavior-training unit of upper limbs and a myoelectric signal-acquisition unit. Two daily behaviors of feeding and drinking were employed to stimulate the motions of animals’ upper limbs for the convenience of the behavior training and signal acquisition. The feasibility of the training system was confirmed by the preliminary experiments on monkeys. Compared with the traditional systems, the system proposed in this study was more convenient for the signal acquisition of the arms of animals, and more suitable for nonhuman primates with different sizes.
2013, 2(4):14-19.
DOI: 10.12146/j.issn.2095-3135.201307003
Abstract:
The applications of present commercially-available myoelectric prostheses are limited due to the difficulty in use and the long training time. The existing control methods can not realize natural controls of the prostheses. In this paper, a control system of multifunctional myoelectrical prostheses which contains a myoelectric-prosthesis controller based on a micro control unit and a multifunction prosthesis clinical training software, was designed and developed using a high-performance microprocessor. The pattern recognition of the electromyogram (EMG) was employed to determine the motion classes. Since the microprocessor is wearable, the system proposed in this study could possibly achieve flexible and natural controls of multifunctional myoelectric prostheses.
The applications of present commercially-available myoelectric prostheses are limited due to the difficulty in use and the long training time. The existing control methods can not realize natural controls of the prostheses. In this paper, a control system of multifunctional myoelectrical prostheses which contains a myoelectric-prosthesis controller based on a micro control unit and a multifunction prosthesis clinical training software, was designed and developed using a high-performance microprocessor. The pattern recognition of the electromyogram (EMG) was employed to determine the motion classes. Since the microprocessor is wearable, the system proposed in this study could possibly achieve flexible and natural controls of multifunctional myoelectric prostheses.
2013, 2(4):20-26.
DOI: 10.12146/j.issn.2095-3135.201307004
Abstract:
When the surface electromyography (sEMG) signals change along with external or internal environment of the human body, general pattern classifiers will lead to a decrease of identification accuracy since they do not update their parameters adaptively. In order to adapt to the time-varying characteristics of sEMG signals, three kinds of adaptive algorithms for updating the parameters of a classifier during the use of artificial limb were introduced to improve the classification accuracy of time-variant sEMG signals. The pilot results of this study show that self-enhancing linear discriminant analysis is an effective solution and cycle substitution linear discriminant analysis presents the best performance but requires a large amount of calculations. The performance of the Kalman adaptive linear discriminant analysis is not prominent when it was used alone, and therefore it needs to be combined with other methods.
When the surface electromyography (sEMG) signals change along with external or internal environment of the human body, general pattern classifiers will lead to a decrease of identification accuracy since they do not update their parameters adaptively. In order to adapt to the time-varying characteristics of sEMG signals, three kinds of adaptive algorithms for updating the parameters of a classifier during the use of artificial limb were introduced to improve the classification accuracy of time-variant sEMG signals. The pilot results of this study show that self-enhancing linear discriminant analysis is an effective solution and cycle substitution linear discriminant analysis presents the best performance but requires a large amount of calculations. The performance of the Kalman adaptive linear discriminant analysis is not prominent when it was used alone, and therefore it needs to be combined with other methods.
2013, 2(4):27-31.
DOI: 10.12146/j.issn.2095-3135.201307005
Abstract:
Robot-assisted rehabilitation which promises to redefine clinical strategies has drawn more and more attention for stroke therapy recently. Compared with classic rehabilitation limited to subjective observation of therapists on patients, the treatment by robotic devices can be more precise to improve the rehabilitation effects. In this paper, a wearable and portable rehabilitation robot with upper limbs of 5 degrees of freedom (DOFs) and upper limbs of 4 DOFs was introduced. The surface electromyographic (sEMG) signals were used to drive all the DOFs of both limbs to aid the training of prosthetic limbs. All data during the rehabilitation, including the sEMG signals and joint motions, can be collected for the purposes of both online analysis and offline storage.
Robot-assisted rehabilitation which promises to redefine clinical strategies has drawn more and more attention for stroke therapy recently. Compared with classic rehabilitation limited to subjective observation of therapists on patients, the treatment by robotic devices can be more precise to improve the rehabilitation effects. In this paper, a wearable and portable rehabilitation robot with upper limbs of 5 degrees of freedom (DOFs) and upper limbs of 4 DOFs was introduced. The surface electromyographic (sEMG) signals were used to drive all the DOFs of both limbs to aid the training of prosthetic limbs. All data during the rehabilitation, including the sEMG signals and joint motions, can be collected for the purposes of both online analysis and offline storage.
2013, 2(4):32-38.
DOI: 10.12146/j.issn.2095-3135.201307006
Abstract:
The use of virtual reality technology in limb rehabilitation training could overcome the limitations of traditional rehabilitation methods, realizing the safe, comfortable and active rehabilitation training. In this paper, a rehabilitation training system based on virtual reality was designed for the recovery of impaired hand functions and evaluated in healthy projects. The training system was developed by using an interactive device, a human-computer interaction software and the virtual environment. The 5DT Data Glove 14 Ultra was used as the interactive device. The human-computer interaction software implemented with Visual Studio 2012 consisted of user management module, data collection module, classification module and real-time gesture recognition module. For the virtual environment (VR), a flash game was developed and used, which could be controlled by hand gestures through the communication between the VR environment and users. The proposed training system could be beneficial in improving the outcome of the hand function rehabilitation. Moreover, the use of flash games could improve the enthusiasm and initiative of the users effectively in rehabilitation training.
The use of virtual reality technology in limb rehabilitation training could overcome the limitations of traditional rehabilitation methods, realizing the safe, comfortable and active rehabilitation training. In this paper, a rehabilitation training system based on virtual reality was designed for the recovery of impaired hand functions and evaluated in healthy projects. The training system was developed by using an interactive device, a human-computer interaction software and the virtual environment. The 5DT Data Glove 14 Ultra was used as the interactive device. The human-computer interaction software implemented with Visual Studio 2012 consisted of user management module, data collection module, classification module and real-time gesture recognition module. For the virtual environment (VR), a flash game was developed and used, which could be controlled by hand gestures through the communication between the VR environment and users. The proposed training system could be beneficial in improving the outcome of the hand function rehabilitation. Moreover, the use of flash games could improve the enthusiasm and initiative of the users effectively in rehabilitation training.
2013, 2(4):39-43.
DOI: 10.12146/j.issn.2095-3135.201307007
Abstract:
This study aims to develop a new approach to visualize the global myoelectric activities related to normal swallowing in human. The high-density surface electromyography (sEMG) signals were recorded by a two-dimensional (2D) 96-electrodes array on the neck region while subjects were performing specified swallowing tasks. The root mean square (RMS) of the sEMG signals was calculated for the 96 channels to construct 2D sEMG maps of the muscle activities. Along the swallowing process, a series of 2D color sEMG maps were concatenated as a dynamic topographical video of swallowing. The dynamic high-density sEMG maps provided the spatial and temporal properties of the electrical muscle activity and presented the muscle contraction coordination which was closely related to the swallowing function. The exeprimental results of this pilot study from five normal subjects show that their sEMG maps represent the consistent patterns in the distribution of muscle activities along with a swallowing process. This might suggest that the dynamic swallowing sEMG maps would be a noninvasive means for visualizing swallowing process and evaluating swallowing function.
This study aims to develop a new approach to visualize the global myoelectric activities related to normal swallowing in human. The high-density surface electromyography (sEMG) signals were recorded by a two-dimensional (2D) 96-electrodes array on the neck region while subjects were performing specified swallowing tasks. The root mean square (RMS) of the sEMG signals was calculated for the 96 channels to construct 2D sEMG maps of the muscle activities. Along the swallowing process, a series of 2D color sEMG maps were concatenated as a dynamic topographical video of swallowing. The dynamic high-density sEMG maps provided the spatial and temporal properties of the electrical muscle activity and presented the muscle contraction coordination which was closely related to the swallowing function. The exeprimental results of this pilot study from five normal subjects show that their sEMG maps represent the consistent patterns in the distribution of muscle activities along with a swallowing process. This might suggest that the dynamic swallowing sEMG maps would be a noninvasive means for visualizing swallowing process and evaluating swallowing function.
2013, 2(4):44-48.
DOI: 10.12146/j.issn.2095-3135.201307008
Abstract:
Objective: to observe the effects of low-frequency electrical stimulation (LES) on healthy adult with somatosensory evoked potential (SEP) and motor evoked potential (MEP). Method: 25 healthy adults (thirteen males and twelve females, with a mean age of 42.9 and a standard deviation of 5.7) participated in the study. SEP and MEP were measured before and after the LES stimulation. Results: After LES, the latency of SEP and MEP for the stimulated side became shorter and the amplitude became greater. These changes in latency and amplitude were statistically significant (P<0.05). For the unstimulated side, the changes of SEP and MEP did not show statistically significant difference. Conclusion: The SEP and MEP parameters, especially the amplitude, can be used to evaluate the effect of LES on central nervous system (CNS).
Objective: to observe the effects of low-frequency electrical stimulation (LES) on healthy adult with somatosensory evoked potential (SEP) and motor evoked potential (MEP). Method: 25 healthy adults (thirteen males and twelve females, with a mean age of 42.9 and a standard deviation of 5.7) participated in the study. SEP and MEP were measured before and after the LES stimulation. Results: After LES, the latency of SEP and MEP for the stimulated side became shorter and the amplitude became greater. These changes in latency and amplitude were statistically significant (P<0.05). For the unstimulated side, the changes of SEP and MEP did not show statistically significant difference. Conclusion: The SEP and MEP parameters, especially the amplitude, can be used to evaluate the effect of LES on central nervous system (CNS).
2013, 2(4):49-55.
DOI: 10.12146/j.issn.2095-3135.201307009
Abstract:
Transcranial magnetic stimulation (TMS) is a non-invasive technique that can be used for brain studying and clinical therapy. Firstly, the technology feature and application of the TMS instrument were introduced. Then several TMS coil positioning methods were evaluated and several key problems about TMS coil positioning were discussed. The aim of this study was to propose a new method for TMS coil positioning. The new method combines three aspects of quantitative information including the brain scalp, brain anatomy and brain function and has great advantages and broad application prospects.
Transcranial magnetic stimulation (TMS) is a non-invasive technique that can be used for brain studying and clinical therapy. Firstly, the technology feature and application of the TMS instrument were introduced. Then several TMS coil positioning methods were evaluated and several key problems about TMS coil positioning were discussed. The aim of this study was to propose a new method for TMS coil positioning. The new method combines three aspects of quantitative information including the brain scalp, brain anatomy and brain function and has great advantages and broad application prospects.
2013, 2(4):56-60.
DOI: 10.12146/j.issn.2095-3135.201307010
Abstract:
Foot drop is the inability to voluntarily dorsiflex the ankle during the swing phase of gait and is usually caused by weakness and damages of the peroneal nerve. The consequences of the foot drop include the decreasing of gait quality, the limiting of mobility, the increasing of falling risk, and great increasing of energy expenditure during walking. Firstly biosignal sensors are used in the drop foot stimulator to detect foot movements. Then the surface drop foot stimulator produces a predefined stimulation profile to the peroneal nerve or tibialis anterial to elicit a dorsiflexion of the foot synchronized with the swing phase of gait to lift the foot. This paper reviewed the fundamentals and current researches of drop foot stimulators. Moreover, the development trends of the closed loop drop foot stimulator were also discussed in the paper.
Foot drop is the inability to voluntarily dorsiflex the ankle during the swing phase of gait and is usually caused by weakness and damages of the peroneal nerve. The consequences of the foot drop include the decreasing of gait quality, the limiting of mobility, the increasing of falling risk, and great increasing of energy expenditure during walking. Firstly biosignal sensors are used in the drop foot stimulator to detect foot movements. Then the surface drop foot stimulator produces a predefined stimulation profile to the peroneal nerve or tibialis anterial to elicit a dorsiflexion of the foot synchronized with the swing phase of gait to lift the foot. This paper reviewed the fundamentals and current researches of drop foot stimulators. Moreover, the development trends of the closed loop drop foot stimulator were also discussed in the paper.
11 Quick Detection of Hearing Loss Using Distortion Product Otoacoustic Emissions Evoked by Swept Tones
2013, 2(4):61-67.
DOI: 10.12146/j.issn.2095-3135.201307011
Abstract:
Distortion product otoacoustic emissions (DPOAEs) are sound energy generated by healthy inner ears when stimulated by two fixed-frequency pure tones. Since DPOAEs are physiologically related with the functional status of the inner ears, DPOAE measurement has been widely used in both hearing screening of newborns and hearing diagnoses of adults. However, there are some limitations in current measurements of DPOAE, such as complex operation, insufficient resolution and low efficiency. In this study, a new method in which frequency-varying swept tones were used to replace pure tones to evoke DPOAEs was proposed to overcome the limitations of current methods. In this method, a threeinterval paradigm was employed to eliminate the stimulus artifacts and a dynamic tracking filter was used to extract highquality swept-tone DPOAEs from the recorded signals. The results show that the swept-tone method can improve both the efficiency and frequency-resolution of current methods. Moreover, the swept-tone DPOAEs within a wide frequency range can help to identify the exact location of the hearing loss. Using swept tones to measure DPOAEs can be beneficial in developing a new type of OAE device with high efficiency to help doctors with accurate diagnoses and appropriate treatments in the clinic.
Distortion product otoacoustic emissions (DPOAEs) are sound energy generated by healthy inner ears when stimulated by two fixed-frequency pure tones. Since DPOAEs are physiologically related with the functional status of the inner ears, DPOAE measurement has been widely used in both hearing screening of newborns and hearing diagnoses of adults. However, there are some limitations in current measurements of DPOAE, such as complex operation, insufficient resolution and low efficiency. In this study, a new method in which frequency-varying swept tones were used to replace pure tones to evoke DPOAEs was proposed to overcome the limitations of current methods. In this method, a threeinterval paradigm was employed to eliminate the stimulus artifacts and a dynamic tracking filter was used to extract highquality swept-tone DPOAEs from the recorded signals. The results show that the swept-tone method can improve both the efficiency and frequency-resolution of current methods. Moreover, the swept-tone DPOAEs within a wide frequency range can help to identify the exact location of the hearing loss. Using swept tones to measure DPOAEs can be beneficial in developing a new type of OAE device with high efficiency to help doctors with accurate diagnoses and appropriate treatments in the clinic.
2013, 2(4):68-73.
DOI: 10.12146/j.issn.2095-3135.201307012
Abstract:
In this study, a novel interactive speech training system based on virtual reality articulation was introduced and its efficiency in the rehabilitation of hearing impaired (HI) children was investigated as well. 20 meaningful words in Mandarin were presented by using a 3D talking head in this system for articulatory training. The Electro-Magnetic Articulography (EMA) and graphic transform technology were used to develop the reality inner articulatory movements of 3D talking head. Furthermore, relevant corpus was organized in a listening module and a speaking module of the system to help to recover the HI children’s language skills. Then, the accuracy of virtual reality (VR) articulatory movement model was evaluated through a series of experiments. Finally, a pilot test was performed on the training of two HI children with the system. The preliminary results show that there is an improvement in the speaking abilities of the tested HI children. Meanwhile, the system was recognized as acceptable and interesting for younger children. The study indicates that the presented training system is effective to articulation training for the HI children.
In this study, a novel interactive speech training system based on virtual reality articulation was introduced and its efficiency in the rehabilitation of hearing impaired (HI) children was investigated as well. 20 meaningful words in Mandarin were presented by using a 3D talking head in this system for articulatory training. The Electro-Magnetic Articulography (EMA) and graphic transform technology were used to develop the reality inner articulatory movements of 3D talking head. Furthermore, relevant corpus was organized in a listening module and a speaking module of the system to help to recover the HI children’s language skills. Then, the accuracy of virtual reality (VR) articulatory movement model was evaluated through a series of experiments. Finally, a pilot test was performed on the training of two HI children with the system. The preliminary results show that there is an improvement in the speaking abilities of the tested HI children. Meanwhile, the system was recognized as acceptable and interesting for younger children. The study indicates that the presented training system is effective to articulation training for the HI children.
2013, 2(4):74-78.
DOI: 10.12146/j.issn.2095-3135.201307013
Abstract:
With the rapid development of rehabilitation medicine and modern technology, rehabilitation medicine and equipment are becoming more and more advanced and sophisticated. Up to now, a lot of new technologies have been introduced into the rehabilitation field, such as virtual reality, computer networks, software engineering, and mechanical engineering. Combining the theoretical basis of rehabilitation medicine and national policies about rehabilitation, the authors analyzed the current status and future directions of the development of rehabilitation medicine and equipment from the following perspectives: technology integration, the fineness of function division, user-friendly design and medical informatization.
With the rapid development of rehabilitation medicine and modern technology, rehabilitation medicine and equipment are becoming more and more advanced and sophisticated. Up to now, a lot of new technologies have been introduced into the rehabilitation field, such as virtual reality, computer networks, software engineering, and mechanical engineering. Combining the theoretical basis of rehabilitation medicine and national policies about rehabilitation, the authors analyzed the current status and future directions of the development of rehabilitation medicine and equipment from the following perspectives: technology integration, the fineness of function division, user-friendly design and medical informatization.
2013, 2(4):79-82.
DOI: 10.12146/j.issn.2095-3135.201307014
Abstract:
The growing popularity of mobile communications and intelligent computing technology provides a wide range of opportunities for mobile medical applications. In this paper, an Android-based mobile terminal was designed and implemented to monitor the physiological parameters of human bodies. Wireless bluetooth technology was used for the communication between the sensor and the mobile terminal to form a body sensor network. The practical applications show that the terminal can help the patients with their physiological monitoring, diagnostics and health management.
The growing popularity of mobile communications and intelligent computing technology provides a wide range of opportunities for mobile medical applications. In this paper, an Android-based mobile terminal was designed and implemented to monitor the physiological parameters of human bodies. Wireless bluetooth technology was used for the communication between the sensor and the mobile terminal to form a body sensor network. The practical applications show that the terminal can help the patients with their physiological monitoring, diagnostics and health management.
