A novel Yamane technique modification: Reverse intraocular lens implantation for simplifying trailing haptic insertion

We described a modified Yamane technique for simplifying trailing haptic insertion in aphakia correction. In Yamane intrascleral intraocular lens (IOL) implantation technique, trailing haptic implantation is challenging for many surgeons. This modification provides an easier and safer way of trailing haptic insertion into the needle tip and decreases the possibility of bending or breaking the trailing haptic.

Efecto de la simulación háptica en la autoeficacia académica de odontólogos en formación

La simulación es un recurso ampliamente utilizado en los procesos formativos en odontología, especialmente para adquirir destrezas motrices y potencialmente en el desarrollo de la autoeficacia. Objetivo: Evaluar el efecto de la simulación háptica en la autoeficacia académica de odontólogos en formación. Materiales y métodos: Este estudio se centró en estudiantes de un curso de anticipación disciplinar (n=134). Se aplicó la escala de autoeficacia general después de dos actividades de tallado con apresto tradicional, mediadas por una sesión de tallado con simulación háptica. Resultados: Al determinar el rol de las dimensiones de autoeficacia en dos actividades de simulación tradicional (ABT1 y ABT2), mediadas por la háptica se obtuvo un promedio de ABT1: x̄=3,27 (n=123) y de ABT2: x̄=3,20 (n=105). De los diez ítems de la escala, hubo diferencia estadística respecto a la disminución del grado de autoeficacia en el Nº1 (p=0,05) y Nº6 (p=0,01). Conclusiones: Se puede establecer que, al utilizar un simulador háptico de manera complementaria a las de apresto tradicional, la intervención influye en la autoeficacia, puesto que se adquiere mayor conciencia de las complejidades asociadas, debiendo desafiar su propia autorregulación para hacerles frente.

Simulation is a widely used resource in dental training processes, especially to acquire motor skills and potentially in the development of self-efficacy. Objective: To evaluate the effect of haptic simulation in the academic self-efficacy of dentists in training. Materials and methods: This study focused on students of a curricular anticipatory course (n=134). The general self-efficacy scale was applied after two carving activities with a traditional approach, complemented by a carving session with haptic simulation. Results: When determining the role of the self-efficacy dimensions in two traditional simulation activities (ABT1 and ABT2) complemented by haptics, we obtained an average of ABT1: x̄=3,27 (n=123) and ABT2: x̄=3,20 (n=105). Of the ten items of the scale, there was a statistical difference regarding the decrease in the degree of self-efficacy in Nº1 (p=0,05) and Nº6 (p=0,01). Conclusions: It can be established that complementing traditional training with a haptic simulator influences self-efficacy, since the students become more aware of the associated complexities, and need to challenge their own self-regulation to deal with them.

Single haptic iris fixation of posterior chamber intraocular lens

Single haptic iris fixation technique is used where there is a loss of 6 clock hours anterior capsular support. It helps the anterior segment surgeon to fix the intraocular lens to the iris on the side of absent capsular support and place the other haptic over the capsular support. A 10-0 polypropylene suture on a long-curved needle is only used to take a suture bite on the side of capsule loss. Meticulous automated anterior vitrectomy is done. Then, the suture loop below the iris is taken out and the loops are twirled multiple times around the haptic. The leading haptic is then gently glided behind the iris, and the trailing haptic is gently placed on the other side using forceps. The suture ends are trimmed and internalized into the anterior chamber and then externalized through the paracentesis using a Kuglen hook, and the knot is tied and secured

Self-rescue technique and Yamane’s technique in situ: Management of intraoperative haptic slippage

Haptic slippage is a frequently encountered and technically demanding complication in Yamane’s surgery. The slipped haptic could be regained when bimanual operations are workable. Management of haptic slippage is difficult when the right hand is occupied by the puncture needle, which could be solved easily with the self-rescue technique, which uses the needle tip as an intraocular instrument for better exposure and easier engagement of the slipped haptic. With the aid of bimanual operations and self-rescue technique, Yamane’s technique in situ is applicable when the haptic of dislocated intraocular lens suits for flange-making.

Identificação de Características e Propriedades Morfológicas em Texturas Táteis: Estudo sobre Gráficos Educativos e Cartografias para Crianças com Deficiência Visual / Identification of Properties and Morphological Characteristics in Tactile Textures: a Study on Educational Graphics and Cartographies for Visual Impaired Children

RESUMO: Este artigo explora as texturas táteis que têm sido utilizadas na confecção de mapas e imagens temáticas para crianças com deficiência visual no Chile nos últimos 20 anos. De um grupo representativo composto por mais de 300 lâminas de conteúdo educacional inclusivo, foram selecionadas 14 texturas para identificar sua natureza, propriedades psicofísicas e características morfológicas a partir de sua composição geométrica. O objetivo foi gerar as bases teóricas e tecnológicas relacionadas ao design e à produção digital de mapas, imagens e gráficos táteis. O trabalho buscou tipificar as formas de relevo e suas possíveis aplicações pelo uso de padrões de repetição que permitam melhorar a linguagem e o reconhecimento das texturas envolvidas com o intuito de expandir e diversificar seu uso em material educativo inclusivo no ensino e na disseminação do conhecimento por meio do toque.

ABSTRACT: This article explores the textures that have been used in the development of thematic maps and images for children with visual impairment in Chile over the last 20 years. From a representative group of more than 300 sheets of inclusive educational content, 14 textures were selected to identify their nature, psychophysical properties and morphological characteristics based on their geometric composition. The aim was to generate the theoretical and technological grounds related to the design and digital production of tactile maps, images, and graphics. The work sought to typify the embossed shapes and their possible applications by using repetition patterns that allow to improve the language and recognition of the textures involved, with the intention of expanding and diversifying their use in inclusive educational material in the teaching and dissemination of knowledge through tact.

Efecto de la retroalimentación visual sobre la velocidad de la marcha después de un accidente cerebrovascular: diseño de caso único / Effects of Visual Feedback on Walking Speed for Stroke Patients: Single-case Design

Introducción. La recuperación de la marcha es uno de los principales objetivos en rehabilitación después de un ACV. Basados en los principios de aprendizaje motor, se han desarrollado nuevas estrategias en neurorrehabilitación basadas en la práctica repetitiva, orientada a la tarea y la retroalimentación. Esto último ha demostrado ser una de las variables clave para el entrenamiento, por su fácil obtención y manipulación. Sin embargo, aún no existen estudios concluyentes que permitan identificar el efecto real de esta variable y su influencia en la recuperación y el desempeño funcional de la marcha. Objetivo. Determinar el efecto de la retroalimentación visual sobre la velocidad de la marcha después de un accidente cerebrovascular en adultos con estadios subagudos y crónicos. Metodología. Diseño de caso único de línea de base múltiple, aleatorio no concurrente de cuatro participantes. Se evaluó la velocidad de la marcha determinando las diferencias en el nivel, la tendencia, la estabilidad de los datos y la no superposición de datos mediante el análisis visual basado en la documentación técnica para diseños de caso único de la What Works Clearinghouse. Resultados. Cuatro participantes con rango de edad de 19 a 73 años fueron incluidos en el estudio. El cambio en el nivel para todos los participantes demostró un incremento en los valores de la velocidad de la marcha después de la introducción de la intervención (media: 0.76 m/s). El análisis visual de la tendencia estimó aceleración para la línea de intervención para tres participantes. Los datos en la fase de base e intervención cumplieron el criterio de estabilidad medido con el método de banda de dos desviaciones estándar (media: 0.05 m/s); los patrones de cambio demostraron efecto inmediato con mejoría gradual durante la intervención para los participantes 1, 3 y 4. El porcentaje de no superposición de datos mostró efectividad de la intervención para tres de los participantes (PND >91.67%). Conclusiones. Los hallazgos presentados en este estudio representan un aporte científico que respalda la pertinencia del uso y aplicación de los principios de aprendizaje motor para el desarrollo de nuevas estrategias en rehabilitación motora. Sin embargo, este estudio constituye un primer paso para realizar estudios más robustos que incluyan replicación de las fases en el estudio y la evaluación del seguimiento para determinar la permanencia de los efectos a largo plazo.

Introduction. Gait recovery is one of the main goals in post-stroke rehabilitation. Based on the principles of motor learning, new strategies have been developed in neurorehabilitation based on repetitive, task-oriented practice, and feedback. The latter has proven to be one of the most critical variables for training, because it is easy to obtain and manipulate. However, there are still no conclusive studies to identify the real effect of this variable and its influence on recovery and functional gait performance. Objective. To determine the effect of visual feedback on gait speed after stroke in adults with subacute and chronic stages.Methodology. Single-case, multiple baseline, non-concurrent randomized, and four-participant design. Gait velocity was assessed by determining differences in level, trend, data stability, and nonoverlapping data using visual analysis based on technical documentation for single-case designs from the What Works Clearinghouse.Results. Four participants ranging in age from 19 to 73 years were included in the study. The change in level for all participants demonstrated an increase in gait velocity values after the introduction of the intervention (mean: 0.76 m/s). Visual trend analysis estimated acceleration for the intervention line for three participants. The data in the baseline and intervention phase met the stability criterion measured with the two standard deviation band method (mean: 0.05 m/s); patterns of change demonstrated immediate effect with gradual improvement during the intervention for participants 1, 3, and 4. The percentage of nonoverlapping data showed effective-ness of the intervention for three of the participants (PND >91.67%).Conclusions. The findings presented in this study represent a scientific contribution that supports the relevance of the use and application of motor learning principles for the development of new strategies in motor rehabilitation. However, this study constitutes a first step towards more robust studies that include replication of the phases in the study and follow-up evaluation to determine the permanence of long-term effects.

A comparative study of tactile perception in blind and sighted subjects

Background: Blind people are underprivileged from visual experience and visual imaginary that result them to become more dependent on haptic system for the job of tactile perception. Thus, the self-guided tactile investigation in blind individuals enables them to recognize the shapes more rapidly than the sighted counterparts. Aim and Objectives: The aim of the study was to see the increased tactile perception among the blind than the blind folded sighted subjects. Materials and Methods: The study was carried out on 150 blind and 181 blindfolded sighted subjects. In this, each subject was instructed to arrange the aluminum oxide abrasive sand papers of different grit size having grade 60, 80, 100, 120, 140, 200, 240, 360, 400, and 600 from rough to smooth as fast and accurate as possible in seconds to express the functions of haptic sense. Results: The present study showed that the blind subjects had outperformed in terms of speed and accuracy of tactile perception. Conclusions: Lack of vision among blind individuals enables their brain to enhance the sense of vision and the previous tactile exposure and memories along with their regular practice enhance the touch perception in terms of speed and accuracy.

Evaluation of subjective vertical perception among stroke patients: a systematic review / Avaliação da percepção vertical subjetiva em pacientes com acidente vascular cerebral: uma revisão sistemática

Abstract Background: Verticality misperception is relatively common among patients after stroke, and it may be evaluated in terms of (a) subjective visual vertical (SVV), (b) subjective haptic vertical (SHV) and (c) subjective postural vertical (SPV). To better understand these assessment methods, we conducted a systematic review of the methodological characteristics of different protocols for evaluating SVV, SHV and SPV among individuals after stroke. Objective: To standardize the methodological characteristics of protocols for evaluating verticality perception after stroke. Methods: We searched the following databases: PUBMED, regional BVS portal (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index and LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Cochrane Library and PEDro. Two review authors independently used the QUADAS method (Quality Assessment of Diagnostic Accuracy Studies) and extracted data. Results: We included 21 studies in the review: most (80.9%) used SVV, eight (38.1%) used SPV and four (19.0%) used SHV. We observed high variability in assessments of verticality perception, due to patient positions, devices used, numbers of repetitions and angle of inclination for starting the tests. Conclusion: This systematic review was one of the first to explore all the methods of assessing verticality perception after stroke, and it provides crucial information on how to perform the tests, in order to guide future researchers/clinicians.

Resumo Antecedentes: A percepção errônea da verticalidade é relativamente comum em pacientes após Acidente Vascular Cerebral (AVC) e pode ser avaliada pelas: (a) vertical visual subjetiva (SVV), (b) vertical háptica subjetiva (SVH) e (c) vertical postural subjetiva (SPV). Para melhor compreender esses métodos de avaliação, realizamos uma revisão sistemática das características metodológicas de diferentes protocolos para avaliações de SVV, SHV e SVP em indivíduos após AVC. Objetivo: Padronizar as características metodológicas de protocolos de avaliação da verticalidade após AVC. Métodos: Foi realizada busca nas bases de dados PUBMED, Portal Regional da BVS (MEDLINE, LILACS, IBECS, CUBMED, Psychology Index, LIS), CINAHL, SCOPUS, Web of Science, Science Direct, Biblioteca Cochrane e PEDro. Dois revisores avaliaram independentemente o QUADAS (Avaliação da Qualidade dos Estudos de Precisão de Diagnóstico) e extraíram os resultados. Resultados: Foram incluídos 21 estudos: a maioria (80,9%) utilizando a SVV, oito (38,1%) a SPV e quatro (19,0%) a SHV. Observou-se grande variabilidade na avaliação da verticalidade, devido às posições dos pacientes, dispositivos utilizados, número de repetições e ângulo de inclinação para iniciar os testes. Conclusão: Esta revisão sistemática é uma das primeiras a explorar todos os métodos de avaliação da verticalidade após o AVC e fornece informações cruciais sobre como realizar os testes para orientar os futuros pesquisadores e clínicos.

Visual and Haptic Feedback Fusion Based on Force Tracking in Upper-limb Rehabilitation Robot System / 中国康复理论与实践

Objective:To solve the issue regarding a low correlation between visual and haptic feedback provided by the current upper-limb rehabilitation training system, this study was implemented based on the end-effector based upper-limb rehabilitation robot developed in the lab. A novel visual and haptic feedback fusion technology based on force tracking was investigated and its effect on upper-limb training was also studied. Methods:Based on the force model constructed in a virtual environment, two types of haptic feedbacks correlated to the visual feedback were designed, including the repulsive force when two objects getting close and the friction force when the object moving above medium surfaces. The haptic feedback constructed in the virtual environment was delivered to the trainees by using force tracking based on robot controlling algorithm. Eight health subjects were recruited and trained with and without feedback fusion. In the training process, the actual and expected haptic feedbacks as well as the surface electromyography (EMG) signals from anterior deltoid, posterior deltoid, biceps, and triceps were collected. The root means square error (RMSE) between the actual and expected haptic feedback was calculated under the feedback fusion training mode to characterize the force tracking-based multi-sensory feedback fusion technology. The integrated EMG values (iEMG) and EMG amplitudes per unit time (EMG/T) under two training modes were measured to explore the effect of feedback fusion technology on the upper-limb motor training. Results:Under feedback fusion training mode, the RMSE between actual and expected haptic feedback was (0.757±0.171) N. The values of iEMG from four muscles were significantly higher (|t| > 7.965, P < 0.001), and the values of EMG/T from the biceps, triceps and anterior deltoid were significantly larger under feedback fusion training mode than under the training mode without feedback fusion. Conclusion:The proposed upper-limb rehabilitation robot training system could accurately transmit the haptic feedback constructed under the virtual environment to the trainees. This system could increase the stimulation to trainees' peripheral nervous function through visual and haptic feedback fusion as well as increase the trainees' training effort. The advantages of force tracking-based visual and haptic feedback fusion technology are to freely construct the force model under the virtual environment and the haptic feedback mode is not constrained by the spatial position. Moreover, two or more types of force models can be superimposed in the same spatial position by using this technology that could improve the matching effect between haptic feedback and visual feedback under a virtual environment. The trainees' motor rehabilitation interest could be stimulated and the experience feeling of human-robot interaction could also be enhanced.

Non-Intrusive, Visual-Less Wearable Haptic Stimuli Navigational Assistance For Elderly With Dementia

@#Age is typically affiliated with the decline of cognitive function and the probability to be diagnosed with neurodegenerative disease, namely dementia. Of all dementia-related deficits, the paper highlights on the decline of wayfinding ability, since it is interrelated with mobility, autonomy, caregiving burden and eventually institutionalization. The sense of directions in elderly is also affected by the sensory changes, while the most obvious sensory declines are both vision and hearing. Hence navigation systems that support mainly on visual and auditory may not be the best option for them. A concept of wearable navigational assistance that is non-intrusive and uses haptic stimuli instead of visual and/or audio signals is presented in this paper. A Usability Test (UT) was performed towards the elderly with dementia at a selected nursing home to investigate how they perceive haptic-feedback as a modality of navigation. The assessments involved three phases: (1) orientation or training, (2) navigation test and (3) further navigation test. Results indicate the potential efficacy of haptic modality as a navigation signal. Improvement on subjects’ navigational performance was shown especially during the further navigation test, signifying the familiarization of the intervention. Employing the haptic modality could be a beneficial substitute for navigational purpose when vision and audio are less appropriate. Nevertheless, as much as the encouraging outcomes from the results and analysis of the assessments are valuable, the constructive reviews attained are indeed important for the future development of the device system.

Progress in surgical techniques for scleral fixation of intraocular lens / 国际眼科杂志(Guoji Yanke Zazhi)

@#Patients with traumatic or congenital disease lead to lens dislocation and posterior capsule rupture after cataract surgery, <i>etc</i>, which cannot be routinely implanted with intraocular lens, can be implanted with different intraocular lenses according to the condition. This article will introduce a variety of surgical methods for posterior chamber intraocular lens scleral fixation, including sutured scleral fixation, sutureless intrascleral fixation and Fibrin glue-assisted sutureless haptic intrascleral fixation. In addition, the postoperative results and complications of the above procedures will be reported and analyzed.

Integración de Un Sistema Robótico de Terapia Ocupacional para Extremidades Superiores con Estimulación Visual/Táctil de Los Pacientes / Integration of an Occupational-Therapy Robotic System for Upper Limbs with Visual/tactile Stimulation of Patients

Resumen: Los ejercicios tradicionales de rehabilitación de extremidades superiores tienen como objetivo principal recuperar la fuerza o rango de movimiento del área lesionada de los pacientes. Una opción alternativa que se ha presentado en los últimos años es el uso de interfaces hápticas, las cuales han mostrado ser herramientas potenciales en el apoyo de las terapias de rehabilitación. En este artículo se presenta un sistema de rehabilitación háptico de movimientos finos en extremidades superiores, cuya característica principal es que los usuarios del sistema pueden interactuar de forma visual y táctil con objetos virtuales mezclados con escenarios reales logrando con ello un ambiente de realidad aumentada. El sistema fue probado en dos etapas, ambas con sujetos que presentaban un grado de discapacidad en extremidades superiores. Los datos recopilados fueron trayectorias seguidas, errores de seguimiento y la actividad muscular obtenida por medio de electromiografía; esta información recolectada permitió analizar de forma cuantitativa el grado de avance de los pacientes. Además, se consideraron las valoraciones hechas por fisioterapeutas, concluyendo que el sistema propuesto puede ser utilizado como una herramienta viable que complementa a las terapias de rehabilitación convencionales.

Abstract: Traditional upper limb rehabilitation exercises are primarily aimed at regaining the strength or range of motion of the patients' injured area. An alternative option that has been presented in the last years is the use of haptic interfaces, which have shown their potential as tools that support rehabilitation therapies. This article presents a haptic system of rehabilitation for fine upper limb movements, whose main characteristic is that users of the system can interact in a visual and tactile fashion with virtual objects mixed with real scenarios, thereby achieving an augmented reality environment. The system was tested in two stages, both with subjects who had a degree of disability in upper limbs. The data collected were followed trajectories, follow-up errors and the muscular activity obtained by means of electromyography; the collected information enabled the analysis, in a quantitative way, of the degree of progress of the patients. In addition, the assessments made by physiotherapists were considered, concluding that the proposed system can be used as a viable complementary tool for conventional rehabilitation therapies.

Effect of visual occlusion and light touch on dynamic postural balance on an unstable platform in elderly and young adult women / Efeito da oclusão visual e do toque suave no equilíbrio postural dinâmico em plataforma instável de idosas e de adultas jovens

ABSTRACT Aging causes the detriment of sensory information that reflects the quality of postural control. The use of light touch has been suggested as a strategy to reduce postural sway even in the absence of vision. However, the effects of this strategy in unstable situations on the support base are unclear. The aim of this study was to analyze the effects of visual occlusion and light touch on the balance of elderly and young adult women on an unstable platform. Twenty elderly women (69.4±6.7 years) and twenty young adult women (20.6±3.2years) performed three attempts at the task which consisted of maintaining balance on an unstable platform on a bipedal base for twenty seconds, with medial-lateral perturbation, in four conditions. The Mann-Whitney U test showed that the elderly women presented worse balance compared to the young adult women in all conditions (p<0.05). The Friedman and Wilcoxon tests demonstrated worse balance with visual occlusion in both groups (p<0.05). On the other hand, there was an improvement in balance using light touch for both vision and no vision conditions (p<0.05). Both groups were able to use the haptic sensory information through light touch to assist in balance maintenance.

RESUMO O envelhecimento causa detrimento nas informações sensoriais que refletem na qualidade do controle postural. O uso do toque suave tem sido sugerido como estratégia para diminuir a oscilação postural mesmo na ausência de visão. Porém, ainda não está claro este efeito em situação de instabilidade da base de suporte. O objetivo do presente estudo foi analisar o efeito da oclusão visual e do toque suave no equilíbrio em plataforma instável de idosas e adultas jovens. Vinte idosas (69,4±6,7 anos) e vinte adultas jovens (20,6±3,2 anos) realizaram três tentativas da tarefa que consistiu em manter o equilíbrio postural dinâmico em plataforma instável, em base bipodal durante vinte segundos, com perturbação médio-lateral em 4 condições. O teste de Mann-Whitney U demonstrou que as idosas apresentaram pior desempenho no equilíbrio em comparação às adultas jovens em todas as condições (p<0,05). Os testes de Friedman e Wilcoxon demonstraram pior desempenho no equilíbrio com a oclusão visual em ambos os grupos (p<0,05). Por outro lado, houve melhora no equilíbrio com o toque tanto na condição com visão quanto sem visão (p<0,05). Ambos os grupos foram capazes de utilizar as informações sensoriais hápticas por meio do toque suave para auxiliar na manutenção do equilíbrio.

Comparison of posterior capsule folds following intracapsular implantation of three types of intraocular lenses with different haptic design / 国际眼科杂志(Guoji Yanke Zazhi)

·AIM: To compare the incidence of posterior capsule folds among different types of intraocular lens (IOL) to determine risk factors of posterior capsule folds. ·METHODS:It was a retrospective study. We collected the cases in which the patients underwent phacoemulsification (PHACO) and IOL implantation and at least one of the three types of IOL was implanted, including 2 - haptic 3 - piece IOLs (HOYA PY60AD), 4-haptic 1-piece IOLs (Bausch &Lomb AO),2-haptic 1-piece IOLs (AMO Tecnis ZCB00). The posterior capsule folds were measured using slit lamp microscope 2d after the surgery. Information of patient's age, gender, length of ocular axis, intraocular pressure, types of IOL were recorded. Posterior capsule fold risk indicators were identified by using logistic regression analysis. ·RESULTS: One hundred eighty-seven patients (242 eyes) had been collected, including 80 eyes implanted with HOYA PY60AD IOLs, 81 eyes implanted with Bausch&Lomb AO IOLs, 81 eyes implanted with AMO Tecnis ZCB00 IOLs. The incidence of posterior capsule folds of patients implanted with HOYA PY60AD IOLs was significantly higher than those of patients implanted with AMO Tecnis ZCB00 IOLs(56.3% vs 38.3%, P=0.027). While the incidence of patients implanted with Bausch &Lomb AO IOLs was significantly lower than those of patients implanted with AMO Tecnis ZCB00 IOLs(14.8% vs 38.3%, P= 0.001). Multi-factor logistics regression analysis demonstrated that independent risk factors were type of IOLs and length of ocular axis. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs increased the risk of posterior capsule folds[P=0.020,OR (95% CI)= 2. 145 ( 1. 129, 4. 073 )], while using Bausch &Lomb AO IOLs reduced the risk [P=0.001, OR (95% CI)= 0. 274 (0.127, 0. 591)]. Shorter ocular axis might increase the risk of posterior capsule folds [P =0.012,OR (95% CI)=0.669(0.489,0.915)].·CONCLUSION: Haptic design should be an important consideration in IOL design. Compared with AMO Tecnis ZCB00 IOLs, using HOYA PY60AD IOLs is more likely to lead to posterior capsule folds formation, while using Bausch & Lomb AO IOLs is less likely to lead the formation. The posterior capsule folds are more engendered in eyes with shorter ocular axis.

Development on Visuo-haptic Augmented Reality in Rehabilitation for Upper Extremities and Hands (review) / 中国康复理论与实践

@#Visuo-haptic augmented reality is an active research topic in the field of human-computer interaction, which helps to enhance the patient's realism when it is applied in the field of upper limb rehabilitation. In this paper, several existing visuo-haptic augmented reality systems on rehabilitation were compared and analyzed from the aspects of system composition, interaction modes and applicable objects.

Immediate effects of an anchor system on the stability limit of individuals with chronic dizziness of peripheral vestibular origin / Efeitos imediatos de um sistema de âncoras no limite de estabilidade de indivíduos com tontura crônica de origem vestibular periférica

Abstract Introduction The symptoms associated with chronic peripheral vestibulopathy exert a negative impact on the independence and quality of life of these individuals, and many individuals continue to suffer from these symptoms even after conventional vestibular rehabilitation. Objective To evaluate the acute effect of an anchor system for balance evaluation of patients with chronic dizziness who failed to respond to traditional vestibular rehabilitation. Methods Subjects over 50 years of age, presenting with chronic dizziness and postural instability of peripheral vestibular origin, participated in the study. The limit of stability was evaluated in three positions using the Balance Master® system: Position 1, standing with the arms along the body; Position 2, standing with the elbows bent at 90º (simulating holding the anchors); and Position 3, with the elbows bent at 90º holding the anchors. The variables of movement latency, endpoint excursion and directional control of movement were evaluated. Results Using the anchor system, significant reduction of time in the response at the beginning of the movement compared to Position 1 (p < 0.05); increased endpoint excursion in the left lateral direction compared to Position 1 (p < 0.05); and more directional control of movement in the anterior and posterior directions (p < 0.05) compared to the other positions, were found. Conclusion While using the system anchor, individuals with chronic peripheral vestibulopathy showed an immediate improvement in the stability limit in relation to the movement latency, endpoint excursion, and directional control of movement variables, suggesting that the haptic information aids postural control.

Resumo Introdução Os sintomas associados à vestibulopatia periférica crônica têm impacto negativo na independência e qualidade de vida dos indivíduos e muitos deles continuam a sofrer desses sintomas, mesmo depois de ter passado pela reabilitação vestibular convencional. Objetivo Avaliar o efeito agudo de um sistema de ancoragem para avaliação do equilíbrio de pacientes com tontura crônica que não responderam à reabilitação vestibular tradicional. Método Participaram do estudo indivíduos com mais de 50 anos que se apresentaram com tontura crônica e instabilidade postural de origem vestibular periférica. O limite de estabilidade foi avaliado em três posições, com o uso do sistema Balance Master®: Posição 1, de pé com os braços pendentes ao longo do corpo; Posição 2, de pé com os cotovelos flexionados em 90º (simulando a posição de segurar as âncoras); e Posição 3, com os cotovelos flexionados em 90º e segurando as âncoras. Foram avaliadas as variáveis de latência de movimento, o ponto final da excursão e o controle direcional do movimento. Resultados Com o uso do sistema de âncoras, ocorreu redução significante no tempo de resposta no início do movimento em comparação com a Posição 1 (p < 0,05); aumento no ponto final da excursão na direção lateral esquerda, em comparação com a Posição 1 (p < 0,05); e mais controle direcional do movimento nas direções anterior e posterior (p < 0,05), em comparação com as demais posições. Conclusão Enquanto usavam o sistema de âncoras, os indivíduos com vestibulopatia periférica demonstraram melhoria imediata no limite da estabilidade em relação às variáveis latência de movimento, ponto final da excursão e controle direcional do movimento. Isso sugere que a informação háptica auxilia no controle postural.

Development of a Robotic Colonoscopic Manipulation System, Using Haptic Feedback Algorithm

PURPOSE: Colonoscopy is one of the most effective diagnostic and therapeutic tools for colorectal diseases. We aim to propose a master-slave robotic colonoscopy that is controllable in remote site using conventional colonoscopy. MATERIALS AND METHODS: The master and slave robot were developed to use conventional flexible colonoscopy. The robotic colonoscopic procedure was performed using a colonoscope training model by one expert endoscopist and two unexperienced engineers. To provide the haptic sensation, the insertion force and the rotating torque were measured and sent to the master robot. RESULTS: A slave robot was developed to hold the colonoscopy and its knob, and perform insertion, rotation, and two tilting motions of colonoscope. A master robot was designed to teach motions of the slave robot. These measured force and torque were scaled down by one tenth to provide the operator with some reflection force and torque at the haptic device. The haptic sensation and feedback system was successful and helpful to feel the constrained force or torque in colon. The insertion time using robotic system decreased with repeated procedures. CONCLUSION: This work proposed a robotic approach for colonoscopy using haptic feedback algorithm, and this robotic device would effectively perform colonoscopy with reduced burden and comparable safety for patients in remote site.

Comparison of Anterior Capsule Stability Following Implantation of Three Single Piece Acrylic Intraocular Lenses with Different Haptic Design

PURPOSE: To compare the anterior capsule contraction and intraocular lens (IOL) decentration among three types of IOL to determine the influence of haptic design on anterior capsule stability. METHODS: One hundred fifty patients were enrolled in this prospective, randomized study and 260 eyes underwent implantation of one of the following IOLs: modified L-haptic IOL (n = 74), modified C-haptic IOL (n = 97), or a plate-haptic IOL (n = 89). The area of the anterior capsule opening, IOL decentration, and capsule overlap were measured using retroillumination photospot 1 day and 2 months after cataract surgery. RESULTS: The area of capsule opening at postoperative day 1 was significantly different between the three IOLs (p < 0.01). All IOLs showed reduction of the anterior capsule opening from 1 day to 2 months after surgery, and greater reduction was shown in the modified C-haptic IOL (p < 0.001). At postoperative month 2, IOL decentration was significantly different between the IOLs and showed a positive correlation with the mean area reduction during month 2. CONCLUSIONS: The degree of anterior capsule contraction and IOL decentration in modified L-haptic IOLs were less than those in modified C-haptic IOLs and comparable to those in plate-haptic IOLs.

Grasp torque control based on experiential learning and haptic feedback / 医疗卫生装备

Objective To propose a grasp torque control based on experimental learning and haptic feedback to facilitate the manipulator in dexterous manipulation.Methods An experience database was built firstly,and then the object was recognized by tactile feedback in the grasp task.If the object had been experitentially grasped,the torque was output based on the database.In case a new object was grasped,the optimal output torque was calculated by iterative learning.Results The experiment showed that the robot hand could find the experiential output torque quickly when encountering the object in database and calculate the torque by iterative learning to achieve grasp task.Conclusion The experiential database grows up when the robot hand learns more and more experience.It can fast output torque like human in the grasp task.

The “correct shake” for “handshake” in glued intrascleral fixation of intraocular lens.

We hereby describe the correct method to perform a “handshake technique” and easy transfer of haptics from one hand to another for glued intrascleral fixation of an intraocular lens (glued IOL). The procedure was implemented in 57 cases that necessitated the application of performing a glued IOL procedure and it resulted in an appropriate and easy externalization of haptic in all the cases. The surgeons’ positioning with reference to the scleral flap is an essential component and the surgeon should always be positioned perpendicular to the plane of scleral flaps and the plane of haptic maneuver. The surgeons who intend to perform glued IOL should adopt this technical point.