Distinct Kinematic and Neuromuscular Activation Strategies During Quiet Stance and in Response to Postural Perturbations in Healthy Individuals Fitted With and Without a Lower-Limb Exoskeleton.

Many individuals with disabling conditions have difficulty with gait and balance control that may result in a fall. Exoskeletons are becoming an increasingly popular technology to aid in walking. Despite being a significant aid in increasing mobility, little attention has been paid to exoskeleton features to mitigate falls. To develop improved exoskeleton stability, quantitative information regarding how a user reacts to postural challenges while wearing the exoskeleton is needed. Assessing the unique responses of individuals to postural perturbations while wearing an exoskeleton provides critical information necessary to effectively accommodate a variety of individual response patterns. This report provides kinematic and neuromuscular data obtained from seven healthy, college-aged individuals during posterior support surface translations with and without wearing a lower limb exoskeleton. A 2-min, static baseline standing trial was also obtained. Outcome measures included a variety of 0 dimensional (OD) measures such as center of pressure (COP) RMS, peak amplitude, velocities, pathlength, and electromyographic (EMG) RMS, and peak amplitudes. These measures were obtained during epochs associated with the response to the perturbations: baseline, response, and recovery. T-tests were used to explore potential statistical differences between the exoskeleton and no exoskeleton conditions. Time series waveforms (1D) of the COP and EMG data were also analyzed. Statistical parametric mapping (SPM) was used to evaluate the 1D COP and EMG waveforms obtained during the epochs with and without wearing the exoskeleton. The results indicated that during quiet stance, COP velocity was increased while wearing the exoskeleton, but the magnitude of sway was unchanged. The OD COP measures revealed that wearing the exoskeleton significantly reduced the sway magnitude and velocity in response to the perturbations. There were no systematic effects of wearing the exoskeleton on EMG. SPM analysis revealed that there was a range of individual responses; both behaviorally (COP) and among neuromuscular activation patterns (EMG). Using both the OD and 1D measures provided a more comprehensive representation of how wearing the exoskeleton impacts the responses to posterior perturbations. This study supports a growing body of evidence that exoskeletons must be personalized to meet the specific capabilities and needs of each individual end-user.

Effects of an exoskeleton-assisted gait training on post-stroke lower-limb muscle coordination.

Objective.Powered exoskeletons have been used to help persons with gait impairment regain some walking ability. However, little is known about its impact on neuromuscular coordination in persons with stroke. The objective of this study is to investigate how a powered exoskeleton could affect the neuromuscular coordination of persons with post-stroke hemiparesis.Approach.Eleven able-bodied subjects and ten stroke subjects participated in a single-visit treadmill walking assessment, in which their motion and lower-limb muscle activities were captured. By comparing spatiotemporal parameters, kinematics, and muscle synergy pattern between two groups, we characterized the normal gait pattern and the post-stroke motor deficits. Five eligible stroke subjects received exoskeleton-assisted gait trainings and walking assessments were conducted pre-intervention (Pre) and post-intervention (Post), without (WO) and with (WT) the exoskeleton. We compared their gait performance between (a) Pre and Post to investigate the effect of exoskeleton-assisted gait training and, (b) WO and WT the exoskeleton to investigate the effect of exoskeleton wearing on stroke subjects.Main results.While four distinct motor modules were needed to describe lower-extremity activities during stead-speed walking among able-bodied subjects, three modules were sufficient for the paretic leg from the stroke subjects. Muscle coordination complexity, module composition and activation timing were preserved after the training, indicating the intervention did not significantly change the neuromuscular coordination. In contrast, walking WT the exoskeleton altered the stroke subjects' synergy pattern, especially on the paretic side. The changes were dominated by the activation profile modulation towards the normal pattern observed from the able-bodied group.Significance.This study gave us some critical insight into how a powered exoskeleton affects the stroke subjects' neuromuscular coordination during gait and demonstrated the potential to use muscle synergy as a method to evaluate the effect of the exoskeleton training.This study was registered at ClinicalTrials.gov (identifier: NCT03057652).

Characterization and real-time removal of motion artifacts from EEG signals.

OBJECTIVE: Accurate implementation of real-time non-invasive brain-machine/computer interfaces (BMI/BCI) requires handling physiological and nonphysiological artifacts associated with the measurement modalities. For example, scalp electroencephalographic (EEG) measurements are often considered prone to excessive motion artifacts and other types of artifacts that contaminate the EEG recordings. Although the magnitude of such artifacts heavily depends on the task and the setup, complete minimization or isolation of such artifacts is generally not possible. APPROACH: We present an adaptive de-noising framework with robustness properties, using a Volterra based non-linear mapping to characterize and handle the motion artifact contamination in EEG measurements. We asked healthy able-bodied subjects to walk on a treadmill at gait speeds of 1-to-4 mph, while we tracked the motion of select EEG electrodes with an infrared video-based motion tracking system. We also placed inertial measurement unit (IMU) sensors on the forehead and feet of the subjects for assessing the overall head movement and segmenting the gait. MAIN RESULTS: We discuss in detail the characteristics of the motion artifacts and propose a real-time compatible solution to filter them. We report the effective handling of both the fundamental frequency of contamination (synchronized to the walking speed) and its harmonics. Event-related spectral perturbation (ERSP) analysis for walking shows that the gait dependency of artifact contamination is also eliminated on all target frequencies. SIGNIFICANCE: The real-time compatibility and generalizability of our adaptive filtering framework allows for the effective use of non-invasive BMI/BCI systems and greatly expands the implementation type and application domains to other types of problems where signal denoising is desirable. Combined with our previous efforts of filtering ocular artifacts, the presented technique allows for a comprehensive adaptive filtering framework to increase the EEG signal to noise ratio (SNR). We believe the implementation will benefit all non-invasive neural measurement modalities, including studies discussing neural correlates of movement and other internal states, not necessarily of BMI focus.

A robust adaptive denoising framework for real-time artifact removal in scalp EEG measurements.

OBJECTIVE: Non-invasive measurement of human neural activity based on the scalp electroencephalogram (EEG) allows for the development of biomedical devices that interface with the nervous system for scientific, diagnostic, therapeutic, or restorative purposes. However, EEG recordings are often considered as prone to physiological and non-physiological artifacts of different types and frequency characteristics. Among them, ocular artifacts and signal drifts represent major sources of EEG contamination, particularly in real-time closed-loop brain-machine interface (BMI) applications, which require effective handling of these artifacts across sessions and in natural settings. APPROACH: We extend the usage of a robust adaptive noise cancelling (ANC) scheme ([Formula: see text] filtering) for removal of eye blinks, eye motions, amplitude drifts and recording biases simultaneously. We also characterize the volume conduction, by estimating the signal propagation levels across all EEG scalp recording areas due to ocular artifact generators. We find that the amplitude and spatial distribution of ocular artifacts vary greatly depending on the electrode location. Therefore, fixed filtering parameters for all recording areas would naturally hinder the true overall performance of an ANC scheme for artifact removal. We treat each electrode as a separate sub-system to be filtered, and without the loss of generality, they are assumed to be uncorrelated and uncoupled. MAIN RESULTS: Our results show over 95-99.9% correlation between the raw and processed signals at non-ocular artifact regions, and depending on the contamination profile, 40-70% correlation when ocular artifacts are dominant. We also compare our results with the offline independent component analysis and artifact subspace reconstruction methods, and show that some local quantities are handled better by our sample-adaptive real-time framework. Decoding performance is also compared with multi-day experimental data from 2 subjects, totaling 19 sessions, with and without [Formula: see text] filtering of the raw data. SIGNIFICANCE: The proposed method allows real-time adaptive artifact removal for EEG-based closed-loop BMI applications and mobile EEG studies in general, thereby increasing the range of tasks that can be studied in action and context while reducing the need for discarding data due to artifacts. Significant increase in decoding performances also justify the effectiveness of the method to be used in real-time closed-loop BMI applications.

Real-time strap pressure sensor system for powered exoskeletons.

Assistive and rehabilitative powered exoskeletons for spinal cord injury (SCI) and stroke subjects have recently reached the clinic. Proper tension and joint alignment are critical to ensuring safety. Challenges still exist in adjustment and fitting, with most current systems depending on personnel experience for appropriate individual fastening. Paraplegia and tetraplegia patients using these devices have impaired sensation and cannot signal if straps are uncomfortable or painful. Excessive pressure and blood-flow restriction can lead to skin ulcers, necrotic tissue and infections. Tension must be just enough to prevent slipping and maintain posture. Research in pressure dynamics is extensive for wheelchairs and mattresses, but little research has been done on exoskeleton straps. We present a system to monitor pressure exerted by physical human-machine interfaces and provide data about levels of skin/body pressure in fastening straps. The system consists of sensing arrays, signal processing hardware with wireless transmission, and an interactive GUI. For validation, a lower-body powered exoskeleton carrying the full weight of users was used. Experimental trials were conducted with one SCI and one able-bodied subject. The system can help prevent skin injuries related to excessive pressure in mobility-impaired patients using powered exoskeletons, supporting functionality, independence and better overall quality of life.

Neural decoding of treadmill walking from noninvasive electroencephalographic signals.

Chronic recordings from ensembles of cortical neurons in primary motor and somatosensory areas in rhesus macaques provide accurate information about bipedal locomotion (Fitzsimmons NA, Lebedev MA, Peikon ID, Nicolelis MA. Front Integr Neurosci 3: 3, 2009). Here we show that the linear and angular kinematics of the ankle, knee, and hip joints during both normal and precision (attentive) human treadmill walking can be inferred from noninvasive scalp electroencephalography (EEG) with decoding accuracies comparable to those from neural decoders based on multiple single-unit activities (SUAs) recorded in nonhuman primates. Six healthy adults were recorded. Participants were asked to walk on a treadmill at their self-selected comfortable speed while receiving visual feedback of their lower limbs (i.e., precision walking), to repeatedly avoid stepping on a strip drawn on the treadmill belt. Angular and linear kinematics of the left and right hip, knee, and ankle joints and EEG were recorded, and neural decoders were designed and optimized with cross-validation procedures. Of note, the optimal set of electrodes of these decoders were also used to accurately infer gait trajectories in a normal walking task that did not require subjects to control and monitor their foot placement. Our results indicate a high involvement of a fronto-posterior cortical network in the control of both precision and normal walking and suggest that EEG signals can be used to study in real time the cortical dynamics of walking and to develop brain-machine interfaces aimed at restoring human gait function.

Toward improved sensorimotor integration and learning using upper-limb prosthetic devices.

To harness the increased dexterity and sensing capabilities in advanced prosthetic device designs, amputees will require interfaces supported by novel forms of sensory feedback and novel control paradigms. We are using a motorized elbow brace to feed back grasp forces to the user in the form of extension torques about the elbow. This force display complements myoelectric control of grip closure in which EMG signals are drawn from the biceps muscle. We expect that the action/reaction coupling experienced by the biceps muscle will produce an intuitive paradigm for object manipulation, and we hope to uncover neural correlates to support this hypothesis. In this paper we present results from an experiment in which 7 able-bodied persons attempted to distinguish three objects by stiffness while grasping them under myoelectric control and feeling reaction forces displayed to their elbow. In four conditions (with and without force display, and using biceps myoelectric signals ipsilateral and contralateral to the force display,) ability to correctly identify objects was significantly increased with sensory feedback.