Stroke rehabilitation does not often integrate both sensory and motor recovery. While subthreshold noise was shown to enhance sensory signal detection at the site of noise application, having a noise-generating device at the fingertip to enhance fingertip sensation and potentially enhance dexterity for stroke survivors is impractical, since the device would interfere with object manipulation. This study determined if remote application of subthreshold vibrotactile noise (away from the fingertips) improves fingertip tactile sensation with potential to enhance dexterity for stroke survivors. Index finger and thumb pad sensation was measured for ten stroke survivors with fingertip sensory deficit using the Semmes-Weinstein Monofilament and Two-Point Discrimination Tests. Sensation scores were measured with noise applied at one of three intensities (40%, 60%, 80% of the sensory threshold) to one of four locations of the paretic upper extremity (dorsal hand proximal to the index finger knuckle, dorsal hand proximal to the thumb knuckle, dorsal wrist, volar wrist) in a random order, as well as without noise at beginning (Pre) and end (Post) of the testing session. Vibrotactile noise of all intensities and locations instantaneously and significantly improved Monofilament scores of the index fingertip and thumb tip (p < .01). No significant effect of the noise was seen for the Two-Point Discrimination Test scores. Remote application of subthreshold (imperceptible) vibrotactile noise at the wrist and dorsal hand instantaneously improved stroke survivors' light touch sensation, independent of noise location and intensity. Vibrotactile noise at the wrist and dorsal hand may have enhanced the fingertips' light touch sensation via stochastic resonance and interneuronal connections. While long-term benefits of noise in stroke patients warrants further investigation, this result demonstrates potential that a wearable device applying vibrotactile noise at the wrist could enhance sensation and grip ability without interfering with object manipulation in everyday tasks.

User gait phase estimation plays a key role for the seamless control of the lower-limb robotic assistive devices (e.g., exoskeletons or prostheses) during ambulation. To achieve this, several studies have attempted to estimate the gait phase using a thigh or shank angle. However, their estimation resulted in some deviation from the actual walking and varied across the walking speeds. In this study, we investigated the different setups using for the machine learning approach to obtain more accurate and consistent gait phase estimation for the robotic transfemoral prosthesis over different walking speeds. Considering the transfemoral prosthetic application, we proposed two different sensor setups: i) the angular positions and velocities of both thigh and torso (S1) and ii) the angular positions and velocities of both thigh and torso, and heel force data (S2). The proposed setups and method are experimentally evaluated with three healthy young subjects at four different walking speeds: 0.5, 1.0, 1.5, and 2.0 m/s. Both results showed robust and accurate gait phase estimation with respect to the ground truth (loss value of S1: 4.54e-03 Vs. S2: 4.70e-03). S1 had the advantage of a simple equipment setup using only two IMUs, while S2 had the advantage of estimating more accurate heel-strikes than S1 by using additional heel force data. The choice between the two sensor setups can depend on the researchers' preference in consideration of the device setup or the focus of the interest.

Falling accidents are costly due to their prevalence in the workplace. Slipping has been known to be the main cause of falling. Understanding the motor response used to regain balance after slipping is crucial to developing intervention strategies for effective recovery. Interestingly, studies on spinalized animals and studies on animals subjected to electrical microstimulation have provided major evidence that the Central Nervous System (CNS) uses motor primitives, such as muscle synergies, to control motor tasks. Muscle synergies are thought to be a critical mechanism used by the CNS to control complex motor tasks by reducing the dimensional complexity of the system. Even though synergies have demonstrated potential for indicating how the body responds to balance perturbations by accounting for majority of the data set’s variability, this concept has not been applied to slipping. To address this gap, data from 11 healthy young adults were collected and analyzed during both unperturbed walking and slipping. Applying an iterative nonnegative matrix decomposition technique, four muscle synergies and the corresponding time-series activation coefficients were extracted. The synergies and the activation coefficients were then compared between baseline walking and slipping to determine shared versus task-specific synergies. Correlation analyses found that among four synergies, two synergies were shared between normal walking and slipping. However, the other two synergies were task-specific. Both limbs were contributing to each of the four synergies, suggesting substantial inter-limb coordination during gait and slip. These findings stay consistent with previous unilateral studies that reported similar synergies between unperturbed and perturbed walking. Activation coefficients corresponding to the two shared synergies were similar between normal walking and slipping for the first 200ms after heel contact and differed later in stance, suggesting the activation of muscle synergies in response to a slip. A muscle synergy approach would reveal the used sub-tasks during slipping, facilitating identification of impaired sub-tasks and potentially leading to a purposeful rehabilitation based on damaged sub-functions.

Phase variables are continuous real-valued functions which parameterize the gait cycle. As such, they can be used to estimate a powered prosthesis user's walking state. It is common to represent the phase variable as a function of the thigh angle. This approach assumes the thigh angle profile and its integral to be sinusoids. However, this assumption does not hold at lower walking speeds which leads to inaccurate heel-strike detection. In this study, we show that the thigh angle and its integral are phase-shifted from the ideal sinusoids by analyzing both able-bodied and amputee walking data. We then propose a novel phase variable incorporating phase-shift that is accurate even at lower walking speeds. We tested two variants of the proposed phase-shifted phase variable on a transfemoral prosthesis in an emulator study. Results show that phase-shifting improves heel-strike detection. Additionally, phase-shifting improves the linearity of the phase variable over the gait cycle. Analysis of the knee and ankle phase portraits showed that phase-shifting results in fewer deviations from the limit cycle.

Neurological disorders are the leading causes of poor balance. Previous studies have shown that biofeedback can compensate for weak or missing sensory information in people with sensory deficits. These biofeedback inputs can be easily recognized and converted into proper information by the central nervous system (CNS), which integrates the appropriate sensorimotor information and stabilizes the human posture. In this study, we proposed a form of cutaneous feedback which stretches the fingertip pad with a rotational contactor, so-called skin stretch. Skin stretch at a fingertip pad can be simply perceived and its small contact area makes it favored for small wearable devices. Taking advantage of skin stretch feedback, we developed a portable sensory augmentation device (SAD) for rehabilitation of balance. SAD was designed to provide postural sway information through additional skin stretch feedback. To demonstrate the feasibility of the SAD, quiet standing on a force plate was evaluated while sensory deficits were simulated. Fifteen healthy young adults were asked to stand quietly under six sensory conditions: three levels of sensory deficits (normal, visual deficit, and visual + vestibular deficits) combined with and without augmented sensation provided by SAD. The results showed that augmented sensation via skin stretch feedback helped subjects correct their posture and balance, especially as the deficit level of sensory feedback increased. These findings demonstrate the potential use of skin stretch feedback in balance rehabilitation.