Name: a human-machine-interface integrating low-cost sensors with a neuromuscular electrical stimulation system for post-stroke balance rehabilitation
Uploaded: 2016-04-12T13:00:00
Description: Watch this Scientific Journal Video about A Human-machine-interface Integrating Low-cost Sensors with a Neuromuscular Electrical Stimulation System for Post-stroke Balance Rehabilitation at JoVE.com

CEFIPRAの傘の下で、CNRS、INRIA、およびDSTでサポートされ、ICST - 研究は、情報通信科学技術共同目標とプログラムのコンテキスト内で行いました。著者らは、実験の開発に向けて、学生、特にRahima Sidiboulenouar、Rishabhセーガル、およびGorishアガルワルのサポートを感謝したいです。

注：HMIソフトウェア・パイプラインは、自由に利用できるオープンソース・ソフトウェアのオンとオフザシェルフ低コストのビデオゲームセンサーベースに開発された（で入手可能な詳細：https://team.inria.fr/nphys4nrehab/software/とhttps： //github.com/NeuroPhys4NeuroRehab/JoVE）。 HMIソフトウェア・パイプラインは、視覚運動バランス療法（VBT）8のためのVRベースのゲームプラットフォームで修飾さ...

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D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+PREP+algorithm+predicts+potential+for+upper+limb+recovery+after+stroke.">The PREP algorithm predicts potential for upper limb recovery after stroke.</a> Brain: A Journal of Neurology. 135 ((Pt 8)), 2527-2535 (2012).</li><li>Dutta, A., Lahiri, D., Kumar, U., Das, A., Padma, M. V. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Post-stroke+engagement-sensitive+balance+rehabilitation+under+an+adaptive+multi-level+electrotherapy:+clinical+hypothesis+and+computational+framework.">Post-stroke engagement-sensitive balance rehabilitation under an adaptive multi-level electrotherapy: clinical hypothesis and computational framework.</a> Neuroscience and Biomedical Engineering. 2 (2), 68-80 (2015).</li></ol>

運動とバランスの治療のために簡単に使用できる、臨床的に有効な低コストのツールは、低リソース設定で神経リハビリテーションのためのパラダイムシフトになります。脳卒中のような神経疾患が劇的に起因する世界の人口2の高齢化に今後も増加するので、非常に高い社会的影響力を持っている可能性があります。能力は、カスタマイズ、モニタ、および最近では通信を介して、?...

局所脳、脊髄、または網膜梗塞によって引き起こされる神経機能障害のエピソードは、ストローク1と呼ばれています。脳卒中は、世界的な健康問題や障害、世界中の1の第四の主要な原因です。インドや中国、世界の二つの最も人口の多い国のような国では、脳卒中による神経性障害が隠さ流行2としてラベル付けされています。脳卒中後の最も一般的な合併症の一つは、脳卒中後3初年度で最大73％の報告された発生率と滝です。脳卒中後の秋には、多因子であり、バランスと視空間無視4のような脊髄と脊柱上の要因の両方が含まれます。 Geurtsと1を同定した同僚5による審査）は、多方向二足立ち、2）低速、3）方 ​​向の不正確さ、との間にシフトする最大の重量を損なわ4）バランスのような単一の環状サブ最大前頭面重量シフトの小さな振幅秋の里のための要因SK。前の作品はそのバランスが粗大運動機能5、6における歩行能力と独立性と関連しているが示されているので、日常生活の活動に必然的な影響が重要になります。また、Geurtsや同僚5は筋力に加えて、脊柱上の多感覚統合（と筋肉の協調7）は現在のプロトコルに欠けているバランスの回復のために重要であることを示唆しました。多感覚統合に向けて、volitionally駆動非侵襲的な電気治療上の我々の仮説8（NMES / SES）は、この適応行動が形となるよう患肢のNMES / SES支援運動時の感覚入力のアクティブな知覚を調節することによって容易にすることができるということです脳は、必要に応じて、代替のモータ経路9を補充することによって、その後の運動出力にこのフィードバックを組み込むことができます。 リソースでvolitionally駆動NMES / SES支援バランストレーニングを達成するために、乏しい設定、低コストのヒューマン・マシン・インタフェース（HMI）は、利用可能なオープンソースソフトウェアと視覚聴覚バイオフィードバックのための既製のビデオゲームのセンサー技術の最近の進歩を活用して開発されました。 NMESは、筋力を改善し、痙性10を減少させることが示されている神経と筋肉の協調電気刺激を含みます。また、SESは予備公開されたワーク11が単独で前脛骨筋の上に適用subsensory刺激が重心動揺を減衰させるのに有効であることが示された感覚を呼び起こすために電流と感覚神経を刺激することを含みます。ここでは、HMIは、（NMES付き）筋肉アンプとして動作するだけでなく、（SESで）求心性フィードバックを強化する足首の筋肉のためのNMES / SESをvolitionally方式の対話的な脳卒中後のバランス療法の中に可能感覚運動統合を行います姿勢の揺れの間に直立姿勢を維持するために、健康的な足関節戦略12,13,14を支援します 。これはDuttaさんら 8に提示仮説に基づいて、非侵襲的な電気治療を通じてもたらさ関連足首の筋肉の増加皮質興奮は足首剛性の改善された脊柱上の変調に貸すことができること。確かに、従来の研究は、NMES / SESはおそらく共同活性化運動感覚繊維15,16の結果として、皮質興奮性の持続的な変化を誘発することを示しています。また、KhaslavskaiaとSinkjaer 17は、NMES / SESの時に存在同時モータ皮質ドライブはモータ皮質の興奮性を高めたこと、ヒトにおいて示されました。したがって、volitionallyドリブンNMES / SESは、脊髄反射の短期的な神経可塑性を誘導することができる（ 例えば 、相反Iaの阻害17）与えられた運動ニューロンプールに経路を降順を経由して投影する皮質ニューロンがでIA-抑制介在ニューロンを介した拮抗運動ニューロンプールを阻害することができますOに向かって、 図1に示すように、18の人間perantコンディショニングパラダイム（Duttaさんら 8を参照してください）。 <img alt="図1" src="/files/ftp_upload/52394/52394fig1.jpg" /> 図1：volitionally駆動神経筋電気刺激（NMES）の下で足首の筋肉の調整を改善するための概念、基礎となるインタラクティブなヒューマン・マシン・インタフェース（HMI）（Duttaさんら 21で詳細は。）圧力中心（COP）を駆動するためのきっかけとターゲットにカーソル-assisted視覚運動バランス療法EEG：脳波、MN：α-運動ニューロン、IN：IA-抑制介在ニューロン、EMG：電、DRG：脊髄後根神経節。 8および37から再生される。 <a href="https://www.jove.com/files/ftp_upload/52394/52394fig1large.jpg" target="_blank">この図の拡大版をご覧になるにはこちらをクリックしてください。</a> 前後（AP）質量（COM）の中央の変位が行われます足首（例えば内側腓腹筋やヒラメ筋など）plantarflexorsと（そのような前脛骨筋など）背屈筋によって内外方向（ML）の変位が足首（例えば前脛骨筋など）イン​​バータや、長腓骨筋としてevertors（によって行われている間そして、）筋肉をブレビス。その結果、筋肉背屈筋足首の弱さと足首の増加痙性plantarflexor筋肉を含む脳卒中に関連した足首の障害は、障害のある姿勢制御につながります。ここでは、敏捷性のトレーニングプログラム6は、転倒6を防止するのに静的ストレッチング/体重移動する運動プログラムよりも効果的かもしれタスクが次第に困難に増加している動的なバランスに挑戦（VR）ベースのゲームのプラットフォームは、仮想現実で活用することができます。例えば、被験者は難易度が次第にアメルする増大させることができる動的な視覚運動バランスタスク中volitionally駆動NMES / SES支援APとMLの変位を行うことができます二足スタンディング時の体重移動でiorate脳卒中後足首固有の制御の問題。資源の乏しい設定でvolitionally駆動NMES / SES支援バランス療法に向けて、我々は提示も低からのデータ収集に使用することができ、視覚的、聴覚バイオフィードバックに向けたモバイル脳/ボディイメージング（モビ）19、のための低コストのHMI MoBILABでオフラインデータ探索のためのコストセンサ（オヘダら 。20を参照のこと ）。

<table border="0" cellpadding="0" cellspacing="0">
	<tbody>
		<tr>
			<td>NMES stimulator</td>
			<td>Vivaltis, France</td>
			<td>PhenixUSBNeo</td>
			<td>NMES stimulator cum EMG sensor (Figure 2b)</td>
		</tr>
		<tr>
			<td>Balance Board</td>
			<td>Nintendo, USA</td>
			<td>Wii Balance Board</td>
			<td>Balance Board (Figure 2b)</td>
		</tr>
		<tr>
			<td>Motion Capture</td>
			<td>Microsoft, USA</td>
			<td>XBOX-360 Kinect</td>
			<td>Motion Capture (Figure 2b)</td>
		</tr>
		<tr>
			<td>Eye Tracker&#160;</td>
			<td>Eye Tribe</td>
			<td>The Eye Tribe</td>
			<td>SmartEye Tracker (Figure 2a)</td>
		</tr>
		<tr>
			<td>EEG Data Acquisition System</td>
			<td>Emotiv, Australia</td>
			<td>Emotiv Neuroheadset</td>
			<td>Wireless EEG headset (Figure 2b)</td>
		</tr>
		<tr>
			<td>EEG passive electrode</td>
			<td>Olimex</td>
			<td>EEG-PE</td>
			<td>EEG passive electrode for EOG and references (6 in number)(Figure 2b)</td>
		</tr>
		<tr>
			<td>EEG active electrode</td>
			<td>Olimex</td>
			<td>EEG-AE</td>
			<td>EEG active electrode (10 in number)(Figure 2b)</td>
		</tr>
		<tr>
			<td>Computer with PC monitor</td>
			<td>Dell</td>
			<td></td>
			<td>Data processing and visual feedback (Figure 2)</td>
		</tr>
		<tr>
			<td>Softwares, EMG electrodes, NMES electrodes, and cables</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
	</tbody>
</table>

a human-machine-interface integrating low-cost sensors with a neuromuscular electrical stimulation system for post-stroke balance rehabilitation

脳卒中は、脳のバースト内の領域または凝固さ、心臓から血液を運ぶ動脈は、それによって酸素と栄養の供給を防止する脳への血流を妨げたとき。引き起こされます脳卒中生存者の約半数は、障害のいくつかの学位を取得して残されています。修復神経リハビリテーションのための革新的な方法論が緊急長期障害を軽減するために必要とされます。内因性または外因性の刺激への応答として、その構造、機能および接続を再編成する神経系の能力は神経可塑性と呼ばれています。神経可塑性はなく、リハビリで、脳卒中後の機能障害に関与しています。有益neuroplastic変化は、神経筋電気刺激（NMES）及び感覚電気刺激（SES）などの非侵襲的な電気療法を用いて容易に行うことができます。 NMESは、SES invoながら電流を連続的に短いパルスでそれらを有効にするには運動神経と筋肉の協調電気刺激を必要とします非常に不快にかろうじて知覚によって異なる感覚が得られる電流と感覚神経の刺激をLVES。ここでは、リハビリテーションの手続きに積極的に皮質の参加は、アクティブな同時知覚と意志の努力を表す生体信号と非侵襲的電気治療（電（EMG）、脳波（EEG）、電図（EOG））を駆動することにより容易にすることができます。資源の乏しい環境で 、 例えばこれを達成するために、低・中所得国では、我々は、既製のビデオゲームのセンサー技術の最近の進歩を活用することで低コストのヒューマン・マシン・インタフェース（HMI）を提示します。本稿では、バランスのリハビリ中に姿勢制御を支援するための非侵襲的な電気治療と視覚、聴覚バイオフィードバックのための低コストの既製のセンサーを統合するオープン・ソース・ソフトウェア・インタフェースについて説明します。私たちは、概念実証健康なボランティアにを実証します。

図4は、円滑追跡タスク中に健常性能の定量化のためにオフラインで抽出された視線の機能を示します。 表1に示されるように、以下の特徴を抽出しました。 機能1 =標的刺激位置と刺激が、水平方向の位置を変更している参加者の注視点の重心との間の百分率偏差。 <p class="jove_content" fo:keep-toget...

Watch this Scientific Journal Video about A Human-machine-interface Integrating Low-cost Sensors with a Neuromuscular Electrical Stimulation System for Post-stroke Balance Rehabilitation at JoVE.com

A Human-machine-interface Integrating Low-cost Sensors with a Neuromuscular Electrical Stimulation System for Post-stroke Balance Rehabilitation

A novel low-cost human-machine interface for interactive post-stroke balance rehabilitation system is presented in this article. The system integrates off-the-shelf low-cost sensors towards volitionally driven electrotherapy paradigm. The proof-of-concept software interface is demonstrated on healthy volunteers.

脳卒中後のバランスリハビリテーションのための神経筋電気刺激システムで低コストのセンサーを統合ヒューマンマシンインターフェース

A stroke is caused when an artery carrying blood from heart to an area in the brain bursts or a clot obstructs the blood flow to brain thereby preventing ...

The overall goal of this procedure is to apply video game sensor technology towards a low cost human machine interface for balance rehabilitation. This is accomplished by first setting up mobile brain body imaging, or MoBI equipment, and software. The second step is to place MoBI sensors on the body to capture physiological data.Next, an eye tracker is used to evaluate post stroke visual pursuit eye movements. Eye tracking will show that gaze related indices can help in delineating post-stroke oculomotor deficits, which may be relevant for planning visuomotor balance therapy. Then, sensors for neuromuscular electrical stimulation, or NMES, assisted in visuomotor balance therapy, under MoBI, are calibrated.The final step is to collect multi-sensor data from low cost sensors during visuomotor balance therapy. We are extending this technology for our home base rehabilitation for stroke patients who suffer from balance loss. Our system includes gaze based, prognostic dual, and one gaze spectrum as an important ingredient in visuomotor balance therapy.So this paradigm shifting technology captures how the visual system, the motor system, and the balance systems walks together after stroke and tries to rehabilitate them through training. So in principle, this technic can be used in other conditions, like Autism Spectrum Disorder, Parkinsonism, Traumatic Brain Injury, and also psychomotor disturbance due to depression. All can be rehabilitated in this training system.Begin by obtaining a projection screen to display the visual bio feedback. Adjust the height so that the center of the screen will be at the subject's eye level. Then place the motion caption sensor in front of the projection screen and aim it at the volume of motion capture.Confirm that the volume of motion capture is 1.5 meters to 2.5 meters in front of the motion capture sensor. Next, place the balance board on the floor, about 2.0 meters away from the motion capture sensor. Leave enough room around the balance board to ensure full body movement.To begin sensor placement for electromyography, or EMG, in the NMES system, ask the subject to sit on a chair. Place the EMG and NMES electrodes bilaterally on the Medial Gastrocnemius and Tibialis Anterior muscles of the subject. Then, connect the electrodes to the wireless NMES simulator system.Next, place the electroencephalogram, or EEG cap, on the subject's head by following the international 10-20 system. Use conductive paste to adhere the electrodes, seen here to the scalp, before connecting them to the wireless EEG headset. Place two passive EEG electrodes above and below one eye to capture the vertical electrooculogram, or EOG.Add another two to the outer campus of each eye to capture the horizontal EOG. Finally, place two passive EEG electrodes on the subject's earlobes to serve as EEG reference electrodes. Begin by placing the eye tracker just below the visual feedback computer monitor and connect it to the visual feedback computer using a USB 3 port.Then, ask the subject to sit at the desk at a distance of 50 centimeters from the eye tracker, adjust the visual feedback computer monitor so that the subject's eyes are at the center of the monitor. In the visual feedback computer, open the eye tribe server and eye tribe when-you-eye to ensure whether the subject's eyes are detected by the Gooey and to perform the eye tracker calibration routine subsequently. Next, ask the subject to look straight at the visual feedback computer monitor for visual cues.Run the eye tracker calibration routine by clicking on the calibrate tab in the Gooey. Run the visual underscore stimulus dot exc in the smart eye folder to execute the virtual reality based interface. Subsequently, run the smart eye dot exc program present in the smart eye folder to acquire the subject's eye gaze data that is synchronized with the virtual reality based task.Ask the subject to follow the fixed and moving visual stimuli at various positions on the visual feedback computer screen in order to evaluate post stroke pursuit eye movements. First, connect the eye tracker and balance board sensors to the visual feedback computer. Turn on the balance board, or BB sensor.Press the button on the BB sensor to make the remote discoverable in the menu. Click on the show or hide icon in the system's task bar, and click bluetooth device icon. Then, click on the added device option and pair the BB as a bluetooth device without using the code to the visual feedback computer.Once the balance board is connected to the visual feedback computer, open the VBT folder, and run the We BB interface dot m file to establish Matt lab BB interface. Have the subject stand on the balance board. Click OK to begin the calibration, then enter the subject's weight and click OK again.Next, connect and turn on the motion capture sensor to the data acquisition computer and ensure that it has fully booted, which is indicated by the green light. Open the LSL folder and start Mocap software to begin streaming of the motion capture sensor data. Turn on the EEG and EOG data acquisition systems connected to the data acquisition computer.To do this, first open the LSL folder and open open vibe acquisition server with LSL dot cmd. Finally, select emotive EPOC from the menu for EEG and EOG and configure the module by clicking on driver properties. Then, click on connect and click on play to start the acquisition server.Begin by asking the subject to stand on the balance board and attach a safety harness. Set a minimum baseline NMES level for upright standing by setting the stimulation frequency at 20 hurtz. Then, increase the pulse width and current level in the NMES software installed in the data acquisition computer until upright standing has been achieved.For NMES assisted VBT, ask the subject to sit on a chair, facing the motion capture sensor with their feet on the balance board. Run the calib sensors program in the data collect folder in order to collect multi sensor calibration data. Finally, ask the subject to perform self initiated maximal reach movements in different directions that affect center of mass location on the visual feedback.Begin by running the collect baseline program in the data collect folder to collect baseline resting state, eyes open, multi sensor data. To do this, ask the subject to stand still for two minutes and look straight at the center of mass location on the visual feedback. Then, run the collected VBT program in the data collect folder to collect sensor data during VBT.Connect the visual feedback computers video output to the projection screen and run the smart IVRT tasks dot exe file in the VBT folder in the visual feedback computer to launch the smart IVRT tasks Gooey. Then, ask the subject to pay attention to the audio and visual prompt on the computer screen and steer the cursor as fast as possible towards randomly presented peripheral targets. Following the Move Phase, ask the subject to hold the cursor at the target location for one second.Following the peripheral hold phase, ask the subject to return back to the central hold position while the system acquires the subject's two d coordinates of center of pressure and the two d coordinates of the gaze data. The eye gaze features were collected with the eye tracker to quantify a subjects performance during a smooth pursuit task for later comparison with post stroke VBT data. Then, for VBT, the protocol used to modify functional reach task to quantify the subject's ability to volitionally shift their center of pressure position as quickly as possible without losing balance, while cued with visual feedback.Here, EOG data shows that during VBT, the FD ratio, or ratio of fixation duration on the target, and the fixation duration on the cursor, increased while the normalized mean squared error decreased. While attempting this procedure it is very important to consider the safety and the comfort of the stroke patient. We expect that a virtual reality based balance rehabilitation system will be potent to address balance disorders of stroke patients.So following this procedure, other additional clinical measures, like the clinical measure of balance and mobility can be far from to comprehensively know how quantitive measures compared to other standard clinical parameters so that we can get a comprehensive picture of functional deficit of a stroke patient and we can comprehensively address this issue in the rehabilitation.

Research

JoVE Journal

Neuroscience

Combining Transcranial Magnetic Stimulation and fMRI to Examine the Default Mode Network

デフォルトモードのネットワークを検査する経頭蓋磁気刺激とfMRIを組み合わせ

The default mode network is a group of brain regions that are active when an individual is not focused on the outside world and the brain is at "wakeful ...

神経科学

The NeuroStar TMS Device: Conducting the FDA Approved Protocol for Treatment of Depression

NeuroStar TMSデバイス：うつ病の治療薬としてFDA承認されたプロトコルを実施

The Neuronetics NeuroStar Transcranial Magnetic Stimulation (TMS) System is a class II medical device that produces brief duration, pulsed magnetic ...

Investigating Outer Hair Cell Motility with a Combination of External Alternating Electrical Field Stimulation and High-speed Image Analysis

外部交互電場刺激と高速画像解析の組み合わせで外有毛細胞の運動性の調査

OHCs are cylindrical sensorimotor cells located in the Organ of Corti, the auditory organ inside the mammalian inner ear. The name "hair cells" derives ...

Reproducible Mouse Sciatic Nerve Crush and Subsequent Assessment of Regeneration by Whole Mount Muscle Analysis

ホールマウントマッスル分析による再現性のあるマウスの坐骨神経クラッシュと再生のその後の評価

Regeneration in the peripheral nervous system (PNS) is widely studied both for its relevance to human disease and to understand the robust regenerative ...

A Low Cost Setup for Behavioral Audiometry in Rodents

げっ歯類における行動聴力検査のための低コストのセットアップ

In auditory animal research it is crucial to have precise information about basic hearing parameters of the animal subjects that are involved in the ...

Isolation of Cerebrospinal Fluid from Rodent Embryos for use with Dissected Cerebral Cortical Explants

解剖大脳皮質植で使用するための齧歯類の胚から脳脊髄液の分離

The CSF is a complex fluid with a dynamically varying proteome throughout development and in adulthood. During embryonic development, the nascent CSF ...

A Low-cost Method for Analyzing Seizure-like Activity and Movement in Drosophila

A Low-cost Method for Analyzing Seizure-like Activity and Movement in Drosophila

における発作様活性を分析し、移動のための低コストの方法<em&gt;ショウジョウバエ</em

Video tracking systems have been used widely to analyze Drosophila melanogaster movement and detect various abnormalities in locomotive behavior. While ...

Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation

経皮的電気神経刺激を使用した神経筋機能の評価

Percutaneous electrical nerve stimulation is a non-invasive method commonly used to evaluate neuromuscular function from brain to muscle (supra-spinal, ...

High-density Electroencephalographic Acquisition in a Rodent Model Using Low-cost and Open-source Resources

低コストかつオープンソースのリソースの使用げっ歯類モデルにおける高密度脳波取得

Advanced electroencephalographic analysis techniques requiring high spatial resolution, including electrical source imaging and measures of network ...

Neurobehavioral Assessments in a Mouse Model of Neonatal Hypoxic-ischemic Brain Injury

新生児低酸素性虚血性脳損傷のマウス モデルにおける神経行動学的評価

We performed unilateral carotid artery occlusion on CD-1 mice to create a neonatal hypoxic-ischemic (HI) model and investigated the effects of neonatal HI ...