Project Title: “Analyzing the complex interaction between impaired neuromuscular and musculoskeletal system to determine if gait abnormalities of children with cerebral palsy are advantageous”. Congratulations Elijah!
During Microsoft’s annual Ability Summit, they announced a new partnership with the University of Washington to establish the Center for Research and Education on Accessible Technology (CREATE) and kicked-off the collaboration with an inaugural investment of $2.5 million. CREATE is an interdisciplinary team whose mission is to make technology, and the world, more accessible.
The CREATE leadership will be comprised of six campus departments and three different colleges including the Steele lab’s own Heather Feldner and Katherine M. Steele. This fantastic news was featured on The Seattle Times and Greek Wire.
Get excited and help us congratulate Heather, Kat, and all those involved and cheer them on to CREATE!
These results suggest that control theory modeling can provide a platform to successfully quantify device performance in the absence of errors arising from motor impairments
Photo (top and bottom) of a user using a slider (top) and muscles (bottom) to control a cursor on the screen. (Top image) Side image of user. User rests their elbow and pinches the slider and moves the slider towards and away from their body to control the cursor. (Bottom image) Side image of user. User is strapped to a rigid device holding a bar with hands supinated towards the ceiling, with the forearms at a 90 degree angle from the upper arms. Electrodes are placed on the biceps and triceps and labelled. Arrows pointing up and down indicate that users move their arm up and down to control the cursor.
Background:Manual device interaction requires precise coordination which may be difficult for users with motor impairments. Muscle interfaces provide alternative interaction methods that may enhance performance, but have not yet been evaluated for simple (eg. mouse tracking) and complex (eg. driving) continuous tasks. Control theory enables us to probe continuous task performance by separating user input into intent and error correction to quantify how motor impairments impact device interaction
Aim: Propose and extend an experimental and analytical method to guide future development of accessible interfaces like muscle interfaces using control theory
Method: We compared the effectiveness of a manual versus a muscle interface for eleven users without and three users with motor impairments performing continuous tasks.
Results: Both user groups preferred and performed better with the muscle versus the manual interface for the complex continuous task.
Interpretation: Results suggest muscle interfaces and algorithms that can detect and augment user intent may be especially useful for future design of interfaces for continuous tasks.
Momona also gave a phenomenal talk on this paper last week in the University of Washington’s ‘DUB Shorts’ series (video posted below). Nice job Momona!
Journal Article in Prosthetics & Orthotics International
A) Smartphone positioning on the front or side of the shank. B) Reflective markers on the the tibial tuberosity (TT) – distal tibia (DT) and lateral epicondyle (LE) – lateral malleolus (LM) were used to compare the accuracy of the smartphone to traditional motion capture. UV markings were used to keep placement of these markers constant while blinding clinicians. C) Sample screenshots of the mobile application, including the set-up screen and results automatically produced after a walking trial.
Background
Assessments of human movement are clinically important. However, accurate measurements are often unavailable due to the need for expensive equipment or intensive processing. For orthotists and therapists, shank-to-vertical angle (SVA) is one critical measure used to assess gait and guide prescriptions. Smartphone-based sensors may provide a widely-available platform to expand access to quantitative assessments.
Objectives
Assess accuracy and repeatability of smartphone-based measurement of SVA compared to marker-based 3D motion analysis.
Method
Four licensed clinicians (two physical therapists and two orthotists) measured SVA during gait with a smartphone attached to the anterior or lateral shank surface of unimpaired adults. We compared SVA calculated from the smartphone’s inertial measurement unit to marker-based measurements. Each clinician completed three sessions/day on two days with each participant to assess repeatability.
Results
Average absolute differences in SVA measured with a smartphone versus marker-based 3D motion analysis during gait were 0.67 ± 0.25° and 4.89 ± 0.72°, with anterior or lateral smartphone positions, respectively. The inter- and intra-day repeatability of SVA were within 2° for both smartphone positions.
Conclusions
Smartphone sensors can be used to measure SVA with high accuracy and repeatability during unimpaired gait, providing a widely-available tool for quantitative gait assessments.
Try it out!
The app for monitoring shank-to-vertical angle is available for you to download and use on either Android or iOS smartphone. Please complete THIS SURVEY which will then send you an e-mail with instructions for installation and use. This app is not an FDA approved medical device and should be used appropriately.
Journal Article in Journal of NeuroEngineering & Rehabilitation
(Left) Example of jerk ratio distribution for one child with cerebral palsy before, during, and after constraint induced movement therapy. (Right) Summary metric of jerk ratio (jerk ratio-50) for all five children with cerebral palsy.
Background
Accelerometers have become common for evaluating the efficacy of rehabilitation for patients with neurologic disorders. For example, metrics like use ratio (UR) and magnitude ratio (MR) have been shown to differentiate movement patterns of children with cerebral palsy (CP) compared to typically-developing (TD) peers. However, these metrics are calculated from “activity counts” – a measure based on proprietary algorithms that approximate movement duration and intensity from raw accelerometer data. Algorithms used to calculate activity counts vary between devices, limiting comparisons of clinical and research results. The goal of this research was to develop complementary metrics based on raw accelerometer data to analyze arm movement after neurologic injury.
Method
We calculated jerk, the derivative of acceleration, to evaluate arm movement from accelerometer data. To complement current measures, we calculated jerk ratio (JR) as the relative jerk magnitude of the dominant (non-paretic) and non-dominant (paretic) arms. We evaluated the JR distribution between arms and calculated the 50th percentile of the JR distribution (JR50). To evaluate these metrics, we analyzed bimanual accelerometry data for five children with hemiplegic CP who underwent Constraint-Induced Movement Therapy (CIMT) and five typically developing (TD) children. We compared JR between the CP and TD cohorts, and to activity count metrics.
Results
The JR50 differentiated between the CP and TD cohorts (CP = 0.578±0.041 before CIMT, TD = 0.506±0.026), demonstrating increased reliance on the non-dominant arm for the CP cohort. Jerk metrics also quantified changes in arm use during and after therapy (e.g., JR50 = 0.378±0.125 during CIMT, 0.591 ± 0.057 after CIMT). The JR was strongly correlated with UR and MR (r = -0.92, 0.89) for the CP cohort. For the TD cohort, JR50 was repeatable across three data collection periods with an average similarity of 0.945±0.015.
Conclusions
Acceleration-derived jerk captured differences in motion between TD and CP cohorts and correlated with activity count metrics. The code for calculating and plotting JR is open-source and available for others to use and build upon. By identifying device-independent metrics that can quantify arm movement in daily life, we hope to facilitate collaboration for rehabilitation research using wearable technologies.
Code
The algorithm for calculating jerk ratio, as well as user-friendly code to produce plots similar to the figure above are provided open-source as Python 3.6 code as a Python Jupyter Notebook within Google Colab. With this resource, research groups can use existing or newly created data from accelerometers to analyze jerk ratio as a complementary metric to existing measures, enabling comparison between research studies or centers that may rely on different sensors and activity count algorithms.
