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AMBITION: What has been done so far?

Mohamed Irfan Mohamed Refai*

1

, Mique Saes

2

,

Ilona Visser

2

,

Hans B. J. Bussmann

4

, Jaap H. Buurke

1,3

, Peter H. Veltink

1

, Gert Kwakkel

2

,

Erwin van Wegen

2

, Carel Meskers

2

, Bert-Jan F. van Beijnum

1

*m.i.mohamedrefai@utwente.nl

Questions asked..

Fig 6: GRAIL lab and a casted foot

Future Studies:

• Studies on Stroke subjects

• Ambulatory UE sensing during ADL

* Minimal and contextual sensing

• Biofeedback Modalities

* Quality of motor function * Feedback Modalities

Develop and evaluate an on-body sensing

and real-time biofeedback system for optimal,

patient-tailored motor rehabilitation in

neurological disorders, aimed at understanding

neural repair and compensation in motor

performance of upper and lower extremities

during daily life.

Affiliations

1Biomedical Signals and Systems, University of Twente 2 Amsterdam University Medical Centre, Amsterdam

3 Roessingh Research and Development, Enschede 4Erasmus Medical Center, Rotterdam

Take Away:

1D Pressure as replacement for 3D

forces and moments

• Contribution of foot kinematics and

kinetics towards CoM/XCoM estimations

• Influence of high/low frequency CoM

information on stability margins

Estimating XCoM without any kinetics

Questions asked..

NeuroCIMT #7 Project Goals

Fig 2: Experimental Setup of ForceShoe and Pressure sensors

Fig 3: Graphical definitions of stability parameters

Fig 5: Comparisons of XCoM estimated using ForceShoe and Subject Specific Models for different walking tasks

Fig 1: Compensatory movement strategies exhibited by hemiplegic subjects

Current and Future Studies

Q2: Influence of walking speed and casting on dynamic margins of

stability (DMoS). Q3: in stroke subjects during a reach and grasp task?How are movement related body functions measured by kine(ma)tic metrics

Q4: Feasibility of an IMU (pelvis & feet) only approach, for ambulatory estimation of stability.

• Restitution vs. Substitution

Understanding differences between true

neurological repair and appearance of alternate/ compensatory patterns

• Ambulatory Sensing in ADL

Feasibility of wearables in measuring quality of movement in ADL

• Biofeedback Modalities

Identifying intelligent feedback and feedback modalities to improve quality of motor

function

• Systematic Literature Review • Reaching as a functional task

• Assessing reliable, valid, and responsive upper limb kinematics measurable by an ambulant setup

• Registration of review: PROSPERO CRD42018100648 • Completion of full TIAB screening

• Full text screening underway

• Stroke Rehabilitation and Recovery Round Table

Q1: Feasibility of using pressure insoles over force sensors as a wearable setup for measuring gait & balance.

Take Away:

• Subjects reduced their step lengths when

casted, when walking at moderate and fast

speeds.

• DMoS

in AP direction increases when

walking speed increases, as XCoM falls

further outside BoS.

• DMoS

increases in ML direction when

walking speed increases, but only t

rue for

slow and fast speeds when casted.

• DMoS is thus sensitive to walking speed and

asymmetrical walking.

• Study also shows compensation strategies of

healthy subjects towards induced asymmetry.

• IMU based approach * Kinematics

* Forces

* Relative distance estimations • Foot IMUs

* Foot kinematics • Pelvis IMU

* CoM oscillations * Body kinetics

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