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Our subproject focuses on understanding how psychological components influence patient innovation outcomes. By identifying gaps between innovators' expectations and experiences, we determined the impact of motivation, social benefit, and skill development on the overall value and originality of patient innovations. Our study of 400 participants revealed that hedonic motivation and capability development lead to the highest evaluation of overall value. We also provide approaches for moderating innovators' expectations to improve the innovation outcome's value and originality. Our research opens new avenues to explore patient innovators' complex motivational structures. In the next steps, we plan to conduct experiments using VR glasses to provide patients with a virtual setting to view and edit their innovations. Additionally, third-rater studies will verify already identified innovations, providing further insights into patient innovation. These steps will enhance our understanding of patient innovation and help develop more effective approaches to innovation in healthcare.

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Goal of this project is the improvement of assistive systems by examining the user perspective using virtual reality applications, physiological and self-report indicators of changes in the perception of the body, perceived agency over the assistive system and the embodiment of orthoses and prostheses. To examine these factors avatars that incorporate the user and the assistive system can be created and their embodiment can be quantified via mechanisms such as the full body illusion. Adaptation to the device can also be examined via self-report, behavioral accuracy measures, physiological measures such as changes in temperature and skin conductance related to the percept of the avatar as well as ecological momentary assessments of longer-term use of the device. In addition, the role of sensory feedback can be quantified and its role in improving the acceptance of an assistive device can be quantified. Experiments will be conducted in healthy participants, persons with cerebral palsy who wear an orthosis and amputees with various types of prostheses. The project is a cooperation between psychology, neuroscience, biomechanics and electrical engineering and information technology as well as sensory technology.

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Our subproject deals with body representation and body schema integration, focusing on mental models of individuals with disabilities regarding acceptance and control of new assistive devices.

Outcomes/Work in progress:

§  Systematic literature review on prosthesis embodiment as both a bachelor thesis and own research --> The findings will be written in the form of a journal paper and sent to suitable journals or conferences (work in progress at the moment)

§  Study 1: Exploratory study on personality traits and body image of amputees

o   The focus of the study lies on the relationship between personality traits, perceived body image, and prosthesis-related data

o   Survey period: 10.04.2023 – 15.05.2023

In planning:

§  Study with intelligent crutches (available in our lab) in order to identify the degree of leg strain and find the optimal value for it, individual preferences and expectancy

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C1: The Influence of functional electrical stimulation (FES) in adult patients with upper motor neuron disease

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C1: The Influence of functional electrical stimulation (FES) in adult patients with upper motor neuron disease

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A common impairment of patients with upper motor neuron disease is a foot drop. It often causes instability and an increased risk of toe dragging and falling. Besides the standard of ankle-foot orthoses (AFO), functional electrical stimulation (FES) of the ankle dorsiflexors is used as an alternative treatment for patients with mild impairments. Compared to classic orthotic concepts, FES shows the advantage of an active ankle dorsiflexion and less ankle joint restrictions while being more comfortable. Even without noticeable improvements during gait, patient’s satisfaction can be high and superior to AFOs.

To be able to understand the beneficial effects of FES, the primary objective of this study is to evaluate the immediate and training effects of FES on gait function. The second and third objectives are to show the effects of FES on dual-task ability while walking and on proprioception. Furthermore, we want to evaluate the effects of FES on the patient’s quality of life in their daily life via Patient Reported Outcome Measures.

A prospective exploratory cohort study will be performed on 30 adults with unilateral foot drop of central origin. Patients, beginning their FES treatment, aged between 18-60 years, with the ability to walk independently without support will be included in the study. All participants will undergo twelve weeks of conventional FES treatment. At the beginning of the treatment (T1) and after twelve weeks (T3), functional and clinical outcomes will be captured. Additionally, during the twelve weeks (T2) Patient Reported Outcome Measures via ambulatory assessments will be captured to evaluate the effects of FES on the patient’s daily life. The FES device is stimulating at least the peroneal nerve during swing phase. Reference data of 15 unaffected individuals will be considered.

In terms of the immediate orthotic effect of FES OFF vs FES ON, early results of two patients for T1 show an increase in gait velocity during normal and dual-task walking, a decrease in cognition rate and an insufficient increase in dorsiflexion during swingphas.

Changes of speed and cognition rate during dual-task walking with FES could be first signs that FES plays an important role in changing the patients ability to perform additional tasks at the same time. To be able to perform dual-task abilities is crucial to interact with the environment sufficiently and therefore decrease chances of falling during daily life.

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Dear LokoAssist-Team,
Please

prepare a short text (max. 1000 characters) summarising the developments and outcomes in in subproject and

upload it together with a picture in the columns to the right (same columns as the posters)

by April 14, 2003. This will help me to prepare my presentation at the LokoAssist symposium.
Thank you so much for your support!
All the best,
André

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update

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Adaptable drive concepts for assistive systems

The aim of the project area A.1 is to develop an optimization platform that enables designers of assistive systems to identify the optimal design for the drive system of an assistive wearable device, considering both subjective and objective criteria. The overview of the optimization platform has been determined, its different components have been identified, and the requirements of each section have been decided.

A proof-of-concept study was conducted with the aim of interpreting the user preference in the face of various states of an assistive wearable device using brain signals. In this study, participants were asked to perform a swinging movement of their knee joint while sitting on a chair in front of a screen and wearing a 1 DOF knee exoskeleton. The state of the exoskeleton was changed by adjusting the pressure of its Pneumatically Actuated Muscle PAM in each trial. Participants were then asked to give a score from 1-5 (1: very easy, 5: very difficult). During the experiment, their brain activity was recorded using an EEG measurement device. 8 people have participated so far, and the acquired data is currently being processed. With this study we hope to find a correlation between the brain activity of participants and their self-reported preference in each state of the device.

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Research project B1 aims to develop new biomechanical models for movement analysis and prediction, providing opportunities for scientific and clinical analysis and exploring mechatronic approaches for assistance systems.

We did a literature review that categorizes the use cases of biomechanical models in assistive device development as guiding the design, optimization, control, combining sensory information and evaluation.

Review outcomes: Biomechanical models can facilitate assistive device design and control. Additionally, using assistive devices to improve existing models, validating simulation results, model-based design, and control for pathological gait and assistance in the frontal plane were also identified as under-researched areas.

We examined current detailed models predicting metabolic cost and found that selecting the right cost function for estimating muscle activation is crucial. Also, using EMG signals with musculoskeletal models improved prediction ability.

Elderly and young gait were compared using the Virtual Pivot Point concept, showing that ground reaction forces in the frontal plane are less focused in elderly gait and decrease in quality with increased speed. Conceptual models and sensitivity analysis suggested that noisy force feedback may be the cause. Potential for clinical analysis and designing assistive devices.

We proposed a bioinspired adaptive model-based controller to aid hip abduction during load-carrying tasks, utilizing GRF and hip abduction angle to adapt the assistance. Our simulations showed reduced metabolic costs during walking with and without load carrying.

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1- Please check the printability
2- Please upload your posters in both pptx and pdf format by 16.4.
3- Please use high quality images
4- You can change the size of the boxes included in the design as you wish.
5- Please write your comments in this padlet directly.

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Title: The role of emotional and cognitive factors in the evaluation of assistive systems using ecological momentary assessment in virtual and augmented reality applications: disturbing or promoting effects?

Short background: Emotions and cognitions strongly regulate and affect our body movements and relate to our body schema. When locomotion is altered and in states when individuals receive an assistive device (prosthesis or orthosis), (daily) dynamics of affective processing as well as an interaction of expression of emotions through movements may hinder an adaptive integration of the assistive system in the body schema.

Aims: To apply a mobile-based application (EMA) to monitor and record sensitive and dynamic emotional, cognitive, and behavioral factors in daily life in the area of embodiment and relate those to advanced VR- and sensor-based assessment tools and measures.

Developments and outcomes so far: 1) Implementation of an EMA design along with VR-based estimates of proprioceptive accuracy and distortions via embodying an avatar with shifted limb positions started, 2) transferred into a more more clinically oriented EMA design in patients with cerebral palsy, and 3) adaptation to prostheses in amputees planned.

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LokoAssist Symp Poster - Asghar Mahmoudi - A1

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LokoAssist Symp Poster - Asghar Mahmoudi - A1

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A2: Novel functional materials for sensors and actuators for assistive systems.     

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A2: Novel functional materials for sensors and actuators for assistive systems.     

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In order to create a dynamic movement model to predict normal/perturbed walking, in this subproject, a perturbed-walking dataset is currently being analyzed. This dataset contains un/perturbed kinematic, kinetic, and EMG measurements of 14 subjects equipped with a gyroscopic angular momentum perturbator that induces perturbations with only minimal effect on CoM excursions. This dataset allows for the investigation of various aspects of human motor control, perturbation recovery strategies and balance schemes, roles of different segments and muscles in coping with perturbation, and other related questions. So far, analyses on kinematic and EMG data have been carried out and the first paper is in preparation. The main outcomes of this work are the identification of different balance strategies, understanding the importance of biarticular muscles in coping with perturbations, and finding the muscle activation sequence in face of perturbations.

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A3: Application of Ferroelectric Sensors for Assistive Devices

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A3: Application of Ferroelectric Sensors for Assistive Devices

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Sensors are indispensable in electronic devices assisting the human locomotion. Typical sensors used are surface electromyography (EMG), measurement of external forces, optical or inertial motion capture systems. With ferroelectric sensors, we introduce a new promising type of sensor in this field.
These artificial piezoelectrets are mechanically flexible and feature a high sensitivity due to their large longitudinal piezoelectric d33 coefficients. Therefore, they qualify for the application at the human body.
Sensory insoles based on ferroelectrets are proved to detect the important features of human gait including the time of the heel strike. The additively manufactured design enables more complex structures with adjustable local sensitivities to be worked on in the future.
Furthermore, we apply ferroelectric sensors as patches directly to the human skin to measure the mechanical muscle contraction. This adds advantages compared to the EMG driven electrical acquisition of muscle activity especially for an early detection of a movement intention.

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Compliant leg function can be a good model for designing and controlling bioinspired robots and assistive devices. As the design and control of different leg joints are other, we investigate all joints for passive and active compliance. First, try replicating the joints' torque with a passive spring by analyzing human hopping data in four hopping frequencies. We optimized the active part parallel to the spring in the second step. We used the force-modulated concept (FMC) as the controller. The ankle joint torque can be replicated with a passive spring. To reproduce the knee joint, the passive spring is insufficient, and a combination of spring with a motor that is being controlled with FMC (GRF feedback) performs better. Our method could not predict hip torque completely; using a more complex model at the hip joint is suggested, such as a biarticular arrangement and damping. We could verify our findings on our robotic testbed, EPA-Hopper-II. We learned: Adjustable passive elasticity is sufficient for replicating human-like ankle joint behavior in hopping. Knee and hip joint functions require actuators. Ankle joint needs stiffness adjustment for different frequencies, and knee joint is the key contributor to energy management, which can be achieved by reflex control.

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Human-in-the-loop experiments enable the involvement of users in the individualization of assistance. In order to investigate if humans are capable of finding suitable assistance control parameters by self-tuning, we conducted a hip exoskeleton walking experiment. In the first part, the participants tuned four control parameters by themselves while walking with the exoskeleton on an instrumented treadmill. Afterwards, we did a metabolic cost evaluation session in order to assess the self-tuned assistance profile.

Preliminary results (5 young and healthy subjects): All subjects were able to find an assistance pattern that felt optimal to them within 13 min (9.9 ± 0.8 min), which is significantly faster than state-of-the-art human-in-the-loop optimization approaches. The metabolic rate while walking with the self-tuned assistance was reduced by 14.8 ± 1.2 % compared to walking with the zero-torque condition (exoskeleton turned off), which is comparable to the metabolic reduction achieved in other hip exoskeleton studies.