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Electrical stimulator with mechanomyography-based real-time monitoring, muscle fatigue detection, and safety shut-off: a pilot study

Naeem J, Hamzaid NA, Azman AW, Bijak M

Biomed Tech (Berl), 2020 Aug 27;65(4):461-468.
PMID: 32304295 DOI: 10.1515/bmt-2019-0191

Functional electrical stimulation (FES) has been used to produce force-related activities on the paralyzed muscle among spinal cord injury (SCI) individuals. Early muscle fatigue is an issue in all FES applications. If not properly monitored, overstimulation can occur, which can lead to muscle damage. A real-time mechanomyography (MMG)-based FES system was implemented on the quadriceps muscles of three individuals with SCI to generate an isometric force on both legs. Three threshold drop levels of MMG-root mean square (MMG-RMS) feature (thr50, thr60, and thr70; representing 50%, 60%, and 70% drop from initial MMG-RMS values, respectively) were used to terminate the stimulation session. The mean stimulation time increased when the MMG-RMS drop threshold increased (thr50: 22.7 s, thr60: 25.7 s, and thr70: 27.3 s), indicating longer sessions when lower performance drop was allowed. Moreover, at thr70, the torque dropped below 50% from the initial value in 14 trials, more than at thr50 and thr60. This is a clear indication of muscle fatigue detection using the MMG-RMS value. The stimulation time at thr70 was significantly longer (p = 0.013) than that at thr50. The results demonstrated that a real-time MMG-based FES monitoring system has the potential to prevent the onset of critical muscle fatigue in individuals with SCI in prolonged FES sessions.
Compression and tension behavior of the prosthetic foam materials polyurethane, EVA, Pelite™ and a combination of polyurethane and EVA: a preliminary study

Lutfi SNN, Abd Razak NA, Ali S, Gholizadeh H

Biomed Tech (Berl), 2021 Jun 25;66(3):317-322.
PMID: 34062632 DOI: 10.1515/bmt-2019-0110

Materials with low-strength and low-impedance properties, such as elastomers and polymeric foams are major contributors to prosthetic liner design. Polyethylene-Light (Pelite™) is a foam liner that is the most frequently used in prosthetics but it does not cater to all amputees' limb and skin conditions. The study aims to investigate the newly modified Foam Liner, a combination of two different types of foams (EVA + PU + EVA) as the newly modified Foam Liner in terms of compressive and tensile properties in comparison to Pelite™, polyurethane (PU) foam, and ethylene-vinyl acetate (EVA) foam. Universal testing machine (AGS-X, Shimadzu, Kyoto, Japan) has been used to measure the tensile and compressive stress. Pelite™ had the highest compressive stress at 566.63 kPa and tensile stress at 1145 kPa. Foam Liner fell between EVA and Pelite™ with 551.83 kPa at compression and 715.40 kPa at tension. PU foam had the lowest compressive stress at 2.80 kPa and tensile stress at 33.93 kPa. Foam Liner has intermediate compressive elasticity but has high tensile elasticity compared to EVA and Pelite™. Pelite™ remains the highest in compressive and tensile stiffness. Although it is good for amputees with bony prominence, constant pressure might result in skin breakdown or ulcer. Foam Liner would be the best for amputees with soft tissues on the residual limbs to accommodate movement.
Fulltext Effectiveness of FES-supported leg exercise for promotion of paralysed lower limb muscle and bone health-a systematic review

Ibitoye MO, Hamzaid NA, Ahmed YK

Biomed Tech (Berl), 2023 Aug 28;68(4):329-350.
PMID: 36852605 DOI: 10.1515/bmt-2021-0195

Leg exercises through standing, cycling and walking with/without FES may be used to preserve lower limb muscle and bone health in persons with physical disability due to SCI. This study sought to examine the effectiveness of leg exercises on bone mineral density and muscle cross-sectional area based on their clinical efficacy in persons with SCI. Several literature databases were searched for potential eligible studies from the earliest return date to January 2022. The primary outcome targeted was the change in muscle mass/volume and bone mineral density as measured by CT, MRI and similar devices. Relevant studies indicated that persons with SCI that undertook FES- and frame-supported leg exercise exhibited better improvement in muscle and bone health preservation in comparison to those who were confined to frame-assisted leg exercise only. However, this observation is only valid for exercise initiated early (i.e., within 3 months after injury) and for ≥30 min/day for ≥ thrice a week and for up to 24 months or as long as desired and/or tolerable. Consequently, apart from the positive psychological effects on the users, leg exercise may reduce fracture rate and its effectiveness may be improved if augmented with FES.
Fulltext Actuators and transmission mechanisms in rehabilitation lower limb exoskeletons: a review

Aliman N, Ramli R, Amiri MS

Biomed Tech (Berl), 2024 Jan 31.
PMID: 38295350 DOI: 10.1515/bmt-2022-0262

Research has shown that rehabilitation lower limb exoskeletons (RLLEs) are effective tools for improving recovery or regaining lower limb function. This device interacts with the limbs of patients. Thus, actuators and power transmission mechanisms are the key factors in determining smooth human‒machine interaction and comfort in physical therapy activities. A multitude of distinct technologies have been proposed. However, we questioned which consideration point in actuator selection and power transmission mechanisms are used for RLLE. A review of the technical characteristics and status of advanced RLLE designs is discussed. We review actuator selection for RLLE devices. Furthermore, the power transmission mechanisms over the years within each of the RLLE devices are presented. The development issues and possible research directions related to actuators and power transmission mechanisms are provided. Most RLLEs are still in the research phase, and only a few have been commercialized. The aim of this paper is to provide researchers with useful information for investigating technological progress and highlight the latest technological choices in RLLE development.
Hand gesture recognition with deep residual network using Semg signal

Khattak AS, Zain ABM, Hassan RB, Nazar F, Haris M, Ahmed BA

Biomed Tech (Berl), 2024 Mar 08.
PMID: 38456275 DOI: 10.1515/bmt-2023-0208

OBJECTIVES: To design and develop a classifier, named Sewing Driving Training based Optimization-Deep Residual Network (SDTO_DRN) for hand gesture recognition.
METHODS: The electrical activity of forearm muscles generates the signals that can be captured with Surface Electromyography (sEMG) sensors and includes meaningful data for decoding both muscle actions and hand movement. This research develops an efficacious scheme for hand gesture recognition using SDTO_DRN. Here, signal pre-processing is done through Gaussian filtering. Thereafter, desired and appropriate features are extracted. Following that, effective features are chosen using SDTO. At last, hand gesture identification is accomplished based on DRN and this network is effectively fine-tuned by SDTO, which is a combination of Sewing Training Based Optimization (STBO) and Driving Training Based Optimization (DTBO). The datasets employed for the implementation of this work are MyoUP Dataset and putEMG: sEMG Gesture and Force Recognition Dataset.
RESULTS: The designed SDTO_DRN model has gained superior performance with magnificent results by delivering a maximum accuracy of 0.943, True Positive Rate (TPR) of 0.929, True Negative Rate (TNR) of 0.919, Positive Predictive Value (PPV) of 0.924, and Negative Predictive Value (NPV) of 0.924.
CONCLUSIONS: The hand gesture recognition using the proposed model is accurate and improves the effectiveness of the recognition.
Development of audio-guided deep breathing and auditory Go/No-Go task on evaluating its impact on the wellness of young adults: a pilot study

Kwa EK, Cheong SK, Ong LK, Lee PF

Biomed Tech (Berl), 2024 Apr 25;69(2):141-150.
PMID: 37856824 DOI: 10.1515/bmt-2023-0410

OBJECTIVES: Numerous studies indicate that deep breathing (DB) enhances wellbeing. Multiple deep breathing methods exist, but few employ audio to reach similar results. This study developed audio-guided DB and evaluated its immediate impacts on healthy population via self-created auditory Go/No-Go task, tidal volume changes, and psychological measures.
METHODS: Audio-guided DB with natural sounds to guide the DB was developed. Meanwhile, audio-based Go/No-Go paradigm with Arduino was built to measure the attention level. Thirty-two healthy young adults (n=32) were recruited. Psychological questionnaires (Rosenberg's Self-Esteem Scale (RSES), Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), Perceived Stress Scale (PSS)), objective measurements with tidal volume and attention level with auditory Go/No-Go task were conducted before and after 5 min of DB.
RESULTS: Results showed a significant increment in tidal volume and task reaction time from baseline (p=0.003 and p=0.033, respectively). Significant correlations were acquired between (1) task accuracy with commission error (r=-0.905), (2) CAMS-R with task accuracy (r=-0.425), commission error (r=0.53), omission error (r=0.395) and PSS (r=-0.477), and (3) RSES with task reaction time (r=-0.47), task accuracy (r=-0.362), PSS (r=-0.552) and CAMS-R (r=0.591).
CONCLUSIONS: This pilot study suggests a link between it and young adults' wellbeing and proposes auditory Go/No-Go task for assessing attention across various groups while maintaining physical and mental wellness.