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Neuromuscular impairments are frequently observed in patients with chronic neck pain (CNP). This study uniquely investigates whether changes in neck muscle synergies detected during gait are sensitive enough to differentiate between people with and without CNP. Surface electromyography (EMG) was recorded from the sternocleidomastoid, splenius capitis, and upper trapezius muscles bilaterally from 20 asymptomatic individuals and 20 people with CNP as they performed rectilinear and curvilinear gait. Intermuscular coherence was computed to generate the functional inter-muscle connectivity network, the topology of which is quantified based on a set of graph measures. Besides the functional network, spectrotemporal analysis of each EMG was used to form the feature set. With the use of Neighbourhood Component Analysis (NCA), we identified the most significant features and muscles for the classification/differentiation task conducted using K-Nearest Neighbourhood (K-NN), Support Vector Machine (SVM), and Linear Discriminant Analysis (LDA) algorithms. The NCA algorithm selected features from muscle network topology as one of the most relevant feature sets, which further emphasize the presence of major differences in muscle network topology between people with and without CNP. Curvilinear gait achieved the best classification performance through NCA-SVM based on only 16 features (accuracy: 85.00%, specificity: 81.81%, and sensitivity: 88.88%). Intermuscular muscle networks can be considered as a new sensitive tool for the classification of people with CNP. These findings further our understanding of how fundamental muscle networks are altered in people with CNP. [ABSTRACT FROM AUTHOR]

Pathological hand tremor (PHT) is a common symptom of Parkinson's disease (PD) and essential tremor (ET), which affects manual targeting, motor coordination, and movement kinetics. Effective treatment and management of the symptoms relies on the correct and in-time diagnosis of the affected individuals, where the characteristics of PHT serve as an imperative metric for this purpose. Due to the overlapping features of the corresponding symptoms, however, a high level of expertise and specialized diagnostic methodologies are required to correctly distinguish PD from ET. In this work, we propose the data-driven NeurDNet model, which processes the kinematics of the hand in the affected individuals and classifies the patients into PD or ET. NeurDNet is trained over 90 hours of hand motion signals consisting of 250 tremor assessments from 81 patients, recorded at the London Movement Disorders Centre, ON, Canada. The NeurDNet outperforms its state-of-the-art counterparts achieving exceptional differential diagnosis accuracy of 95.55 % . In addition, using the explainability and interpretability measures for machine learning models, clinically viable and statistically significant insights on how the data-driven model discriminates between the two groups of patients are achieved. [ABSTRACT FROM AUTHOR]

Non-motor symptoms in Parkinson's Disease (PD) predate motor symptoms and substantially decrease quality of life; however, detection, monitoring, and treatments are unavailable for many of these symptoms. Temporal perception abnormalities in PD are generally attributed to altered Basal Ganglia (BG) function. Present studies are confounded by motor control facilitating movements that are integrated into protocols assessing temporal perception. There is uncertainty regarding the BG's influence on timing processes of different time scales and how PD therapies affect this perception. In this study, PD patients using Levodopa (n = 25), Deep Brain Stimulation (DBS; n = 6), de novo patients (n = 6), and healthy controls (n = 17) completed a visual temporal perception task in seconds and sub-section timing scales using a computer-generated graphical tool. For all patient groups, there were no impairments seen at the smaller tested magnitudes (using sub-second timing). However, all PD groups displayed significant impairments at the larger tested magnitudes (using interval timing). Neither Levodopa nor DBS therapy led to significant improvements in timing abilities. Levodopa resulted in a strong trend towards impairing timing processes and caused a deterioration in perceptual coherency according to Weber's Law. It is shown that timing abnormalities in PD occur in the seconds range but do not extend to the sub-second range. Furthermore, observed timing deficits were shown to not be solely caused by motor deficiency. This provides evidence to support internal clock models involving the BG (among other neural regions) in interval timing, and cerebellar control of sub-second timing. This study also revealed significant temporal perception deficits in recently diagnosed PD patients; thus, temporal perception abnormalities might act as an early disease marker, with the graphical tool showing potential for disease monitoring. [ABSTRACT FROM AUTHOR]

Compared with motor deficits, sensory information processing in Parkinson's disease (PD) is relatively unexplored. While there is increasing interest in understanding the sensory manifestations of PD, the extent of sensory abnormality in PD has remained relatively unexplored. Furthermore, most investigations on the sensory aspects of PD involve motor aspects, causing confounding results. As sensory deficits often arise in early PD development stages, they present a potential technological target for diagnosis and disease monitoring that is affordable and accessible. Considering this, the current study's aim is to assess visual spatiotemporal perception independent of goal directed movements in PD by designing and using a scalable computational tool. A flexible 2-D virtual reality environment was created to evaluate various cases of visual perception. Using the tool, an experimental task quantifying the visual perception of velocity was tested on 37 individuals with PD and 17 age-matched control participants. Results: PD patients, both ON and OFF PD therapy, displayed perceptual impairments (p = 0.001 and p = 0.008, respectively) at slower tested velocity magnitudes. These impairments were even observed in early stages of PD (p = 0.015). Visual velocity perception is impaired in PD patients, which suggests impairments in visual spatiotemporal processing occur in PD and provides a promising modality to be used with disease monitoring software. Visual velocity perception shows high sensitivity to PD at all stages of the disease. Dysfunction in visual velocity perception may contribute to observed motor dysfunction in PD. [ABSTRACT FROM AUTHOR]

This paper presents a novel multimodal training platform integrated with hand-over-hand (HOH) haptic guidance for dual-console surgical robotic systems such as the da Vinci Si system. The expert-in-the-loop (EIL) framework incorporates a fuzzy interface system in order to provide a trainee with adaptive authority over the procedure as well as hand-over-hand haptic guidance adjusted in real time based on the proficiency level of the trainee. The EIL expertise-oriented framework enables performance of a surgical procedure by an expert surgeon on a patient, while simultaneously providing a trainee at any stage of the motor-skills development with multimodal training without jeopardizing patient safety. Closed-loop stability of the system is investigated using the circle criterion and it is shown that the proposed architecture is unconditionally stable. Experimental evaluations are presented in support of the proposed platform through the implementation of a dual-console surgical setup consisting of the classic da Vinci surgical system (Intuitive Surgical, Inc., Sunnyvale, CA, USA) and the dV-Trainer master console (Mimic Technology, Inc., Seattle, WA, USA). To the best of our knowledge, the implemented setup is the first research platform for dual-console studies involving the classic da Vinci surgical system. [ABSTRACT FROM AUTHOR]

In this paper, a composite controller is proposed for single-link flexible manipulators exposed to external tip force disturbances. In the proposed scheme, the extended Kalman filter is utilized to observe the environmental forces and the Lyapunov redesign robust controller is applied to control the destabilizing effect of the observation errors in noisy situations. The observed force can be utilized in different applications (such as tele-surgical robotics) in order to eliminate the necessity of additional force sensors. This fact is important for structural miniaturization and cost reduction. The main contributions of this paper are (1) proposing a disturbance observation technique for in-contact flexible link manipulators (note that the challenge of Jacobian singularity is studied as a possible diverging factor of the observation) and (2) proposing the composite robust controller to eliminate the destabilizing effect of estimation errors. The advantages of the proposed control scheme over the conventional techniques are analyzed. Simulation results are given for a single-link flexible manipulator to illustrate the effectiveness of the composite control technique and experimental results are given to validate the performance of the observation method. [ABSTRACT FROM AUTHOR]

In this paper, a control methodology is proposed for dual-user teleoperation system in the presence of unknown constant communication time delay. To satisfy dual-user system-desired objectives, three impedance characteristics are defined as the desired closed-loop system. In order to satisfy the desired impedance characteristics, a sliding-mode-based impedance controller is applied. The proposed controller affords unknown communication delay, an issue that is disregarded in the previous studies performed on dual-user systems. The nonlinear gain of the controller is achieved independent of time delay caused by communication channels. Therefore, the necessity of measurement or estimation of the time delay is relaxed. In addition, the stability analysis is presented for the closed-loop system using the passivity theory. The validity of the proposed controller scheme is demonstrated via experimental results performed on a dual-user system in the presence of unknown communication delay. In addition, due to lack of availability of forces corresponding to the operators’ hand that are required in the proposed controller, a Kalman Filter-based Force Observer (KFFO) is proposed. [ABSTRACT FROM AUTHOR]

Depression diagnosis is a challenging clinical task currently conducted mostly using subjective criteria. It is well known that depression alters the neural activity in the brain, so that the corresponding neurophysiological signature may be measured using non-invasive electroencephalography (EEG) signals. These, in turn, may be possible to decode using machine learning algorithms. Despite the extensive literature, the existing techniques rely on several channels and obtrusive systems. In this paper, and for the first time, the diagnostic power of each EEG channel for depression detection is analyzed using Neighborhood Component Analysis (NCA). Our results indicate that a mere two features collected from one EEG channel suffice for reliable diagnosis. To evaluate the performance of the proposed method, a dataset comprising seven minutes of EEG recording from 84 subjects is used. The data was divided into two separate sets, one for feature selection and one for diagnostic classification. We delineate brain regions that have the strongest discriminative power linked to depression diagnosis. Thus, we identified one electrode (i.e., AF4) located on the frontal lobe, which can be used to diagnose depression with high accuracy. After evaluation of a series of shallow machine learning methods, we achieved the classification accuracy of 80.8%, sensitivity of 60% and specificity of 99.7% with two features from one electrode. We also achieved the highest classification accuracy of 91.8%, the specificity of 93.5%, and sensitivity of 90% with two electrodes and three features. Our findings show that it is possible to significantly reduce the complexity of algorithms to diagnose depression with the motivation of use in highly accessible wearable devices. [ABSTRACT FROM AUTHOR]

Functional muscle network is a critical concept in describing functional synergistic muscle synchronization and functional connectivity needed for the execution of complex motor tasks. Muscle network is typically derived from decomposition of intermuscular coherence (IMC) at different frequency bands of multichannel electromyography (EMG) measurements, which potentially limits out-of-clinic applications. In this investigation, we introduce muscle network analysis to assess the functional coordination and functional connectivity of muscles based on mechanomyography (MMG). We focus on a targeted group of muscles vital for activities of daily living (ADLs) in the upper-limb. Functional muscle networks are evaluated for ten able-bodied participants and three upper-limb amputees. Muscle activity was acquired from a custom-made wearable armband of MMG sensors placed over four superficial muscles around the forearm (flexor carpi radialis (FCR), brachioradialis (BR), extensor digitorum communis (EDC), and flexor carpi ulnaris (FCU)) while participants performed four different hand gestures. Muscle connectivity analysis at multiple frequency bands shows significant topographical differences across gestures for low (i.e., $< $ 5 Hz) and high (i.e., $>$ 12 Hz) activation frequencies as well as observable network differences between amputee and non-amputee subjects. Results demonstrate MMG can be used for the analysis of functional muscle connectivity and mapping of synergistic functional synchronization of upper-limb muscles in complex movement tasks. The new physiological modality provides key insights into neural circuitry of motor coordination. Findings further offer the concomitant outcomes of demonstrating feasibility of MMG to map muscle coherence from a neurophysiological perspective and providing a mechanistic basis for its translation in human-robot interface. [ABSTRACT FROM AUTHOR]

Designing efficient and labor-saving prosthetic hands requires powerful hand gesture recognition algorithms that can achieve high accuracy with limited complexity and latency. In this context, the paper proposes a Compact Transformer-based Hand Gesture Recognition framework referred to as CT-HGR , which employs a vision transformer network to conduct hand gesture recognition using high-density surface EMG (HD-sEMG) signals. Taking advantage of the attention mechanism, which is incorporated into the transformer architectures, our proposed CT-HGR framework overcomes major constraints associated with most of the existing deep learning models such as model complexity; requiring feature engineering; inability to consider both temporal and spatial information of HD-sEMG signals, and requiring a large number of training samples. The attention mechanism in the proposed model identifies similarities among different data segments with a greater capacity for parallel computations and addresses the memory limitation problems while dealing with inputs of large sequence lengths. CT-HGR can be trained from scratch without any need for transfer learning and can simultaneously extract both temporal and spatial features of HD-sEMG data. Additionally, the CT-HGR framework can perform instantaneous recognition using sEMG image spatially composed from HD-sEMG signals. A variant of the CT-HGR is also designed to incorporate microscopic neural drive information in the form of Motor Unit Spike Trains (MUSTs) extracted from HD-sEMG signals using Blind Source Separation (BSS). This variant is combined with its baseline version via a hybrid architecture to evaluate potentials of fusing macroscopic and microscopic neural drive information. The utilized HD-sEMG dataset involves 128 electrodes that collect the signals related to 65 isometric hand gestures of 20 subjects. The proposed CT-HGR framework is applied to 31.25, 62.5, 125, 250 ms window sizes of the above-mentioned dataset utilizing 32, 64, 128 electrode channels. Our results are obtained via 5-fold cross-validation by first applying the proposed framework on the dataset of each subject separately and then, averaging the accuracies among all the subjects. The average accuracy over all the participants using 32 electrodes and a window size of 31.25 ms is 86.23%, which gradually increases till reaching 91.98% for 128 electrodes and a window size of 250 ms. The CT-HGR achieves accuracy of 89.13% for instantaneous recognition based on a single frame of HD-sEMG image. The proposed model is statistically compared with a 3D Convolutional Neural Network (CNN) and two different variants of Support Vector Machine (SVM) and Linear Discriminant Analysis (LDA) models. The accuracy results for each of the above-mentioned models are paired with their precision, recall, F1 score, required memory, and train/test times. The results corroborate effectiveness of the proposed CT-HGR framework compared to its counterparts. [ABSTRACT FROM AUTHOR]

Unrecognized deterioration of COVID-19 patients can lead to high morbidity and mortality. Most existing deterioration prediction models require a large number of clinical information, typically collected in hospital settings, such as medical images or comprehensive laboratory tests. This is infeasible for telehealth solutions and highlights a gap in deterioration prediction models based on minimal data, which can be recorded at a large scale in any clinic, nursing home, or even at the patient's home. In this study, we develop and compare two prognostic models that predict if a patient will experience deterioration in the forthcoming 3 to 24 h. The models sequentially process routine triadic vital signs: (a) oxygen saturation, (b) heart rate, and (c) temperature. These models are also provided with basic patient information, including sex, age, vaccination status, vaccination date, and status of obesity, hypertension, or diabetes. The difference between the two models is the way that the temporal dynamics of the vital signs are processed. Model #1 utilizes a temporally-dilated version of the Long-Short Term Memory model (LSTM) for temporal processes, and Model #2 utilizes a residual temporal convolutional network (TCN) for this purpose. We train and evaluate the models using data collected from 37,006 COVID-19 patients at NYU Langone Health in New York, USA. The convolution-based model outperforms the LSTM based model, achieving a high AUROC of 0.8844–0.9336 for 3 to 24 h deterioration prediction on a held-out test set. We also conduct occlusion experiments to evaluate the importance of each input feature, which reveals the significance of continuously monitoring the variation of the vital signs. Our results show the prospect for accurate deterioration forecast using a minimum feature set that can be relatively easily obtained using wearable devices and self-reported patient information. [ABSTRACT FROM AUTHOR]

Objective: Objective evaluation of physiological responses using non-invasive methods for the assessment of vocal performance and voice disorders has attracted great interest. This paper, for the first time, aims to implement and evaluate perilaryngeal-cranial functional muscle networks. The study investigates the variations in topographical characteristics of the network and the corresponding ability to differentiate vocal tasks. Method: Twelve surface electromyography (sEMG) signals were collected bilaterally from six perilaryngeal and cranial muscles. Data were collected from eight subjects (four females) without a known history of voice disorders. The proposed muscle network is composed of pairwise coherence between sEMG recordings. The network metrics include (a) network degree and (b) weighted clustering coefficient (WCC). Results: The varied phonation tasks showed the median degree, and WCC of the muscle network ascend monotonically, with a high effect size ($|r_{rb}|\sim 0.5$). Pitch glide, singing, and speech tasks were significantly distinguishable using degree and WCC ($|r_{rb}|\sim 0.8$). Also, pitch glide had the highest degree and WCC among all tasks (degree $>0.7$ , WCC $>0.75$). In comparison, classic spectrotemporal measures showed far less effectiveness (max $|r_{rb}|=0.12$) in differentiating the vocal tasks. Conclusion: Perilaryngeal-cranial functional muscle network was proposed in this paper. The study showed that the functional muscle network could robustly differentiate the vocal tasks while the classic assessment of muscle activation fails to differentiate. Significance: For the first time, we demonstrate the power of a perilaryngeal-cranial muscle network as a neurophysiological window to vocal performance. In addition, the study also discovers tasks with the highest network involvement, which may be utilized in the future to monitor voice disorders and rehabilitation. [ABSTRACT FROM AUTHOR]

Bilateral telerobotic systems have attracted a great deal of interest during the last two decades. The major challenges in this field are the transparency and stability of remote force rendering, which are affected by network delays causing asynchrony between the actions and the corresponding reactions. In addition, the overactivation of stabilizers further degrades the fidelity of the rendered force field. In this article, a real-time frequency-based delay compensation approach is proposed to maximize transparency while reducing the activation of the stabilization layer. The algorithm uses a regulated bound-limited multiple Fourier linear combiner to extract the dominant frequency of force waves. The estimated weights are used in conjunction with the relatively phase-lead harmonic kernels to reconstruct the signal and generate a compensated wave to reduce the effect of the delay. The reconstructed force will then pass through a modulated time-domain passivity controller to guarantee the stability of the system. We will show that the proposed technique will reduce the force-tracking error by 40% and the activation of the stabilizer by 79%. It is shown, for the first time, that through the utilization of online adaptive frequency-based prediction, the asynchrony between transmitted waves through delayednetworks can be significantly mitigated while stability can be guaranteed with less activation of the stabilization layer. [ABSTRACT FROM AUTHOR]

Sensory information is critical for motor coordination. However, understanding sensorimotor integration is complicated, especially in individuals with impairment due to injury to the central nervous system. This research presents a novel functional biomarker, based on a nonlinear network graph of muscle connectivity, called InfoMuNet, to quantify the role of sensory information on motor performance. Thirty-two individuals with post-stroke hemiparesis performed a grasp-and-lift task, while their muscle activity from 8 muscles in each arm was measured using surface electromyography. Subjects performed the task with their affected hand before and after sensory exposure to the task performed with the less-affected hand. For the first time, this work shows that InfoMuNet robustly quantifies changes in functional muscle connectivity in the affected hand after exposure to sensory information from the less-affected side. > 90% of the subjects conformed with the improvement resulting from this sensory exposure. InfoMuNet also shows high sensitivity to tactile, kinesthetic, and visual input alterations at the subject level, highlighting its potential use in precision rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Background: The assessment and treatment of writer's cramp is complicated due to the variations in the forces and angles of involved joints. Additionally, in some cases compensatory movements for cramp relief further complicates assessment. Currently these variables are subjectively measured with clinical scales and visual assessments. This subjectivity makes it difficult to successfully administer interventions such as Botulinum toxin injection or orthotics resulting in poor efficacy and significant side effects.Method: A multi-sensor system was used to record finger and wrist forces along with deviation angles at the wrist, elbow and shoulder while 9 patients with writer's cramp performed a series of standardized tasks on surfaces inclined at different angles. Clinical, kinetic, and kinematic information regarding cramping was collected.Results: First, four tasks appeared to best predict cramp occurrence. Second, unique biomechanical profiles emerged for patients regarding force, angles and cramp severity. Third, cluster analyses using these features showed a clear separation of patients into two severity classes. Finally, a relationship between severity and kinetic-kinematic information suggested that primary cramping versus compensatory movements could be potentially inferred.Conclusions: The results demonstrate that using a set of standardized tasks and objective measures, individual profiles for arm movements and applied forces associated with writer's cramp can be generated. The clinician can then accurately target the biomechanics specifically, whether it is with injection or other rehabilitative measures, fulfilling an important unmet need in the treatment of writer's cramp. [ABSTRACT FROM AUTHOR]

Neurorobotic augmentation (e.g., robotic assist) is now in regular use to support individuals suffering from impaired motor functions. A major unresolved challenge, however, is the excessive cognitive load necessary for the human–machine interface (HMI). Grasp control remains one of the most challenging HMI tasks, demanding simultaneous, agile, and precise control of multiple degrees-of-freedom (DoFs) while following a specific timing pattern in the joint and human–robot task spaces. Most commercially available systems use either an indirect mode-switching configuration or a limited sequential control strategy, limiting activation to one DoF at a time. To address this challenge, we introduce a shared autonomy framework centred around a low-cost multi-modal sensor suite fusing: (a) mechanomyography (MMG) to estimate the intended muscle activation, (b) camera-based visual information for integrated autonomous object recognition, and (c) inertial measurement to enhance intention prediction based on the grasping trajectory. The complete system predicts user intent for grasp based on measured dynamical features during natural motions. A total of 84 motion features were extracted from the sensor suite, and tests were conducted on 10 able-bodied and 1 amputee participants for grasping common household objects with a robotic hand. Real-time grasp classification accuracy using visual and motion features obtained 100%, 82.5%, and 88.9% across all participants for detecting and executing grasping actions for a bottle, lid, and box, respectively. The proposed multimodal sensor suite is a novel approach for predicting different grasp strategies and automating task performance using a commercial upper-limb prosthetic device. The system also shows potential to improve the usability of modern neurorobotic systems due to the intuitive control design. [ABSTRACT FROM AUTHOR]