Biomedical Engineering and Bioengineering Commons^™

Unobtrusive Assessment Of Upper-Limb Motor Impairment Using Wearable Inertial Sensors, Brandon R. Oubre

Doctoral Dissertations

Many neurological diseases cause motor impairments that limit autonomy and reduce health-related quality of life. Upper-limb motor impairments, in particular, significantly hamper the performance of essential activities of daily living, such as eating, bathing, and changing clothing. Assessment of impairment is necessary for tracking disease progression, measuring the efficacy of interventions, and informing clinical decision making. Impairment is currently assessed by trained clinicians using semi-quantitative rating scales that are limited by their reliance on subjective, visual assessments. Furthermore, existing scales are often burdensome to administer and do not capture patients' motor performance in home and community settings, resulting in a …

Quantifying And Reversing Compensatory Movements By Persons Post-Stroke In The Ambient Setting, Aaron Miller

Doctoral Dissertations

Nearly 800,000 people in the United States suffer stroke annually. Following the onset of stroke, survivors will exhibit deficits, such as hemiplegia, which will limit their function and ability to perform activities of daily living (ADLs). In order to regain independence, many stroke survivors will employ maladaptive compensatory strategies to help with the completion of tasks. Compensation is generally defined as any performance of a task that is different than the way it may have been performed before the onset of a neurodegenerative disorder. While for some severely impaired individuals, compensation may be necessary, for most these maladaptive strategies ultimately …

Biomechanically Inspired Assistive Technology To Restore Movement Of The Upper Limbs After Stroke, Ariel Thomas

Graduate Theses, Dissertations, and Problem Reports

A stroke often damages the neural structures responsible for movement. Stroke is a heterogeneous disease, affecting each survivor differently. There are common motor features of a stroke, but even these features vary across time as an individual proceeds through different stages of recovery. The different ways in which stroke motor impairment can present itself are often overlooked, but these differences are fundamental to the understanding of the disease and its recovery. When motor assessments are capable of acquiring information necessary to parse out a detailed profile of each stroke case, this will lead to an improved neuromechanical understanding of the …

Eeg Characterization Of Sensorimotor Networks: Implications In Stroke, Dylan Blake Snyder

Dissertations (1934 -)

The purpose of this dissertation was to use electroencephalography (EEG) to characterize sensorimotor networks and examine the effects of stroke on sensorimotor networks. Sensorimotor networks play an essential role in completion of everyday tasks, and when damaged, as in stroke survivors, the successful completion of seemingly simple motor tasks becomes fantasy. When sensorimotor networks are impaired as a result of stroke, varying degrees of sensorimotor deficits emerge, most often including loss of sensation and difficulty generating upper extremity movements. Although sensory therapies, such as the application of tendon vibration, have been shown to reduce the sensorimotor deficits after stroke, the …

Reaching Performance In Heathy Individuals And Stroke Survivors Improves After Practice With Vibrotactile State Feedback, Valay A. Shah

Dissertations (1934 -)

Stroke causes deficits of cognition, motor, and/or somatosensory functions. These deficits degrade the capability to perform activities of daily living (ADLs). Many research investigations have focused on mitigating the motor deficits of stroke through motor rehabilitation. However, somatosensory deficits are common and may contribute importantly to impairments in the control of functional arm movement. This dissertation advances the goal of promoting functional motor recovery after stroke by investigating the use of a vibrotactile feedback (VTF) body-machine interface (BMI). The VTF BMI is intended to improve control of the contralesional arm of stroke survivors by delivering supplemental limb-state feedback to the …

Indirect Structural Connectivity As A Biomarker For Stroke Motor Recovery, Miguel Renato Sotelo Munoz

Dissertations (1934 -)

In this dissertation project, we demonstrated that diffusion magnetic resonance imaging and measures of indirect structural brain connectivity are sensitive to changes in fiber integrity and connectivity to remote regions in the brain after stroke. Our results revealed new insights into the effects local lesions have on global connectivity—in particular, the cerebellum—and how these changes in connectivity and integrity relate to motor impairment. We tested this methodology on two stroke groups—subacute and chronic—and were able to show that indirect connectivity is sensitive to differences in connectivity during stroke recovery. Our work can inform clinical methods for rehabilitating motor function in …

Muscle Coordination Contributes To Function After Stroke; Proprioception Contributes To Control Of Posture, Movement, Maria Bengtson

Dissertations (1934 -)

More than half of stroke survivors experience persistent upper extremity motor impairments that can negatively impact quality of life and independence. Effective use of the upper extremity requires coordination of agonist/antagonist muscle pairs, as well as coordination of multiple control actions for stabilizing and moving the arm. In this dissertation, I present three studies in which I recorded isometric torque production, single joint movement and stabilization, and clinical measures of function and impairments after stroke to evaluate the extent to which changes in coordination of agonist/antagonist muscles and of sequential control actions contribute to deficits after stroke. In Aim 1, …

Assessment Of A Hand Exoskeleton On Proximal And Distal Training In Virtual Environments For Robot Mediated Upper Extremity Rehabilitation, Kevin Abbruzzese

Dissertations

Stroke is the leading cause of disability in the United States with approximately 800,000 cases per year. This cerebral vascular accident results in neurological impairments that reduce limb function and limit the daily independence of the individual. Evidence suggests that therapeutic interventions with repetitive motor training can aid in functional recovery of the paretic limb. Robotic rehabilitation may present an exercise intervention that can improve training and induce motor plasticity in individuals with stroke. An active (motorized) hand exoskeleton that provides support for wrist flexion/extension, abduction/adduction, pronation/supination, and finger pinch is integrated with a pre-existing 3-Degree of Freedom (DOF) haptic …

Engineering Synthetic Feedback To Promote Recovery Of Self-Feeding Skills In People With Sensory Deficits Due To Stroke, Alexis Krueger

Master's Theses (2009 -)

Kinesthesia refers to sensations of limb position and movement, and deficits of upper limb kinesthetic feedback are common after stroke, impairing stroke survivors’ ability to perform the fundamental reaching and stabilization behaviors needed for daily functions like self-feeding. I attempt to mitigate the negative impact of post-stroke kinesthesia deficits by evaluating the utility of vibrotactile sensory substitution to restore closed-loop kinesthetic feedback of the upper limb. As a first step, this study evaluated performance in healthy individuals during fundamental reaching, stabilization, and tracking behaviors while using supplemental vibrotactile feedback encoding either limb state information or goal-aware error information. First, I …

Lesion Identification And The Effect Of Lesion On Motor Mapping After Stroke, Ruixi Zhou

McKelvey School of Engineering Theses & Dissertations

Stroke is the most common cause of long-term severe disability and the motor system that is most commonly affected in stroke. One of the mechanisms that underlies recovery of motor deficits is reorganization or remapping of functional representations around the motor cortex. This mechanism has been shown in monkeys, but results in human subjects have been variable. In this thesis, I used a database that includes longitudinal behavioral and multimodal imaging data in both stroke patients and healthy controls for two research projects. Firstly, I improved an automatic lesion segmentation method to aid in the identification of the location and …

Structural-Functional Brain Connectivity Underlying Integrative Sensorimotor Function After Stroke, Benjamin Thomas Kalinosky

Dissertations (1934 -)

In this dissertation research project, we demonstrated the relationship between the structural and functional connections across the brain in stroke survivors. We used this information to predict arm function in stroke survivors, suggesting that the tools developed through this research will be useful for prescribing individualized rehabilitation strategies in people after stroke. Current clinical methods for rehabilitating sensorimotor function after stroke are not based on the locus of injury in the brain. Instead, therapies are generalized, treating symptoms such as weakness and spasticity. This results in outcomes that are highly variable, with severity of impairment immediately following stroke as the …

Plasticity Of The Cortical Representation Of Finger Extensors Induced By Paired Associative Stimulation, Ian Anthony Gerard Lafond

Dissertations

This dissertation first explored associative plasticity of the human motor cortical representation with the use of noninvasive transcranial magnetic stimulation (TMS) paired with peripheral electrical stimulation. Paired Associative Stimulation (PAS) has grown in popularity because of its potential clinical applications. PAS techniques are used in combination with electromyography (EMG) measurements to study cortical excitability and features of hand movement. This work focuses on a cohesive approach to answer central questions about: the ideal mechanism to facilitate cortical plasticity via PAS, the interaction between the behavior performed and type of stimulation delivered to the targeted cortical network and the effects of …

An Investigation Of Kinetic Visual Biofeedback On Dynamic Stance Symmetry, Trisha J. Massenzo

Theses and Dissertations

The intent of the following research is to utilize task-specific, constraint-induced therapies and apply towards dynamic training for symmetrical balance. Modifications to an elliptical trainer were made to both measure weight distributions during dynamic stance as well as provide kinetic biofeedback through a man-machine interface. Following a review of the background, which includes research from several decades that are seminal to current studies, a design review is discussed to cover the design of the modified elliptical (Chapter 2).

An initial study was conducted in a healthy sample population in order to determine the best visual biofeedback representation by comparing different …

Role Of Sensation In Altered Phalanx Grip Force In Persons With Stroke, Leah R. Enders

Theses and Dissertations

Many individuals experience hand impairment after stroke leading to decreased ability to perform daily living activities. Previous research studies have investigated how stroke survivors' pinch grip control differs from healthy individuals, even though many individuals can only grasp with power grip after stroke. Furthermore, many stroke survivors experience tactile sensory deficit in their paretic limb in addition to motor deficit. It is currently unknown how stroke induced tactile sensory deficit affects power grip force directional control, which is important in terms of preventing object slippage and power grip normal force generation. Additionally it is unknown if power grip could be …

Dynamic Balance Control During Treadmill Walking In Chronic Stroke Survivors, Eric Richard Walker

Dissertations (1934 -)

Maintaining dynamic balance is an important component of walking function that is likely impaired in chronic stroke survivors, evidenced by an increased prevalence of falls. Dynamic balance control requires maintaining the center of mass (COM) within the base of support during movement. During walking, dynamic balance control is achieved largely by modifying foot placement to adjust the base of support. However, chronic stroke survivors have difficulty with both precision control of foot placement, as well as reduced control of COM movement. The objective of this dissertation was to characterize dynamic balance control strategies during walking in chronic stroke survivors. Additionally, …

Supraspinal Control Of Unilateral Locomotor Performance: An Fmri Study Using A Custom Pedaling Device, Brett Arand

Master's Theses (2009 -)

This study aimed to develop a novel unilateral pedaling device, validate its function, and use it in an fMRI study of bilateral vs. unilateral locomotor control. The new device is MRI compatible and allows for conventional coupled bilateral pedaling, along with decoupled unilateral pedaling. It was designed with an assistance mechanism to simulate the presence of the non-contributing leg while pedaling unilaterally. During coupled bilateral pedaling, the two legs work in unison: while one leg is extending in the downstroke, it provides support to lift the other leg back up as it is flexing in the upstroke. The device uses …

Fibrinogen-Conjugated Gold-Coated Magnetite Nanoparticles For Antiplatelet Therapy, Evan Schuerer Krystofiak

Theses and Dissertations

Ischemic stroke is the world's second leading cause of death and accounts for 2-4% of total worldwide healthcare costs. Ischemic stroke is caused by the occlusion of arteries responsible for supplying blood to the brain, which can result in disability or death. Arterial blood clots consist of aggregates of activated platelets wrapped in a mesh of fibrin. Tissue plasminogen activator, the only current FDA-approved treatment for ischemic stroke, functions by lysing fibrin in a blood clot. Unfortunately, tissue plasminogen activator significantly increases bleeding risks, which restricts its use. Alternatively, targeting and disrupting platelets within a clot could improve stroke outcome. …

Use Of Focused Ultrasound For Transcranial Sonothrombolysis, Golnaz Ahadi

Wayne State University Dissertations

Worldwide, stroke is the second most common cause of death. Ischemic stroke remains accountable for the majority of the 20 million devastating stroke events occurring globally each year. Use of transcranial focused ultrasound (FUS) for sonothrombolysis is a new research field for ischemic stroke treatment. If shown to be effective, FUS sonothrombolysis could become a widely available treatment option for the majority of the stroke sufferers that do not qualify or do not have access to current thrombolytic treatment options, such as tPA or neurointerventional methods.

The current study was an in vitro transcranial FUS headsystem investigation for the potential …

Development Of A Closed-Loop Force Reduction Mechanism In A Gait Rehabilitation Device, Jeffrey Frankart

Theses and Dissertations

Elliptical trainers are prescribed in rehabilitative exercise but difficult to implement in populations with significant functional gait deficits. Typical elliptical machines do not mimic normal gait and therefore require modifications for clinical rehabilitation. This research builds on previous modifications of an elliptical trainer designed to simulate level-surface walking. This design differed from a commercial version. It included articulated footplates and an electromechanically-driven virtual-cam to control footplate position. Ankle dorsiflexion elicited lower-extremity muscle spasticity which produced an unwanted gait variant during stroke patient testing. Spasticity is a hyperexcitable stretch reflex causing inefficient gait. This project’s purpose was to develop an autonomous …

Pedaling-Related Brain Activation In People Post-Stroke: An Fmri Study, Nutta-On Promjunyakul

Dissertations (1934 -)

This study aimed to enhance our understanding of supraspinal control of locomotion in stroke survivors and its relationship to locomotor impairment. We focused mainly on the locomotor component of walking, which involves rhythmic, reciprocal, flexion and extension movements of multiple joints in both legs. Functional magnetic resonance imaging (fMRI) was used to record human brain activity while pedaling was used as a model of locomotion. First, we examined the spatiotemporal characteristics of hemodynamic responses recorded with fMRI and found that they were different in stroke survivors and control subjects. However, these differences were not substantial enough to require altering the …

Virtual Reality Visual Feedback And Its Effect On Brain Excitability, Soha Saleh

Dissertations

This dissertation examines manipulation of visual feedback in virtual reality (VR) to increase excitability of distinct neural networks in the sensorimotor cortex. The objective is to explore neural responses to visual feedback of motor activities performed in complex virtual environments during functional magnetic resonance imaging (fMRI), and to identify sensory manipulations that could further optimize VR rehabilitation of persons with hemiparesis. In addition, the effects of VR therapy on brain reorganization are investigated. An MRI-compatible VR system is used to provide subjects with online visual feedback of their hand movement. First, the author develops a protocol to analyze variability in …

Abnormal Neuromuscular Fatigue And Motor Performance Of The Knee Extensors Post Stroke, Henry Kuhnen

Master's Theses (2009 -)

Stroke causes paresis in leg muscles, such as the knee extensors, that significantly impairs motor control and function during tasks such as walking. Reduced endurance and increased kinematic asymmetries during walking over time indicate paretic musculature may fatigue more quickly than non-paretic musculature. The primary purpose of this study was to identify abnormalities in neuromuscular fatigue (reduction in force over time) of the paretic knee extensors and associate them with motor performance.

We investigated the effects of repeated six second isometric submaximal (30% of maximum voluntary contraction) knee extensor fatiguing contractions on task failure and motor performance in ten chronic …

Comparison Of An Ankle-Foot-Orthosis And Neuroprosthesis During Level And Non-Level Walking For Individuals Post-Stroke, Michelle Beverly Gallagher

Master's Theses (2009 -)

This study used gait analysis to compare the efficacy of the two foot drop treatments (ankle-foot-orthosis and neuroprosthesis) and to contrast the stimulation control of the two different neuroprosthesis sensors during level and non-level ambulation of post-stroke individuals.

Eight subjects completed two gait analysis sessions, once while using a study-provided articulated AFO and the other while using a WalkAide. After four weeks of acclimation to the device, each subject performed two minute walking trials on a level, inclined and declined treadmill. Kinematic and heart rate data were collected for all sessions. Plantar pressure and WalkAide tilt, heel loading, and stimulation …

Role Of Tendon Vibration In Multijoint Reflex Coupling In The Hemiparetic Arm Post Stroke, Bani Gadhoke

Master's Theses (2009 -)

Post stroke hemiparesis causes reflex coupling in multiple muscles of the arm, leading to atypical movements that hamper motor control. In particular, people post-stroke can become unstable while holding the arm at the end of a planar motion. Recently, we have found that tendon vibration of the wrist flexors improves the stability of the arm during a hold task. The objective of the current study was to identify the effects of vibration applied to the wrist flexors on the biceps and triceps stretch reflexes, generated using a tendon tapper. In people post-stroke, tendon tap perturbations of the biceps and triceps …

Sensorimotor Control Of 3d Arm Movement And Stability In Post-Stroke Hemiparesis, Kakanand Alfonsomarie Srungboonmee

Dissertations (1934 -)

Deficits of the affected arm in people with post-stroke hemiparesis have been generally associated with decreased strength and increased spasticity. These deficits are varied in proximal (shoulder) and distal (elbow) joints which results in an overall impairment during movement or during stabilization of hand position in space. In this study, reaching of the hemiparetic arm in 3D workspace was characterized by a curved and non-smooth endpoint trajectory and a reduced functional range of motion, compared to the unimpaired arm. Smoother trajectories were observed in the acceleration phase more than the deceleration phase, which was common to both the stroke subjects …

Design And Validation Of An Mr Conditional Upper Extremity Evaluation System To Study Brain Activation Patterns After Stroke, Rubing Xu

Master's Theses (2009 -)

Stroke is the third leading cause of death and second most frequent cause of disability in the United States. Stroke rehabilitation methods have been developed to induce the cortical reorganization and motor-relearning that leads to stroke recovery. In this thesis, we designed and developed an MR conditional upper extremity reach and grasp movement evaluation system for the stroke survivors to study their kinematic performances in reach and grasp movement and the relationship between kinematic metrics and the recovery level measured by clinical assessment methods. We also applied the system into the functional MRI experiments to identify the ability to study …