Spasticity is a neurological disorder in which a target group of muscles remain in a contracted state. In addition to interfering with the function of these muscles, spasticity causes chronic pain and discomfort. Often found in patients with cerebral palsy, multiple sclerosis, or stroke history, spasticity affects an estimated twelve million people worldwide. Not only does spasticity cause discomfort and loss of function, but the condition can lead to contractures, or permanent shortenings of the muscle and connective tissue, if left untreated. Current treatments for spasticity are primarily different forms of muscle relaxant pharmaceuticals. Almost all of these drugs, however, carry unwanted side effects, including total muscle weakness, liver toxicity, and possible dependence. Additionally, kinesiotherapy, conducted by physical therapists at rehabilitation clinics, is often prescribed to people suffering from spasticity. Since kinesiotherapy requires frequent practice to be effective, proper treatment requires constant professional care and clinic appointments, discouraging patient compliance. Consequently, a medical device that could automate relief for spasticity outside of a clinic is desired in the market. While a number of different dynamic splints for hand spasticity are currently on the market, research has shown that these devices, which simply brace the hand in an extended position, do not work through any mechanism to decrease spastic tension over time. Two methods of temporarily reducing spasticity that have been observed in clinical studies are cryotherapy, or the decrease of temperature on a target area, and electrotherapy, which is the delivery of regulated electrical pulses to a target area. It is possible that either of these mechanisms could be incorporated into a medical device aimed toward spastic relief. In fact, electrotherapy is used in a current market device called the SaeboStim, which is advertised to help stroke recovery and spastic reduction. The purpose of this paper is to evaluate the viability of a potential spastic relief device that utilizes cryotherapy to a current and closest competitor, the SaeboStim. The effectiveness of each device in relieving spasticity is reviewed. The two devices are also compared on their ability to address primary customer needs, such as convenience, ease of use, durability, and price. Overall, it is concluded that the cryotherapy device more effectively relieves hand spasticity in users, although the SaeboStim's smaller size and better convenience gives it market appeal, and reveals some of the shortcomings in the preliminary design of the cryotherapy device.

Lower-limb prosthesis users have commonly-recognized deficits in gait and posture control. However, existing methods in balance and mobility analysis fail to provide sufficient sensitivity to detect changes in prosthesis users' postural control and mobility in response to clinical intervention or experimental manipulations and often fail to detect differences between prosthesis users and non-amputee control subjects. This lack of sensitivity limits the ability of clinicians to make informed clinical decisions and presents challenges with insurance reimbursement for comprehensive clinical care and advanced prosthetic devices. These issues have directly impacted clinical care by restricting device options, increasing financial burden on clinics, and limiting support for research and development. This work aims to establish experimental methods and outcome measures that are more sensitive than traditional methods to balance and mobility changes in prosthesis users. Methods and analysis techniques were developed to probe aspects of balance and mobility control that may be specifically impacted by use of a prosthesis and present challenges similar to those experienced in daily life that could improve the detection of balance and mobility changes. Using the framework of cognitive resource allocation and dual-tasking, this work identified unique characteristics of prosthesis users’ postural control and developed sensitive measures of gait variability. The results also provide broader insight into dual-task analysis and the motor-cognitive response to demanding conditions. Specifically, this work identified altered motor behavior in prosthesis users and high cognitive demand of using a prosthesis. The residual standard deviation method was developed and demonstrated to be more effective than traditional gait variability measures at detecting the impact of dual-tasking. Additionally, spectral analysis of the center of pressure while standing identified altered somatosensory control in prosthesis users. These findings provide a new understanding of prosthetic use and new, highly sensitive techniques to assess balance and mobility in prosthesis users.

Object manipulation is a common sensorimotor task that humans perform to interact with the physical world. The first aim of this dissertation was to characterize and identify the role of feedback and feedforward mechanisms for force control in object manipulation by introducing a new feature based on force trajectories to quantify the interaction between feedback- and feedforward control. This feature was applied on two grasp contexts: grasping the object at either (1) predetermined or (2) self-selected grasp locations (“constrained” and “unconstrained”, respectively), where unconstrained grasping is thought to involve feedback-driven force corrections to a greater extent than constrained grasping. This proposition was confirmed by force feature analysis. The second aim of this dissertation was to quantify whether force control mechanisms differ between dominant and non-dominant hands. The force feature analysis demonstrated that manipulation by the dominant hand relies on feedforward control more than the non-dominant hand. The third aim was to quantify coordination mechanisms underlying physical interaction by dyads in object manipulation. The results revealed that only individuals with worse solo performance benefit from interpersonal coordination through physical couplings, whereas the better individuals do not. This work showed that naturally emerging leader-follower roles, whereby the leader in dyadic manipulation exhibits significant greater force changes than the follower. Furthermore, brain activity measured through electroencephalography (EEG) could discriminate leader and follower roles as indicated power modulation in the alpha frequency band over centro-parietal areas. Lastly, this dissertation suggested that the relation between force and motion (arm impedance) could be an important means for communicating intended movement direction between biological agents.

Electromyography (EMG) is an extremely useful tool in extracting control signals from the human body. Needle electromyography is the current standard for obtaining superior quality muscle signals and obtaining signals corresponding to individual muscles. However, needle EMG faces many problems when converting from the laboratory to marketable devices, specifically in home devices. Many patients have issues with needles and the extra care required of needle EMG is prohibitive. Therefore, a surface EMG device that can obtain clear signals from individual muscles would be valuable to many markets in the development of next generation in home devices. Here, signals from surface EMG were analyzed using a low noise EMG evaluation system (RHD 2000; Intan Technologies). The signal to noise ratio (SNR) was calculated using MatLab. The average SNR is 4.447 for the Extensor Carpi Ulnaris, and 7.369 for the Extensor Digitorum Communis. Spectral analysis was performed using the Welch approach in MatLab. The power spectrum indicated that low frequency signals dominate the EMG of small hand muscles. Also, harmonic bands of 60Hz noise were present as part of the signal which should be accounted for with filters in future iterations of the testing method. Provided is evidence that strong, independent signals were acquired and could be used in further application of surface EMG corresponding to lifting of the fingers.

Background. Proprioception plays a large role in everyday functioning, involving both information of body position and movement (Johnson & Panayotis, 2010). Clinical assessments of proprioception are largely subjective and are not reliable measures for testing proprioception in impaired or unimpaired individuals. Recent advancements in technology and robotics have brought about new assessments that involve position matching and other paradigms. However, the results are confined to the horizontal plane and only look at a very small subset of human proprioceptive ability. Objective. The present study looks to overcome these limitations and examine differences in proprioceptive sensitivity across different directions in 3D space. Methods. Participants were recruited from Arizona State University to perform a "same-different" discrimination test using a robotic arm. Each participant was tested along two of the three directions, and within each direction, proprioception at four distances (1-4 cm) was tested. Performance was quantified using percent correct, d' analysis, and permutation testing on median and variance values. Results. Proprioceptive sensitivity was significantly greater in the up direction vs. down and back across all distances. The greatest difference in sensitivity occurred at 3 cm; permutation tests using median and variance values from percent correct and d' found statistical significance at this distance in the up vs. down and up vs. back comparisons. Conclusions. There is evidence that proprioceptive sensitivity is greater in an anti-gravity direction (up), in comparison to gravity-assisted or gravity-neutral (down and back) directions.

The human hand relies on information from surrounding environment to distinguish objects based on qualities like size, texture, weight, and compliance. The size of an object can be determined from tactile feedback, proprioception, and visual feedback. This experiment aims to determine the accuracy of size discrimination in physical and virtual objects using proprioceptive and tactile feedback. Using both senses will help determine how much proprioceptive and tactile feedback plays a part in discriminating small size variations and whether replacing a missing sensation will increase the subject's accuracy. Ultimately, determining the specific contributions of tactile and proprioceptive feedback mechanisms during object manipulation is important in order to give prosthetic hand users the ability of stereognosis among other manipulation tasks. Two different experiments using physical and virtual objects were required to discover the roles of tactile and proprioceptive feedback. Subjects were asked to compare the size of one block to a previous object. The blocks increased in size by two millimeter increments and were randomized in order to determine whether subjects could correctly identify if a box was smaller, larger, or the same size as the previous box. In the proprioceptive experiment subjects had two sub-sets of experiments each with a different non-tactile cue. The experiment demonstrated that subjects performed better with physical objects compared to virtual objects. This suggests that size discrimination is possible in the absence of tactile feedback, but tactile input is necessary for accuracy in small size discrimination.

The role of retention and forgetting of context dependent sensorimotor memory of dexterous manipulation was explored. Human subjects manipulated a U-shaped object by switching the handle to be grasped (context) three times, and then came back two weeks later to lift the same object in the opposite context relative to that experience on the last block. On each context switch, an interference of the previous block of trials was found resulting in manipulation errors (object tilt). However, no significant re-learning was found two weeks later for the first block of trials (p = 0.826), indicating that the previously observed interference among contexts lasted a very short time. Interestingly, upon switching to the other context, sensorimotor memories again interfered with visually-based planning. This means that the memory of lifting in the first context somehow blocked the memory of lifting in the second context. In addition, the performance in the first trial two weeks later and the previous trial of the same context were not significantly different (p = 0.159). This means that subjects are able to retain long-term sensorimotor memories. Lastly, the last four trials in which subjects switched contexts were not significantly different from each other (p = 0.334). This means that the interference from sensorimotor memories of lifting in opposite contexts was weaker, thus eventually leading to the attainment of steady performance.

Motor behavior is prone to variable conditions and deviates further in disorders affecting the nervous system. A combination of environmental and neural factors impacts the amount of uncertainty. Although the influence of these factors on estimating endpoint positions have been examined, the role of limb configuration on endpoint variability has been mostly ignored. Characterizing the influence of arm configuration (i.e. intrinsic factors) would allow greater comprehension of sensorimotor integration and assist in interpreting exaggerated movement variability in patients. In this study, subjects were placed in a 3-D virtual reality environment and were asked to move from a starting position to one of three targets in the frontal plane with and without visual feedback of the moving limb. The alternating of visual feedback during trials increased uncertainty between the planning and execution phases. The starting limb configurations, adducted and abducted, were varied in separate blocks. Arm configurations were setup by rotating along the shoulder-hand axis to maintain endpoint position. The investigation hypothesized: 1) patterns of endpoint variability of movements would be dependent upon the starting arm configuration and 2) any differences observed would be more apparent in conditions that withheld visual feedback. The results indicated that there were differences in endpoint variability between arm configurations in both visual conditions, but differences in variability increased when visual feedback was withheld. Overall this suggests that in the presence of visual feedback, planning of movements in 3D space mostly uses coordinates that are arm configuration independent. On the other hand, without visual feedback, planning of movements in 3D space relies substantially on intrinsic coordinates.

Motor behavior is prone to variable conditions and deviates further in disorders affecting the nervous system. A combination of environmental and neural factors impacts the amount of uncertainty. Although the influence of these factors on estimating endpoint positions have been examined, the role of limb configuration on endpoint variability has been mostly ignored. Characterizing the influence of arm configuration (i.e. intrinsic factors) would allow greater comprehension of sensorimotor integration and assist in interpreting exaggerated movement variability in patients. In this study, subjects were placed in a 3-D virtual reality environment and were asked to move from a starting position to one of three targets in the frontal plane with and without visual feedback of the moving limb. The alternating of visual feedback during trials increased uncertainty between the planning and execution phases. The starting limb configurations, adducted and abducted, were varied in separate blocks. Arm configurations were setup by rotating along the shoulder-hand axis to maintain endpoint position. The investigation hypothesized: 1) patterns of endpoint variability of movements would be dependent upon the starting arm configuration and 2) any differences observed would be more apparent in conditions that withheld visual feedback. The results indicated that there were differences in endpoint variability between arm configurations in both visual conditions, but differences in variability increased when visual feedback was withheld. Overall this suggests that in the presence of visual feedback, planning of movements in 3D space mostly uses coordinates that are arm configuration independent. On the other hand, without visual feedback, planning of movements in 3D space relies substantially on intrinsic coordinates.

Humans rely on a complex interworking of visual, tactile and proprioceptive feedback to accomplish even the most simple of daily tasks. These senses work together to provide information about the size, weight, shape, density, and texture of objects being interacted with. While vision is highly relied upon for many tasks, especially those involving accurate reaches, people can typically accomplish common daily skills without constant visual feedback, instead relying on tactile and proprioceptive cues. Amputees using prosthetic hands, however, do not currently have access to such cues, making these tasks impossible. This experiment was designed to test whether vibratory haptic cues could be used in replacement of tactile feedback to signal contact for a size discrimination task. Two experiments were run in which subjects were asked to identify changes in block size between consecutive trials using wither physical or virtual blocks to test the accuracy of size discrimination using tactile and haptic feedback, respectively. Blocks randomly increased or decreased in size in increments of 2 to 12 mm between trials for both experiments. This experiment showed that subjects were significantly better at determining size changes using tactile feedback than vibratory haptic cues. This suggests that, while haptic feedback can technically be used to grasp and discriminate between objects of different sizes, it does not lend the same level of input as tactile cues.