Advancements in movement restoration have accelerated in recent years while the restoration of somatosensation has progressed relatively slowly. This dissertation attempts to partially correct this oversight by developing an electrotactile feedback system that might be used to restore the sense of touch.Initially, the perceptual parameters of the skin regions likely to be used as a source of tactile information (the fingertip) and as a destination for electrotactile feedback (the back of the neck) were evaluated. The perceptual parameters of tactile threshold sensitivity, spatial acuity, and gain scaling were collected from subjects for both regions of skin. These same parameters were also gathered in response to electrotactile stimulation of the neck. The threshold sensitivity and spatial acuity of the fingertip was found to be far superior to that on the back of the neck, yet the mechanical perceptual gain scaling parameters of the neck were similar to that of the finger tip. Yet, the psychometric functions for electrical stimulation on the neck differed markedly in gain sensitivity from that of mechanical stimulation. A mapping function between the two modalities was then calculated based upon the tactile and electrotacile characterization data that was collected.An electrotactile feedback system was then developed based upon the calculated mapping function, allowing conversion of force applied to an artificial sensor on the fingertip to a perceptually equivalent electrical stimulus on the neck. The system proved to be quite effective: Subjects were able to effectively evaluate electrical stimulus that was derived from application of force to the sensor on the fingertip. The perceptual gain scaling for the feedback system matched that of natural mechanical stimulation.A grip force matching task was evaluated in test subjects under three conditions: a) normal tactile sensation, b) anesthesia of the fingers, and c) anesthesia of the fingers with restored tactile information via the electrotactile feedback system. The relative loss in grip-force matching ability when tactile feedback was abolished by local anesthetic was mild, indicating a strong ability for individuals to generate target force levels using other forms of feedback. Electrotactile feedback, therefore, offered only modest improvement when deployed in the anesthetized hand.

Au cours des dernières décennies, le développement rapide de la technologie sans fil et micro-électronique a provoqué un profond impact sur notre vie quotidienne. Parallèlement à la tendance, les technologies d'assistance ont été révolutionnées en termes de miniaturisation et de portabilité. Les traditionnels encombrants systèmes de dispositifs aidés, à connexion filaire sont maintenant remplacés par d'autres plus compacts, légers et portables. Le nombre de personnes aveugles et ayant une déficience visuelle continue à faire face à de nombreuses difficultés dans la vie quotidienne, en particulier dans la mobilité et la navigation. La théorie de la substitution sensorielle dans laquelle l'information obtenue d'une modalité sensorielle, peut atteindre les structures du cerveau physiologiquement par d'autres modalités sensorielles; par conséquent, il est possible pour les personnes aveugles et malvoyantes d'obtenir les informations désirées par d'autres sens. Sur la base de ces technologies et principes, nous voulons améliorer le Tongue Display Unit, un dispositif de visio-tactile lingual a été inventé par le professeur Bach-y-Rita à un, dispositif à long terme sans fil portable pour la navigation. Afin de rendre ce dispositif autonome, certaines propriétés doivent être étudiées: l'optimisation de la consommation d'énergie (à faire à long terme) et la communication sans fil efficace. Nous avons fait un examen très détaillé afin de choisir les composants optimaux et la méthode adéquate pour notre système. La conception du matériel a été effectuée en choisissant le meilleur algorithme. Le module émetteur-récepteur sans fil basé sur ZigBee contribue à réduire la consommation globale d'énergie. Notre antenne omnidirectionnelle est appropriée pour une utilisation chez les personnes aveugles qui ne peuvent pas être orientés à l'avance. Nous avons modifié tous les composants de la TDU, du matériel au logiciel, à partir du contrôleur à l'actionneur. La conception de l'ensemble d'électrodes n'est pas rectangulaire comme traditionnellement mais sous une forme ronde avec un soutien utilisé pour la direction et à la navigation. Enfin, le système a été validé par TDU fonctionnement en temps réel et testé sur les utilisateurs réels. Les performances du système en termes de design et d'énergie ont été améliorées. La communication sans fil est plus efficace et consomme moins d'énergie. Les premiers résultats sur les essais des utilisateurs montrent une assez bonne perception de notre TDU. / Over the last decades, the rapid development of wireless technology and microelectronic has caused a profound impact on our daily lives. Alongside the trend, assistive technologies have revolutionized in terms of miniaturization and wearability. The traditional bulky aided devices systems with wired connection are now replaced by the compact, lightweight and portable ones. The number of blind and visually impaired people continues to deal with many difficulties in daily lives, especially in mobility and navigation. The theory of sensory substitution in which information gained from one sensory modality can reach brain structures physiologically through other sensory modalities; therefore, it is possible for the blind and visually impaired people to get desired information via other senses. Based on these technologies and principles, we want to enhance the Tongue Display Unit, a lingual visuo-tactile device was invented by Professor Bach-y-Rita to a wireless, wearable, long-term device for navigation. In order to make such device, some properties have to be studied: optimization of energy consumption (to make it long-term) and efficient wireless communication. We made a very detailed review in order to choose the optimal components and method for our system. The hardware design was calculated and selected the best algorithm. The ZigBee-based wireless transceiver module contributes to reducing the overall power consumption. Our omnidirectional antenna is appropriate for usage in blind people who cannot orient in advance. We modified all components of the TDU, from the hardware to software, from controller to actuator. The design of the electrode array is not rectangular as traditional but in a round shape which is supportively used for direction and navigation. Lastly the TDU system was validated by real-time operation and tested on real users. The performance of the system in terms of design and energy has been improved. The wireless communication is more effective and consumes less power. The primary results on users' trials show rather good perception on our TDU.

Diploma the 'is deals wi th the research of effect of biofeedback in the form of electrotactile stimulation of tongue in the patients with balance disorders eaused by the cerebellar lesion. For the therapeutic program 4 patients with cerebellar ataxia at the age of38 - 74 years were chosen. Subjects have partieipated in the therapeutic program with the application of biofeedback, they were training postural stability while visual control was excluded and they were using electrotacti le signal on the tongue for orientation. I used neurological tests BESTest and Dynamic Oait Index, questionnaire The Activities- Specific Balance Confidence (ABC) Scale, Dizziness I Tandicap Inventory (D ll) a Visual Analogue Scale (VAS), and examination by stati posturography for evaluation of postural stability in the patients. I supposed that therapy by biofeedback in the form of electrotactile stimulation of tongue improves postural stability in the patients with balance disorders caused by cerebellar lesion. Powered by TCPDF (www.tcpdf.org)

INTRODUCTION This graduation theses considers with the influence of rehabilitation by electrotactile stimulation of the tongue on stability of stance and gait in patients with degenerative cerebellar ataxia. Electrotactile stimulation of the tongue is an innovative method based on biofeedback principle, which uses additive sensory information about the position of the head to train the postural stability METHOD We used this method in six patients (four men and two women) with this disease. Patients went through intensive twelve-day therapy. The duration of the lessons was 30 minutes twice a day. We examined postural stability of the patients by using clinical evaluations (Balance Evaluation Systems Test, Dynamic Gait Index), posturography (modified Clinical Test of Sensory Interaction for Balance) and questionnaires (Activities -specific Balance Confidence, Dizziness Handicap Inventory) before and after the therapy. RESULTS The patients showed significant improvement in both clinical tests after the therapy. The results of posturography measurement are not so definite - the significant improvement was achieved only in some measured parameters. Both questionnaires did not show significant improvement. CONCLUSION The results of this study show, that electrotactile stimulation tongue could have a...

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Introduction: Biofeedback based on sensory substitution is a new method to treat patients with postural disorders. BrainPort provides tongue electrotactile stimulation. This innovative technique was developed for vestibular dysfunction of peripheral origin. Primarily for patients who had no benefits from conventional rehabilitation. Tongue electrotactile stimulation seems to be useful for central vestibula dysfunction as well. We are dealing with effect of BrainPort in therapy of degenerative cerebellar ataxia. We are interested in whether the effects persist for one month after the rehabilitation program. Methods: The methods are applied in 6 patients with degenerative cerebellar ataxia, verified by clinical testing, posturography, and genetic testing or verification of cerebellar lesions by MRI. Patients underwent an 12-day intensive rehabilitation program with BrainPort. Treatment was carried out 2 times a day. Patients were learning appropriate postural corrections to maintain signal in the middle of the tongue. To assess the effect of therapy we used posturography, standardized clinical tests - BESTest, Dynamic Gait Index (DGI) and standardized questionnaires - The Activities-Specific Balance Confidence Scale (ABC) and Dizzines Inventroy Handicap (DHI). The examination was performed before...

The graduation thesis deals with the issue of balance disorders due to a cerebellar damage. It deals in detail with the treatment of patients suffering from degenerative cerebellar ataxia and with the use of biofeedback technologies as means of postural stability treatment. The aim of practical part of this work was to investigate the effectiveness of therapy using biofeedback for patients suffering from progressive ataxia due to cerebellar neurodegeneration. The research sample consisted of 8 patients. The patients underwent a total of 18 therapy sessions within a twelve-day rehabilitative program. The therapy contained a training of stability in various positions with the elimination of visual control. A device provided an additive information about head sways for the patients via a tongue electrotactile stimulation. The effects were assessed by means of posturography, functional clinical tests (BESTest, Dynamic Gait Index) and questionnaires (Activities-specific Balance Confidence Scale, Dizziness Handicap Inventory). Three assessments were performed: immediately before, immediately after, and 30 days after the rehabilitative program. A statistical analysis of the data showed significant improvement in all observed parameters. In addition, there was no loss of the benefits in the interval of 30...

Sensory feedback possesses the possibility of adding a new dimension to many applications, including, but not limited to, prosthetics and surgical robots for improved control, virtual reality for incorporation of another sense, and phantom limb pain reduction for amputees. Electrotactile stimulation provides a compact, light-weight, energy efficient, highly responsive, and non-invasive option for sensory feedback; however, it has been found to commonly elicit unnatural or uncomfortable sensations for the user. To address this issue, this thesis was designed to test the impact of the different electrotactile stimulus parameters – current amplitude and polarity, pulse width, frequency, and waveform – on the user’s perceived sensation and afferent neural response. The relationship between sensation and neural response was also analysed. The aim of this thesis was to create guidelines to assist in the design and use of electrotactile stimulation. Neural data and matching psychophysical data from one healthy subject and purely psychophysical data from three others were gathered while applying electrotactile stimulations of different parameter combinations on the dorsal side of the hand or lower arm. Significant (p < 0.05) correlations and differences were found in all three relationships between electrotactile stimulus parameters, primary afferent response, and perceived sensation. Current (specifically negative) or pulse width control in monophasic waveforms were deemed most appropriate in applications that relay information through varying intensity. However, monophasic waveforms produced more discomfort, rendering biphasic waveforms more suitable when mild, local, and more natural sensations are of greater importance. Surprisingly, the data also suggested higher sensitivity to positive currents. While lower values of current amplitude and pulse width increased neural spike count, stimulus frequency could reliably control neural firing at all tested frequencies. Spike counts were moderately to strongly correlated with perceived intensity; however, practically identical neural responses could elicit different sensations. High current pulses at low frequencies induced spikes with the shortest latency – but with greater risk of discomfort. Due to limitations in sample size, generalisability is limited, and this thesis should be considered a pilot study to guide future investigations. The results suggest that recording from single and multiple afferent nerve fibres simultaneously would improve the understanding of the neural population response to electrotactile stimuli. Moreover, the one-to-one neural response to electrotactile stimuli raised the question of whether an electrotactile stimulation based on a natural spike pattern could replicate the original sensation. A future study testing this hypothesis may find a new approach to designing painless electrotactile stimulations for sensory feedback use. / Sensorisk återkoppling har möjlighet att drastiskt förbättra många användningsområden, t.ex. genom att bidra till enklare kontroll av proteser och kirurgiska robotar, mer verklighetstrogna VR-spel, och minskade fantomsmärtor hos patienter med amputeringar. Elektrisk hudstimulering erbjuder ett kompakt, lätt, energisnålt, hög-responsivt och icke-invasivt alternativ för sensorisk återkoppling – dock framkallar denna metod ofta onaturliga och obehagliga förnimmelser för användaren. Detta examensarbete bemöter detta problem genom att undersöka effekten av stimuleringsparametrar som strömstyrka, pulsbredd, frekvens och vågform på försökspersonens upplevda förnimmelse samt den afferenta nervresponsen. Även relationen mellan förnimmelse och nervrespons analyserades. Examensarbetets ändamål var att skapa riktlinjer för att förenkla designen och användandet av elektrisk hudstimulering. Nervdata med matchande psykofysiska data samlades från en frisk försöksperson, samt enbart psykofysiska data från tre andra, under olika elektriska hudstimuleringar (med varierande parametervärden) på handens dorsala sida eller på underarmen. Signifikanta (p < 0.05) korrelationer och skillnader fanns i alla tre relationer mellan parametrarna för elektrisk hudstimulering, primärafferent respons och upplevd förnimmelse. Kontroll av ström (i synnerhet negativ) eller pulsbredd i monofasisk vågform visade sig vara mest fördelaktigt i applikationer där information kommuniceras till användaren genom att variera den upplevda intensiteten. Dock skapade denna vågform mer obehag, och bifasiska vågformer bedömdes mer passande då milda, lokala, och mer naturliga förnimmelser är av högre värde. Positiv ström upplevdes, förvånande, starkare än negativ. Vid låga värden på ström och pulsbredd var dessa faktorer viktiga gällande antalet aktionspotentialer (AP), men stimuleringsfrekvensen kunde kontrollera antalet AP vid alla frekvenser. Mängden AP var måttligt till starkt korrelaterad med upplevd intensitet – samtidigt kunde praktiskt taget identiska nervresponser vara kopplade till olika förnimmelser. Lågfrekvent stimulering med hög ström hade kortast latenstid, men högre risk för obehag. P.g.a. lågt antal försökspersoner är generaliserbarheten begränsad och detta examensarbete bör beaktas som en förstudie för att guida framtida forskning. Resultaten från denna studie antyder att en tydligare bild av populationsresponsen skulle kunna skapas genom samtidig läsning av ett flertal enskilda nervfibrer samtidigt. Det faktum att varje stimulering kunde ge upphov till en AP väckte frågan: kan ett stimuleringsmönster baserat på en naturlig nervrespons återskapa den ursprungliga förnimmelsen? En studie som testar denna hypotes har möjligheten att finna ett nytt tillvägagångssätt för att skapa smärtfri elektrisk hudstimulering för sensorisk återkoppling.