FundaÃÃo Cearense de Apoio ao Desenvolvimento Cientifico e TecnolÃgico / A proposta do estudo consiste na anÃlise do conceito AlteraÃÃo da percepÃÃo sensorial tÃtil em pacientes com Acidente Vascular Cerebral (AVC), realizada com anÃlise da literatura e opiniÃo de peritos. O estudo visa possivelmente atualizar a taxonomia de DiagnÃsticos de Enfermagem (DE), tendo em vista que o DE referente a essa alteraÃÃo nÃo consta mais na classificaÃÃo da NANDA Internacional (NANDA-I), apesar de alteraÃÃes na percepÃÃo sensorial tÃtil serem identificadas frequentemente em pacientes com AVC. Os objetivos do estudo sÃo: Analisar o conceito AlteraÃÃo da percepÃÃo sensorial tÃtil em pacientes com acidente vascular cerebral. Identificar atributos crÃticos, antecedentes e consequentes de AlteraÃÃo da percepÃÃo sensorial tÃtil em pacientes com acidente vascular cerebral; Apresentar as definiÃÃes conceituais e as referÃncias empÃricas de AlteraÃÃo da percepÃÃo sensorial tÃtil em pacientes com acidente vascular cerebral; Validar com peritos a definiÃÃo conceitual (conceito diagnÃstico), os antecedentes (fatores relacionados) e os consequentes (caracterÃsticas definidoras) da AlteraÃÃo da percepÃÃo sensorial tÃtil. Foram realizadas duas etapas: na primeira foram identificados atributos, antecedentes e consequentes de AlteraÃÃes da percepÃÃo sensorial tÃtil em pacientes com AVC com base na literatura, a partir da busca nas bases de dados: Scopus, Pubmed e Cinahl, alÃm de consulta a livros texto; e a segunda consistiu em verificar a opiniÃo de peritos a respeito do conceito (conceito diagnÃstico), dos antecedentes (fatores relacionados) e consequentes (caracterÃsticas definidoras), com suas respectivas definiÃÃes conceituais e referÃncias empÃricas desse fenÃmeno. ApÃs a realizaÃÃo das etapas propostas obtiveram-se os seguintes resultados: IdentificaÃÃo dos atributos crÃticos, fatores relacionados e caracterÃsticas definidoras do fenÃmeno AlteraÃÃo da percepÃÃo sensorial tÃtil em pacientes com AVC, possibilitando a reformulaÃÃo do conceito dessa condiÃÃo clÃnica. De acordo com a AnÃlise de conceito e apÃs a validaÃÃo por peritos, o fenÃmeno AlteraÃÃo da percepÃÃo sensorial tÃtil em pacientes com AVC envolve trÃs atributos crÃticos: EstÃmulo ideal, RecepÃÃo intacta e AlteraÃÃo na interpretaÃÃo. Esses atributos possibilitaram a construÃÃo do conceito: AlteraÃÃo ou incapacidade de interpretar estÃmulos que entram em contato com a superfÃcie corporal do indivÃduo, fornecidos em condiÃÃes ideais e com recepÃÃo intacta pelos receptores tÃteis cutÃneos superficiais e profundos. Quanto aos componentes do fenÃmeno, foram definidos os fatores relacionados com seus respectivos conceitos e definiÃÃes operacionais: Gravidade do AVC e LocalizaÃÃo do AVC. Foram determinadas as caracterÃsticas definidoras com seus respectivos conceitos e definiÃÃes operacionais: AlteraÃÃo na percepÃÃo de toque leve, AlteraÃÃo na percepÃÃo de pressÃo, AlteraÃÃo na percepÃÃo de temperatura, AlteraÃÃo na percepÃÃo de textura, AlteraÃÃo na estereognosia, ExtinÃÃo de um estÃmulo simultÃneo, AlteraÃÃo na percepÃÃo de localizaÃÃo tÃtil e DiscriminaÃÃo somatossensorial prejudicada. Espera-se que os resultados obtidos possam ser aplicados na assistÃncia a pessoas com AVC com alteraÃÃes sensoriais tÃteis, possibilitando uma prÃtica de cuidado mais extensiva e fundamentada no conhecimento cientÃfico. Ademais, espera-se que o desenvolvimento deste estudo seja um passo inicial e importante para uma nova inclusÃo desta resposta humana na taxonomia de diagnÃsticos de enfermagem da NANDA-I. / The purpose of the study is to analyze the concept of Alteration tactile sensory perception in patients with stroke, performed with analysis of literature and opinion of experts. The study aims to update the taxonomy of nursing diagnoses (ND), considering that the ND regarding this change does not appear more in the classification of NANDA International (NANDA-I), despite the change of tactile sensory perception often be identified in patients with stroke. The study objectives are: To analyze the concept of Alteration in tactile sensory perception in patients with stroke. Identify critical attributes, antecedents and consequences of Alteration in tactile sensory perception in patients with stroke; introduced the conceptual definitions and references empirical Alteration in tactile sensory perception in patients with stroke; Validate experts with the conceptual definition (diagnostic concept), background (related factors) and the resulting (defining characteristics) of Alteration in tactile sensory perception. There were two stages, the first identified attributes, antecedents and consequences of Alteration of tactile sensory perception in people with stroke based on the literature, form the search in databases: Scopus, Pubmed and Cinahl and consulting textbooks; and the second check in the opinion of the experts, about the concept (concept diagnosis), the background ( related factors) and consequent (defining characteristics), with their definitions conceptual and empirical references this phenomenon. After, performing the steps proposed produced the following results: Identification of critical attributes, related factors and defining characteristics of the phenomenon Alteration of tactile sensory perception in patients with stroke, enabling the reformulation of the concept of this clinical condition. According to the analysis of concept and after validation by experts, the phenomenon Alteration of tactile sensory perception in patients with stroke involves three critical attributes: Stimulus ideal, Reception intact and Change in interpretation. These attributes allowed the construction of the concept: Change or inability to interpret stimuli that come into contact with the individual body surface, provided ideal conditions for reception and tactile receptors by intact skin and shallow. As for the components of the phenomenon were defined factors associated with their respective concepts and operational definitions: Severity of stroke and stroke location. Defining characteristics were determined with their respective concepts and operational definitions: Change in perception of light touch, Change in perception of pressure, Change in perception of temperature, Change in the perception of texture, Change in stereognosis, Extinction a simultaneous stimuli, Change in perception of tactile location and Discrimination somatosensory impaired. It is hoped that the results can be applied in assisting people with stroke with tactile sensory changes making the practice more extensive care and based on scientific knowledge. Moreover, it is expected that the development of this study is an initial step to a new and important inclusion of human response in the taxonomy of nursing diagnoses from NANDA-I.

Whenever you touch yourself, that touch feels distinctly different from when someone else touches you. In particular, self-generated touch is perceived as less intense. This is a phenomenon called somatosensory attenuation. Touch to the self, regardless of self- or other generated, is perceived through a first-person perspective, whereas touch to other is perceived through a third-person perspective. The present study aimed to explore how self-touch is perceived when the self is observed through other perspectives. Here it was found that self-touch in a mirror and third-person perspective lowers the sense of ownership of the observed hand, as well as the agency of the touch. In particular, the sense of ownership and agency were lower in the third-person perspective relative to mirror perspective. Further, no qualitative differences in touch perception were observed across the three perspectives. There was no relationship between the sense of ownership and agency, and these qualitative differences. Lastly, there were no correlations between either of these experimental aspects (ownership, agency, qualitative) and autism traits and self-reported interoceptive abilities. The present study extends the knowledge and understanding of self-touch, and how visual perspective influences. The present study also highlights areas of applications, such as immersive virtual reality and clinical research.

Contextualização: Os testes de sensibilidade tátil da mão existentes não permitem considerar diferentes receptores, detectar variações na faixa de normalidade ou caracterizar o processo de desenvolvimento e envelhecimento. Objetivo: Elaborar um conjunto de atividades-testes para avaliar sensibilidade tátil da mão que forneça escore e tempo de execução das tarefas, com rotina de aplicação e coleta de dados detalhada em manual. Método: Para elaboração do teste foi realizada revisão da literatura e reuniões de grupo para criação de atividades-testes, seleção de materiais e elaboração do manual. Teste e manual foram submetidos à avaliação de 30 pareceristas, em 3 fases, cada uma com 10 examinadores. Resultado: O Teste de sensibilidade tátil da mão, denominado THPH (do inglês, test of haptic perception of hand) desenvolvido tem por objetivo graduar a sensibilidade tátil manual, considerando diferentes domínios sensoriais: depressão, elevação, textura, densidade, barognosia e reconhecimento de formas planas, tridimensionais de pequena e grande elevação. Cada atividade-teste possui um material específico. O escore pode variar de 0 a 57, sendo 0 a pior nota. Na primeira etapa foram sugeridas 12 modificações e aceitas 9 delas. As estruturas de teste de depressão, elevação, barognosia e reconhecimento de formas foram consideradas adequadas. Na segunda etapa foram sugeridas 3 modificações e aceita uma. As estruturas do teste de depressão foram modificadas novamente. Na terceira etapa foram dadas sugestões de continuidade do estudo. Conclusão: O processo metodológico escolhido permitiu a elaboração de um manual descritivo de atividades-testes específicas para avaliar seis diferentes domínios da sensibilidade tátil a partir da organização de grupo de trabalho e direcionamento fornecido por 30 pareceristas / Background: The tests of tactile sensitivity of hand do not allow considering different receptors, to detect variations in the range of normality or characterize the process of development and aging. Objective: To develop a set of activities-tests to assess tactile sensitivity of the hand to provide score and runtime, routine of application and collection of data. Method: It was performed a literature review, group meetings for test creation and materials testing and preparation of the manual. Test and its manual were submitted to 30 reviewers in 3 stages, each one with 10 examiners. Result: The Test of Haptic Perception of Hand (THPH) developed aims to graduate tactile sensitivity of hand according to the different sensory domains: depression, elevation, texture, density, weight perception and shape recognition, each one with the respective material. The score may range from 0 to 57, with 0 being the worst rating. In the first stage with participation of 10 examiners it was suggested 12 changes, of which 9 were accepted. The structures of the test domain depression, elevation, and shape recognition barognosis were considered adequate. In the second stage the structures of the depression were changed again. In the third step suggestions were given to continuity of the study. Conclusion: The chosen methodological process allowed the preparation of a manual illustrative and specific material to evaluate six different domains of tactile manual with the group organization and direction provided by 30 examiners in three phases

Introdução: Os estudos, a respeito das condições de sensibilidade e força ao longo da vida, ainda são escassos, principalmente os que abordam vários aspectos da sensibilidade como sensibilidade à pressão, vibratória, dolorosa e da força de pinça e preensão. Algumas pesquisas apontam para a redução da força muscular com o avanço da idade, mas desconhecem o seu comportamento, magnitude e os hábitos de vida que podem influenciar nessa evolução. Objetivo: Analisar, através de testes específicos, a evolução da sensibilidade e da força manual em grupo de voluntários saudáveis nas diferentes idades acima de 20 anos e investigar a influência de alguns hábitos de vida. Casuística e Métodos: A força e a sensibilidade das mãos foram avaliadas em um estudo seccional em 116 voluntários humanos. Realizamos testes específicos de sensibilidade e de força em um grupo de voluntários saudáveis acima de 20 anos, compreendida entre 21 e 96 anos de idade. A pesquisa foi desenvolvida entre 2006 e 2010 e avaliou 70 mulheres e 46 homens. Foram aplicados testes de avaliação bimanual das forças de pinça e preensão (dinamômetros B&L Pinch-Gauge® e Jamar®), sensibilidades ao toque (Monofilamentos de Semmes-Weinstein), à discriminação de dois pontos (Mackinnon-Dellon disk-criminator®) estática e móvel, à vibração (diapasão) e o limiar mínimo percebido e máximo tolerado frente ao estímulo elétrico. Para a análise estatística foram realizadas as correlações das diversas variáveis através dos testes de Correlação de Pearson, de Spearman, Regressão Multivariada além da elaboração de equações multifatoriais e linha de regressão. Resultados: Os valores da pinça polpa a polpa e três pontos diminuíram com o avanço da idade, foram maiores no gênero masculino, e sofreram influência positiva em quem pratica atividade física e nos que tocam instrumento musical; sendo o gênero o fator mais determinante. Os valores da pinça lateral e preensão Jamar® obtiveram resultados semelhantes, porém a idade foi o fator que mais influenciou nos resultados. A sensibilidade discriminativa móvel e estática piora com a idade, é melhor nos homens e sofre influência em quem toca instrumento musical. A idade é o fator mais importante para determinar a sensibilidade à pressão e à discriminação estática e móvel entre dois pontos. No teste de Tolerância ao Estimulo Elétrico, observamos que quanto maior a idade, maior a intensidade que a pessoa precisa para começar a sentir o estímulo. A tolerância máxima ao estímulo elétrico somente foi correlacionada positivamente ao gênero, sendo mais tolerada nos homens. Não foi encontrada alteração à sensibilidade vibratória quando avaliada com o diapasão. É possível estimar com equações de regressão, os valores de força e sensibilidade ao longo do envelhecimento da mão e assim, diferenciar as alterações causadas por patologias ou pelo processo natural de envelhecimento ao longo da vida. Conclusões: A sensibilidade e a força da mão pioram com a idade. É possível estimar a evolução fisiológica da sensibilidade e força das mãos em homens e mulheres no decorrer do envelhecimento. Alguns hábitos podem influenciar a evolução da sensibilidade e da força, como a prática de instrumentos musicais e atividade física / Introduction: The studies concerning the conditions of sensitivity and strength throughout life are still scarce, mainly those which address several aspects of sensitivity such as sensitivity to pressure, vibratory sensitivity, pain sensitivity, and pinch and grasp strength sensitivity. Some research studies indicate that muscular strength is reduced as age advances, but they lack information about its behavior, magnitude and life habits that can influence this evolution. Objective: To analyze, through specific tests, the evolution of sensitivity and hand strength in a group of healthy volunteers in different ages above 20 years and investigate the influence of some life habits. Case studies and Methods: Hand strength and sensitivity were evaluated in a cross-sectional study in 116 human volunteers. We performed specific tests of sensitivity and strength in a group of healthy volunteers aged between 21 and 96 years. Research was developed between 2006 and 2010, having assessed 70 females and 46 males. The following tests were applied, namely test of bimanual evaluation of pinch and grasp strength (B&L Pinch-Gauge® and Jamar® dynamometers), touch test (Semmes-Weinstein Monofilament), test of sensitivity to moving and static two-point discrimination(Mackinnon-Dellon diskcriminator ®), vibration (tuning fork) and minimal and maximal thresholds of tolerance to electric stimulus. For the statistical analysis the correlations of several variables were performed through Pearson Correlation Test, Spearman, Multivariate Regression, besides multifactorial equations and regression line. Results: The values of tip pinch and three points decreased with advancing age, were greater in the male gender, and suffered positive influence in those who do physical activities and those who play musical instruments, gender being the most determining factor. The values of lateral pinch and Jamar grip achieved similar results, but age was the factor that mostly influenced the results. Moving and static discriminatory sensitivity is impaired with age, is better in males and reflects the influence of playing a musical instrument. Age is the most important factor to determine sensitivity to pressure and moving and static discrimination between two points. In the Tolerance to Electric Stimulus Test we observed that the greater the age, the greater the intensity needed for a person to start feeling the stimulus. Maximal tolerance to electric stimulus was positively correlated only with gender, being better tolerated in males. No alteration was found in the vibratory sensitivity evaluated by means of the tuning fork. It is possible to calculate by regression equations the values of strength and sensitivity throughout hand aging and so distinguish the alterations caused by pathologies or by the natural process of aging during lifetime. Conclusions: Sensitivity and hand strength grow worse with age. It is possible to estimate the physiologic evolution of sensitivity and hand strength in males and females with aging. Some habits can influence the evolution of sensitivity and strength, such as playing musical instruments and physical exercise

abstract: Robotic systems are outmatched by the abilities of the human hand to perceive and manipulate the world. Human hands are able to physically interact with the world to perceive, learn, and act to accomplish tasks. Limitations of robotic systems to interact with and manipulate the world diminish their usefulness. In order to advance robot end effectors, specifically artificial hands, rich multimodal tactile sensing is needed. In this work, a multi-articulating, anthropomorphic robot testbed was developed for investigating tactile sensory stimuli during finger-object interactions. The artificial finger is controlled by a tendon-driven remote actuation system that allows for modular control of any tendon-driven end effector and capabilities for both speed and strength. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. Next, attention was focused on real-time artificial perception for decision-making. A robotic system needs to perceive its environment in order to make decisions. Specific actions such as “exploratory procedures” can be employed to classify and characterize object features. Prior work on offline perception was extended to develop an anytime predictive model that returns the probability of having touched a specific feature of an object based on minimally processed sensor data. Developing models for anytime classification of features facilitates real-time action-perception loops. Finally, by combining real-time action-perception with reinforcement learning, a policy was learned to complete a functional contour-following task: closing a deformable ziplock bag. The approach relies only on proprioceptive and localized tactile data. A Contextual Multi-Armed Bandit (C-MAB) reinforcement learning algorithm was implemented to maximize cumulative rewards within a finite time period by balancing exploration versus exploitation of the action space. Performance of the C-MAB learner was compared to a benchmark Q-learner that eventually returns the optimal policy. To assess robustness and generalizability, the learned policy was tested on variations of the original contour-following task. The work presented contributes to the full range of tools necessary to advance the abilities of artificial hands with respect to dexterity, perception, decision-making, and learning. / Dissertation/Thesis / Doctoral Dissertation Mechanical Engineering 2016

Introdução: Os estudos, a respeito das condições de sensibilidade e força ao longo da vida, ainda são escassos, principalmente os que abordam vários aspectos da sensibilidade como sensibilidade à pressão, vibratória, dolorosa e da força de pinça e preensão. Algumas pesquisas apontam para a redução da força muscular com o avanço da idade, mas desconhecem o seu comportamento, magnitude e os hábitos de vida que podem influenciar nessa evolução. Objetivo: Analisar, através de testes específicos, a evolução da sensibilidade e da força manual em grupo de voluntários saudáveis nas diferentes idades acima de 20 anos e investigar a influência de alguns hábitos de vida. Casuística e Métodos: A força e a sensibilidade das mãos foram avaliadas em um estudo seccional em 116 voluntários humanos. Realizamos testes específicos de sensibilidade e de força em um grupo de voluntários saudáveis acima de 20 anos, compreendida entre 21 e 96 anos de idade. A pesquisa foi desenvolvida entre 2006 e 2010 e avaliou 70 mulheres e 46 homens. Foram aplicados testes de avaliação bimanual das forças de pinça e preensão (dinamômetros B&L Pinch-Gauge® e Jamar®), sensibilidades ao toque (Monofilamentos de Semmes-Weinstein), à discriminação de dois pontos (Mackinnon-Dellon disk-criminator®) estática e móvel, à vibração (diapasão) e o limiar mínimo percebido e máximo tolerado frente ao estímulo elétrico. Para a análise estatística foram realizadas as correlações das diversas variáveis através dos testes de Correlação de Pearson, de Spearman, Regressão Multivariada além da elaboração de equações multifatoriais e linha de regressão. Resultados: Os valores da pinça polpa a polpa e três pontos diminuíram com o avanço da idade, foram maiores no gênero masculino, e sofreram influência positiva em quem pratica atividade física e nos que tocam instrumento musical; sendo o gênero o fator mais determinante. Os valores da pinça lateral e preensão Jamar® obtiveram resultados semelhantes, porém a idade foi o fator que mais influenciou nos resultados. A sensibilidade discriminativa móvel e estática piora com a idade, é melhor nos homens e sofre influência em quem toca instrumento musical. A idade é o fator mais importante para determinar a sensibilidade à pressão e à discriminação estática e móvel entre dois pontos. No teste de Tolerância ao Estimulo Elétrico, observamos que quanto maior a idade, maior a intensidade que a pessoa precisa para começar a sentir o estímulo. A tolerância máxima ao estímulo elétrico somente foi correlacionada positivamente ao gênero, sendo mais tolerada nos homens. Não foi encontrada alteração à sensibilidade vibratória quando avaliada com o diapasão. É possível estimar com equações de regressão, os valores de força e sensibilidade ao longo do envelhecimento da mão e assim, diferenciar as alterações causadas por patologias ou pelo processo natural de envelhecimento ao longo da vida. Conclusões: A sensibilidade e a força da mão pioram com a idade. É possível estimar a evolução fisiológica da sensibilidade e força das mãos em homens e mulheres no decorrer do envelhecimento. Alguns hábitos podem influenciar a evolução da sensibilidade e da força, como a prática de instrumentos musicais e atividade física / Introduction: The studies concerning the conditions of sensitivity and strength throughout life are still scarce, mainly those which address several aspects of sensitivity such as sensitivity to pressure, vibratory sensitivity, pain sensitivity, and pinch and grasp strength sensitivity. Some research studies indicate that muscular strength is reduced as age advances, but they lack information about its behavior, magnitude and life habits that can influence this evolution. Objective: To analyze, through specific tests, the evolution of sensitivity and hand strength in a group of healthy volunteers in different ages above 20 years and investigate the influence of some life habits. Case studies and Methods: Hand strength and sensitivity were evaluated in a cross-sectional study in 116 human volunteers. We performed specific tests of sensitivity and strength in a group of healthy volunteers aged between 21 and 96 years. Research was developed between 2006 and 2010, having assessed 70 females and 46 males. The following tests were applied, namely test of bimanual evaluation of pinch and grasp strength (B&L Pinch-Gauge® and Jamar® dynamometers), touch test (Semmes-Weinstein Monofilament), test of sensitivity to moving and static two-point discrimination(Mackinnon-Dellon diskcriminator ®), vibration (tuning fork) and minimal and maximal thresholds of tolerance to electric stimulus. For the statistical analysis the correlations of several variables were performed through Pearson Correlation Test, Spearman, Multivariate Regression, besides multifactorial equations and regression line. Results: The values of tip pinch and three points decreased with advancing age, were greater in the male gender, and suffered positive influence in those who do physical activities and those who play musical instruments, gender being the most determining factor. The values of lateral pinch and Jamar grip achieved similar results, but age was the factor that mostly influenced the results. Moving and static discriminatory sensitivity is impaired with age, is better in males and reflects the influence of playing a musical instrument. Age is the most important factor to determine sensitivity to pressure and moving and static discrimination between two points. In the Tolerance to Electric Stimulus Test we observed that the greater the age, the greater the intensity needed for a person to start feeling the stimulus. Maximal tolerance to electric stimulus was positively correlated only with gender, being better tolerated in males. No alteration was found in the vibratory sensitivity evaluated by means of the tuning fork. It is possible to calculate by regression equations the values of strength and sensitivity throughout hand aging and so distinguish the alterations caused by pathologies or by the natural process of aging during lifetime. Conclusions: Sensitivity and hand strength grow worse with age. It is possible to estimate the physiologic evolution of sensitivity and hand strength in males and females with aging. Some habits can influence the evolution of sensitivity and strength, such as playing musical instruments and physical exercise

Contextualização: Os testes de sensibilidade tátil da mão existentes não permitem considerar diferentes receptores, detectar variações na faixa de normalidade ou caracterizar o processo de desenvolvimento e envelhecimento. Objetivo: Elaborar um conjunto de atividades-testes para avaliar sensibilidade tátil da mão que forneça escore e tempo de execução das tarefas, com rotina de aplicação e coleta de dados detalhada em manual. Método: Para elaboração do teste foi realizada revisão da literatura e reuniões de grupo para criação de atividades-testes, seleção de materiais e elaboração do manual. Teste e manual foram submetidos à avaliação de 30 pareceristas, em 3 fases, cada uma com 10 examinadores. Resultado: O Teste de sensibilidade tátil da mão, denominado THPH (do inglês, test of haptic perception of hand) desenvolvido tem por objetivo graduar a sensibilidade tátil manual, considerando diferentes domínios sensoriais: depressão, elevação, textura, densidade, barognosia e reconhecimento de formas planas, tridimensionais de pequena e grande elevação. Cada atividade-teste possui um material específico. O escore pode variar de 0 a 57, sendo 0 a pior nota. Na primeira etapa foram sugeridas 12 modificações e aceitas 9 delas. As estruturas de teste de depressão, elevação, barognosia e reconhecimento de formas foram consideradas adequadas. Na segunda etapa foram sugeridas 3 modificações e aceita uma. As estruturas do teste de depressão foram modificadas novamente. Na terceira etapa foram dadas sugestões de continuidade do estudo. Conclusão: O processo metodológico escolhido permitiu a elaboração de um manual descritivo de atividades-testes específicas para avaliar seis diferentes domínios da sensibilidade tátil a partir da organização de grupo de trabalho e direcionamento fornecido por 30 pareceristas / Background: The tests of tactile sensitivity of hand do not allow considering different receptors, to detect variations in the range of normality or characterize the process of development and aging. Objective: To develop a set of activities-tests to assess tactile sensitivity of the hand to provide score and runtime, routine of application and collection of data. Method: It was performed a literature review, group meetings for test creation and materials testing and preparation of the manual. Test and its manual were submitted to 30 reviewers in 3 stages, each one with 10 examiners. Result: The Test of Haptic Perception of Hand (THPH) developed aims to graduate tactile sensitivity of hand according to the different sensory domains: depression, elevation, texture, density, weight perception and shape recognition, each one with the respective material. The score may range from 0 to 57, with 0 being the worst rating. In the first stage with participation of 10 examiners it was suggested 12 changes, of which 9 were accepted. The structures of the test domain depression, elevation, and shape recognition barognosis were considered adequate. In the second stage the structures of the depression were changed again. In the third step suggestions were given to continuity of the study. Conclusion: The chosen methodological process allowed the preparation of a manual illustrative and specific material to evaluate six different domains of tactile manual with the group organization and direction provided by 30 examiners in three phases

The explorative scanning movements of the hands have been compared to those of the eyes. The visual process is known to be composed of alternating phases of saccadic eye movements and fixation pauses. Descriptive results suggest that during the haptic exploration of objects short movement pauses occur as well.The goal of the present study was to detect these \"explorative stops\"(ES) during one-handed and two-handed haptic explorations of various objects and patterns, and to measure their duration. Additionally, the associations between the following variables were analyzed:(a) between mean exploration time and duration of ES, (b) between certain stimulus features and ES frequency, and (c) the duration of ES during the course of exploration.

The first part of the Thesis explores the specifics (developmental and educational) of a visually impaired pupil. The sense of touch is defined as being the major compensatory sense of visually impaired people. It also describes the principles and forms of the effective haptization and proposes suitable activities for the development of the touch perception. Through the basic tactile-graphics procedures, the text gets to its central theme, which is the tactile books (books with textures designed for the visually impaired). These books, as well as the possibilities of their borrowing or purchasing, are presented to a reader. Using the analysis and comparison of the available specialized materials, the Thesis summarizes the methodical procedures used for the creation of the tactile textbooks, which are suitable for the integrated visually impaired children in the lessons of the Czech Language. KEYWORDS: the sense of touch, touch perception, tactile books, visually impaired pupils, tactile graphics

下颌角缩小术是一种非常流行、有效、并广泛用于修饰脸部轮廓的手术方式。手术中所用到的主要工具有往复锯和圆头磨钻，这两种手术工具工作时有一个共同的特点：通过其高速运转去除骨质。缺乏经验的医生通常需要较长周期的训练，来学习和熟悉如何操作这两种手术工具，并在操作过程中避免由于无法控制好工具与骨骼的触碰以及工具运转时的在骨骼上的移动所造成的危险。具有视觉和触觉反馈的虚拟手术模拟系统为医生们练习手术技巧提供了一种可行并且安全的方式。然而，创建高速运转的手术工具与坚硬的骨骼之间的真实触觉交互模型是一个非常有挑战性的任务。 / 这篇论文设计并实现了虚拟下颌角缩小手术模拟系统，并且创建高保真度的视觉和触觉反馈来增强虚拟手术环境的真实性。文章提出了基于冲量理论的力反馈模型用来模拟作用在工具上的碰撞力和力矩。在不同的往复速率或者旋转速度的情况下，所提出的模型都可以为医生提供可信真实的力感反馈。并且针对磨钻在磨骨是震动明显对磨骨操作有较大影响的特点，论文还提出了一个三维震动模型来模拟磨骨时作用在钻轴上的橫向震动和轴向震动。同时，论文还提出了用于模拟手术中骨质去除以及重建的实时绘制方法。为了验证力模型的真实性，我们还创建了机械平台，采集磨骨和截骨过程中产生的真实力数据，从而用来与虚拟手术中产生的力数据进行比较。最后，还引入真实病人的CT扫描数据来对虚拟手术系统进行实证研究，评估创建的系统是否可以用于训练具有不同手术经验的医生。实证研究的结果也验证了所提出的虚拟手术系统的有效性。 / Mandibular angle reduction is a popular and efficient procedure widely used to alter the facial contour. The primary surgical instruments, the reciprocating saw and the round burr, employed in the surgery have a common feature: operating at a high-speed. Generally, inexperienced surgeons need a longtime practice to learn how to minimize the risks caused by the uncontrolled contacts and cutting motions in manipulation of instruments with high-speed reciprocation or rotation. Virtual reality (VR)-based surgical simulations with both visual and haptic feedbacks provide novice surgeons with a feasible and safe way to practise their surgical skill. However, creating realistic haptic interactions between a high-speed rotary or reciprocating instrument and stiff bone is a challenging task. In this work, a virtual reality-based surgical simulator for the mandibular angle reduction was designed and implemented. High-fidelity visual and haptic feedbacks are provided to enhance the perception in a realistic virtual surgical environment. The impulse-based haptic model was proposed to simulate the contact forces and torques on the instruments. It provides convincing haptic sensation for surgeons to control the instruments under different reciprocation or rotation velocities. Also, in order to mimic the lateral and axial burring vibration forces, a three dimensional vibration model has been developed. The real-time methods for bone removal and reconstruction during surgical procedures have been proposed to support realistic visual feedbacks. The simulated contact forces were verified by comparing against the actual force data measured through the constructed mechanical platform. An empirical study based on the patient-specific data was conducted to evaluate the ability of the proposed system in training surgeons with various experiences. The results confirm the validity of our simulator. / Detailed summary in vernacular field only. / Detailed summary in vernacular field only. / Wang, Qiong. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2012. / Includes bibliographical references (leaves 100-114). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract also in Chinese. / Abstract --- p.i / Acknowledgement --- p.v / Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- Contributions of the Thesis --- p.5 / Chapter 1.2 --- Thesis Roadmap --- p.7 / Chapter 2 --- Related Work --- p.9 / Chapter 2.1 --- Virtual Orthopaedic Surgical Simulator --- p.9 / Chapter 2.2 --- Haptic Rendering for Virtual Surgery --- p.11 / Chapter 2.3 --- Evaluation of the Virtual System --- p.14 / Chapter 3 --- System Design --- p.17 / Chapter 3.1 --- Overall System Framework --- p.17 / Chapter 4 --- Bone-burring Surgical Simulation --- p.21 / Chapter 4.1 --- Impulse-Based Modeling of Haptic Simulation of Bone-Burring --- p.22 / Chapter 4.1.1 --- Basic Assumptions --- p.22 / Chapter 4.1.2 --- Bone-Burring Contact Description --- p.25 / Chapter 4.1.3 --- Burring Force Modeling --- p.29 / Chapter 4.2 --- Simulation of Bone Removal --- p.41 / Chapter 4.2.1 --- Bone Removal model --- p.41 / Chapter 4.2.2 --- Adaptive Subdividing Removal Surface --- p.42 / Chapter 4.3 --- Implementation and Experimental Results --- p.52 / Chapter 4.3.1 --- Force Evaluation --- p.53 / Chapter 4.3.2 --- Task-based Evaluation --- p.57 / Chapter 4.3.3 --- Time Performance --- p.61 / Chapter 5 --- Bone-sawing Surgical Simulation --- p.64 / Chapter 5.1 --- Impulse-Based Modeling of Haptic Simulation of Bone-Sawing --- p.65 / Chapter 5.1.1 --- Haptic Saw Instruments Description --- p.65 / Chapter 5.1.2 --- Sawing Force Modeling --- p.67 / Chapter 5.1.3 --- Sawing Torque Constraint --- p.70 / Chapter 5.2 --- Real-time Bone Mesh Reconstruction --- p.74 / Chapter 6 --- Evaluation --- p.78 / Chapter 6.1 --- Haptic Feedback Evaluation --- p.79 / Chapter 6.1.1 --- Mechanical Platform Setup --- p.79 / Chapter 6.1.2 --- Comparison of The Measured and Simulated forces --- p.81 / Chapter 6.2 --- Empirical Study --- p.85 / Chapter 6.2.1 --- Patient Specific Data --- p.87 / Chapter 6.2.2 --- Objective Performance Metrics --- p.89 / Chapter 6.2.3 --- Evaluation Results --- p.90 / Chapter 7 --- Conclusion --- p.94 / Publication List --- p.98 / Bibliography --- p.100