L'objectif de cette thèse est l'étude des interactions mécaniques entre la langue et le palais dans la production de parole et la déglutition. Cette interaction est cruciale car elle détermine la morphologie de la langue et son évolution dans le temps avant et après les contacts. Elle ne peut cependant pas être étudiée avec des approches cinématiques conventionnelles, car l'amplitude des mouvements est trop faible. La première partie de la thèse est consacrée à la conception d'un dispositif expérimental permettant de mesurer ces interactions sans perturber l'appareil vocal. La première particularité est que le dispositif est utilisé sur des patients édentés appareillés. Nous utilisons un duplicata de la prothèse complète maxillaire pour insérer des capteurs miniatures à jauges de contrainte dont les caractéristiques de réponse sont optimisées et qui permettent de mesurer la pression mécanique exercée par la langue sur le palais. La seconde particularité est qu’il existe une procédure d'étalonnage, associée aux capteurs, qui utilise une Colonne d’Eau Sèche. Elle applique une pression sur le capteur via une membrane en latex déformable, capable de simuler le comportement visco-élastique de la langue sur le palais. La deuxième partie de la thèse décrit le protocole de recherche clinique visant à (1) caractériser l'interaction langue-palais au cours de la prononciation et de la déglutition normales sur des individus édentés que nous considérons adaptés à leur prothèse complète (Cohorte 1), (2) observer l'adaptation dans une étude longitudinale des patients édentés nouvellement appareillés (Cohorte 2). Ce projet comprend, pour les deux cohortes, la description des objectifs, le protocole expérimental, la description fine des paramètres pertinents et la méthode statistique de traitement des données. Toutefois, le processus de rédaction et de soumission de ce protocole à un Comité de Protection des Personnes (CPP) a été plus long que prévu et l’étude clinique n’a pu être menée dans le cadre de cette thèse. C’est pourquoi, dans la troisième partie de la thèse, nous avons utilisé les données enregistrées dans l’étude de faisabilité, auprès d'un adulte édenté francophone. Les résultats montrent que notre dispositif permet d'explorer des hypothèses théoriques cruciales dans la parole comme l'existence de cibles virtuelles au-dessus du palais ou le rôle du palais dans la mise en forme du conduit aérien des consonnes fricatives. Les résultats des données enregistrées lors de la déglutition sont moins clairs, mais l'enchaînement temporel précis des contacts peut être décrit, ce qui permet de préciser comment les mouvements ondulatoires de la langue pendant la phase orale de la déglutition exploitent les contacts avec le palais. Les retombées cliniques de cette thèse permettent une meilleure connaissance du rôle fonctionnel des prothèses complètes et d’envisager la conception de prothèses qui seraient adaptées aux spécificités de chaque patient, notamment pour la rééducation des sujets traités chirurgicalement après des cancers de la langue, dans le cadre des taches de production de parole et de déglutition / The aim of the thesis is the study of the mechanical interaction between tongue and palate in speech production and swallowing. This interaction is crucial since it determines the shape of the tongue and its time evolution before and after contacts occur. Yet it cannot be studied with conventional kinematic approaches, since magnitude of movements is too small. The first part of the thesis was devoted to the design of an experimental setup to measure this interaction without perturbing the vocal tract. The first specificity is that the setup is used on subjects who are edentulous and wear a complete denture. We use a duplicate of the complete denture to insert miniature strain gauge sensors with enhanced response characteristics, that enable the measure of the mechanical pressure exerted by the tongue in different locations of the palate, without altering the shape of the palatal arch. The second specificity is that the calibration procedure uses a Dried Water Column (DWC) that applies pressure on the sensor via a deformable latex membrane, that simulates the way tongue touches the palate. The second part of the thesis enabled the design of an experimental protocol aiming at (1) providing a characterization of the tongue-palate interaction in normal speech production and swallowing based on edentulous subjects whom we consider to have adapted to their complete denture (cohort 1), (2) observing the adaptation process in a longitudinal study of edentulous subjects who are new users of complete denture (cohort 2). This work includes for two cohorts the design of the subject inclusion criteria, the motor tasks and the statistical method for the data analysis. However, unforeseen long delays were faced in the application process for the ethical approval and no data were collected in this context. Hence the third part of the thesis used data recorded in our most recent pilot study, with a French speaking edentulous adult. It is shown that our setup makes possible to tackle crucial theoretical questions in speech production such as the existence of virtual targets above the palate in stops or the role of the palate in the air channel shaping in fricatives. Results of swallowing tasks are less clear, but it is shown that precise time sequencing of contacts can be described, making possible the specification of how the ondulatory movements of the tongue in the oral phase of swallowing takes advantage of palatal contacts. In conclusion implications of this thesis are presented for a functional assessment of complete dentures, and the design of dentures that would be adapted to each subject’s specificities

Current Ambient Intelligence and Intelligent Environment research focuses on the interpretation of a subject’s behaviour at the activity level by logging the Activity of Daily Living (ADL) such as eating, cooking, etc. In general, the sensors employed (e.g. PIR sensors, contact sensors) provide low resolution information. Meanwhile, the expansion of ubiquitous computing allows researchers to gather additional information from different types of sensor which is possible to improve activity analysis. Based on the previous research about sitting posture detection, this research attempts to further analyses human sitting activity. The aim of this research is to use non-intrusive low cost pressure sensor embedded chair system to recognize a subject’s activity by using their detected postures. There are three steps for this research, the first step is to find a hardware solution for low cost sitting posture detection, second step is to find a suitable strategy of sitting posture detection and the last step is to correlate the time-ordered sitting posture sequences with sitting activity. The author initiated a prototype type of sensing system called IntelliChair for sitting posture detection. Two experiments are proceeded in order to determine the hardware architecture of IntelliChair system. The prototype looks at the sensor selection and integration of various sensor and indicates the best for a low cost, non-intrusive system. Subsequently, this research implements signal process theory to explore the frequency feature of sitting posture, for the purpose of determining a suitable sampling rate for IntelliChair system. For second and third step, ten subjects are recruited for the sitting posture data and sitting activity data collection. The former dataset is collected byasking subjects to perform certain pre-defined sitting postures on IntelliChair and it is used for posture recognition experiment. The latter dataset is collected by asking the subjects to perform their normal sitting activity routine on IntelliChair for four hours, and the dataset is used for activity modelling and recognition experiment. For the posture recognition experiment, two Support Vector Machine (SVM) based classifiers are trained (one for spine postures and the other one for leg postures), and their performance evaluated. Hidden Markov Model is utilized for sitting activity modelling and recognition in order to establish the selected sitting activities from sitting posture sequences.2. After experimenting with possible sensors, Force Sensing Resistor (FSR) is selected as the pressure sensing unit for IntelliChair. Eight FSRs are mounted on the seat and back of a chair to gather haptic (i.e., touch-based) posture information. Furthermore, the research explores the possibility of using alternative non-intrusive sensing technology (i.e. vision based Kinect Sensor from Microsoft) and find out the Kinect sensor is not reliable for sitting posture detection due to the joint drifting problem. A suitable sampling rate for IntelliChair is determined according to the experiment result which is 6 Hz. The posture classification performance shows that the SVM based classifier is robust to “familiar” subject data (accuracy is 99.8% with spine postures and 99.9% with leg postures). When dealing with “unfamiliar” subject data, the accuracy is 80.7% for spine posture classification and 42.3% for leg posture classification. The result of activity recognition achieves 41.27% accuracy among four selected activities (i.e. relax, play game, working with PC and watching video). The result of this thesis shows that different individual body characteristics and sitting habits influence both sitting posture and sitting activity recognition. In this case, it suggests that IntelliChair is suitable for individual usage but a training stage is required.

<p>Glaucoma is the leading cause of irreversible blindness worldwide. While current therapies aim to lower elevated intraocular pressure (IOP) to prevent blindness, they often do not provide the desired long-term efficacy, can fail over time, and have systemic side effects. Electroceutical stimulation can be a solution to many of these current issues with glaucoma treatment, as it is believed to have fewer systemic side effects and quicker response times. The goal of this work is to develop and demonstrate a novel system using electrical stimulation to lower intraocular pressure. I present data from a human clinical study and an ongoing clinical trial of the IOPTx™ system, a wearable electroceutical for treating glaucoma, that provides preliminary evidence of efficacy and safety. <a>Furthermore, no current glaucoma treatments allow for closed-loop, continuous monitoring of IOP, requiring more frequent doctor visits or forcing patients and clinicians to operate in the dark. Using an electroceutical therapeutic device with closed-loop feedback and continuous IOP recording can improve glaucoma management. I combined a pressure sensor with this electroceutical therapy, implanted the sensor and stimulation coils in rabbits, and stimulated the eyes. However, to better understand the optimal stimulation parameters, long-term effects, and mechanisms of action, an integrated circuit is designed as part of a fully implantable, closed-loop device. The chip was fabricated in 0.18 </a>µm CMOS process and validated on the benchtop and <i>in vivo</i>. In the future, this electroceutical device has the potential to be a novel treatment for patients suffering from glaucoma.</p>

Cette thèse explore les capacités d’une intelligence ambiante équipée d’un réseau de capteurs de pression au sol. Elle traite le problème de la perception d’un environnement au travers un réseau de capteurs de basse résolution. Les difficultés incluent l’interpretation des poids dispersés pour des objets avec multiples supports, l’ambiguïté de poids entre des objets, la variation du poids des personnes pendant les activités dynamiques, etc. Nous introduisons des nouvelles techniques, partiellement inspirées du domaine de la vision par l’ordinateur, pour la détection, le suivi et la reconnaissance des entités qui se trouvent sur le sol. Nous introduisons également des nouveaux modes d’interaction entre les environnements équipés de tels capteurs aux sols, et les robots qui évoluent dans ces environnements. Ceci permet l’interprétation non-intrusive des événements qui ont lieu dans des environnements dotés d’une intelligence ambiante, avec des applications dans l’assistance automatisée à domicile, l’aide aux personnes âgées, le diagnostic continu de la santé, la sécurité, et la navigation robotique / This thesis explores the capabilities of an ambient intelligence equipped with a load-sensing floor. It deals with the problem of perceiving the environment through a network of low-resolution sensors. Challenges include the interpretation of spread loads for objects with multiple points of support, weight ambiguities between objects, variation of persons’ weight during dynamic activities, etc. We introduce new techniques, partly inspired from the field of computer vision, for detecting, tracking and recognizing the entities located on the floor. We also introduce new modes of interaction between environments equipped with such floor sensors and robots evolving inside them. This enables non-intrusive interpretation of events happening inside environments with embedded ambient intelligence, with applications in assisted living, senile care, continuous health diagnosis, home security, and robotic navigation

Die vorliegende Arbeit umfasst die Entwicklung einer neuartigen Drucksonde, welche die faseroptischen Sensortypen Fabry-Pérot-Interferometer und Faser-Bragg-Gitter als Hybridsensor kombiniert und minimalinvasiv im Gefäßsystem oder Hohlorganen platziert werden soll. Die simultane Auswertung aller Sensoren ermöglicht die Erfassung des räumlich und zeitlich verteilten Druckes. Die diagnostische Relevanz der Hybridsonde zur Analyse von Stenosen wird an den Krankheitsbildern der koronaren Herzkrankheit und der lumbalen Spinalkanalstenose aufgezeigt. Anhand von experimentellen in vitro Untersuchungen sowie eines in vivo Tierversuches wird die Leistungsfähigkeit der Hybridsonde zur verteilten Druckmessung evaluiert sowie das Potential der Neuentwicklung in der medizinischen Diagnostik bestätigt. Ausgehend von den gewonnen klinischen Daten wird eine Entwicklungsperspektive für ein Medizinprodukt zur minimalinvasiven Diagnostik aufgezeigt.:Abkürzungs- und Formelzeichenverzeichnis ix Vorwort 1 1. Einleitung 3 2. Medizinische Grundlagen 9 3. Technische und physikalische Grundlagen 23 4. Referenzdrucksensor 47 5. Faseroptische Hybridsonde 85 6. In vivo Tierversuch 115 7. Erkenntnisgewinn 135 8. Zusammenfassung und Ausblick 143 Anhang 147 Literaturverzeichnis 159 Abbildungsverzeichnis 175 Tabellenverzeichnis 179 Thesen 181 / This thesis presents the development of a novel pressure probe combining a fiber optic Fabry-Pérot-Interferometer and Fiber Bragg Gratings as a hybrid probe. The application is minimally invasive manometry of the vascular system as well as hollow organs. The simultaneous evaluation of several pressure reading points enables the detection of spatially and temporally distributed pressure. The diagnostic relevance of the hybrid probe for the analysis of stenoses severity is demonstrated at the application for coronary heart disease and lumbar spinal stenosis. By means of experimental in vitro investigations as well as an in vivo animal trial the hybrid probe's performance for distributed pressure sensing is assessed. Furthermore, this confirms the potential of the new development for medical diagnostics. Based on the clinical data obtained, a development perspective for a medical device for minimally invasive diagnostics is presented.:Abkürzungs- und Formelzeichenverzeichnis ix Vorwort 1 1. Einleitung 3 2. Medizinische Grundlagen 9 3. Technische und physikalische Grundlagen 23 4. Referenzdrucksensor 47 5. Faseroptische Hybridsonde 85 6. In vivo Tierversuch 115 7. Erkenntnisgewinn 135 8. Zusammenfassung und Ausblick 143 Anhang 147 Literaturverzeichnis 159 Abbildungsverzeichnis 175 Tabellenverzeichnis 179 Thesen 181