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Ronald van 't Veld
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Reducing the Soleus Stretch Reflex With Conditioning
Exploring Game- and Impedance-Based Biofeedback
Journal article
(2021)
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Ronald van 't Veld, Eline Flux, A.C. Schouten, Marjolein van der Krogt, H. van der Kooij, Edwin H.F. Van Asseldonk
People with spasticity, i.e., stretch hyperreflexia, have a limited functional independence and mobility. While a broad range of spasticity treatments is available, many treatments are invasive, non-specific, or temporary and might have negative side effects. Operant conditioning of the stretch reflex is a promising non-invasive paradigm with potential long-term sustained effects. Within this conditioning paradigm, seated participants have to reduce the mechanically elicited reflex response using biofeedback of reflex magnitude quantified using electromyography (EMG). Before clinical application of the conditioning paradigm, improvements are needed regarding the time-intensiveness and slow learning curve. Previous studies have shown that gamification of biofeedback can improve participant motivation and long-term engagement. Moreover, quantification of reflex magnitude for biofeedback using reflexive joint impedance may obtain similar effectiveness within fewer sessions. Nine healthy volunteers participated in the study, split in three groups. First, as a reference the “Conventional” group received EMG- and bar-based biofeedback similar to previous research. Second, we explored feasibility of game-based biofeedback with the “Gaming” group receiving EMG- and game-based biofeedback. Third, we explored feasibility of game- and impedance-based biofeedback with the “Impedance” group receiving impedance and game-based biofeedback. Participants completed five baseline sessions (without reflex biofeedback) and six conditioning sessions (with reflex biofeedback). Participants were instructed to reduce reflex magnitude without modulating background activity. The Conventional and Gaming groups showed feasibility of the protocol in 2 and 3 out of 3 participants, respectively. These participants achieved a significant Soleus short-latency (M1) within-session reduction in at least –15% in the 4th–6th conditioning session. None of the Impedance group participants showed any within-session decrease in Soleus reflex magnitude. The feasibility in the EMG- and game-based biofeedback calls for further research on gamification of the conditioning paradigm to obtain improved participant motivation and engagement, while achieving long-term conditioning effects. Before clinical application, the time-intensiveness and slow learning curve of the conditioning paradigm remain an open challenge.
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People with spasticity, i.e., stretch hyperreflexia, have a limited functional independence and mobility. While a broad range of spasticity treatments is available, many treatments are invasive, non-specific, or temporary and might have negative side effects. Operant conditioning of the stretch reflex is a promising non-invasive paradigm with potential long-term sustained effects. Within this conditioning paradigm, seated participants have to reduce the mechanically elicited reflex response using biofeedback of reflex magnitude quantified using electromyography (EMG). Before clinical application of the conditioning paradigm, improvements are needed regarding the time-intensiveness and slow learning curve. Previous studies have shown that gamification of biofeedback can improve participant motivation and long-term engagement. Moreover, quantification of reflex magnitude for biofeedback using reflexive joint impedance may obtain similar effectiveness within fewer sessions. Nine healthy volunteers participated in the study, split in three groups. First, as a reference the “Conventional” group received EMG- and bar-based biofeedback similar to previous research. Second, we explored feasibility of game-based biofeedback with the “Gaming” group receiving EMG- and game-based biofeedback. Third, we explored feasibility of game- and impedance-based biofeedback with the “Impedance” group receiving impedance and game-based biofeedback. Participants completed five baseline sessions (without reflex biofeedback) and six conditioning sessions (with reflex biofeedback). Participants were instructed to reduce reflex magnitude without modulating background activity. The Conventional and Gaming groups showed feasibility of the protocol in 2 and 3 out of 3 participants, respectively. These participants achieved a significant Soleus short-latency (M1) within-session reduction in at least –15% in the 4th–6th conditioning session. None of the Impedance group participants showed any within-session decrease in Soleus reflex magnitude. The feasibility in the EMG- and game-based biofeedback calls for further research on gamification of the conditioning paradigm to obtain improved participant motivation and engagement, while achieving long-term conditioning effects. Before clinical application, the time-intensiveness and slow learning curve of the conditioning paradigm remain an open challenge.
Incremental nonlinear dynamic inversion (INDI) is a variation on nonlinear dynamic inversion (NDI), retaining the high-performance characteristics, while reducing model dependency and increasing robustness. After a successful flight test with a multirotor micro aerial vehicle, the question arises whether this technique can be used to successfully design a flight control system for aircraft in general. This requires additional research on aircraft characteristics that could cause issues related to the stability and performance of the INDI controller. Typical characteristics are additional time delays due to data buses and measurement systems, slower actuator and sensor dynamics, and a lower control frequency. The main contributions of this article are 1) an analytical stability analysis showing that implementing discrete-time INDI with a sampling time smaller than 0.02s results in large stability margins regarding system characteristics and controller gains; 2) a simulation study showing significant performance degradation requiring controller adaptation due to actuator measurement bias, angular rate measurement noise, angular rate measurement delay and actuator measurement delay; and 3) the use of a real-time time delay identification algorithm based on latency to successfully synchronize the angular rate and actuator measurement delay together with pseudo control hedging (PCH) to prevent oscillatory behavior.
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Incremental nonlinear dynamic inversion (INDI) is a variation on nonlinear dynamic inversion (NDI), retaining the high-performance characteristics, while reducing model dependency and increasing robustness. After a successful flight test with a multirotor micro aerial vehicle, the question arises whether this technique can be used to successfully design a flight control system for aircraft in general. This requires additional research on aircraft characteristics that could cause issues related to the stability and performance of the INDI controller. Typical characteristics are additional time delays due to data buses and measurement systems, slower actuator and sensor dynamics, and a lower control frequency. The main contributions of this article are 1) an analytical stability analysis showing that implementing discrete-time INDI with a sampling time smaller than 0.02s results in large stability margins regarding system characteristics and controller gains; 2) a simulation study showing significant performance degradation requiring controller adaptation due to actuator measurement bias, angular rate measurement noise, angular rate measurement delay and actuator measurement delay; and 3) the use of a real-time time delay identification algorithm based on latency to successfully synchronize the angular rate and actuator measurement delay together with pseudo control hedging (PCH) to prevent oscillatory behavior.