Smartphone-based sensory augmentation technology for home-based balance training

This paper describes the design and development of a smartphone-based sensory augmentation technology through vibrotactile biofeedback to support home-based balance training for individuals with balance disorders. The proposed system comprises a smartphone and a 3rd party sensor/actuator module. The smartphone's application software communicates with the wearable module wirelessly via Bluetooth, provides instructions for a recommended balance training exercises (i.e., dynamic weight-shifting exercises) in clinical and/or home-based balance rehabilitation settings, and displays knowledge of results after the completion of the exercise. The 3rd party sensor/actuator module incorporates a nine degrees-of-freedom inertial measurement unit (IMU) and four vibrating actuators (tactors) for vibrotactile biofeedback. To estimate the body motion, a sensor fusion algorithm is developed based on an Extended Kalman Filter (EKF) to yield accurate and reliable orientation of the IMU. For dynamic weight-shifting exercises, a motion generation algorithm is developed by taking a user's limits of stability (LOS). Furthermore, an algorithm for continuous coding scheme to control real-time vibrotactile biofeedback is developed to provide a user with the error magnitude while he/she is performing the recommended balance training exercises. The proposed system is the first step towards developing a portable balance training technology with vibrotactile biofeedback that could eventually be used at home.

[1]  Barry Smyth,et al.  Development and user evaluation of a virtual rehabilitation system for wobble board balance training , 2008, 2008 30th Annual International Conference of the IEEE Engineering in Medicine and Biology Society.

[2]  S G Lisberger,et al.  The neural basis for learning of simple motor skills. , 1988, Science.

[3]  K H Sienko,et al.  Effects of multi-directional vibrotactile feedback on vestibular-deficient postural performance during continuous multi-directional support surface perturbations. , 2009, Journal of vestibular research : equilibrium & orientation.

[4]  Oonagh M. Giggins,et al.  Biofeedback in rehabilitation , 2013, Journal of NeuroEngineering and Rehabilitation.

[5]  R. Cumming,et al.  Interventions for preventing falls in elderly people. , 2003, The Cochrane database of systematic reviews.

[6]  M. Guerraz,et al.  Evaluation of a visual biofeedback on the postural control in Parkinson's disease , 2014, Neurophysiologie Clinique/Clinical Neurophysiology.

[7]  Stephan Riek,et al.  Strength versus muscle power-specific resistance training in community-dwelling older adults. , 2008, The journals of gerontology. Series A, Biological sciences and medical sciences.

[8]  L Freeman,et al.  A fall prevention program for the home environment. , 2001, Home care provider.

[9]  Kathleen H. Sienko,et al.  A cutaneous positioning system , 2014, Experimental Brain Research.

[10]  Wiebren Zijlstra,et al.  Audio-Biofeedback training for posture and balance in Patients with Parkinson's disease , 2011, Journal of NeuroEngineering and Rehabilitation.

[11]  Jiping He,et al.  Journal of Neuroengineering and Rehabilitation Open Access Recent Developments in Biofeedback for Neuromotor Rehabilitation Review of Early Biofeedback Therapy Current Developments in Biofeedback in Neurorehabilitation Table 1: Function of Basic Modules in Multisensing Biofeedback Systems for Task T , 2022 .

[12]  M. Tinetti Clinical practice. Preventing falls in elderly persons. , 2003, The New England journal of medicine.

[13]  M. Roller,et al.  Multifactorial Intervention with Balance Training as a Core Component Among Fall‐prone Older Adults , 2009, Journal of geriatric physical therapy.

[14]  Marco Dozza,et al.  Audio-biofeedback improves balance in patients with bilateral vestibular loss. , 2005, Archives of physical medicine and rehabilitation.

[15]  R. Cumming,et al.  Quality of life related to fear of falling and hip fracture in older women: a time trade off study. , 2000, BMJ.

[16]  A. Galecki,et al.  Effects of biofeedback on secondary-task response time and postural stability in older adults. , 2012, Gait & posture.

[17]  S. Gandevia,et al.  Cutaneous receptors contribute to kinesthesia at the index finger, elbow, and knee. , 2005, Journal of neurophysiology.

[18]  E. Finkelstein,et al.  The costs of fatal and non-fatal falls among older adults , 2006, Injury Prevention.

[19]  Anne Forster,et al.  Physical rehabilitation for older people in long-term care. , 2013, The Cochrane database of systematic reviews.

[20]  B. Bloem,et al.  Why old people fall (and how to stop them) , 2007, Practical Neurology.

[21]  K. H. Sienkoa Effects of multi-directional vibrotactile feedback on vestibular-deficient postural performance during continuous multi-directional support surface perturbations , 2015 .

[22]  D. Basta,et al.  Vibrotactile neurofeedback balance training in patients with Parkinson's disease: reducing the number of falls. , 2013, Gait & posture.

[23]  C. Wall,et al.  The effect of vibrotactile feedback on postural sway during locomotor activities , 2013, Journal of NeuroEngineering and Rehabilitation.

[24]  Pavel Kolář,et al.  Exercise with visual feedback improves postural stability after vestibular schwannoma surgery , 2010, European Archives of Oto-Rhino-Laryngology.

[25]  Geoffrey E. Hinton,et al.  Learning representations by back-propagating errors , 1986, Nature.

[26]  C. Wall,et al.  Vibrotactile tilt feedback improves dynamic gait index: a fall risk indicator in older adults. , 2009, Gait & posture.

[27]  J. Allum,et al.  The effects of vibrotactile biofeedback training on trunk sway in Parkinson's disease patients. , 2012, Parkinsonism & related disorders.

[28]  Catherine Sherrington,et al.  Exercise to prevent falls in older adults: an updated meta-analysis and best practice recommendations. , 2011, New South Wales public health bulletin.

[29]  Shu Chen,et al.  A Wearable Device for Real-Time Motion Error Detection and Vibrotactile Instructional Cuing , 2011, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[30]  Yohan Payan,et al.  Effectiveness of an electro-tactile vestibular substitution system in improving upright postural control in unilateral vestibular-defective patients. , 2008, Gait & posture.

[31]  A. Dey,et al.  Relevance of balance measurement tools and balance training for fall prevention in older adults , 2014 .

[32]  W. Leslie,et al.  Preventing falls in elderly persons. , 2003, The New England journal of medicine.

[33]  Kathleen H Sienko,et al.  Postural Reorganization Induced by Torso Cutaneous Covibration , 2013, The Journal of Neuroscience.

[34]  F. Horak,et al.  Auditory biofeedback substitutes for loss of sensory information in maintaining stance , 2007, Experimental Brain Research.

[35]  Rachel Proffitt,et al.  Development of an Interactive Game-Based Rehabilitation Tool for Dynamic Balance Training , 2010, Topics in stroke rehabilitation.

[36]  J. Demongeot,et al.  Sensory supplementation system based on electrotactile tongue biofeedback of head position for balance control , 2008, Neuroscience Letters.

[37]  Jeonghee Kim,et al.  Cell phone based balance trainer , 2012, Journal of NeuroEngineering and Rehabilitation.