Effect of Exercise with Rhythmic Auditory Stimulation on Muscle Coordination and Gait Stability in Patients with Diabetic Peripheral Neuropathy: A Randomized Controlled Trial

Background: Diabetic peripheral neuropathy (DPN) changes leg muscle coordination during walking and reduces stability. The aim of this study was to determine whether rhythmic auditory stimulation (RAS) affected the gait performance of patients with DPN. Methods: Forty DPN patients (mean age, 59.1 ± 9.4 y) were randomly allocated to RAS and control groups in equal numbers. The participants in each group underwent 2 weeks of supervised rehabilitative treatment (40 min/day) as inpatients. This included walking twice a day, during which the RAS group participants walked in time with a metronome set at a self-chosen, comfortable rate. We compared gait function, lower limb muscle co-contraction, and gait stability before and after the intervention for both groups, calculated the change in score for each parameter, and assessed differences between the groups with unpaired t-tests and ANCOVA. Results: RAS was associated with significant improvement in all parameters. In the control group, there was no improvement in cadence, co-contraction, or gait stability (vertical). Compared with the control group, the RAS group showed improvement in co-contraction and gait stability. Conclusion: RAS may be helpful for improving the lower limb muscle coordination and gait function of DPN patients.

Investigation of Braking Timing of Drivers for Design of Pedestrian Collision Avoidance System

The braking behavior of drivers when a pedestrian comes out from the sidewalk to the road was analyzed using a driving simulator. Based on drivers＇ braking behavior, the braking control timing of the system for avoiding the collision with pedestrians was proposed. In this study, the subject drivers started braking at almost the same time in terms of TTC （Time to Collision）, regardless of the velocity of a subject vehicle and crossing velocity of pedestrians. This experimental result showed that brake timing of the system which can minimize the interference for braking between drivers and the system is 1.3 s of TTC. Next, the drivers＇ braking behavior was investigated when the system controlled braking to avoid collision at this timing. As a result, drivers did not show any change of braking behavior with no excessive interference between braking control by the system and braking operation by drivers for avoiding collisions with pedestrians which is equivalent to the excessive dependence on the system.

An EMG-Based Biomimetic Variable Stiffness Modulation Strategy for Bilateral Motor Skills Relearning of Upper Limb Elbow Joint Rehabilitation

Bilateral rehabilitation systems with bilateral or unilateral assistive robots have been developed for hemiplegia patients to recover their one-side paralysis.However,the compliant robotic assistance to promote bilateral inter-limb coordination remains a challenge that should be addressed.In this paper,a biomimetic variable stiffness modulation strategy for the Variable Stiffness Actuator(VSA)integrated robotic is proposed to improve bilateral limb coordination and promote bilateral motor skills relearning.An Electromyography(EMG)-driven synergy reference stiffness estimation model of the upper limb elbow joint is developed to reproduce the muscle synergy effect on the affected side limb by independent real-time stiffness control.Additionally,the bilateral impedance control is incorporated for realizing compliant patient-robot interaction.Preliminary experiments were carried out to evaluate the tracking performance and investigate the multiple task intensities’influence on bilateral motor skills relearning.Experimental results evidence the proposed method could enable bilateral motor task skills relearning with wide-range task intensities and further promote bilateral inter-limb coordination.