In recent years, advances in modern technology have altered the practice of surgery from open to minimally invasive surgery (MIS) aided by robots. Teleoperated surgical robotic systems (TSRSs) provide numerous significant benefits for MIS over traditional approaches, including improved safety, more efficient and precise surgery, better cosmesis, shorter recovery time, and reduced postoperative pain. Existing TSRSs’ master consoles, with improvements in vision systems, designs, and control methods, have significantly enhanced human–robot interactions, resulting in safer and more accurate medical intervention operations. Despite advances, haptic technologies, including sensors, machine assistance, and intuitive devices for user interfaces, are still limited, resulting in less effective usage of TSRSs for surgical operations. This review presents a summary of the emerging TSRSs with a focus on their user interfaces. In addition, advanced sensing, haptic, smart garments, and medical image artificial intelligence (AI) assistance technologies are shown with their potential for use in master consoles of the TSRSs are shown. Finally, a discussion on the need for a smart human‐robot interface for TSRSs is given.

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/adsr.202200036

Advanced User Interfaces for Teleoperated Surgical Robotic Systems

https://www.mdpi.com/1424-8220/21/14/4744/pdf

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice.

Background Our study aims to validate a commercially available inertial measurement unit (IMU) system against a standard laboratory-based optical motion capture (OMC) system for shoulder measurements in a clinical context. Methods The validation analyses were conducted on 19 healthy male volunteers. Twelve reflective markers were placed on each participant’s trunk, scapula and across the arm and one IMU was attached via a self-adhesive strap on the forearm. A single tester simultaneously collected shoulder kinematic data for four shoulder movements: flexion, extension, external rotation, and abduction. Agreement between OMC system and IMU measurements was assessed with Bland-Altman analyses. Secondary analysis included mean biases, root mean square error (RMSE) analysis and Welch’s t-test. Results Bland-Altman limits of agreement (LoA) exceeded the acceptable range of mean difference for 95% of the population (−22.27°, 11.31°). The mean bias showed high levels of agreement within 8° for all four movements. More than 60% of participants demonstrated mean bias less than 10° between methods. Statistically significant differences were found between measurements for abduction (P<0.001) and flexion (P=0.027) but not for extension and external rotation (P≥0.05). Conclusions Our study shows preliminary evidence for acceptable accuracy of a commercially available IMU against an OMC system for assessment of shoulder movements by a single tester. The IMU also exhibits similar whole degree of error compared to a standard goniometer with potential for application in remote rehabilitation.

/pdf/assessment-of-shoulder-range-of-motion-using-a-commercially-2sop0nq8.pdf

Assessment of shoulder range of motion using a commercially available wearable sensor—a validation study

Background—Movement patterns in dyskinetic cerebral palsy (DCP) are characterized by abnormal postures and involuntary movements. Current evaluation tools in DCP are subjective and time-consuming. Sensors could yield objective information on pathological patterns in DCP, but their reliability has not yet been evaluated. The objectives of this study were to evaluate (i) reliability and (ii) discriminative ability of sensor parameters. Methods—Inertial measurement units were placed on the arm, forearm, and hand of individuals with and without DCP while performing reach-forward, reach-and-grasp-vertical, and reach-sideways tasks. Intra-class correlation coefficients (ICC) were calculated for reliability, and Mann–Whitney U-tests for between-group differences. Results—Twenty-two extremities of individuals with DCP (mean age 16.7 y) and twenty individuals without DCP (mean age 17.2 y) were evaluated. ICC values for all sensor parameters except jerk and sample entropy ranged from 0.50 to 0.98 during reach forwards/sideways and from 0.40 to 0.95 during reach-and-grasp vertical. Jerk and maximal acceleration/angular velocity were significantly higher for the DCP group in comparison with peers. Conclusions—This study was the first to assess the reliability of sensor parameters in individuals with DCP, reporting high between- and within-session reliability for the majority of the sensor parameters. These findings suggest that pathological movements of individuals with DCP can be reliably captured using a selection of sensor parameters.

/pdf/reliability-and-discriminative-validity-of-wearable-sensors-mv34xe5x.pdf

Reliability and Discriminative Validity of Wearable Sensors for the Quantification of Upper Limb Movement Disorders in Individuals with Dyskinetic Cerebral Palsy

Inertial Measurement Units have become one of the most widely used instruments in Human Activity Recognition and clinical applications. Their performance needs to be validated against gold standard systems to be reliably used for any particular application. In this study, we validated MPU9250 in TTGO T-Wristband smart band (Shenzhen Xinyuan Electronic Technology© Ltd.) against MetaMotionR (MBIENTLABO, San Fransisco, USA) for the Lee Silverman Voice Treatment-BIG (LSVT-BIG) and functional activities. The validation metrics in this study are the Pearson’s correlation and Root Mean Square Error (RMSE) between acceleration and gyroscope readings, the Bland-Altman plots for the error in acceleration magnitudes, and linear regression on the error in acceleration magnitudes. Our results show that sensor readings between the IMUs were highly correlated, with a few exceptions. RMSE was mostly less than 0. 05g and 15°/s. Proportional biases between the error in acceleration magnitudes and the mean acceleration magnitudes were mostly insignificant, with the significant ones having a slope of no greater than 0.1 over a range of at most 2g. Our findings show that the TTGO T-Wristband is a valid choice for kinematic measurements for LSVT-BIG and functional activities. 

Validating TTGO T-Wristband Smart Band for the Lee Silverman Voice Treatment-BIG and Functional Activities

Residual motion of upper limbs in individuals who experienced cervical spinal cord injury (CSCI) is vital to achieve functional independence Several interventions were developed to restore shoulder range of motion (ROM) in CSCI patients However, shoulder ROM assessment in clinical practice is commonly limited to use of a simple goniometer Conventional goniometric measurements are operator-dependent and require significant time and effort Therefore, innovative technology for supporting medical personnel in objectively and reliably measuring the efficacy of treatments for shoulder ROM in CSCI patients would be extremely desirable This study evaluated the validity of a customized wireless wearable sensors (Inertial Measurement Units-IMUs) system for shoulder ROM assessment in CSCI patients in clinical setting Eight CSCI patients and eight healthy controls performed four shoulder movements (forward flexion, abduction, and internal and external rotation) with dominant arm Every movement was evaluated with a goniometer by different testers and with the IMU system at the same time Validity was evaluated by comparing IMUs and goniometer measurements using Intraclass Correlation Coefficient (ICC) and Limits of Agreement (LOA) inter-tester reliability of IMUs and goniometer measurements was also investigated Preliminary results provide essential information on the accuracy of the proposed wireless wearable sensors system in acquiring objective measurements of the shoulder movements in CSCI patients

https://www.mdpi.com/1424-8220/21/4/1057/pdf

An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting.

Giacomo Lucchesi

Papers

An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting.