Curtis Merring - Academia.edu (original) (raw)
Papers by Curtis Merring
We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger moveme... more We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger movements of those surviving severe disabilities to complete daily tasks using compliant joints. In this paper, we present results from a practical EMG control strategy conducted with spinal cord injury (SCI) patients (C5, C6 and C7) in which the subjects completed daily tasks controlling Maestro with electromyography (EMG) signals from their forearm muscles. With its compliant actuation and its degrees of freedom (DOF) that match the natural finger movements, Maestro is capable of helping the subjects grasp and manipulate a variety of daily objects (more than 15 from a standardized set). To generate control commands for Maestro, an artificial neural network algorithm was implemented along with a probabilistic control approach to classify and deliver four hand poses robustly with three EMG signals measured from the forearm and palm. Increase in the scores of a standardized test, called the Sol...
Des dispositifs et des procedes pour detecter le mouvement articulaire d'un utilisateur. Dans... more Des dispositifs et des procedes pour detecter le mouvement articulaire d'un utilisateur. Dans des modes de realisation particuliers, les dispositifs peuvent comprendre un faisceau pouvant etre deflechi relie a un utilisateur par l'intermediaire d'un patch adhesif situe entre le cou et l'epaule de l'utilisateur. Une retroaction audio et haptique peut etre fournie a l'utilisateur lorsque le faisceau pouvant etre deflechi deflechit en raison du mouvement de l'articulation.
The Journal of Spinal Cord Medicine, 2011
Objective: To determine the association between peripheral blood flow and spasticity in individua... more Objective: To determine the association between peripheral blood flow and spasticity in individuals with spinal cord injury (SCI). Design: A cross-sectional study with measurements of muscle spasticity and whole-limb blood flow in individuals with SCI.
PM&R, 2009
labile hypertension following spinal cord injury. Program Description: Description of the use of ... more labile hypertension following spinal cord injury. Program Description: Description of the use of acetylcholinesterase inhibitor in the treatment of autonomic dysfunction related orthostatic hypotension in persons with spinal cord injury. Setting: Rehabilitation Institute. Results: The initial work up included evaluation of possible causes for autonomic dysreflexia which was negative. On symptomatic treatment of hypertenison with antihypertensives, the patient developed recurrent syncopal episodes. He was hypothesized to have orthostatic hypotension with rebound hypertension secondary to autonomic dysfunction. He was started on a trial of midodrine and fludrocortisone for management of orthostatic hypotension. However,the patient now developed supine hypertension, and midodrine was discontinued. Instead, pyridostigmine, an acetylcholinesterase inhibitor was used with good results. The patient had good blood pressure control with no further episodes of labile hypertension and syncopal attacks. Discussion: Orthostatic hypotension is a known complication associated with autonomic dysfunction in spinal cord injury. Pharmacological interventions with drugs such as midodrine, a sympathomimetic, and fludrocortisone, a mineralocorticoid, are indicated when non pharmacological measures fail. In our patient diagnosed with autonomic dysfunction, a trial with midodrine caused supine hypertension and had to be discontinued. Instead, pyridostigmine, an acetylcholinesterase inhibitor, which has been found to be effective in managing neurogenic orthostatic hypotension, was used with good outcome. The mechanism of action suggested is enhanced sympathetic ganglionic transmission especially during orthostasis without causing significant supine hypertension. Conclusions: Acetylcholinesterase inhibition can be a useful pharmacological agent in the management of autonomic dysfunction in spinal cord injured persons.
PM&R, 2009
Disclosures: J. Chung, None. Patients or Programs: A 24-year-old healthy man. Program Description... more Disclosures: J. Chung, None. Patients or Programs: A 24-year-old healthy man. Program Description: The patient dove in the water near Athens, Greece. Before reaching the bottom, and without trauma, he experienced sudden left-sided neck pain. He then developed left hemiplegia within several minutes. Brain magnetic resonance imaging (MRI) demonstrated left medullary infarction involving the pyramid, extending posteriorly towards the floor of the 4th ventricle. Neck and brain magnetic resonance angiography (MRA) showed dissection of the left vertebral artery, tapering to total occlusion at the vertebrobasilar junction. Patient was started on enoxaparin, and subsequently placed on warfarin. Physical examination revealed mild dysarthria, right eye nystagmus, normal cranial nerve function, normal sensation with mild proprioceptive deficit in his fingers, hyperreflexia on the left, and significant left-sided hemiplegia. Patient was admitted to inpatient rehabilitation. He required assistance in all functional areas. Patient made significant developments during the admission. Electrical stimulation to his left lower extremity helped to facilitate function. He wore a hinged left ankle foot orthosis to counteract foot drop and to improve ambulation. At discharge, the patient was able to ambulate without an assistive device. Further developments will be discussed. Setting: Urban tertiary rehabilitation center. Results: Patient developed left vertebral artery dissection after diving, leading to left medullary stroke with left hemiplegia. The extensive dissection resulted in lateral medullary syndrome, causing immediate onset of symptoms and resulting in a long recovery period with residual weakness. Discussion: This is the first reported case, to our knowledge, of VAD immediately following a dive into shallow waters. Possible causes are discussed with review of literature. Radiological workup is presented. Conclusions: The differential diagnosis for neurological symptoms consistent with stroke in young individuals should include VAD after diving. Though not considered direct trauma, cervical hyperextension from the impact of the head with the water could cause extensive vertebral artery dissection.
Occupational Therapy In Health Care, 2011
ABSTRACT This case report summarizes results of a new standardized evidence-based treatment proto... more ABSTRACT This case report summarizes results of a new standardized evidence-based treatment protocol regarding neuromuscular electrical stimulation (NMES) and somatosensory stimulation (SS) for a chronic stroke patient. The protocol included treatment five times per week, up to 3 hr per day for 20 months. Treatment included 20 min active NMES followed by two to three hr of SS. Repetitive task practice activities were performed during SS for targeted muscle groups. Remarkable functional recovery was noted with all outcome measures, including the Chedoke-McMaster Stroke Assessment and the Action Research Arm Test, suggesting prolonged NMES and SS therapy should be investigated further.
Medicine & Science in Sports & Exercise, 2011
In this paper, we present an electromyography (EMG)-driven assistive hand exoskeleton for spinal-... more In this paper, we present an electromyography (EMG)-driven assistive hand exoskeleton for spinal-cord-injury (SCI) patients. We developed an active assistive orthosis, called Maestro, which is light, comfortable, compliant, and capable of providing various hand poses. The EMG signal is obtained from a subject’s forearm, post-processed, and classified for operating Maestro. The performance of Maestro is evaluated by a standardized hand function test, called the Sollerman hand function test. The experimental results show that Maestro improved the hand function of SCI patients.
Wearable Technologies
We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger moveme... more We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger movements of those surviving severe disabilities to complete daily tasks using compliant joints. In this paper, we present results from an electromyography (EMG) control strategy conducted with spinal cord injury (SCI) patients (C5, C6, and C7) in which the subjects completed daily tasks controlling Maestro with EMG signals from their forearm muscles. With its compliant actuation and its degrees of freedom that match the natural finger movements, Maestro is capable of helping the subjects grasp and manipulate a variety of daily objects (more than 15 from a standardized set). To generate control commands for Maestro, an artificial neural network algorithm was implemented along with a probabilistic control approach to classify and deliver four hand poses robustly with three EMG signals measured from the forearm and palm. Increase in the scores of a standardized test, called the Sollerman hand fu...
2017 International Conference on Rehabilitation Robotics (ICORR), 2017
In this paper, we address two of the most important challenges in development and control of assi... more In this paper, we address two of the most important challenges in development and control of assistive hand orthosis. First, supported by experimental results, we present a method to determine an optimal set of grasping poses, essential for grasping daily objects. Second, we present a method for determining the minimal number of surface EMG sensors and their locations to carry out EMG-based intention recognition and to control the assistive device by differentiating between the hand poses.
Stroke, 2013
Background: Somatosensory stimulation using electrical microcurrents (MSOMA) has proven efficacio... more Background: Somatosensory stimulation using electrical microcurrents (MSOMA) has proven efficacious for treatment of pain and tissue healing however little is known about its use to augment hemipar...
2017 IEEE International Conference on Robotics and Automation (ICRA)
We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger moveme... more We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger movements of those surviving severe disabilities to complete daily tasks using compliant joints. In this paper, we present results from a practical EMG control strategy conducted with spinal cord injury (SCI) patients (C5, C6 and C7) in which the subjects completed daily tasks controlling Maestro with electromyography (EMG) signals from their forearm muscles. With its compliant actuation and its degrees of freedom (DOF) that match the natural finger movements, Maestro is capable of helping the subjects grasp and manipulate a variety of daily objects (more than 15 from a standardized set). To generate control commands for Maestro, an artificial neural network algorithm was implemented along with a probabilistic control approach to classify and deliver four hand poses robustly with three EMG signals measured from the forearm and palm. Increase in the scores of a standardized test, called the Sol...
Des dispositifs et des procedes pour detecter le mouvement articulaire d'un utilisateur. Dans... more Des dispositifs et des procedes pour detecter le mouvement articulaire d'un utilisateur. Dans des modes de realisation particuliers, les dispositifs peuvent comprendre un faisceau pouvant etre deflechi relie a un utilisateur par l'intermediaire d'un patch adhesif situe entre le cou et l'epaule de l'utilisateur. Une retroaction audio et haptique peut etre fournie a l'utilisateur lorsque le faisceau pouvant etre deflechi deflechit en raison du mouvement de l'articulation.
The Journal of Spinal Cord Medicine, 2011
Objective: To determine the association between peripheral blood flow and spasticity in individua... more Objective: To determine the association between peripheral blood flow and spasticity in individuals with spinal cord injury (SCI). Design: A cross-sectional study with measurements of muscle spasticity and whole-limb blood flow in individuals with SCI.
PM&R, 2009
labile hypertension following spinal cord injury. Program Description: Description of the use of ... more labile hypertension following spinal cord injury. Program Description: Description of the use of acetylcholinesterase inhibitor in the treatment of autonomic dysfunction related orthostatic hypotension in persons with spinal cord injury. Setting: Rehabilitation Institute. Results: The initial work up included evaluation of possible causes for autonomic dysreflexia which was negative. On symptomatic treatment of hypertenison with antihypertensives, the patient developed recurrent syncopal episodes. He was hypothesized to have orthostatic hypotension with rebound hypertension secondary to autonomic dysfunction. He was started on a trial of midodrine and fludrocortisone for management of orthostatic hypotension. However,the patient now developed supine hypertension, and midodrine was discontinued. Instead, pyridostigmine, an acetylcholinesterase inhibitor was used with good results. The patient had good blood pressure control with no further episodes of labile hypertension and syncopal attacks. Discussion: Orthostatic hypotension is a known complication associated with autonomic dysfunction in spinal cord injury. Pharmacological interventions with drugs such as midodrine, a sympathomimetic, and fludrocortisone, a mineralocorticoid, are indicated when non pharmacological measures fail. In our patient diagnosed with autonomic dysfunction, a trial with midodrine caused supine hypertension and had to be discontinued. Instead, pyridostigmine, an acetylcholinesterase inhibitor, which has been found to be effective in managing neurogenic orthostatic hypotension, was used with good outcome. The mechanism of action suggested is enhanced sympathetic ganglionic transmission especially during orthostasis without causing significant supine hypertension. Conclusions: Acetylcholinesterase inhibition can be a useful pharmacological agent in the management of autonomic dysfunction in spinal cord injured persons.
PM&R, 2009
Disclosures: J. Chung, None. Patients or Programs: A 24-year-old healthy man. Program Description... more Disclosures: J. Chung, None. Patients or Programs: A 24-year-old healthy man. Program Description: The patient dove in the water near Athens, Greece. Before reaching the bottom, and without trauma, he experienced sudden left-sided neck pain. He then developed left hemiplegia within several minutes. Brain magnetic resonance imaging (MRI) demonstrated left medullary infarction involving the pyramid, extending posteriorly towards the floor of the 4th ventricle. Neck and brain magnetic resonance angiography (MRA) showed dissection of the left vertebral artery, tapering to total occlusion at the vertebrobasilar junction. Patient was started on enoxaparin, and subsequently placed on warfarin. Physical examination revealed mild dysarthria, right eye nystagmus, normal cranial nerve function, normal sensation with mild proprioceptive deficit in his fingers, hyperreflexia on the left, and significant left-sided hemiplegia. Patient was admitted to inpatient rehabilitation. He required assistance in all functional areas. Patient made significant developments during the admission. Electrical stimulation to his left lower extremity helped to facilitate function. He wore a hinged left ankle foot orthosis to counteract foot drop and to improve ambulation. At discharge, the patient was able to ambulate without an assistive device. Further developments will be discussed. Setting: Urban tertiary rehabilitation center. Results: Patient developed left vertebral artery dissection after diving, leading to left medullary stroke with left hemiplegia. The extensive dissection resulted in lateral medullary syndrome, causing immediate onset of symptoms and resulting in a long recovery period with residual weakness. Discussion: This is the first reported case, to our knowledge, of VAD immediately following a dive into shallow waters. Possible causes are discussed with review of literature. Radiological workup is presented. Conclusions: The differential diagnosis for neurological symptoms consistent with stroke in young individuals should include VAD after diving. Though not considered direct trauma, cervical hyperextension from the impact of the head with the water could cause extensive vertebral artery dissection.
Occupational Therapy In Health Care, 2011
ABSTRACT This case report summarizes results of a new standardized evidence-based treatment proto... more ABSTRACT This case report summarizes results of a new standardized evidence-based treatment protocol regarding neuromuscular electrical stimulation (NMES) and somatosensory stimulation (SS) for a chronic stroke patient. The protocol included treatment five times per week, up to 3 hr per day for 20 months. Treatment included 20 min active NMES followed by two to three hr of SS. Repetitive task practice activities were performed during SS for targeted muscle groups. Remarkable functional recovery was noted with all outcome measures, including the Chedoke-McMaster Stroke Assessment and the Action Research Arm Test, suggesting prolonged NMES and SS therapy should be investigated further.
Medicine & Science in Sports & Exercise, 2011
In this paper, we present an electromyography (EMG)-driven assistive hand exoskeleton for spinal-... more In this paper, we present an electromyography (EMG)-driven assistive hand exoskeleton for spinal-cord-injury (SCI) patients. We developed an active assistive orthosis, called Maestro, which is light, comfortable, compliant, and capable of providing various hand poses. The EMG signal is obtained from a subject’s forearm, post-processed, and classified for operating Maestro. The performance of Maestro is evaluated by a standardized hand function test, called the Sollerman hand function test. The experimental results show that Maestro improved the hand function of SCI patients.
Wearable Technologies
We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger moveme... more We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger movements of those surviving severe disabilities to complete daily tasks using compliant joints. In this paper, we present results from an electromyography (EMG) control strategy conducted with spinal cord injury (SCI) patients (C5, C6, and C7) in which the subjects completed daily tasks controlling Maestro with EMG signals from their forearm muscles. With its compliant actuation and its degrees of freedom that match the natural finger movements, Maestro is capable of helping the subjects grasp and manipulate a variety of daily objects (more than 15 from a standardized set). To generate control commands for Maestro, an artificial neural network algorithm was implemented along with a probabilistic control approach to classify and deliver four hand poses robustly with three EMG signals measured from the forearm and palm. Increase in the scores of a standardized test, called the Sollerman hand fu...
2017 International Conference on Rehabilitation Robotics (ICORR), 2017
In this paper, we address two of the most important challenges in development and control of assi... more In this paper, we address two of the most important challenges in development and control of assistive hand orthosis. First, supported by experimental results, we present a method to determine an optimal set of grasping poses, essential for grasping daily objects. Second, we present a method for determining the minimal number of surface EMG sensors and their locations to carry out EMG-based intention recognition and to control the assistive device by differentiating between the hand poses.
Stroke, 2013
Background: Somatosensory stimulation using electrical microcurrents (MSOMA) has proven efficacio... more Background: Somatosensory stimulation using electrical microcurrents (MSOMA) has proven efficacious for treatment of pain and tissue healing however little is known about its use to augment hemipar...
2017 IEEE International Conference on Robotics and Automation (ICRA)