Tesi etd-05112026-085844
Link copiato negli appunti
Tipo di tesi
Corso Ordinario Secondo Livello
Autore
PAU, CHIARA
URN
etd-05112026-085844
Titolo
Influence of Pneumatic Haptic Feedback on Balance Control in Individuals with Spinal Cord Injury Under Epidural
Electrical Stimulation
Struttura
Classe Scienze Sperimentali
Corso di studi
INGEGNERIA - INGEGNERIA
Relatori
tutor Prof. MAZZONI, ALBERTO
relatore Ing. PROIETTI, TOMMASO
relatore Ing. PROIETTI, TOMMASO
Parole chiave
- Nessuna parola chiave trovata
Data inizio appello
11/06/2026;
Disponibilità
parziale
Riassunto analitico
This thesis investigates the impact of spinal cord injury (SCI) on postural control and evaluates the effectiveness of a novel pressure-based haptic feedback device in improving balance in individuals with SCI undergoing epidural electrical stimulation (EES). SCI is a severe neurological condition resulting from traumatic or non-traumatic damage to the spinal cord, leading to partial or complete loss of motor, sensory, and autonomic functions below the level of injury. The extent of impairment depends on the level and severity of the lesion and is commonly classified using the ASIA Impairment Scale. In addition to the initial mechanical damage, a cascade of secondary processes, including ischemia and inflammation, further exacerbates neural injury and limits recovery. Current clinical interventions primarily aim to stabilize the injury and prevent further damage, as the adult central nervous system has limited regenerative capacity.
In recent years, epidural electrical stimulation has emerged as a promising neuromodulatory approach to restore motor function after SCI. By activating sensory afferent pathways and increasing the excitability of spinal circuits below the lesion, EES enables the re-engagement of residual neural networks and facilitates motor outputs such as standing and stepping. However, despite these advancements, postural control remains significantly impaired. Individuals undergoing EES often rely on external support or compensatory strategies, indicating that motor recovery alone is insufficient to ensure stable and autonomous balance. This limitation is largely attributed to the disruption of sensory pathways, which impairs the central nervous system’s ability to accurately estimate body position and integrate sensory information for balance regulation.
Postural control is inherently a complex sensorimotor process that requires continuous integration of visual, vestibular, and somatosensory inputs to regulate the position of the body’s center of mass within the base of support. In individuals with SCI, both motor output and sensory feedback are compromised, leading to increased postural sway, reduced stability, and impaired responses to perturbations. Even when motor activity is partially restored through EES, alterations in sensory processing and sensorimotor integration continue to limit effective balance control. These observations highlight the critical role of sensory information in maintaining stability and underscore the need for complementary approaches targeting sensory deficits.
To address this gap, external sensory feedback systems have been developed to augment or substitute missing sensory information. These systems provide real-time cues about body orientation, movement, or interaction with the environment, thereby supporting postural regulation. Among the available modalities, visual and auditory feedback present practical limitations, such as high attentional demand and environmental interference. Haptic feedback, particularly tactile stimulation, offers a more direct and intuitive alternative. Vibrotactile systems have shown promising results in improving balance and gait in various populations, and studies on light touch demonstrate that even minimal tactile input can significantly enhance postural stability.
However, pressure-based haptic feedback, which provides continuous and modality-matched information related to force and body orientation, remains largely unexplored in the context of SCI. This thesis specifically focuses on evaluating the effect of a novel pressure-based haptic feedback device on balance in individuals with thoracic SCI undergoing EES. By delivering intuitive and spatially meaningful cues, this approach aims to enhance sensory integration and improve postural control during both static and dynamic tasks.
Overall, this work seeks to bridge the gap between motor restoration and functional balance by combining neuromodulation with sensory augmentation, contributing to the development of more effective rehabilitation strategies for individuals with spinal cord injury.
In recent years, epidural electrical stimulation has emerged as a promising neuromodulatory approach to restore motor function after SCI. By activating sensory afferent pathways and increasing the excitability of spinal circuits below the lesion, EES enables the re-engagement of residual neural networks and facilitates motor outputs such as standing and stepping. However, despite these advancements, postural control remains significantly impaired. Individuals undergoing EES often rely on external support or compensatory strategies, indicating that motor recovery alone is insufficient to ensure stable and autonomous balance. This limitation is largely attributed to the disruption of sensory pathways, which impairs the central nervous system’s ability to accurately estimate body position and integrate sensory information for balance regulation.
Postural control is inherently a complex sensorimotor process that requires continuous integration of visual, vestibular, and somatosensory inputs to regulate the position of the body’s center of mass within the base of support. In individuals with SCI, both motor output and sensory feedback are compromised, leading to increased postural sway, reduced stability, and impaired responses to perturbations. Even when motor activity is partially restored through EES, alterations in sensory processing and sensorimotor integration continue to limit effective balance control. These observations highlight the critical role of sensory information in maintaining stability and underscore the need for complementary approaches targeting sensory deficits.
To address this gap, external sensory feedback systems have been developed to augment or substitute missing sensory information. These systems provide real-time cues about body orientation, movement, or interaction with the environment, thereby supporting postural regulation. Among the available modalities, visual and auditory feedback present practical limitations, such as high attentional demand and environmental interference. Haptic feedback, particularly tactile stimulation, offers a more direct and intuitive alternative. Vibrotactile systems have shown promising results in improving balance and gait in various populations, and studies on light touch demonstrate that even minimal tactile input can significantly enhance postural stability.
However, pressure-based haptic feedback, which provides continuous and modality-matched information related to force and body orientation, remains largely unexplored in the context of SCI. This thesis specifically focuses on evaluating the effect of a novel pressure-based haptic feedback device on balance in individuals with thoracic SCI undergoing EES. By delivering intuitive and spatially meaningful cues, this approach aims to enhance sensory integration and improve postural control during both static and dynamic tasks.
Overall, this work seeks to bridge the gap between motor restoration and functional balance by combining neuromodulation with sensory augmentation, contributing to the development of more effective rehabilitation strategies for individuals with spinal cord injury.
File
| Nome file | Dimensione |
|---|---|
Ci sono 1 file riservati su richiesta dell'autore. |
|