Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics
IntroductionCarpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study app...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-01-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2024.1319965/full |
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| author | Mehmet Akif Akdağ Ahmet Kıvanç Menekşeoğlu Hatice Seğmen Berk Gözek Merve Damla Korkmaz Burak Güçlü |
| author_facet | Mehmet Akif Akdağ Ahmet Kıvanç Menekşeoğlu Hatice Seğmen Berk Gözek Merve Damla Korkmaz Burak Güçlü |
| author_sort | Mehmet Akif Akdağ |
| collection | DOAJ |
| description | IntroductionCarpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study applied a novel ultrasonic stimulation method to test tactile sensitivity in CTS and also a mixed-reality-assisted (MR-assisted) exercise program which measured hand movements and provided haptic feedback for rehabilitation.MethodsTwenty patients with mild unilateral CTS took part in the experiments. A mid-air haptics device (Ultrahaptics STRATOS Explore) was used to apply amplitude-modulated ultrasound waves (carrier frequency: 40 kHz) onto the skin to create tactile stimulation mechanically. Participants performed a two-alternative forced-choice task for measuring tactile thresholds at 250-Hz modulation frequency. They were tested at the index fingers and the thenar eminences of both hands. Additionally, 15 CTS patients used an MR-assisted program to do hand exercises with haptic feedback. Exercise performance was assessed by calculating errors between target and actual hand configurations. System Usability Scale (SUS) was adopted to verify the practical usability of the program.ResultsThresholds at the thenar eminences of the affected and healthy hands were not significantly different. While the thresholds at the healthy index fingers could be measured, those of the affected fingers were all higher than the stimulation level produced by the maximum output from the ultrasound device. In the exercise program, a significant positive correlation (ρ = 0.89, p < 0.001) was found between the performance scores and the SUS scores, which were above the criterion value established in the literature.DiscussionThe results show that thenar tactile sensitivity is not affected in mild CTS as expected from the palmar cutaneous branch of the median nerve (PCBm), but index finger threshold is likely to be higher. Overall, this study suggests that mid-air haptics, with certain improvements, may be used as a preliminary test in the clinical setting. Moreover, the device is promising to develop gamified rehabilitation programs and for the treatment follow-up of CTS. |
| first_indexed | 2024-03-08T13:19:58Z |
| format | Article |
| id | doaj.art-b59d7f6443ea459088d3ad20e0b360e1 |
| institution | Directory Open Access Journal |
| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-08T13:19:58Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neuroscience |
| spelling | doaj.art-b59d7f6443ea459088d3ad20e0b360e12024-01-18T04:18:06ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2024-01-011810.3389/fnins.2024.13199651319965Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air hapticsMehmet Akif Akdağ0Ahmet Kıvanç Menekşeoğlu1Hatice Seğmen2Berk Gözek3Merve Damla Korkmaz4Burak Güçlü5Institute of Biomedical Engineering, Boğaziçi University, İstanbul, TürkiyeDepartment of Physical Medicine and Rehabilitation, University of Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, TürkiyeDepartment of Neurology, University of Health Sciences, Istanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, TürkiyeInstitute of Biomedical Engineering, Boğaziçi University, İstanbul, TürkiyeDepartment of Physical Medicine and Rehabilitation, University of Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, TürkiyeInstitute of Biomedical Engineering, Boğaziçi University, İstanbul, TürkiyeIntroductionCarpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy, which causes numbness and pain in the thumb, the index and middle fingers and the radial side of the ring finger. Regular hand exercises may improve the symptoms and prevent carpal tunnel surgery. This study applied a novel ultrasonic stimulation method to test tactile sensitivity in CTS and also a mixed-reality-assisted (MR-assisted) exercise program which measured hand movements and provided haptic feedback for rehabilitation.MethodsTwenty patients with mild unilateral CTS took part in the experiments. A mid-air haptics device (Ultrahaptics STRATOS Explore) was used to apply amplitude-modulated ultrasound waves (carrier frequency: 40 kHz) onto the skin to create tactile stimulation mechanically. Participants performed a two-alternative forced-choice task for measuring tactile thresholds at 250-Hz modulation frequency. They were tested at the index fingers and the thenar eminences of both hands. Additionally, 15 CTS patients used an MR-assisted program to do hand exercises with haptic feedback. Exercise performance was assessed by calculating errors between target and actual hand configurations. System Usability Scale (SUS) was adopted to verify the practical usability of the program.ResultsThresholds at the thenar eminences of the affected and healthy hands were not significantly different. While the thresholds at the healthy index fingers could be measured, those of the affected fingers were all higher than the stimulation level produced by the maximum output from the ultrasound device. In the exercise program, a significant positive correlation (ρ = 0.89, p < 0.001) was found between the performance scores and the SUS scores, which were above the criterion value established in the literature.DiscussionThe results show that thenar tactile sensitivity is not affected in mild CTS as expected from the palmar cutaneous branch of the median nerve (PCBm), but index finger threshold is likely to be higher. Overall, this study suggests that mid-air haptics, with certain improvements, may be used as a preliminary test in the clinical setting. Moreover, the device is promising to develop gamified rehabilitation programs and for the treatment follow-up of CTS.https://www.frontiersin.org/articles/10.3389/fnins.2024.1319965/fulltouchpsychophysicssomatosensory systemcarpal tunnel syndromemid-air hapticsneuropathy |
| spellingShingle | Mehmet Akif Akdağ Ahmet Kıvanç Menekşeoğlu Hatice Seğmen Berk Gözek Merve Damla Korkmaz Burak Güçlü Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics Frontiers in Neuroscience touch psychophysics somatosensory system carpal tunnel syndrome mid-air haptics neuropathy |
| title | Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics |
| title_full | Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics |
| title_fullStr | Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics |
| title_full_unstemmed | Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics |
| title_short | Measuring tactile sensitivity and mixed-reality-assisted exercise for carpal tunnel syndrome by ultrasound mid-air haptics |
| title_sort | measuring tactile sensitivity and mixed reality assisted exercise for carpal tunnel syndrome by ultrasound mid air haptics |
| topic | touch psychophysics somatosensory system carpal tunnel syndrome mid-air haptics neuropathy |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2024.1319965/full |
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