Searcharxiv⌕ Search

arXiv subjects

Yohan Payan

Publications and source records attributed to Yohan Payan.

At least 73 records · Page 4Linked to original sources

Inter-individual variability in sensory weighting of a plantar pressure-based, tongue-placed tactile biofeedback for controlling posture

The purpose of the present experiment was to investigate whether the sensory weighting of a plantar pressure-based, tongue-placed tactile biofeedback for controlling posture could be subject to inter-individual variability. To achieve this goal, 60 young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Overall, results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition, evidencing the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling posture during quiet standing. Results further showed a significant positive correlation between the CoP displacements measured in the No-biofeedback condition and the decrease in the CoP displacements induced by the use of the biofeedback. In other words, the degree of postural stabilization appeared to depend on each subject's balance control capabilities, the biofeedback yielding a greater stabilizing effect in subjects exhibiting the largest CoP displacements when standing in the No-biofeedback condition. On the whole, by evidencing a significant inter-individual variability in sensory weighting of an additional tactile information related to foot sole pressure distribution for controlling posture, the present findings underscore the need and the necessity to address the issue of inter-individual variability in the field of neuroscience.

physics.med-ph↗

Aid to Percutaneous Renal Access by Virtual Projection of the Ultrasound Puncture Tract onto Fluoroscopic Images

Background and Purpose: Percutaneous renal access in the context of percutaneous nephrolithotomy (PCNL) is a difficult technique, requiring rapid and precise access to a particular calix. We present a computerized system designed to improve percutaneous renal access by projecting the ultrasound puncture tract onto fluoroscopic images. Materials and Methods: The system consists of a computer and a localizer allowing spatial localization of the position of the various instruments. Without any human intervention, the ultrasound nephrostomy tract is superimposed in real time onto fluoroscopic images acquired in various views. Results: We tested our approach by laboratory experiments on a phantom. Also, after approval by our institution's Ethics Committee, we validated this technique in the operating room during PCNL in one patient. Conclusion: Our system is reliable, and the absence of image-processing procedures makes it robust. We have initiated a prospective study to validate this technique both for PCNL specialists and as a learning tool.

physics.med-ph↗

Controlling posture using a plantar pressure-based, tongue-placed tactile biofeedback system

The present paper introduces an original biofeedback system for improving human balance control, whose underlying principle consists in providing additional sensory information related to foot sole pressure distribution to the user through a tongue-placed tactile output device. To assess the effect of this biofeedback system on postural control during quiet standing, ten young healthy adults were asked to stand as immobile as possible with their eyes closed in two conditions of No-biofeedback and Biofeedback. Centre of foot pressure (CoP) displacements were recorded using a force platform. Results showed reduced CoP displacements in the Biofeedback relative to the No-biofeedback condition. The present findings evidenced the ability of the central nervous system to efficiently integrate an artificial plantar-based, tongue-placed tactile biofeedback for controlling control posture during quiet standing.

physics.med-ph↗

Artificial Tongue-Placed Tactile Biofeedback for perceptual supplementation: application to human disability and biomedical engineering

The present paper aims at introducing the innovative technologies, based on the concept of "sensory substitution" or "perceptual supplementation", we are developing in the fields of human disability and biomedical engineering. Precisely, our goal is to design, develop and validate practical assistive biomedical and/technical devices and/or rehabilitating procedures for persons with disabilities, using artificial tongue-placed tactile biofeedback systems. Proposed applications are dealing with: (1) pressure sores prevention in case of spinal cord injuries (persons with paraplegia, or tetraplegia); (2) ankle proprioceptive acuity improvement for driving assistance in older and/or disabled adults; and (3) balance control improvement to prevent fall in older and/or disabled adults. This paper presents results of three feasibility studies performed on young healthy adults.

physics.med-ph↗

Prévention des escarres chez les paraplégiques : une nouvelle approche par électrostimulation linguale

Pressure ulcers are recognized as a major health issue in individuals with spinal cord injuries and new approaches to prevent this pathology are necessary. An innovative health strategy is being developed through the use of computer and sensory substitution via the tongue in order to compensate for the sensory loss in the buttock area for individuals with paraplegia. This sensory compensation will enable individuals with spinal cord injuries to be aware of a localized excess of pressure at the skin/seat interface and, consequently, will enable them to prevent the formation of pressure ulcers by relieving the cutaneous area of suffering. This work reports an initial evaluation of this approach and the feasibility of creating an adapted behavior, with a change in pressure as a response to electro-stimulated information on the tongue. Obtained during a clinical study in 10 healthy seated subjects, the first results are encouraging, with 92% success in 100 performed tests. These results, which have to be completed and validated in the paraplegic population, may lead to a new approach to education in health to prevent the formation of pressure ulcers within this population. Keywords: Spinal Cord Injuries, Pressure Ulcer, Sensory Substitution, Health Education, Biomedical Informatics.

physics.med-ph↗

Guiding the surgical gesture using an electro-tactile stimulus array on the tongue: A feasibility study

Under conventional "open-" surgery, the physician has to take care of the patient, interact with other clinicians and check several monitoring devices. Nowadays, the Computer Assisted Surgery proposes to integrate 3D cameras in the operating theatre in order to assist the surgeon in performing minimal-invasive surgical punctures. The cameras localize the needle and the computer guides the surgeon towards an intracorporeal clinically-defined target. A visualization system (screen) is employed to provide the surgeon with indirect visual spatial information about the intracorporeal positions of the needle. The present work proposes to use another sensory modality to guide the surgeon thus keeping the visual modality fully dedicated to the surgical gesture. For this, the sensory substitution paradigm using the Bach-y-Rita's "Tongue Display Unit" (TDU) is exploited to provide to the surgeon information of the position tool. The TDU device is composed of a 6x6 matrix of electrodes transmitting electrotactile information on the tongue surface. The underlying idea consists in transmitting information about the deviation of the needle movement with regard to a pre-planned "optimal" trajectory. We present an experiment assessing the guidance effectiveness of an intracorporeal puncture under TDU guidance with respect to the performance evidenced under a usual visual guidance system.

physics.med-ph↗

Intra-operative quantification of the surgical gesture in orbital surgery: Application to the proptosis reduction

Proptosis is characterized by a protrusion of the eyeball due to an increase of the orbital tissue volume. To recover a normal eyeball positioning, the most frequent surgical technique (BROD technique) consists in the osteotomy of orbital walls combined with a loading on the eyeball to initiate tissue decompression. This paper proposed an experimental method to quantify the intra-operative clinical gesture in proptosis reduction, and the pilot study concerned one clinical case. The eyeball's backward displacement was measured by an optical 3D localizer and the load applied by the surgeon was simultaneously measured by a custom-made force gauge. Quasi-static stiffness of the intra-orbital content was evaluated. The average values for the whole experiment was 16 N (SD: 3 N) for the force exerted by the surgeon and 9 mm (SD: 4 mm) for the eyeball backward displacement. The averaged quasi-static stiffness of the orbital content was evaluated to 2.4 N/mm (SD: 1.2) and showed a global decrease of 45% post-operatively.

physics.med-ph↗

A 3D biomechanical vocal tract model to study speech production control: How to take into account the gravity?

This paper presents a modeling study of the way speech motor control can deal with gravity to achieve steady-state tongue positions. It is based on simulations carried out with the 3D biomechanical tongue model developed at ICP, which is now controlled with the Lambda model (Equilibrium-Point Hypothesis). The influence of short-delay orosensory feedback on posture stability is assessed by testing different muscle force/muscle length relationships (Invariant Characteristics). Muscle activation patterns necessary to maintain the tongue in a schwa position are proposed, and the relations of head position, tongue shape and muscle activations are analyzed.

physics.med-ph↗

Evaluation of a lingual interface as a passive surgical guiding system

Under conventional "open-" surgery, the physician has to take care of the patient, interact with other clinicians and check several monitoring devices. Nowadays, the Computer Assisted Surgery proposes to integrate 3D cameras in the operating theatre in order to assist the surgeon in performing minimal-invasive surgical punctures. The cameras localize the needle and the computer guides the surgeon towards an intracorporeal clinically-defined target. A visualization system (screen) is employed to provide the surgeon with indirect visual spatial information about the intracorporeal positions of the needle. The present work proposes to use another sensory modality to guide the surgeon thus keeping the visual modality fully dedicated to the surgical gesture. For this, the sensory substitution paradigm using the Bach-y-Rita's "Tongue Display Unit" (TDU) is exploited to provide to the surgeon information of the position tool. The TDU device is composed of a 6x6 matrix of electrodes transmitting electrotactile information on the tongue surface. The underlying idea consists in transmitting information about the deviation of the needle movement with regard to a pre-planned "optimal" trajectory.

physics.med-ph↗

A 3D Finite Element evaluation of the exophthalmia reduction

This paper presents a first evaluation of the feasibility of Finite Element modelling of the orbital decompression, in the context of exophthalmia. First simulations are carried out with data extracted from a patient TDM exam. Results seem to qualitatively validate the feasibility of the simulations, with a Finite Element analysis that converges and provides a backward movement of the ocular globe associated with displacements of the fat tissues through the sinuses. This FE model can help a surgeon for the planning of the exophthalmia reduction, and especially for the position and the size of the decompression hole. To get an estimation of the fat tissues volume affected by the surgery, an analytical model seems to provide quicker results for an equivalent efficiency.

physics.med-ph↗

Percutaneous renal puncture: requirements and preliminary results

This paper introduces the principles of computer assisted percutaneous renal puncture, that would provide the surgeon with an accurate pre-operative 3D planning on CT images and, after a rigid registration with space-localized echographic data, would help him to perform the puncture through an intuitive 2D/3D interface. The whole development stage relied on both CT and US images of a healthy subject. We carried out millimetric registrations on real data, then guidance experiments on a kidney phantom showed encouraging results.

physics.med-ph↗

Computer aided planning for orthognatic surgery

A computer aided maxillofacial sequence is presented, applied to orthognatic surgery. It consists of 5 main stages: data acquisition and integration, surgical planning, surgical simulation, and per operative assistance. The planning and simulation steps are then addressed in a way that is clinically relevant. First concepts toward a 3D cephalometry are presented for a morphological analysis, surgical planning, and bone and soft tissue simulation. The aesthetic surgical outcomes of bone repositioning are studied with a biomechanical Finite Element soft tissue model.

physics.med-ph↗

Framework and Bio-Mechanical Model for a Per-Operative Image-Guided Neuronavigator Including 'Brain-Shift' Compensation

In this paper we present a methodology to adress the problem of brain tissue deformation referred to as "brainshift". This deformation occurs throughout a neurosurgery intervention and strongly alters the accuracy of the neuronavigation systems used to date in clinical routine which rely solely on preoperative patient imaging to locate the surgical target, such as a tumour or a functional area. After a general description of the framework of our intraoperative image-guided system, we propose a biomechanical model of the brain which can take into account interactively such deformations as well as surgical procedures that modify the brain structure, like tumour or tissue resection.

physics.med-ph↗

Evaluating soft tissue simulation in maxillofacial surgery using pre and post-operative CT scan

One of the most important issue in soft tissue modeling is to assess the quality of the simulations. A validation protocol is presented based on two CT scans of the patient acquired before and after cranio-maxillofacial surgery. The actual bones repositioning realized during the intervention are accurately measured and reproduced. A evaluation of the soft tissue deformation is then computed using a finite element model of the face. The simulations are therefore compared, qualitatively and quantitatively, with the actual outcome of the surgery. This protocol enable to rigorously evaluate different modeling methods, and to assess the clinical relevance of soft tissue simulation in maxillofacial surgery.

physics.med-ph↗

Reproduction of hypopnea phenomenon using a physical and numerical model

Obstructive sleep apnea syndrome is now considered as a major health care topic. An in-vitro setup which reproduces and simplifies upper airway geometry has been the basis to study the fluid/walls interaction that leads to an apnea. It consists of a rigid pipe (the pharynx) in contact with a deformable latex cylinder filled with water (the tongue). Air flows out of the rigid pipe and induces pressure forces on the cylinder. We present a numerical model of this setup: a finite element model of the latex cylinder is in interaction with a fluid model. Simulation of an hypopnea (partial collapsus of the airway) has been possible and in agreement with observations from the in-vitro setup. The same phenomenon has been simulated on a soft palate model obtained from a patient sagittal radiography. These first results encourage us to improve the model so as it could reproduce the complete apnea phenomenon, and be used for a planification purpose in sleep apnea surgery.

physics.med-ph↗

Modélisation biomécanique tri-dimensionnelle de l'articulateur lingual pour étudier le contrôle de la parole

A 3D biomechanical dynamical model of human tongue is presented, which is elaborated to test in the future hypotheses about speech motor control. Tissue elastic properties are accounted for in Finite Element Modelling (FEM). The FEM mesh was designed in order to facilitate implementation of muscle arrangement in the tongue. Therefore, its structure was determined on the basis of accurate anatomical data. Mechanically, the hypothesis of hyperelasticity was adopted. Muscles are modelled as general force generators that act on anatomically specified sets of nodes of the FEM structure. Simulations, using ANSYS software, of the influence of muscle activations onto the tongue shape are presented.

physics.med-ph↗