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In the global context, advancements in technology and science have rendered virtual, augmented, and mixed-reality technologies capable of transforming clinical care and medical environments by offering enhanced features and improved healthcare services. This paper aims to present a mixed reality-based system to control a robotic wheelchair for people with limited mobility. The test group comprised 11 healthy subjects (six male, five female, mean age 35.2 ± 11.7 years). A novel platform that integrates a smart wheelchair and an eye-tracking-enabled head-mounted display was proposed to reduce the cognitive requirements needed for wheelchair movement and control. The approach's effectiveness was demonstrated by evaluating our system in realistic scenarios. The demonstration of the proposed AR head-mounted display user interface for controlling a smart wheelchair and the results provided in this paper could highlight the potential of the HoloLens 2-based innovative solutions and bring focus to emerging research topics, such as remote control, cognitive rehabilitation, the implementation of patient autonomy with severe disabilities, and telemedicine. [ABSTRACT FROM AUTHOR]

Electroencephalographic (EEG) signal processing and machine learning can support neurologists' work in discriminating Psychogenic Non-Epileptic Seizure (PNES) from epilepsy. PNES represents a neurological disease often misdiagnosed. Although the symptoms of PNES patients can be similar to those exhibited by epileptic patients, EEG signals during a psychogenic seizure do not show ictal patterns such as in epilepsy. Therefore, PNES diagnosis requires long-term EEG video. Applying signal processing and machine-learning methodologies could help clinicians find helpful information in the clinical diagnosis of PNES by analyzing EEG signals registered in resting conditions and in a short time. These methodologies should prevent long EEG recording sessions and avoid inducing seizures in the subjects. The aim of our study is to develop and validate several machine-learning models on a larger dataset, consisting of 225 EEGs (75 healthy, 75 PNES, and 75 subjects with epilepsy). A deep analysis of our results shows that changes in the evaluation strategy led to changes in accuracy from 45% to 83.98% for a standard Light Gradient Boosting Machine (LGBM) classifier. Our findings suggest that it is necessary to operate a very rigorous control in terms of experimental data collection (patient selection, signal acquisition) and terms of validation strategies to obtain and reproducible results. [ABSTRACT FROM AUTHOR]

Brain-computer interfaces (BCI) can detect specific EEG patterns and translate them into control signals for external devices by providing people suffering from severe motor disabilities with an alternative/additional channel to communicate and interact with the outer world. Many EEG-based BCIs rely on the P300 event-related potentials, mainly because they require training times for the user relatively short and provide higher selection speed. This paper proposes a P300-based portable embedded BCI system realized through an embedded hardware platform based on FPGA (field-programmable gate array), ensuring flexibility, reliability, and high-performance features. The system acquires EEG data during user visual stimulation and processes them in a real-time way to correctly detect and recognize the EEG features. The BCI system is designed to allow to user to perform communication and domotic controls. [ABSTRACT FROM AUTHOR]

Adopting telemonitoring services during the pandemic for people affected by chronic disease is fundamental to ensure access to health care services avoiding the risk of COVID-19 infection. Among chronic diseases, Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig's disease, is a progressive neurodegenerative disease of adulthood, caused by the loss of spinal, bulbar and cortical motor neurons, which leads to paralysis of the voluntary muscles and, also, involves respiratory ones. Therefore, remote monitoring and teleconsulting are essential services for ALS patients with limited mobility, as the disease progresses, and for those living far from ALS centres and hospitals. In addition, the COVID 19 pandemic has increased the need to remotely provide the best care to patients, avoiding infection during ALS centre visits. The paper illustrates an innovative, secure medical monitoring and teleconsultation mobile cloud-based system for disabled people, such as those with ALS (Amyotrophic Lateral Sclerosis). The design aims to remotely monitor biosignals, such as ECG (electrocardiographic) and EMG (electromyographic) signals of ALS patients in order to prevent complications related to the pathology. [ABSTRACT FROM AUTHOR]

Monitoring physical activity in medical and clinical rehabilitation, in sports environments or as a wellness indicator is helpful to measure, analyze and evaluate physiological parameters involving the correct subject's movements. Thanks to integrated circuit (IC) technologies, wearable sensors and portable devices have expanded rapidly in monitoring physical activities in sports and tele-rehabilitation. Therefore, sensors and signal acquisition devices became essential in the tele-rehabilitation path to obtain accurate and reliable information by analyzing the acquired physiological signals. In this context, this paper provides a state-of-the-art review of the recent advances in electroencephalogram (EEG), electrocardiogram (ECG) and electromyogram (EMG) signal monitoring systems and sensors that are relevant to the field of tele-rehabilitation and health monitoring. Mostly, we focused our contribution in EMG signals to highlight its importance in rehabilitation context applications. This review focuses on analyzing the implementation of sensors and biomedical applications both in literature than in commerce. Moreover, a final review discussion about the analyzed solutions is also reported at the end of this paper to highlight the advantages of physiological monitoring systems in rehabilitation and individuate future advancements in this direction. The main contributions of this paper are (i) the presentation of interesting works in the biomedical area, mainly focusing on sensors and systems for physical rehabilitation and health monitoring between 2016 and up-to-date, and (ii) the indication of the main types of commercial sensors currently being used for biomedical applications. [ABSTRACT FROM AUTHOR]

The pandemic emergency of the coronavirus disease 2019 (COVID-19) shed light on the need for innovative aids, devices, and assistive technologies to enable people with severe disabilities to live their daily lives. EEG-based Brain-Computer Interfaces (BCIs) can lead individuals with significant health challenges to improve their independence, facilitate participation in activities, thus enhancing overall well-being and preventing impairments. This systematic review provides state-of-the-art applications of EEG-based BCIs, particularly those using motor-imagery (MI) data, to wheelchair control and movement. It presents a thorough examination of the different studies conducted since 2010, focusing on the algorithm analysis, features extraction, features selection, and classification techniques used as well as on wheelchair components and performance evaluation. The results provided in this paper could highlight the limitations of current biomedical instrumentations applied to people with severe disabilities and bring focus to innovative research topics. [ABSTRACT FROM AUTHOR]

The diagnosis of psychogenic nonepileptic seizures (PNES) by means of electroencephalography (EEG) is not a trivial task during clinical practice for neurologists. No clear PNES electrophysiological biomarker has yet been found, and the only tool available for diagnosis is video EEG monitoring with recording of a typical episode and clinical history of the subject. In this paper, a data-driven machine learning (ML) pipeline for classifying EEG segments (i.e., epochs) of PNES and healthy controls (CNT) is introduced. This software pipeline consists of a semiautomatic signal processing technique and a supervised ML classifier to aid clinical discriminative diagnosis of PNES by means of an EEG time series. In our ML pipeline, statistical features like the mean, standard deviation, kurtosis, and skewness are extracted in a power spectral density (PSD) map split up in five conventional EEG rhythms (delta, theta, alpha, beta, and the whole band, i.e., 1–32 Hz). Then, the feature vector is fed into three different supervised ML algorithms, namely, the support vector machine (SVM), linear discriminant analysis (LDA), and Bayesian network (BN), to perform EEG segment classification tasks for CNT vs. PNES. The performance of the pipeline algorithm was evaluated on a dataset of 20 EEG signals (10 PNES and 10 CNT) that was recorded in eyes-closed resting condition at the Regional Epilepsy Centre, Great Metropolitan Hospital of Reggio Calabria, University of Catanzaro, Italy. The experimental results showed that PNES vs. CNT discrimination tasks performed via the ML algorithm and validated with random split (RS) achieved an average accuracy of 0.97 ± 0.013 (RS-SVM), 0.99 ± 0.02 (RS-LDA), and 0.82 ± 0.109 (RS-BN). Meanwhile, with leave-one-out (LOO) validation, an average accuracy of 0.98 ± 0.0233 (LOO-SVM), 0.98 ± 0.124 (LOO-LDA), and 0.81 ± 0.109 (LOO-BN) was achieved. Our findings showed that BN was outperformed by SVM and LDA. The promising results of the proposed software pipeline suggest that it may be a valuable tool to support existing clinical diagnosis. [ABSTRACT FROM AUTHOR]