Veritas D1.3.2

Accessible and Assistive ICT
VERITAS
Virtual and Augmented Environments and Realistic User Interactions To
achieve Embedded Accessibility DesignS
247765
Parameterized human physical models
Deliverable No. D1.3.2
SubProject No. SP1 SubProject Title User Modelling
Workpackage No. W1.3 Workpackage Title Physical models
Activity No. A1.3.4 Activity Title Parameterized human

physical models
Authors: Hunor Erdelyi, Nicola Cofelice, Oriol Marin, Stijn

Donders, Dirk Roesems (LMS); Eleni Chalkia
(CERTH/HIT); Mauro Da Lio, Mariolino De Cecco
(UNITN); Francesco Palma, Giuseppe Varalda
(CRF); Andrew McDonough, Vicente Arturo Romero
Zaldivar (ATOS); Villy Portouli, Nikos Drosos
(BYTE); Thanos Tsakiris, Kostantinos Moustakas
(CERTH/ITI); Serge Bovarie (CAF); Karel Van
Isacker (MCA); Roberto Orselli, Gianluca De Toma
(SMARTEX); Ana Maria Navarro Cerd, Juan
Bautista Mochol Ages (ITACA).
Status (F: final; D: draft; RD: revised D

draft):
Dissemination level: PU (Public)

VERITAS-D1.3.2 PU Grant Agreement # 247765
File Name: D132_2012-01-26_FINAL
Project start date and duration: 01 January 2010, 48 Months
December 2011 2 LMS

Version History table

Version no. Dates and comments
1 30th of June 2010; 1st draft prepared by LMS.
2 11th of August 2011; 2nd draft prepared by LMS.
3 5th of December 2011; 3rd draft prepared by LMS
5 26th of January 2012; final version for review by LMS
December 2011 3 LMS

Table of contents
Version History table .................................................................................................... 3
Table of contents .......................................................................................................... 4
List of figures ................................................................................................................ 8
List of tables ............................................................................................................... 10
List of abbreviations ................................................................................................... 11
Executive Summary .................................................................................................... 13
1. VERITAS project structure ................................................................................. 14
2. Metrics ................................................................................................................. 14
2.1. Description of the metrics of motor impairments .......................................... 14
2.1.1. Gait parameters ................................................................................... 15
2.1.2. Upper body parameters ....................................................................... 16
2.1.3. Video sensing ...................................................................................... 16
2.1.4. Lower body parameters ....................................................................... 17
2.1.5. Strength parameters ............................................................................ 17
2.1.6. Dexterity/control parameters ................................................................ 17
2.1.7. Torso parameters ................................................................................. 18
2.2. Description of the metrics of speech impairments ....................................... 18
2.2.1. Percentage of consonants correct (PCC) ............................................. 18
2.2.2. Articulation Competence Index (ACI) ................................................... 19
2.3. Metrics of hearing impairments Decibel as function of the frequency .......... 19
2.4. Description of the metrics of visual impairments .......................................... 20
3. Disabilities ........................................................................................................... 21
3.1. Classification (2010 ICD CODE) ................................................................. 21
3.2. Motor disabilities ......................................................................................... 22
3.2.1. Parkinson disease ................................................................................ 23
3.2.2. Dystonia ............................................................................................... 23
3.2.3. Multiple sclerosis .................................................................................. 24
3.2.4. Stroke .................................................................................................. 24
3.2.5. Rheumatoid arthritis ............................................................................. 25
3.2.6. Gout ..................................................................................................... 26
3.2.7. Kyphosis and lordosis .......................................................................... 26
3.2.8. Ankylosing spondylitis .......................................................................... 27
3.2.9. Hand Osteoarthritis .............................................................................. 29
3.2.10. Gonarthrosis (osteoarthritis of the knee) .............................................. 29
3.2.11. Coxarthrosis (osteoarthritis of the hip) .................................................. 29
3.2.12. Shoulder adhesive capsulitis ................................................................ 29
December 2011 4 LMS

3.2.13. Cerebral palsy ...................................................................................... 30

3.2.14. Hereditary and idiopathic neuropathies ................................................ 31
3.2.15. Elderly .................................................................................................. 31
3.3. Visual disabilities ......................................................................................... 32
3.3.1. Glaucoma ............................................................................................ 32
3.3.2. Senile or Age Related Macular Degeneration (AMD) ........................... 32
3.3.3. Diabetic retinopathy ............................................................................. 33
3.3.4. Color vision deficiencies ....................................................................... 33
3.4. Speech disabilities ...................................................................................... 33
3.4.1. Stuttering ............................................................................................. 33
3.4.2. Cluttering ............................................................................................. 33
3.4.3. Dysarthria ............................................................................................ 33
3.4.4. Muteness, no speech ........................................................................... 34
3.4.5. Apraxia of speech ................................................................................ 34
3.5. Hearing disabilities ...................................................................................... 34
4. Multisensorial Platform (MP) .............................................................................. 35
4.1. Summary table of MP composition .............................................................. 35
4.2. Short Description of instruments ................................................................. 37
4.2.1. Video sensing ...................................................................................... 37
4.2.2. Electrogoniometer ................................................................................ 38
4.2.3. Human glove ........................................................................................ 39
4.2.4. Motion tracking - Kinect ........................................................................ 39
4.2.5. Motion tracking - Bumblebee ................................................................ 39
4.2.6. Multi-axes load cell............................................................................... 40
4.2.7. Force panel .......................................................................................... 41
4.2.8. Garment MOCAP ................................................................................. 42
4.2.9. Inertial Platform .................................................................................... 43
4.2.10. Audiometry station ............................................................................... 44
4.3. Overview of metrics measurements with corresponding instruments........... 44
4.3.1. Reach envelope test ............................................................................ 44
4.3.2. Knee flexion ......................................................................................... 45
4.3.3. Elbow flexion/extension ........................................................................ 45
4.3.4. Wrist ulnar bend/radial bend ................................................................ 46
4.3.5. Wrist flexion/extension ......................................................................... 46
4.3.6. Phalanges ROM ................................................................................... 47
4.3.7. Weight shift .......................................................................................... 47
4.3.8. Step length ........................................................................................... 47
December 2011 5 LMS
4.3.9. Step width ............................................................................................ 47

4.3.10. Stride length ......................................................................................... 47
4.3.11. Step Asymmetries ................................................................................ 47
4.3.12. Double Support Duration ...................................................................... 48
4.3.13. Gait cycle ............................................................................................. 48
4.3.14. Cadence .............................................................................................. 48
4.3.15. Velocity ................................................................................................ 48
4.3.16. Pull and Push force .............................................................................. 48
4.3.17. In and Out force ................................................................................... 49
4.3.18. Elbow Joint Torque .............................................................................. 49
4.3.19. Shoulder Joint Torque .......................................................................... 49
4.3.20. Continuous tracking tasks .................................................................... 49
4.3.21. Human Transfer Function..................................................................... 50
4.3.22. Fittss law ............................................................................................. 51
4.3.23. Joint angular velocity............................................................................ 52
4.3.24. Hip Flexion/Extension .......................................................................... 52
4.3.25. Hip Adduction/Abduction ...................................................................... 53
4.3.26. Sagittal flexion of torso ......................................................................... 53
4.3.27. Lateral flexion of torso .......................................................................... 53
4.3.28. Neck Extension/Flexion ........................................................................ 53
4.3.29. Neck Lateral Bend................................................................................ 54
4.3.30. Wrist supination/pronation .................................................................... 54
5. Prioritization of the parameters ......................................................................... 55
5.1. Prioritization of motor impairments .............................................................. 55
5.1.1. Parkinson ............................................................................................. 55
5.1.2. Dystonia ............................................................................................... 55
5.1.3. Multiple Sclerosis ................................................................................. 56
5.1.4. Hereditary and Idiopathic Neuropathies ............................................... 56
5.1.5. Stroke .................................................................................................. 56
5.1.6. Cerebral palsy ...................................................................................... 57
5.1.7. Rheumatoid arthritis ............................................................................. 57
5.1.8. Gout ..................................................................................................... 57
5.1.9. Hand osteoarthritis ............................................................................... 57
5.1.10. Coxarthhiritis ........................................................................................ 58
5.1.11. Gonarthiritis.......................................................................................... 58
5.1.12. Kyphosis and lordosis .......................................................................... 58
5.1.13. Ankylosing spondylitis .......................................................................... 58
December 2011 6 LMS
5.1.14. Shoulder Capsulitis .............................................................................. 59

5.1.15. Elderly .................................................................................................. 59
5.2. Prioritization of hearing impairments ........................................................... 59
5.3. Prioritization of speech impairments ............................................................ 59
5.4. Prioritization of vision impairments .............................................................. 59
6. Generic Physical Virtual User Model ................................................................. 60
6.1. Introduction ................................................................................................. 60
6.2. Extended Abstract User Model .................................................................... 61
6.3. Links to Task analysis ................................................................................. 62
6.4. Experimental Data collection ....................................................................... 63
6.5. Virtual User Model ....................................................................................... 68
7. Conclusions ........................................................................................................ 69
8. References........................................................................................................... 70
8.1. Rheumatoid arthritis .................................................................................... 70
8.2. Gout ............................................................................................................ 71
8.3. Kyphosis ..................................................................................................... 71
8.4. Lordosis ...................................................................................................... 71
8.5. Ankylosis spondilytis ................................................................................... 71
8.6. Hand Ostearthiris ........................................................................................ 71
8.7. Gonarthrosis ............................................................................................... 72
8.8. Coxarthrosis ................................................................................................ 72
8.9. Shoulder adhesive capsulitis ....................................................................... 72
8.10. Parkinsons ................................................................................................. 72
8.11. Dystonia ...................................................................................................... 73
8.12. Multiple sclerosis ......................................................................................... 74
8.13. Cerebral palsy ............................................................................................. 74
8.14. Hereditary and idiopathic neuropathies ....................................................... 75
8.15. Stroke ......................................................................................................... 75
8.16. Elderly ......................................................................................................... 76
8.17. Glaucoma.................................................................................................... 77
8.18. METRICS .................................................................................................... 77
8.18.1. Fittss law ............................................................................................. 77
8.18.2. PCC ..................................................................................................... 77
8.19. Hearing Impairments ................................................................................... 77
ANNEX A: Measurements: Raw data ......................................................................... 78
ANNEX B: Measurements: Processed data .............................................................. 78
ANNEX C: Generic Physical Virtual User Model ....................................................... 78
December 2011 7 LMS

List of figures
Figure 2-1 - Gait metrics ................................................................................................................. 16
Figure 3-1 - Stroke .......................................................................................................................... 25
Figure 3-2 - Examples of hand in extension and flexion .................................................................. 26
Figure 3-3 - Volume (cone segment) representing the hand workspace ......................................... 26
Figure 3-4 - Kyphosis and lordosis .................................................................................................. 27
Figure 3-5 - Normal spine and spine with excessive kyphosis and lordosis..................................... 27
Figure 3-6 - Cobb angle (or L1-S1 angle)........................................................................................ 27
Figure 3-7 - Vertebras angles ......................................................................................................... 28
Figure 3-8 - KTA angle.................................................................................................................... 28
Figure 3-9 - Description of knee ROM and model of muscle-tendon-function .................................. 29
Figure 3-10 - Serial model of the human shoulder complex ............................................................ 30
Figure 3-11 - Views of person with normal vision (left) and with AMD (right) ................................... 33
Figure 4-1 - Example of camera implementation ............................................................................. 38
Figure 4-2 - Electrogoniometer and example of knee implementation ............................................. 39
Figure 4-3 - Sensorized glove ......................................................................................................... 39
Figure 4-4 - Kinect camera ............................................................................................................. 39
Figure 4-5 - Bumblebee Stereo Camera ......................................................................................... 40
Figure 4-6 - Camera implementation for gait metrics measure ........................................................ 40
Figure 4-7 - Multi-axes-cell an overview of the cell .......................................................................... 40
Figure 4-8 - Force panel front and side view ................................................................................... 41
Figure 4-9 - Force Panel where arrays of buttons are shown .......................................................... 42
Figure 4-10 - MOCAP setup overview............................................................................................. 43
Figure 4-11 - Relative segments kinematics extraction and joint angles estimation ........................ 43
Figure 4-12 - Inertial Platform ......................................................................................................... 44
Figure 4-13 - Reach envelope test .................................................................................................. 45
Figure 4-14 - Knee Flexion/Extension ............................................................................................. 45
Figure 4-15 - Elbow flexion/extension ............................................................................................. 46
Figure 4-16 - Wrist Ulnar-Radial Bend ............................................................................................ 46
Figure 4-17 - Wrist Flexion-Extension ............................................................................................. 46
Figure 4-18 - Pull/Push force .......................................................................................................... 48
Figure 4-19 - Out/In Force .............................................................................................................. 49
Figure 4-20 - Force panel with the vertical line shown on the LCD for transfer-function estimation
procedure ....................................................................................................................................... 51
Figure 4-21 - Fittss Law representation .......................................................................................... 52
Figure 4-22 - Hip Flexion/Extension ................................................................................................ 53
Figure 4-23 - Hip Adduction/Abduction ........................................................................................... 53
December 2011 8 LMS
Figure 4-24 - Neck Extension.......................................................................................................... 54

Figure 4-25 - Lateral Bend .............................................................................................................. 54
Figure 4-26 - Wrist supination/pronation ......................................................................................... 54
Figure 6-1 - Merging information into the generic Physical Virtual User Model ................................ 60
Figure 6-2 - Extended AUM table information ................................................................................. 61
Figure 6-3 - Task analysis table information.................................................................................... 62
Figure 6-4 - Data processing procedure .......................................................................................... 66
Figure 6-5 - Data statistical results .................................................................................................. 67
Figure 6-6 - Relevant information in the Generic Physical Virtual User Model table ........................ 68
December 2011 9 LMS

List of tables
Table 2-1 - Gait metrics .................................................................................................................. 15
Table 2-2 - Upper body metrics....................................................................................................... 16
Table 2-3 - Video Sensing metrics .................................................................................................. 16
Table 2-4 - Lower body metrics....................................................................................................... 17
Table 2-5 - Strength parameters ..................................................................................................... 17
Table 2-6 - Dexterity control parameters ......................................................................................... 17
Table 2-7 - Torso parameters ......................................................................................................... 18
Table 2-8 - Hearing Loss Functional limitations............................................................................... 19
Table 3-1 - ICD classification for motor ........................................................................................... 21
Table 3-2 - ICD classification for speech ......................................................................................... 22
Table 3-3 - ICD visual disabilities .................................................................................................... 22
Table 3-4 - Hearing disabilities ........................................................................................................ 22
Table 4-1 - MP sensors................................................................................................................... 35
Table 4-2 - Parameters and instruments ......................................................................................... 35
Table 4-3 - Scenario for the vision sensing system ......................................................................... 37
Table 4-4 - Camera implantation coordinates in the vehicle. ........................................................... 38
Table 4-5 - Human Transfer Function parameters .......................................................................... 51
Table 5-1 - Prioritization criteria table.............................................................................................. 55
Table 6-1- Final Prioritization of metrics measured with the MP ...................................................... 64
Table 6-2- Final list of test sites, considered disabilities and patients .............................................. 65
Table 6-3- Final list of sensors used in the Multisensorial Platform ................................................. 65
December 2011 10 LMS

List of abbreviations
Abbreviation Explanation
A Activity
ACI Articulation Competence Index
AMD Age Related Macular Degeneration
ASHA American Speech-Language-Hearing Association
AUM Abstract User Model
BLSA Baltimore Longitudinal Study of Aging
CMC Carpometacarpal joints
CP Cerebral Palsy
D Deliverable
DIP Distal interphalangeal joints
DOF Degree of freedom
DoW Description of Work
HTF Human Transfer Function
ICD International Classification of Diseases
ID Internal Deliverable
KTA Kyphosis Tilt Angle
LCD Liquid crystal display
LLF Lumbar lateral flexion
MP Multisensorial platform
MS Multiple sclerosis
NIA National Institute of Aging
OA Osteoarthritis
OAG Open Angle Glaucoma
PCC Percentage of consonants correct
PEXG Pseudoexfoliation glaucoma
PI Pelvic incidence
PIP Proximal interphalangeal joints
POAG Primary open angle glaucoma
PT Pelvic Tilt
PTT Percentage Time in Target
RDI Relative Distortion Index
RMSE Root Mean Square Error
Abbreviation Explanation
ROM Range of motion

SNHL Sensorineural hearing loss
SP Subproject
SS Sacral Slope
TOF Time of Flight
VUM Virtual User Model
WHO World Health Organization
WP Work package

Executive Summary
This deliverable D1.3.2 fits in the wider scope of the development of the VERITAS physical models
of elderly people and humans with disabilities for the five application scenarios that VERITAS is
targeting. The overall strategy for D1.3.2 has been to merge the outcomes of Physical Abstract User
Model (included in the D1.3.1), the outcomes of the Experimental campaign carried out with the
Multisensorial Platform (outcomes of the A1.3.3) and task model definition (A1.7.1).
As outcome of this process, the present document D1.3.2 describes the Parameterized Human
Physical Models, detailing how information about disabilities, related metrics, measured data
obtained with the Multisensorial Platform during the measurement campaign, tasks, subtasks and
primitive tasks are merged together to obtain the Generic Physical Virtual User Model. A detailed
description of the above-mentioned process and the constituting elements is given in the following
chapters:
Chapter 1: is a short overview of how the current deliverable links to the VERITAS project and
different activities and deliverables.
Chapter 2: gives a review of the considered Metrics. A broad classification of motor impairments is
given in this chapter. Motor, speech, hearing and visual metrics are detailed.
Chapter 3: provides a brief explanation of the disabilities, which are subdivided into four groups:
motor, speech, visual and hearing. This chapter has the purpose of providing general information
about every disability and gives some backup to the prioritization of metrics.
Chapter 4: describes the Multisensorial Platform. In this chapter the sensors which compose the
Multisensorial Platform are presented, relating these to the measured parameters, describing briefly
also how the sensors can be used in the measurements. The Multisensorial Platform is used to
measure specific metrics with subjects having different disabilities.
Chapter 5: presents the Prioritization of metrics. Starting from the disabilities and metrics presented
in Chapter 3 and Chapter 2 respectively 15 Motor Disabilities, 5 Speech impairments, 6 Visual and
5 Hearing impairments have been successfully prioritized. The process followed three main points
of view: literature survey, compatibility with the sensors present in the Multisensorial Platform and a
biomechanical analysis.
Chapter 6: presents the Generic Physical Virtual User Model, describing the process of merging the
information & provides more details on the different constituent parts. More specifically, this chapter
gives an overview of how the information described in previous chapters (Metrics, Disabilities,
Multisensorial Platform and Prioritization of the parameters) is built into the Physical Virtual User
Model. Subchapters of Chapter 6 describe the extended Abstract User Model, the obtained and
processed numerical data delivered by the measurements with the Multisensorial Platform based on
a final list of metrics considered for the measurements, the tasks and how these relate to the
Generic Physical Virtual User Model. Finally, a description of the Generic Physical Virtual User
Model is given.
The tables containing numerical data are reported in the Annexes as follows:
ANNEX A: Measurements: Raw data
ANNEX B: Measurements: Processed data
ANNEX C: Generic Physical Virtual User Model

1. VERITAS project structure

VERITAS project documents are very large and complex, therefore we focus on the key points of
every one to understand better the aim of the project. The documents studied are:
ID1.2.1: Sensors information.
D1.3.1: Metrics, disabilities and Abstract User Model table (Relation between metrics and
disabilities).
ID1.3.2: Ontologies (process of putting information together) and prioritization of diseases.
ID1.7.1: Virtual User Model for different Scenarios tables.
2. Metrics
The Virtual User Model (as presented in Chapter 6 and in the ANNEX C: Generic Physical Virtual
User Model) is building on the Abstract User Model as presented in D1.3.1, extending the list of
metrics with new ones which were measured with the Multisensorial Platform and do not appear in
the AUM. In this chapter an overview of all metrics present in the VUM is given.
2.1. Description of the metrics of motor impairments

A broad classification of motor impairments is given as follows. This classification discriminates
functional aspects, which, in turn, call for different metrics (and later different modelling methods).
Kinematics functional limitations: Reduction in mobility of joints, velocity of joints,
(possibly geometry of joints and bones) and ultimately reach and dexterity abilities.
Dynamics functional limitations: Reduction in muscle strength and ultimately the ability to
produce useful forces.
Control Functional limitation: Neuromuscular deficiencies, which ultimately results in
difficulty of controlling movements.
Kinematics functional limitations arise mostly from reduction of joint range of motion (M block) or
from reduction in joint speed (G block). These limitations are easily described by range and speed
limitations of joint parameters. Joint range/speed are for the most part directly observable and they
will be later easy to map onto parameters of the chosen simulation models (e.g., shoulder abduction
can be measured, and transformed into parameters for the articulated kinematic chains of
simulation manikins). However not all joints can be observed: for example rotations of single spine
joints is not (easily) observable. Only the overall displacements are easy to measure and to find in
the literature. Aside from the range of motion and speed of joints, there might also be deformities of
joints and links (bones). These can be, in principle, modelled with parameters that describe the
spatial position of successive joints in the kinematic chain, as for example the Denavit-HartenBerg
notation.
Dynamics functional limitations means reduced muscle forces (M block) or reduced muscle control
(G block). Muscle forces cannot be easily observed directly. In facts, what can be measured is the
force applied by limbs (hands, feet, etc.). These have to be converted into joint parameter (forces of
single muscles) by means of some identification techniques. However the identification technique is
in principle quite easy for forces (it calls for an inverse dynamic analysis).
Control functional limitations are caused by deficiencies of motor neurons in any point of the chain
that goes from motor cortex to cerebellum to spine and to muscles. Such deficiencies can be
measured by task performance indices (as an example the gait parameters). In turn, depending on
the modelling techniques used, proper model parameters have to be found to reproduce such
performance indices.
Kinematic limitations are the easiest to observe and model, moreover those ones for which data
exists in literature (although sometimes incomplete) are close to the modelling need and are more
abundant and available. Conversely, control deficiencies are more difficult to observe, are related to
specific task and are more difficult to map onto parameters of the simulation models.
The metrics of motor impairments have been defined, partly from the contribution of ID1.3.1 and
D1.3.1 and partly here. The following groups of metrics were identified:
Gait parameters
Upper body kinematic parameters
Lower body kinematic parameters
Torso kinematic parameters
Strength parameters
Dexterity and control, task-related, performance indicators
Video sensing
2.1.1. Gait parameters

Table 2-1 - Gait metrics
Term Description
Weight shift is the transmission of the weight load from one foot to the
Weight shift
other during normal gait or specific tasks.
Is defined as the anterior displacement of the foot from foot strike to
Step length
contra lateral foot strike.
Is the medio-lateral distance between the feet. It is measured as the
distance, perpendicular to the direction of progression, between a
Step width
point on one foot and the same point on the other food at the
subsequent contact. See also Figure 2-1 -
Stride length is the distance between two successive placements of
the same foot, consisting of two step lengths. In other words the
Stride length
distance travelled by one person during one cycle. See also Figure
2-1 -
The period of time between any two identical events in the walking or
running cycle. There are two main phases in gait: a). Stance phase,
Gait cycle during which the foot is on the ground and b). Swing phase where the
same foot is no longer in contact with the ground and the leg and leg
is swinging through in preparation for the next foot strike.
Cadence represents the number of steps in the unit time in analogy
with cycling where cadence represents the number of rotation per
Cadence
minute. It is related to gait cycle time: in fact it is the inverse of half
gait cycle time
A physical quantity that values the rate of change in position. The
Velocity scalar absolute value (magnitude) of velocity is speed. Velocity is a
measure of a bodys motion in a given direction.
The frames of the double support phase for a gait cycle are estimated
as the ones where the distance between the feet is greater than 95%
Double Support Duration of the stride length. By calculating the number of frames where the
double support occurs, the proportion of the double support to the
whole gait cycle is calculated.

Term Description
Using the step length for each foot, the proportion of the left to right
Step Asymmetries
step length is calculated.
Figure 2-1 - Gait metrics
2.1.2. Upper body parameters

Table 2-2 - Upper body metrics
Term Description
The neck flexion/extension is the motion that occurs when a head
Neck flexion/extension
moves backward/forward.
The neck flexion/extension is the motion that occurs when the head
Neck lateral Bend
moves laterally.
Flexion is the bending movement that decreases the angle between
arm and forearm. Extension is the opposite of flexion: it is a
Elbow flexion/extension
straightening movement that increases the angle between arm and
forearm.
Wrist ulnar bend/radial Rotation or torsion of the wrist.
bend
Wrist flexion/extension Flexion or extensions of the wrist respect the forearm.
Phalanges flexion Position of the fingers into a static position. Can be measured with the
extension fingers in flexion and extension.
Pronation: is the rotation of the forearm that moves the palm from an
Wrist supination/pronation anterior-facing position to a posterior facing position. Supination: is the
opposite of pronation.
2.1.3. Video sensing

Table 2-3 - Video Sensing metrics
Term Description
The subject will be seated in a desk (empty of other objects) and
will be requested to perform a curve with their hands covering
Reach envelope
the maximum area they can reach. The video sensor will
provide the area covered.

2.1.4. Lower body parameters

Table 2-4 - Lower body metrics
Term Description
Knee flexion/extension Knee-hip flexion occurs during the stance and swing phases of the
cycle. In stiff-knee gait, knee gait, knee flexion during swing is
diminished. Straightening the joint resulting in an increase of angle;
moving the lower leg away from the back of the thigh.
Hip flexion/extension Straightening the joint resulting in an increase of angle, moving the
thigh or top of the pelvis backward. Bending the joint resulting in a
decrease of angle, moving the thigh or top of the pelvis forward.
Hip adduction/abduction Medial movement toward the midline of the body; moving the thigh
inward with hip straight
Lower body joint angular Similar to joint angles the most studied in gait analysis are the ankle,
velocity knee, and hip. With increasing walking or running speed increase
also the joint angular velocity. Again the patterns of the angular
velocity curve over a gait cycle are important.
2.1.5. Strength parameters

Table 2-5 - Strength parameters
Term Description
Pull Force Force Exerted by the hand and arm in a pull action
Push Force Force Exerted by the hand and arm in a push action
Force Exerted Force Exerted by the hand and arm in a In and Out
In and Out Force
force action
Torque generated on the elbow joint when the patient is performing a
Elbow Joint Torque
strength action.
Torque generated on the wrist joint when the patient is performing a
Shoulder Joint Torque
strength action.
2.1.6. Dexterity/control parameters

Table 2-6 - Dexterity control parameters
Test Term Description
Continuous Percentage Time in Target Percentage of time the touch is inside the
tracking tasks (PTT) [%] circular target travelling along a circular path.
Mean Deviation to Trajectory Deviation between the cursor point and the
(MD2T) point touched by the subject.
Standard deviation of Deviation The standard deviation of Deviation to
to Trajectory (STD_D2T) Trajectory.
Mean Deviation to Path Minimum deviation between the circular path
(MD2P) and the point touched by the subject.
Standard deviation of Deviation The standard deviation of Deviation to Path.
to Path (STD_D2P)
Mean Speed Target (MST) MST is the angular velocity of the target that

Test Term Description

the subject must follow. This velocity is
constant.
Mean Speed (MS) The Mean Speed
Standard deviation speed Standard deviation of the measured trajectory
(STD_S) speed.
Human Transfer rms Root mean square error of the steady state
Function reached with respect to the reference. Gives
an estimate of the reached accuracy
tau Delay, corresponding to the reaction time
wZ Frequency of the zero on the numerator.
From this frequency on the zero takes effect.
wP Cut frequency of the 1th order pole
Csi Damping factor of the second order pole
wN Natural frequency of the second order pole
Fittss law A Intercept parameter of the Fittss regression
line
B Linear coefficient of the Fittss regression line
2.1.7. Torso parameters

Table 2-7 - Torso parameters
Term Description
Sagittal flexion of torso Flexion of the torso in the plane running from front to back that
divides the body or any of its parts into sinister (left) and dexter
(right) sides.(lateral plane)
Lateral flexion of torso Flexion of the torso running from side to side that divides the
body or any of its parts into anterior and posterior (or dorsal and
ventral) parts (frontal plane)
2.2. Description of the metrics of speech impairments

Some approaches for the voice classification that have recently been researched, use various
pattern classification methods.
2.2.1. Percentage of consonants correct (PCC)

PCC measures severity as a function of the percentage of consonants the client produces correctly
out of the total number of consonants the client attempts.
PCC is determined with the following formula:
(total number of correct consonants/total number of intended consonants)*100=PCC.
The clients level of severity is determined using the following scale:
85% = Normal development
65-85% = Mild to moderate disorder

50%-65% = Moderate to severe disorder

<50 = Severe disorder
2.2.2. Articulation Competence Index (ACI)

ACI is the percentage of consonant distortions out of the total of speech sounds that the client
attempts determined with the following formula: ACI= (PCC+RDI)/2 where RDI (Relative Distortion
Index) is obtained with: RDI = (total number of distortion errors/total number of speech errors)*100.
2.3. Metrics of hearing impairments Decibel as function of the

frequency
The degree of hearing loss refers to the severity of the loss. Someone with normal hearing can hear
sounds of all different loudness and pitch, while a person with a hearing loss might be able to hear
sounds of particular frequency only, or might hear nothing at all. Sound is measures in decibels
[dB]. There are several categories that are typically used.
The next table is a summative table that presents the levels of deafness, the quantitative measures
of each level and the functional limitations a person can have in each type which will be used in
VERITAS.
The organization American Speech-Language-Hearing Association (ASHA) measures hearing loss
by using the following categories:
Table 2-8 - Hearing Loss Functional limitations
Level of hearing loss dB Functional limitations
25-40 Some people may have difficulty in following speech mainly
in noisy situations.
Mild Hearing Loss
Some people may wear a hearing aid. A lot of people will
not.
41-70 Some people may have difficulty in following speech
without a hearing aid. They may also have great difficulty in
noisy situations.
They may find both a hearing aid and skills helpful,
Moderate Hearing
although in a group situation they may find difficulty with
Loss
background noise picked up on their hearing aid.
Some people will be able to use the telephone if it has
amplification. A special telephone may be needed or an
inductive coupler for use with their hearing aid.
71-95 Hearing aids may be of little to no help
The written word may be the only way that some people
Severe Hearing Loss can communicate.
The conventional telephone will be of no use even with
amplification.

Level of hearing loss dB Functional limitations

96+ Hearing aids may be of little to no help
Some people will use British Sign Language if they have
been deaf from birth or early childhood.
Profound Hearing
Loss The written word may be the only way that some people
can communicate.
The conventional telephone will be of no use even with
amplification.
2.4. Description of the metrics of visual impairments

Visuals skills assessment currently involves the assessment of:
Visual Acuity: the ability to perceive details presented with good contrast.
Visual Field: the ability to simultaneously perceive visual information from various parts of
the environment.
Contrast sensitivity: the ability to perceive patterns of poor contrast. Loss of this ability can
interfere significantly with many daily activities.
Glare sensitivity: including delayed Glare recovery, Photophobia and reduced or delayed
Light and Dark Adaptation are other functions that may interfere with proper contrast
perception.
Color vision deficiencies: Inability to perceive differences between some of the colors.
Visual Picture Quality: Seeing functions involving the quality of the picture. Inclusions:
impairments such as in seeing stray lights, affected picture quality (floaters or webbing),
picture distortion, and seeing stars or flashes.

3. Disabilities
Disabilities can be defined at any impairment (elderly people, motor, visual, hearing, etc...) that
affect a persons daily life in performing specific actions.
Disability is caused by impairments to various subsystems of the body - these can be broadly sorted
into the following categories:
Motor disabilities
Visual disabilities
Speech disabilities
Hearing impairments
3.1. Classification (2010 ICD CODE)

Assignation from ICD 70 (International Classification of Diseases) ICD-10
Group G: Nervous systems disease. Neuromuscular disease
Group M: Musculoskeletal disorders: Myopathy, Arthropathy, Ostechondropathy
Group H: Disease of the eye and adnexa.
Group R(47-49): Symptoms and signs involving speech and voice
Group F: Behavioral and emotional disorders with onset usually occurring in childhood and
adolescence
Table 3-1 - ICD classification for motor
MOTOR DISABILITIES
Pathology ICD code
Rheumatoid arthritis M05-M06
Gout M10
Kyphosis M40
Lordosis M40
Ankilosing spondylitis M45
Hand osteoarthritis M16
Gonarthrosis M17
Coxartrothis M16
Shoulder adhesive capsulitis M75
Multiple sclerosis G35
Cerebral palsy G80-G83
Hereditary and idiopathic neuropathy G60
Stroke I64
Dystonia G24
Parkinson disease G20-G22
Elderly Not classified
Table 3-2 - ICD classification for speech

SPEECH DISABILITIES
Pathology ICD code
Stuttering/stammering F98.5
Cluttering F98.6
Dysarthria R47.0
Muteness H91.3
Apraxia R48.2
Table 3-3 - ICD visual disabilities

VISUAL DISABILITIES
Pathology ICD code
Diabetic retinopathy H36.0
Glaucoma H40
Senile or age related degeneration H35.3
Color vision deficiencies H53.5
Table 3-4 - Hearing disabilities

HEARING DISABILITIES
Pathology ICD code
Conductive hearing loss, bilateral, unilateral with unrestricted hearing H90.0-H90.2
on the contralateral side or unspecified.
Sensorineural hearing loss, bilateral, unilateral with unrestricted H90.2-H90.5
hearing on the contralateral side or unspecified.
Mixed hearing loss conductive and sensorineural hearing loss, H90.6-H90.8
bilateral, unilateral with unrestricted hearing on the contralateral side
or unspecified.
Hearing loss, unspecified H91.9
3.2. Motor disabilities

The World Health Organization (WHO) [2] endorsed a classification of various diseases and other
health problems, called International Classification of Disease (ICD). From an overview of this
classification, it is clear that the number of disability types is very large for this reason we focus on
the most common, as presented below.

3.2.1. Parkinson disease

Parkinson disease is a degenerative disorder of the central nervous system. It results from the
death by unknown causes of the dopamine-containing cells of the substantia nigra, which is a
region of the midbrain.
Resting Tremor: About 70 percent of people with Parkinsons experience a slight tremor in the
early stage of the disease, either in the hand or foot on one side of the body, or less commonly in
the jaw or face. The tremor appears as a "beating" or oscillating movement. Because the
Parkinson's tremor usually appears when a person's muscles are relaxed, it is called "resting
tremor." This means that the affected body part trembles when it is not doing work, and it usually
subsides when a person begins an action. The tremor often spreads to the other side of the body as
the disease progresses, but remains most apparent on the original side of occurrence [37].
Bradykinesia (Slow Movement): is the phenomenon of a person experiencing slow movements. In
addition to slow movements, a person with bradykinesia will probably also have incomplete
movement, difficulty initiating movements and sudden stopping of ongoing movement. People who
have bradykinesia may walk with short, shuffling steps .Bradykinesia and rigidity can occur in the
facial muscles, reducing a person's range of facial expressions and resulting in a "mask-like"
appearance [38], [39].
Rigidity: also called increased muscle tone, means stiffness or inflexibility of the muscles. Muscles
normally stretch when they move, and then relax when they are at rest. In rigidity, the muscle tone
of an affected limb is always stiff and does not relax, sometimes resulting in a decreased range of
motion. For example, a person who has rigidity may not be able to swing his or her arms when
walking because the muscles are too tight. Rigidity can cause pain and cramping [37].
Postural Instability (Impaired Balance and Coordination): people with Parkinsons disease often
experience instability when standing or impaired balance and coordination. These symptoms,
combined with other symptoms such as bradykinesia, increase the change of falling. People with
balance problems may have difficulty making turns or abrupt movements. They may go through
periods of freezing, which is when a person fells stuck to the ground and finds it difficult to start
walking. The slowness and incompleteness of movement can also affect speaking and swallowing
[37].
3.2.2. Dystonia
Dystonia is a general term that describes a range of movement disorders which cause involuntary
muscle spasms and contractions (tightening). The spasms and contractions that are associated with
dystonia can cause the affected body parts to make repetitive movements and take on unusual and
awkward postures [54].
Dystonia is thought to be a neurological condition, i.e. a condition that is caused by underlying
problems with the nervous system and brain. However, in most cases, other functions of the brain,
such as intelligence, memory and language are unaffected.
The symptoms of dystonia can vary depending on the form of dystonia that you have. Some forms
of dystonia and their associated symptoms are described below [55].
Cervical spasms: the symptoms of cervical dystonia can range from mild to severe. The symptoms
of muscle spasms and contractions can lead to the additional symptoms of neck pain and stiffness.
Blepharospasm: is a type of focal, late-onset dystonia that affects the muscles around your eyes.
Symptoms of blepharospam included: eye irritation, sensitivity to light (photophobia) ,uncontrollable
blinking , uncontrollable closing of the eyes in the most severe cases, a person cannot open their
eyes for several minutes, effectively making them blind for short periods of time.

Facial spasms: Hemifacial spasm is a type of focal, late-onset dystonia that causes the muscles on
one side of the face to spasm.
Body spasms: additional symptoms are also: muscle spasms the limbs or torso can take on an
abnormal, twisted posture, a foot, leg or arm can turn inwards, body parts can jerk rapidly.
3.2.3. Multiple sclerosis

Multiple sclerosis (MS) is one of the most common diseases of the central nervous system. MS is
the result of damage to myelin-a protective sheath surrounding nerve fibers of the central nervous
system. When myelin is damaged, this interferes with propagation of messages between the brain
and other parts of the body.
Symptoms vary widely and include:
Difficulty walking or performing tasks that require coordination: gait problems in multiple
sclerosis are caused by a variety of factors. MS frequently causes fatigue, also damage the nerve
pathways may hamper coordination [62].
Loss of sensation: the vast nervous system includes many sensory nerve fibers dedicated to
helping you be aware of your environment. They provide the sense of touch in your fingers, and
your ability to feel cold or heat on all parts of your body. When these fibers are damaged through
multiple sclerosis, your sense of touch may be replaced by feelings of numbness or tingling. Parts of
your body may feel burning or cold, even though there is no heat or chill present. Symptoms can be
temporary (flare-ups or relapses) or more progressive, and can occur in various parts of the body.
This could be just one part of an arm or leg, in the whole lower half of the body, say below the
navel, or in a collection of numb patches occurring randomly all over the body [62].
Fatigue and weakness: many people with multiple sclerosis experience fatigue or tiredness. But
since fatigue can be a sign of so many other diseases too, it is not often immediately identified as
being caused by multiple sclerosis. Fatigue occurs in both relapsing multiple sclerosis and in the
more progressive types of the disease. It can often last for a few months during which time your
energy is used up every day with just a little exertion [62].
Tremors: is estimated to occur in about 25 to 60 per cent of the patients with multiple sclerosis.
Tremor can involve some body parts directly related to movements: head, neck, trunk and limbs
[63].
Loss of muscle strength in arms and legs: the nervous system contains large numbers of nerve
fibers that control movement - what we call motor function. Often, multiple sclerosis is active on the
nerve fibers that control muscle movement. Many people with multiple sclerosis lose muscular
strength in the arms and legs as the disease progresses. The loss can range from reduced dexterity
(the fingers no longer work so well) to paralysis of an arm or leg. Loss of muscular strength occurs
not only in the form of flare-ups or relapses (temporary attacks) but also as a gradual (progressive)
process without recovery. Depending on the severity, you may need to rely on a cane, crutches, or
even a wheelchair to get around [64].
3.2.4. Stroke
Stroke is a cerebrovascular accident Figure 3-1 (also called CVA) causing insufficient oxygen
supply to a region of the brain. It can either be due to an ischemia (blockage of blood flow) or a
hemorrhage. Either way, a region of the brain is damaged and ceases its functions. When the
affected region is related to motor functions motor disabilities are produced [90].

Figure 3-1 - Stroke

Usually only one side of the body is involved. Depending on the brain area that is affected, stroke
(as for what concerns motor deficit) can produce the following gross consequences:
Hemiplegia (paralysis of one side of the body);
Alteration of voluntary movements (apraxia);
Alteration of movement coordination;
Reduction of muscle responsiveness;
Inability to turn head to one side;
Walking problems;
Balance problems;
Vertigo;
Reduction of tactile sensitivity;
Face and eyes muscles weakness;
Nystagmus (involuntary eye movements)
As a consequence the ability to manipulate objects (reach, point, grasp, manipulate, etc...) and to
move around (walk, stand, sit etc) can be severely affected.
Post stroke rehabilitation allows partial recovery of the lost functions by training other regions of the
brain. Nonetheless, survivors still hold various degrees of disabilities, which depend largely on the
extension and localization of the damaged area.
3.2.5. Rheumatoid arthritis

Rheumatoid arthritis is a highly inflammatory polyarthritis often leading to joint destruction, deformity
and loss function.
In general, patients develop seropositive rheumatoid factor within one year of developing
symptoms. Overall, patients who are seropositive have a more severe disease course with more
joint deformities, x-ray damage, disability and inflammation outside of the joints. However, there are
many exceptions to these rules.
The most affected part for this disability is:
Neck: rheumatoid arthritis affects neck mobility with basic movements such as flexion/extension,
rotation, lateral bend [10].
Hand: arthritis causes functional limitations of the hand Figure 3-2 basic movements such as grip
and pinch strength, flexion-extension of the fingers, etc

Figure 3-2 - Examples of hand in extension and flexion

The working space of the hand is then computed using the above circles and the palm width,
according to Figure 3-3 which depicts the approximated shape of the hand workspace
Figure 3-3 - Volume (cone segment) representing the hand workspace
Knee: the disability can affect to the knee range of motion decreasing angles of flexion and
extension [14].
3.2.6. Gout
Gout is a common form of inflammatory arthritis, and its prevalence among older patients is
especially rising [17]. Acute gout is a common cause of arthritis [18], [17]. The joints that are
commonly involved are:
Metatarsal joint;
The base of the big toe;
Knee joint;
Wrist joint;
Joint of the fingers
3.2.7. Kyphosis and lordosis

Kyphosis, also called hunchback, is a common condition of a curvature of the upper spine Figure
3-4 and Figure 3-5. It can be the result of degenerative diseases (such as arthritis), developmental
problems, and osteoporosis with compression fractures of the vertebrae, and/or trauma.
Lordosis is a medical term used to describe an inward of a portion of the vertebral column. Lordosis
may also increase at puberty sometimes not becoming evident until early or mid-20s. Imbalances in
muscle strength and length are also a cause, such as weak hamstrings, or tight hip flexors [20].

Figure 3-5 - Normal spine and spine with excessive

Figure 3-4 - Kyphosis and lordosis
kyphosis and lordosis
As for what concerns gait parameters we refer to [21], which takes into account the effect of sagittal
trunk posture on the gait of able-body subjects. Understanding the effect of trunk posture on gait is
of interest since alterations in trunk posture often occur with age or in the presence of spinal
pathologies, such as Kyphosis.
Concerning lordosis, we first introduce the angle used to assess the disease: it is depicted in Figure
3-6 and is representative of the lumbar lordosis.
Figure 3-6 - Cobb angle (or L1-S1 angle)
3.2.8. Ankylosing spondylitis

Ankylosing spondylitis (AS) is defined as the formation of a stiff joint by consolidation of the
articulating surfaces and inflammation of the vertebral column. In AS the spine becomes rigid from
the occipital to the sacrum. This leads to a stooped position, witch inability to see the horizon and a
shock absorption decrease.
Gait: parameters as trunk, hip, ankle range of motion (ROM) and stride length are affected [24].
Spine movements: some of parameters used to assess the disease are [24], [25], [26].
Pelvic incidence (PI): angle between a line drawn from center of the hip axis to the center of
the superior endplate of S1 and perpendicular to the endplate.
Sacral Slope (SS): angle formed between the sacral endplate and the horizontal plane.
Pelvic Tilt (PT): angle between the vertical plane and a straight line joining the centers of the
femoral heads and the center of the sacral endplate.
C7 Tilt (C7T): the L line is defined by the line joining the center of C7 and the center of the
sacral endplate. The C7 (Figure 3-7) tilt is the angle formed between the L line and the
horizontal plane.
Spino-Sacral Angle (SSA): it was the angle between the L line and the sacral endplate.
Kyphosis Tilt Angle as shown in Figure 3-8 (KTA)
Chest expansion: using a tape, it consists in the change in circumference of the patients
chest at the level of the 4th intercostal space;
Cervical spine posture: it is measures by means with a pair of compasses and a ruler as the
distance from C7 to the wall;
Thoracic spine posture: it is measured by means of Debrunners kyphometer, between Th2-
3 and Th11-12;
Lumbar spine posture: it is measured by means of Debrunners kyphometer, between Th11-
12 and S1-2;
Cervical rotation: distance between tip of nose and ACJ in neutral and maximal ipsilateral
rotation. Between two positions calculated for right/left rotation. Smaller difference indicates
a more restricted range. Measured with plastic tape measure;
Fingertip-to-floor distance: distance between tip of right middle finger and the floor following
maximal lumbar flexion, whilst maintaining knee extension; smaller distances indicates
greater movement. Measured with a retractable steel tape measure;
Lumbar lateral flexion (LLF): distance between tip of ipsilateral middle finger and the floor
following maximal LLF, maintaining heel contact with floor and without trunk rotation. Smaller
distance indicates greater movement. Measured with a retractable steel tape measure;
Modified Schober index (15 cm): Distance between two marks placed 15 cm apart in
standing (10 cm proximal and 5 cm distal to the PSIS) following maximal forward flexion of
the spine. Larger difference indicates greater lumbar movement. Measured with a plastic
tape measure;
Tragus-to-wall distance (TWD): horizontal distance between right tragus and wall, standing
with heels and buttocks against the wall (to prevent pivoting), knees extend and chin drawn
in. Larger distances indicate worse spinal/upper cervical posture. Measured with a
retractable steel tape measure.
Figure 3-7 - Vertebras angles Figure 3-8 - KTA angle

3.2.9. Hand Osteoarthritis

Osteoarthritis (OA) is the most common joint disorder, affecting about 12% of people. Osteoarthritis
can be classified into either primary or secondary. Primary OA is degenerative disorder correlated to
age, but not caused by aging (there are people that are not affected). The cartilage covering the
ends of the bones forming a joint gradually deteriorates. Contact between bones, inflammation and
outgrow of spurs can happen. Overall joints become stiffer, cause pain and have reduced range of
motion, causing disabilities like reduced strength and mobility.
Secondary OA is caused by diseases like diabetes, by injuries, joint overload due to obesity and a
number of other syndromes.
The most affected joints are: hands, feet, knees and hips. This section deals with the hand OA, the
following sections will deal with knee and hip.
Hand osteoarthritis typically involves the distal interphalangeal joints (DIP), the proximal
interphalangeal joints (PIP), and the first carpometacarpal (CMC) joints, and affect up to 75% of
women aged 60 to 70 years [30].
3.2.10. Gonarthrosis (osteoarthritis of the knee)

Gonarthosis (Figure 3-9) is osteoarthritis of the knee joint, generally implying early joint surface
damage of any kind. This causes the joint motion to decrease [31].
Figure 3-9 - Description of knee ROM and model of muscle-tendon-function
3.2.11. Coxarthrosis (osteoarthritis of the hip)

This is a non-inflammatory degenerative disease of the hip joint which usually appears in late
middle or old age. It is characterized by growth or maturational disturbances in femoral neck and
head, as well as acetabular dysplasia. A dominant symptom is pain on weight-bearing or motion
[34].
3.2.12. Shoulder adhesive capsulitis

Frozen shoulder, medically referred to as adhesive capsulitis, is a disorder in which the shoulder
capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes
inflamed and stiff, and grows together with abnormal bands of tissue, called adhesions, greatly
restricting motion and causing chronic pain. Adhesive capsulitis is a painful and disabling condition.
Certain movements can cause sudden onset of tremendous pain and cramping that can last several
minutes.

Figure 3-10 - Serial model of the human shoulder complex

The angles sF, sA and sR Figure 3-10 represent the shoulder flexion-extension, the shoulder
abduction-adduction and the shoulder rotation. The angles gF, gA, gR are the upper arm flexion-
extension, the upper arm adduction-abduction and the upper arm rotation. Linear coordinate sT is
the shoulder translation [35].
3.2.13. Cerebral palsy

Cerebral Palsy (CP) [71] is a broad set of motor disorders which are caused by damages to the
cerebellum and its connections to the motor cortex, which occur during pregnancy, birth or in the
very first years of life (up to three years). No cure is known for any of the different types and
subtypes of CP. The disease is non-progressive as for what concerns the neurological aspects, but
it is progressive as for what concerns the orthopedics aspects (due to permanent muscle
contraction).
CP may be accompanied by disturbances of sensation, perception, cognition, speech, behavior
and/or by a seizure disorders.
CP is classified according to following types (which reflects different damaged brain areas):
Spastic CP: spastic CP is the most frequent type (~80%).Its caused by damages to the
upper motor neurons and to the corticospinal tract, which in turn becomes no longer able to
regulate muscle tone. Consequently, the group of muscles that depend on the damaged
brain structures result constantly contracted and become hypertonic. There are subtypes of
Spastic CP, depending on the affected limbs:
Spastic hemiplagia occurs when one side is affected (this is the worst clinical case).
Spastic diplegia is when both lower limbs are affected (this is the most common type).
Spastic diplegia impairs gait. A gait pattern called scissor gait is typical of this disease.
Spastic monoplegia, triplegia and quadriplegia occur when one, three or four limbs are
respectively affected.
The affected limbs may present violent uncontrolled movements (clonus) and involuntary
contractions (spasms).
Voluntary and passive movements are difficult because of the excessive muscle tone. People
affected by Spastic CP experience a strong resistance to movements of the affected limbs.
The degree of spasticity varies widely from person to person:

Ataxia: it is the least frequent case (~10%).It is caused by damages in the cerebellum that
lead to hypotonia and tremors and lack of muscle coordination. Thus many manual tasks like
object handling, pointing, writing, etc. it is difficult for these people. Also balance problems
while walking are reported.
Dyskinetic CP: it occurs in 10-20% of cases. It causes mixed muscle tones, which in turn
cause difficulty to achieve coordinate motion. For example walking, sitting, holding objects
and reaching specific spots to grasp objects. Involuntary movements can also occur [72].
Hypotonic CP: it causes insufficient muscle tone. People with hypotonic CP can move very
little.
Gait is affected by CP in several aspects: unsteady gait balance problems, scissor walking, toe
walking, equinus gait are the most common effects.
Speech disorders are frequent in people with CP. Dysarthria is estimated to range from 31% to
88%. Speech problems are caused by poor respiratory control and reduced movement control in the
oral-facial muscles.
3.2.14. Hereditary and idiopathic neuropathies

Idiopathic neuropathy is a disorder that affects the peripheral nerves and has no identifiable primary
cause. The common symptoms are numbness, tingling and pain; more rarely could be tremors [85].
Symptoms usually begin in late childhood or early adulthood. The metrics affected are:
Hand Function: loss of hand strength and manual dexterity are common symptoms [86].
Gait and Posture: the disease affects distal muscle strength and sensation due to
degeneration of the longer peripheral nerves. Thus gait and posture are often the most
affected functions [88].
3.2.15. Elderly
Aging, besides the change of being affected by one of many diseases, involves the decline of
several cognitive and physical functions. Reaction time and muscular strength are two examples.
[97]
The Baltimore Longitudinal Study of Aging (BLSA) is the US longest-running scientific study of
human aging, supported by the US National Institute of Aging (NIA) [98]. The study begun in 1958
to trace the effects of aging in humans and to distinguish between the true effects of aging and
those processes, including disease, socioecnonomic disadvantage, and lack of educational
opportunity, that may appear or become pronounced with time but are biologically irrelevant to the
underlying mechanism of human aging [99].
Fine motor skills: A review of studies concerning the effect of aging on fine motor skills was made
by Krampe [100]. Timing is related to the exercise and internal clock [101] which forms the baseline
for motion planning and which does not apparently decline in healthy adults.
As for what concerns age-related changes in maximum speed and accuracy of fine motor
movements, the overall patterns of results from many studies indicates that older adults take longer
to plan (i.e. initiate after a starting signal) or restructure arm movements than young adults do and
their movements tend to be less smooth, that is, more segmented [102].
Fittss Law: Paper [105] provides data according to the Fittss law for elder people using mouse.
Elder people were 15 subjects in the age range 56-74 who had just completed a 36 hours computer
literacy course.
Loss of muscle strength: The gradual loss of skeletal muscle mass, strength, and quality that
takes place with advancing age is often called sarcopenia [106]. Reduced muscle strength is
predictive of functional limitation and physical disability in older people [107], [108]. Independent of
physical illness, there is evidence that cognitive impairment and depression are associated with
functional limitation and physical disability.
Effect of sarcopenia on lower extremities performance (walk and sit functions): A study [109]
concerning the effect of reduced muscle strength on physical function is. The study compared 30
young man, 31 older man and 39 older men with mobility limitations. The study measured:
Muscle strength
The time to walk 50 m
The time to ascend a single flight of stairs
The time to ascend a single flight of stairs
The time to ascend 12 steps as fast as possible while carrying two canvases as described
and used for the loaded 50m walk.
Lift a weighted basked (equivalent to 15% of body weight)
Gait and balance: Gait speed in older adults is a good measure of overall walking performance.
Changes in gait patterns with ageing have been described in many studies and a decline in gait
speed appears as one of the most consistent age-associated changes [110]. Slower walking of
older adults was related to fear to fall, muscle weakness and impairments of motor control. In other
paper [111] can be seen which range of motion of joints of the hip, knee and ankle in the anterior
posterior angle and medial-lateral-plane are affected.
3.3. Visual disabilities
3.3.1. Glaucoma
Glaucoma is a disease in which the optic nerve is damaged, leading to progressive, irreversible loss
of vision.
Symptoms: hazy or blurred vision and the appearance of rainbow-colored circles around bright
lights [112], [113].
Visual field defects are either diffuse depressions of the visual field or localized defects that conform
to nerve fiber bundle patterns.
Glaucoma is the term for a diverse group of eye diseases, all of which involve progressive damage
to the optic nerve. Glaucoma is usually, but not always, accompanied by high intraocular (internal)
fluid pressure. Optic nerve damage produces certain characteristic visual field defects in the
individuals peripheral (side), as well as central, vision. Symptoms: Subtle loss of contrast, difficulty
driving at night, loss of peripheral vision, loss of central vision in terminal cases. When glaucoma
progresses the resultant optic nerve damage causes an irreversible loss of peripheral vision.
Types of Glaucoma:
Open Angle Glaucoma (OAG)
o Primary open angle glaucoma (POAG)
o Angle closure glaucoma
o Congenital glaucoma
o Secondary
Pseudoexfoliation glaucoma (PEXG)
3.3.2. Senile or Age Related Macular Degeneration (AMD)

AMD is condition, which usually affects older adults which results in a loss of vision in the center of
the field (the macula) because of damage of the retina. Because the peripheral vision is not affected
as we can see on Figure 3-11, people with macular degeneration can learn to use their remaining
vision to continue most activities.
Figure 3-11 - Views of person with normal vision (left) and with AMD (right)
3.3.3. Diabetic retinopathy

Diabetic retinopathy is a complication of diabetes that results from damage to the blood vessels of
the light-sensitive tissue at the black of the eye (retina). Symptoms may include: blurred or
fluctuating vision, blind spots, impaired color vision. Diabetic retinopathy usually affects both eyes.
3.3.4. Color vision deficiencies

Color vision deficiency is the inability to perceive differences between some of the colors that able
bodied persons can distinguish.
Based on clinical appearance, partial color blindness can be distinguished in two major types:
people, who have difficulty distinguishing between red and green, and people who have difficulty
distinguishing between blue and yellow.
3.4. Speech disabilities
3.4.1. Stuttering
The flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables,
words or phrases, and involuntary silent pauses or blocks in which the stutterer is unable to produce
sounds.
Symptoms:
Repetition: a unit of speech, such as a sound, syllable, word, or phrase is repeated
Prolongations: unnatural lengthening of continuant sounds
Blocks: inappropriate cessation of sound and air.
3.4.2. Cluttering
A rapid rate of speech with breakdown in fluency, but no repetitions or hesitations, of a severity to
give rise to diminished speech intelligibility. Speech is erratic and dysrhythmic, with rapid jerky
spurts that usually involve faulty phrasing patterns.
3.4.3. Dysarthria
Motor speech disorder resulting from neurological injury, characterized by poor articulation. Any of
the speech subsystems (respiration, phonation, resonance, prosody, articulation and movements of
jaw and tongue) can be affected.
Symptoms:
Phonation: Phonatory dysfunction [403]
Monopitch (in all types of dysarthria)
Harsh voice (in all types of dysarthria)
sound prolongation,
syllable duration: (a 1 syllable word, as a 2 syllable word: daydial), words with long
voiceless stops
Fundamental frequency range modification.
Inter-utterance variability of syllable duration.
3.4.4. Muteness, no speech

Muteness or mutism is a kind of speech disorder that causes an inability to speak. The term mute
originates from the Latin word mutus, for silent.
3.4.5. Apraxia of speech

A disorder caused by damage to specific areas of the cerebrum, characterized by loss of the ability
to execute or carry out learned purposeful movements, despite having the desire and the physical
ability to perform the movements. It is a disorder of motor planning which may be acquired or
developmental, but may not be caused by incoordination, sensory loss, or failure to comprehend
simple commands (which can be tested by asking the person to recognize the correct movement
from a series).
3.5. Hearing disabilities

Hearing impairment is difficult to be statistically defined among the population and this is why can
find a wide range of results worldwide. Also there are different ways of identifying the hearing
impairment.
The estimated demographic figure from these organizations has ranged from 22 million deaf and
hard of hearing to as high as 36 million deaf and hard of hearing, which means approximately 15%
of the whole USA population [2].
If one has a hearing loss, the odds are such that the probability has a sensorineural loss.
Sensorineural hearing loss (SNHL) accounts for about 90% of all hearing loss.
In conductive hearing loss, the second most common form of hearing loss, sound is not transmitted
into inner ear. An example of conductive hearing loss is plugging up of the ear by ear wax. Other
things that cause conductive hearing losses are fluid in the middle ear, and disorders of the small
bones in the middle ear.
However, the actual severity of hearing loss is measured as follows:
Mild Hearing Loss
Moderate Hearing Loss
Severe Hearing Loss
Profound Hearing Loss
Another important hearing disability is Presbycusis, which can be defined as the cumulative effect of
aging on hearing. It is defined as a progressive bilateral symmetrical age-related sensorineural
hearing loss. The hearing loss is most marked at higher frequencies.

4. Multisensorial Platform (MP)

The large variety of metrics makes it almost impossible to measure all of them with the same
system or set of sensor. For example for some cases a metric, like range of motion (valid for some
joints) has nothing to do with a metric related with dexterity and control (reaction time for example).
To ensure all the metrics can be properly measured, a platform of sensors with different
characteristics and properties must be composed. This chapter focuses on this aspect naming
every sensor, with their characteristics and more importantly, what metrics can be measured with
them. The sensors capable of measuring the metrics described below compose the Multisensorial
Platform (MP).
4.1. Summary table of MP composition

Two tables are displayed: the first only with the sensors group and the second table shows the
relation between sensors and parameters (metrics).
Table 4-1 - MP sensors
Group System
Video sensing Omni vision camera set up
Electrogoniometer
Wearable systems [3],[4],[5] Human glove
Inertial Platform
Kinect
Motion tracking [9]
Bumblebee
Multi-axes load cell
Environmental sensors[6],[7],[8] Force panel
MOCAP
Table 4-2 - Parameters and instruments

Parameter Instrument
Weight shift Motion tracking
Step length Motion tracking
Step width Motion tracking
Stride length Motion tracking
Step Asymmetries Motion tracking
Gait parameters Double Support Duration Motion tracking
Gait cycle Motion tracking
Electrogoniometer
Cadence Motion tracking
Electrogoniometer
Velocity Motion tracking
Upper body Neck Extension / Flexion Inertial platform

parameters Neck Lateral Bend Inertial platform
Elbow flexion/extension Garment MOCAP
Inertial platform
Wrist ulnar bend/radial bend Human Glove
Wrist flexion/extension Human Glove
Phalanges ROM Human Glove
Wrist pronation/supination Inertial platform
Video sensing Reach envelope Video Sensing
Knee flexion/extension Garment MOCAP
Electrogoniometer
Hip flexion/extension Garment MOCAP
Lower body Electrogoniometer

parameters Hip adduction/abduction Garment MOCAP
Electrogoniometer
Joint angular velocity Garment MOCAP
Electrogoniometer
Pull force Multi-axes load cell
Push force Multi-axes load cell
In and Out force Multi-axes load cell
Strength parameters
Elbow Joint Torque Multi-Axes load cell + Inverse
dynamic algorithm
Shoulder Joint Torque Multi-Axes load cell + Inverse
dynamic algorithm
Continuous tracking tasks
Percentage time in target (PTT) Force Panel
Mean Deviation to Trajectory (MD2T) Force Panel
Standard deviation of Deviation to Trajectory Force Panel
(STD_D2T)
Mean Deviation to Path (MD2P) Force Panel
Standard deviation of Deviation to Path Force Panel
(STD_D2P)
Mean Speed Target (MST) Force Panel
Dexterity/control
Mean Speed (MS) Force Panel
Standard deviation speed (STD_S) Force Panel
Human Transfer Function
tau Force Panel
wZ Force Panel
wP Force Panel
csi Force Panel
wN Force Panel

rms Force Panel
Fittss Law
A Force Panel
B Force Panel
Sagittal flexion of torso Inertial Platform
Torso parameters
Lateral flexion of torso Inertial Platform
4.2. Short Description of instruments
4.2.1. Video sensing

The video sensing device is a motion detection system based on three cameras positioned all
around the subject to be observed.
Video sensing (CAF): upper limb position (mainly on seated subject, including also Continental
video sensors not for walking analysis)
Sensors positioning: there are always 3 cameras, in order to have enough information to be
able to do 3D reconstruction form different angles
The operation of the system is based on an algorithm that uses both correlation method and optical
flows method for motion detection. After calibration of the cameras (needed to obtain intrinsic
parameters: focal length, optical center, distortion factor, etc. and extrinsic parameters: rotation,
translation), the system is able to obtain 3D information about upper limb positions of seated
subjects in various environments (automotive cockpit, working places, etc.)
Table 4-3 - Scenario for the vision sensing system
Application domain Scenario Parameters Sensor involved
Automotive Car interior accessibility 3D dynamic position of Video sensor
desktop simulation the upper limb
Central rear view mirror
tuning
Lateral mirror tuning
Gear changing
Functionalities in
desktop simulation
On-board navigation
system Programming
AUDIO system
programming and
tuning
The preferred implementation of the motion detection systems includes up to 3 cameras located all
around the subject to be observed. This implementation guarantees a good observation of all his
movements ensuring that at least two camera field of view are not occluded and allowing a 3D
reconstruction and analysis scene.

Figure 4-1 - Example of camera implementation

The cameras positions are given relative to the center of the steering wheel. (X and Z are horizontal
axis, Y is the vertical axis)
Table 4-4 - Camera implantation coordinates in the vehicle.
X [cm] Y [cm] Z [cm] Tolerance
[cm]
Camera 1 40 -60 -80 +/- 15
Camera 2 40 -50 -15 +/- 15
Camera 3 100 -35 10 +/- 15
Hardware implementation: cameras are connected to the CPU and the CAN, to be
connected to the ADAS system
Algorithm: it takes 2 images at 2 different time steps, filters the noise of the image,
processes the images, makes a segmentation process and recognizes the movement of the
driver, like gear shifting and changing the radio station etc.
4.2.2. Electrogoniometer
This system monitors angles using a rotary position sensor (a resistive sensor). It will be used to
produce an armored knee and (if needed) an armored elbow (Figure 4-2).
Strength: it can be used to monitor free movements with limited hindrance to users.
Weakness: it can be used only for joints with 1 DoF.

Figure 4-2 - Electrogoniometer and example of knee implementation
4.2.3. Human glove

This system monitors 17 DoF out of 22 present in the human hand. Strengths: it can be used to
monitor free movements with limited hindrance to users.
Human glove (Figure 4-3) recognizes a set of static position of the hand.
Figure 4-3 - Sensorized glove
4.2.4. Motion tracking - Kinect

This system uses a TOF (Time Of Flight) camera to accurately create depth maps for an image. It
can be used with CERTH/ITIs algorithms to extract gait parameters with high precision.
Strengths: it is a very versatile system that can be used to measure a wide range of parameters
regarding motion tracking and activity detection.
Weaknesses: it monitors users in a 4x4 space (maximum).
Figure 4-4 - Kinect camera
4.2.5. Motion tracking - Bumblebee

This system uses a stereoscopic camera to accurately create depth maps for an image. It can be
used with CERTH/ITIs algorithms to extract gait parameters with high precision.
Strengths: similarly to the above, it is a very versatile system that can be used to measure a wide
range of parameters regarding motion tracking and activity detection.
Weaknesses: it monitors users in a 4x4 space (maximum).

Figure 4-5 - Bumblebee Stereo Camera

The motion tracking module setup consists of two cameras placed perpendicular to the recording
area (as shown in Figure 4-6).
For the recordings, the subjects will be asked to:
Stand in the middle of the recording area facing one camera for a number of seconds (~15).
Walk in the direction as shown Figure 4-6, twice in each direction (to omit any environmental
noise).
All parameters will be extracted using the frames captured from the two cameras.
Figure 4-6 - Camera implementation for gait metrics measure
4.2.6. Multi-axes load cell

The target for this instrument is to obtain measures on the forces exerted by upper limbs (see
Figure 4-7). As far as forces are a function of grasp and posture, the grasp interface will be
interchangeable and the measurement shall be complemented by motion capture system able to
acquire the human joint angles. The Multi axes load cell measures the planar force exerted by the
user, i.e. the force in 2 directions.
Weakness: measures the force with a defined grip interface.
Figure 4-7 - Multi-axes-cell an overview of the cell

The system will be composed of 4 springs, a cardan joint, a handle and 2 position sensors that
measure the stroke as a function of the exerted force. The handle can be changed if necessary. The
system shall be interfaced to some fixed support or to a device the user must interact with.

4.2.7. Force panel

The Force panel measures the position of the touch, its force and the time sequences while
interacting with a 2D interface. It is able to give information about response time, finger contact
force, field view and some cognitive parameters.
Strength: it is versatile, and can be used to measure physical and some cognitive parameters (but
for each test specific software must be developed ad hoc).
Weakness: the interface is a 15 screen
The main components of the system are: a PC to display the image on the LCD (Figure 4-8); an
embedded system that powers horizontally and vertically the touch panel and reads the partitioned
voltage proportional to the two coordinates, it also reads the three force sensors and send data to
the PC; three force sensors; a touch panel in front of the LCD; proximity electronics to drive the LCD
and to acquire the force transducers.
Figure 4-8 - Force panel front and side view

Many applications can be developed with this instrument. An example is shown below (Figure
4-9).
This example is about a cognitive test where arrays of buttons are shown. Then the patient is
asked to press the button of the row B and of the column 3. The reaction time and the task
accomplishment percentage, i.e. the score, are acquired and then displayed or recorded for
further statistics.

Figure 4-9 - Force Panel where arrays of buttons are shown
4.2.8. Garment MOCAP

The Garment MOCAP measures the human kinematic parameters (human body angle trajectories,
as function of time and postures, velocity) of motion by means of vision sensors and a special
garment.
Strengths: it is very versatile, being able to measure many parameters. The garment for some
subjects is easy to wear leading therefore to a fast setup and measurement time. The garment has
a low impact over the subject motion.
Weaknesses: it monitors users in a 2x2x2 m3 space (maximum) and it is not portable. For some
users the garment can be difficult or impossible to wear. The maximum acquisition frequency is 10
Hz therefore only relatively slow movements can be acquired and the velocity accuracy can be
considered low because it is estimated by means of a derivative calculation at 100 ms basis.
The hardware system comprises a multi camera setup of 12 cameras. The cameras are calibrated
in its intrinsic and extrinsic parameters in a working space of about 2x2x2 m3. The extrinsic camera
parameters are updated before each measurement campaign. The garment is composed of a suit
with black background and about 3000 colored markers (as shown in Figure 4-10) whose positions
in the space are estimated by means of the cameras giving in its row output a dense cloud of points.

Figure 4-10 - MOCAP setup overview

One example of application is the relative segments kinematics extraction and joint angles
estimation of the data shown in the previous paragraph. This is related to the motion of the
lower limbs were the position of the rotation axes and the angle trajectories are estimated as we
can see in Figure 4-11.
Figure 4-11 - Relative segments kinematics extraction and joint angles estimation
4.2.9. Inertial Platform

Inertial platform (Figure 4-12): trunk and legs inclination. The inertial platform gives information
about activity classification and walking activity:
Trunk and legs inclination (angles relative at the ground)
Activity classification: resting, sitting, etc.
Walking activity: step frequency/velocity

Figure 4-12 - Inertial Platform

Accelerometers are very useful instruments that provide quantitative measurements. Since
accelerometers respond to both acceleration due to gravity and acceleration due to body
movement, these devices are proper to measuring movements and activity of human body by
means of wearable system.
The use of mono-axial accelerometers positioned on the chest and thigh, is reported to detect
subject posture.
4.2.10. Audiometry station

This system monitors the level of hearing in a range between 125 to 8.000 Hertz, providing a txt file
where the hearing of each frequency is measured in dB.
Strengths: it can be done with any kind of PC using good quality headphones, as the jack output is
a standard (in terms of sound volume); it can be done without the assistance of an operator.
Weaknesses: closed software, not possible to initiate from VERITAS network.
4.3. Overview of metrics measurements with corresponding

instruments
4.3.1. Reach envelope test

Instrument: Video Sensing
The reach envelope is the work area one is able to access without excessive reaching (Figure
4-13). This area is specific to every individual and depends on body size, but generally the normal
reach area is about 45 cm from the body. The maximum area is typically 45 60 cm. This area may
be less for people with shorter arms and more for people with longer arms. More details about the
reach envelope can be found in:
http://www.lanl.gov/orgs/pa/newsbulletin/2003/06/23/safety_tip_ergo.html
The testing procedure:
The subject will be seated in a desk (empty of other objects) and will be requested to perform a
curve with their hands covering the maximum area they can reach. The video sensor will provide
the area covered.
Video system provides the 3D position of the wrist. Having the subject move its hand around the
area he/she can reach and tracking the wrist movement, the reach envelope can be estimated.
This procedure will be repeated twice, once for the primary zone (comfort zone, the subject does
not stretch his/hers hands at full length) and once for the maximum area (secondary zone, the user

is stretching to reach maximum area). Also, since the video sensor can only track one hand at time,
the test has to be repeated for both hands.
Figure 4-13 - Reach envelope test
4.3.2. Knee flexion

Instrument: Electrogoniometer and Mocap
The electrogoniometer is placed in an armored knee. After a medium calibration (two points
possibly but not necessary 0 and 90, maximum time: 3 minutes), it can be used both in the
analysis of the primitive task (simple flexion/extension of the knee, see picture above) and during
standard tasks.
The Garment MoCap can be used to measure the Knee flexion during a dedicated measurement
procedure targeted to estimate such parameters one at a time. This to explicitly avoid generating
disturbing effects correlated with other motion parameters.
An example of posture during the procedure is shown in Figure 4-14.
Figure 4-14 - Knee Flexion/Extension
4.3.3. Elbow flexion/extension

Instrument: Inertial platform and Mocap
The Inertial platform system can be used for measuring primitive tasks, as shown in Figure 4-15.
In real-life scenarios, forearm supination/pronation must be considered as a source of noise, as, to
avoid its influence (it can potentially break the goniometer) the part of the support to be fixed on the
forearm should be very short (5 to 7 cm), introducing an error which would largely invalidate the
measure.
The Garment MoCap can be used to measure the Elbow flexion/extension during a dedicated
measurement procedure targeted to estimate such parameters one at a time. This to explicitly avoid
generating disturbing effects correlated with other motion parameters. In this case forearm
supination/pronation can be a disturbing effect according to which algorithm is employed to recover
the joints position and angles. SfM methods currently employed at UNITN suffer the forearm
supination/pronation motions.

Figure 4-15 - Elbow flexion/extension
4.3.4. Wrist ulnar bend/radial bend

Instrument: Humanware glove.
Radial and ulnar bend is the side-to-side movement of the hand at the wrist, toward or away from
the thumb. The Humanware Glove can be used for both analyses of the primitive tasks and in real-
life scenarios.
Figure 4-16 - Wrist Ulnar-Radial Bend
4.3.5. Wrist flexion/extension

Wrist flexion is the downward or inward movement of the wrist which results in the palm facing
inward (see illustration below): bending the joint resulting in a decrease of angle; moving the palm of
the hand toward the front of the forearm.
Wrist extension is the upward movement of the wrist to which results in the palm facing outward:
straightening the joint resulting in an increase of angle, moving the back of the hand toward the
back of the forearm.
The Humanware Glove can be used for both the analysis of the primitive tasks and in real-life
scenarios.
Figure 4-17 - Wrist Flexion-Extension

4.3.6. Phalanges ROM

Phalanges Range of Motion is measured with the Humanware glove and can be used for both the
analysis of the primitive tasks and in real-life scenarios.
4.3.7. Weight shift

Instrument: Motion Tracking Module
Weight shift can be assessed as the oscillation of the body during gait. Weight shift is estimated
using the feets midpoint and the heads center of mass and by estimating the inclination of their
connecting vector. For body oscillation, marginal values, as well as variation during a gait cycle are
of interest.
4.3.8. Step length

Step length is defined as the anterior displacement of the foot from foot strike to contra lateral foot
strike. In both cases the same given point on foot is measured, usually is the midpoint of the
distance between the most posterior part of the calcareous and the 1st or 5th caput metatarsal. Its
unit is either [m] or [cm]. People can control gait speed by changing this parameter: greater step
length, faster speed. Step length is estimated by locating the left and right foot 3D point in the
double support gait phase for the right and left foot separately (with respect to which foot is in front).
4.3.9. Step width

Step width is the mediolateral distance between the feet. It is measured as the distance,
perpendicular to the direction of progression, between a point on one foot (usually at its initial
contact) and the same point on the other foot at the subsequent contact. The width will therefore
depend on which point is chosen. In the motion capture module the center of the hell is used, which
is often used in bibliography. Its unit is either [m] or [cm]. For the step width estimation, information
from the frontal camera is required. Step width is calculated in the double support phase as well as
in the midstance position. This allows a better modeling of the feet trajectory during gait. For the
step width calculation the center of gravity point for each foot is used, along with the 3D information
extracted from the camera. The step width is calculated as the vertical to the gait direction distance
between the feet.
4.3.10. Stride length

Stride length is the distance between two successive placements of the same foot, consisting of two
step lengths. In other words it is the distance travelled by one person during one cycle. With normal
subjects, the two step lengths will be approximately equal, but with certain patients there will be an
asymmetry between the left and right sides. Similar to step length it is measured either in [m] or
[cm].
4.3.11. Step Asymmetries

Symmetry is assumed in unilateral gait studies or when pooling right and left limb data. Using the
step length for each foot, the proportion of the left to right step length is calculated.

4.3.12. Double Support Duration

Double support duration is described as the percentage of the gait cycle during which both limbs
make contact with the floor. The frames of the double support phase for a gait cycle are estimated
as the ones where the distance between the feet is greater than 95% of the stride length. By
calculating the number of frames where the double support occurs, the proportion of the double
support to the whole gait cycle is calculated.
4.3.13. Gait cycle

Instrument: Motion Tracking Module and Electrogoniometer
Gait cycle refers to a full cycle of human gait, i.e. is the period of time between two identical events
in the walking cycle. Within the VERITAS motion tracking module, an approach using
autocorrelation of the input periodic signal was developed in order to determine the gait cycle.
Instead of measuring only in a temporal manner the sum of the foreground pixels, the time series of
the width of the silhouette sequence were additionally calculated. Data from the side camera is used
for Gait Cycle extraction.
4.3.14. Cadence
Instrument: Motion Tracking Module and Electrogoniometer
Cadence is the total number of revolutions per minute or number of steps taken within a minute,
and is used as a measure of athletic performance. Step rate is commonly called cadence. Cadence
is calculated in steps per minute. It is the second gait parameter after step length with which people
can control gait speed: greater cadence, increased speed. It is estimated by calculating the number
of complete gait cycles per minute. Since the typical cadence is ~100 steps per minute, a value that
would require a much larger metering area than the available one, cadence is estimated by
calculating the mean step time (in seconds) and extracting the mean cadence.
4.3.15. Velocity
Velocity is the average meters/second that the subject travels. Data from the side camera is used to
extract speed, by measuring the bodys center of mass speed.
4.3.16. Pull and Push force

Instrument: Multi-Axes load cell
The Multi-axes load cell can be used to measure the Pull and Push force during a measurement
procedure targeted to estimate such parameters one at a time. This is to explicitly avoid generating
disturbing effects correlated with other motion and/or strength parameters.
Figure 4-18 - Pull/Push force

4.3.17. In and Out force

Instrument: Multi-Axes load cell
The Multi-axes load cell can be used to measure the IN and OUT force during a dedicated
generating disturbing effects correlated with other motion and/or strength parameters.
An example of posture during the procedure is shown in the Figure 4-19.
Figure 4-19 - Out/In Force
4.3.18. Elbow Joint Torque

Instrument: Multi-Axes load cell + Inverse dynamic algorithm
Multi-Axes load cell can measure the force on the end effector exerted by the patient through a
haptic system. Then using an Inverse dynamic algorithm the torque is calculated on the Elbow joint.
4.3.19. Shoulder Joint Torque

Instrument: Multi-Axes load cell + Inverse dynamic algorithm
Multi-Axes load cell can measure the force on the end effector exerted by the patient through a
haptic system. Then using an Inverse dynamic algorithm the torque is calculated on the Shoulder
joint.
4.3.20. Continuous tracking tasks

Instrument: Force Panel
Dexterity control regards parameters that influence the tracking abilities. Tracking can be divided
into two main categories: discrete tracking and continuous tracking. Tracking can be done also in
the force domain therefore leading to the Space-Force tracking tasks category.
Continuous tracking requires the subjects to follow a continuously moving target and try to stay
within the target window as much as possible. The parameters are listed in the Continuous tracking
tasks family. A different way to obtain the same set of parameters is by estimating the human
transfer function and its inherent noise. It was therefore added the category Human Transfer
Function. This function summarizes the stimuli-motion relation as a function of frequency
considering the human response linear.
The joint Space-Force tracking tasks require following predefined paths while controlling the exerted
force level. The parameters are listed in the Space-Force tracking tasks family.
Subjects will be asked to follow a continuously moving target along a circle pattern and to stay
within the target window as much as possible. The circle pattern is screen-centered with a diameter
equaling 90% height of the workspace. The target smoothly moves with a speed of 12
seconds/circle in the counter-clockwise direction.
By means of the above procedure the following parameters can be measured:

Percentage time in target (PTT) is the percentage of time in target. Percentage of the time the touch
is inside the circular target travelling along the circular path [%].
PTT: percentage of the time (4.1)
Mean Deviation to Trajectory (MD2T) is the deviation between the cursor point and the point
touched by the subject [mm].
(4.2)
Standard deviation of Deviation to Trajectory (STD_D2T) is the standard deviation of deviation to

trajectory [mm].
(4.3)
Standard deviation of Deviation to Trajectory (MD2P) is the standard deviation of deviation to

trajectory (minimum deviation between the circular path and the point touched by the subject) [mm].
(4.4)
Standard deviation of Deviation to Path (STD_D2P) is the standard deviation of deviation to path
[mm].
(4.5)
Mean Speed (MS) is the mean speed [m/s].
(4.6)
Mean Speed Target (MST) is the angular velocity of the target that the subject must follow. This
velocity is constant.
(4.7)
Standard deviation speed (STD_S) is the standard deviation of the measured trajectory speed [m/s].
(4.8)
4.3.21. Human Transfer Function

Subjects will be asked to follow a continuously moving vertical line moving in horizontal direction
and to stay aligned with it as much as possible (Figure 4-20). The line motion is a white noise
truncated at 20 Hz.
The human transfer function (HTF) can be considered of the following form:

(4.9)
In the excel file the parameters are named in the following correspondence:
Table 4-5 - Human Transfer Function parameters

Model tau P rms
Excel file tau wZ wP csi wN rms
Dimension [s] [rad/s] [rad/s] [s] [rad/s] [mm]
Meaning of the parameters:

- tau: delay, corresponding to the reaction time
- wZ: frequency of the zero on the numerator. From this frequency on the zero takes effect.
- wP: cut frequency of the 1th order pole
- csi: damping factor of the second order pole
- wN: natural frequency of the second order pole
- rms: is the root mean square error of the steady state reached with respect to the reference.
Gives an estimate of the reached accuracy
NOTE: if one of the parameters reaches the value 100 means that the zero/pole can be omitted
(reached the optimization limit).
Figure 4-20 - Force panel with the vertical line shown on the LCD for transfer-function estimation
procedure
4.3.22. Fittss law

The parameters reported in the family Eurythmokinesimeter are mostly redundant with the Fittss
law ones. They are therefore deleted from this report and shall not be considered for VERITAS
parameters measurement.

The Fitts's law, proposed by Paul Fitts in 1954, is a heuristic model of human movement in human
interaction and ergonomics which models the time required to move to a target area as a function of
the distance to and the size of the target. Fitts's law is used to model the act of pointing, either by
physically touching an object with a hand or finger, or virtually, by pointing to an object on a
computer display using a pointing device. The resulting model of the Fittss law is inherently linked
to the aim of minimizing the final positional variance for the specified movement duration and/or to
minimize the movement duration for a specified final positional variance determined by the task.
To estimate the Fitts's law will be asked to the user to touch one target and in the minimum time the
other subsequently appearing (Figure 4-21). The following picture shows one example of screen
shot during the test procedure. To be statistically sound the test will be repeated at least 30 times.
Figure 4-21 - Fittss Law representation

In Figure 4-21 on the left a screen shot of one of the point to point motion task. The distance and
the circles diameters change randomly. On the right the linear law obtained.
By means of the above procedure the following parameters will be measured:
A is the reaction time.
B is the inverse of the index of performance.
4.3.23. Joint angular velocity

Instrument: Mocap
The angular velocity can be estimated from angle trajectories applying a derivative operation. This
operation can be approximated by the ratio of the finite difference in joint angles and the video
frame rate.
Unfortunately the finite difference approximation gives a good estimate of only the mean velocity
and a poor estimation of the instantaneous velocity. This estimation is worse as the sample time,
i.e. the camera frame rate, increases.
A quantification of the approximation and thus the uncertainty in velocity estimation can be done
only according to the actual movements.
4.3.24. Hip Flexion/Extension

The Garment MoCap can be used to measure the Knee flexion during a dedicated measurement
procedure targeted to estimate such parameters one at a time. This to explicitly avoid generating
disturbing effects correlated with other motion parameters.
Figure 4-22 - Hip Flexion/Extension
4.3.25. Hip Adduction/Abduction

The Garment MoCap can be used to measure the Hip adduction/abduction during a dedicated
generating disturbing effects correlated with other motion parameters.
An example of posture during the procedure is shown in Figure 4-23 below.
Figure 4-23 - Hip Adduction/Abduction
4.3.26. Sagittal flexion of torso

Instrument: Inertial platform.
This instrument can be easily calibrated and provide a rapid measure of its angle with regards to
ground, considering zero as the starting position. The measure is largely dependent on the position
where the sensor is placed on patients torso
4.3.27. Lateral flexion of torso

Similarly to the above, after calibrating the inertial platform it will provide a rapid measure of its
angle with regards to ground, considering zero as the starting position. The measure is largely
dependent on the position where the sensor is placed on patients torso
4.3.28. Neck Extension/Flexion

The inertial platform can be placed in a forehead band or a cap and used to monitor this movement.
After calibration, it can be used both in the analysis of the primitive task (simple sagittal
flexion/extension of the neck, see picture below) and during standard tasks. In the latter case a
monitoring of torso inclination could be added to separate neck and torso flexion (Figure 4-24).

Figure 4-24 - Neck Extension
4.3.29. Neck Lateral Bend

Similarly to the above if the inertial platform is placed in a forehead band or a cap it can be used to
monitor the heads movement. After performing the calibration, it can be used both in the analysis of
the primitive task (simple lateral flexion/extension of the neck, see picture below) and during
standard tasks. In the latter case a monitoring of torso inclination could be added to separate neck
and torso lateral flexion (Figure 4-25).
Figure 4-25 - Lateral Bend
4.3.30. Wrist supination/pronation

Pronation is the rotation of the forearm that moves the palm from an anterior-facing position to a
posterior facing position, or palm facing down. Supination is the opposite of pronation, the rotation
of the forearm so that the palm faces interiorly, or palm facing up. The hand is supine (facing
interiorly) in the anatomical position.
Figure 4-26 - Wrist supination/pronation

5. Prioritization of the parameters

5.1. Prioritization of motor impairments
The prioritization of the parameters affected by the motor impairments has been carried out
following the following steps:
Literature review: literature of VERITAS physical Abstract User Model (included in the
D131), paying close attention to the motor disabilities already identified and to the parameter
already present in the table.
Analysis of the parameters which are measurable with the current version of the
Multisensorial platform Table 4-1.
The procedure of final prioritization of motor metrics has been the following, as it shows on Table
5-1. The prioritization of metrics can be found also in the VUM table. (ANNEX C: Generic Physical
Virtual User Model). An overview of the measured metrics and corresponding prioritization is given
in Table 6-1.
Table 5-1 - Prioritization criteria table
Parameter Prioritization Criteria
High Low
Relevant for disability Not affected by the disability
AND OR
Measurable with the current version of the Not measurable with the Multisensorial
Multisensorial platform platform
5.1.1. Parkinson
Parkinson is a disease which affects a muscle tone, making it stiffer. When the stiffness in a muscle
increases, the capacity of that muscle to carry out specific action is affected. The metrics more
affected with this pathology are the Range of motion.
If the ROM of hip or knee is affected, as consequence the gait will be affected too and therefore gait
parameters have been added (to provide the maximum information possible about this effect).
Instability and tremors are other important aspects of this disease. Tremors can directly affect basic
tasks that can be performed with hands and wrists (writing, turn a car steering wheel, etc.).
Overview on the affected parameters:
Gait cycle: High [50], [51], [52]
Upper body: Low
Lower body: ROM High [52]
Strength: High
Dexterity/control: High [42]
5.1.2. Dystonia
Dystonia is a motor disease that affects muscles, causing spasms and contractions. When the body
is affected for a long time by Dystonia can make the patient take unusual and awkward postures.

If the patient is not capable of standing in a normal position, he will not be able to perform a natural
gait action (i.e. his step length will be shorter, his gait asymmetry will increase as consequence of
displacement of the center of gravity as cause of unusual postures).
In this case the muscles are not stiff (as in Parkinson for example) but awkward postures and
unusual postures will affect ROM of several body joints angles. This is the reason for which all the
ROM parameters have been added with a high priority.
Gait cycle: High [56]
Upper body: High [58], [59]
Lower body: High [53]
Strength: High [60]
5.1.3. Multiple Sclerosis

Multiple sclerosis is a disease with a relation with the central nervous system; the pathology causes
loss of sensation, fatigue (when the subject is trying to perform an action several times). Loss or
muscle strength in arms and legs is a common effect of Sclerosis.
ROM metrics for lower body have been tagged with High priority because the references found in
literature. For upper body parameters no value has been found in the literature.
Gait cycle: High [65], [66]
Upper body: High
Lower body: High [68], [67]
Strength: High [69]
5.1.4. Hereditary and Idiopathic Neuropathies

Idiopathic neuropathy is a disorder that affects the peripheral nerves and has no identifiable primary
cause. Hands functions are affected, as it can be seen in [87]. Gait and Posture: slow decline in
distal muscle strength and sensation due to degeneration of the longer peripheral nerves. The Gait
parameters and lower body metrics are strictly related as we can see in paper [88]
This disease affects control system but it has not been found any value in literature. This disease
can be considered critical for the moment and subject of more studies.
Upper body: N/A (not enough data found in literature)
Strength: High [87]
Dexterity/control: N/A (not enough data found in literature)
5.1.5. Stroke
A large number of parameters have been found in literature. Stroke affects almost all metrics
measurable with the MP. Prioritization following the point of Table 5-1:
Upper body: High [96]
Lower body: High [93], [94]

Strength: Low [90]
5.1.6. Cerebral palsy

Parameters regarding upper body force, lower body and dexterity/control have been found in
literature.
Gait cycle: High [79], [81]
Strength: High [75], [73]
5.1.7. Rheumatoid arthritis

The pathologies and parameters found in literature are related with:
- Neck (ROM): Not measurable with MP [10]
- Hand: fingers ROM and hand strength affected
- Knee: ROM metrics
These parameters considered with high priority. For dexterity and upper body, literature references
have not been found.
Upper body: High (for hand and wrist parameters)
Strength: High [13]
Dexterity/control: Low
5.1.8. Gout
Literature shows that Gout affects gait cycle metrics. Metrics regarding lower body have not been
found in literature.
Upper body: High (for hand and wrist parameters)
Lower body: Low
Strength: Low
5.1.9. Hand osteoarthritis

Fingers ROM and hand strength parameters found in literature. Lower body, gait and control
parameters considered of low priority for this disability.
Gait cycle: Low
Upper body: High (for hand and wrist parameters) [30]
Lower body: Low

Strength: High [30]
5.1.10. Coxarthhiritis
ROM parameters of hip found in literature.
Values for gait Parameters have not been found in literature but are strongly related to lower body
metrics and cannot be neglected.
Gait cycle: High
Upper body: Low
Strength: Low
5.1.11. Gonarthiritis
ROM parameters of knee found in literature.
Values for gait Parameters have not been found in literature but are strongly related to lower body
metrics and cannot be neglected.
Gait cycle: High [32], related to biomechanics criteria but not found in literature
Upper body: Low
Strength: Low
5.1.12. Kyphosis and lordosis

Lower body and Gait parameters found in literature, considered then of high priority.
Upper body: Low
Strength: Low
5.1.13. Ankylosing spondylitis

Trunk parameters affected (not measurable with MP). Directly related to gait parameters found in
literature (D131), considered of high propriety.
Parameters regarding upper body, strength and dexterity/control values have not been found in
literature, and considering the pathology can be considered of low priority for this disability.
Upper body: Low
Lower body: High
Strength: Low
5.1.14. Shoulder Capsulitis

Shoulder Capsulitis affects only Shoulder joints. Not found any values of strength in literature. Rest
of the metrics regarding upper body can be considered of low priority.
Gait cycle: Low
Lower body: Low
Strength: Low
5.1.15. Elderly
Elderly or aging according to literature survey has a primary effect in the gait cycle, lower body,
strength and control.
Upper body: Low
Strength: High [107], [108]
Dexterity/control: High [100], [105]
5.2. Prioritization of hearing impairments

Conductive hearing loss: High
Sensorial Hearing Loss: High
Mixed Hearing loss: High
Presbycusis: High
5.3. Prioritization of speech impairments

PCC: High
ACI: High
5.4. Prioritization of vision impairments

Visual acuity: High
Visual Picture quality: High
Visual field: Low
Color vision: Low

6. Generic Physical Virtual User Model

6.1. Introduction
The main objective of the activity related to the present deliverable is the development of the final
and parameterized human physical models.
The generic Physical Virtual User Model (VUM), as described in this chapter, is a parameterized
user model developed in VERITAS, relying on real user measurements in real testing conditions.
Moreover, the generic Physical VUM contains information related to user tasks, disabilities and
metrics with their corresponding numerical values.
Figure 6-1 - Merging information into the generic Physical Virtual User Model
Consequently the information merged in the generic Physical Virtual User Model can be
represented visually as seen in Figure 6-1. According to this block diagram, the VUM fuses together
the outcomes of D1.3.1 (Abstract User Models), ID1.7.1 (Task Models) and A1.3.3 as follows:
D1.3.1 Abstract User Model (AUM): the AUM with disabilities and metrics generated based
on existing standards, guidelines and analysis of existing models, and existing practices.
A1.3.3 Measurements with the multisensorial platform: the generic Physical Virtual User
Model will be trained with the data measured with the multisensorial platform during the
measurement campaigns.
ID1.7.1 VERITAS task analysis: appropriate scenario tables with the related tasks and
subtasks.
As it can be noticed the information described in previous chapters (Metrics, Disabilities,
Multisensorial Platform and Prioritization of the parameters) is merging together in the Physical
Virtual User Model.
In the following subchapters the different constituent parts of the generic Physical Virtual User
Model are described and finally the VUM table is presented.

6.2. Extended Abstract User Model

D1.3.1 describes the Physical Abstract User Model (AUM) of VERITAS. The AUM contains sets of
disease-related parameters and data that are abstract, i.e., independent of the actual modeling
technique, which will be used to produce virtual users.
Abstract data and parameters describe functional limitations. The main information present in the
AUM table is:
ICD classification
Short pathology description
Parameters (metrics) based on literature survey for every disability
The process of developing the Abstract User Model (AUM) starts from the necessity of prioritization
of diseases: the most frequent and critical diseases are identified and prioritized as described in
previous chapters.
Next step is to define the physical parameters in order to characterize the human body. The aim of
this step is to extrapolate the most critical biomechanical metrics, subdivided into groups (torso
parameters or strength parameters for example) and analyze if those parameters can be measured.
In order to provide useful information for the experimental campaign, prioritization and filtering of the
parameters was done (considering also if they are measurable with the Multisensorial Platform)
through a process of literature survey and biomechanical analysis, obtaining in this way the list of
prioritization of metrics for each disability.
Finally, literature survey was performed on deriving numerical data for the respective parameters for
the disabled and elderly people (for the pathologies with highest priority).
An important extension of the AUM to obtain the Extended AUM relies in that the Extended AUM
table also indicates the degree of priority for every metric for each disability. Since the Abstract User
Model is related only to a literature survey, it does not take into account if these metrics are
measurable by the available Multisensorial platform or not. Therefore, information about the
measurability of a parameter with the Multisensorial Platform was included in the Extended Abstract
User Model tables.
A caption of the extended AUM table is presented in Figure 6-2. In this figure the information related
to the AUM is marked with green and the extension with blue.
Figure 6-2 - Extended AUM table information

As a conclusion, the Extended AUM provides the following added information with respect to the
AUM (Figure 6-2):
Multisensorial platform sensor: indicates which sensor (or sensors in some cases) can be
used to measure a specific parameter.
Priority: following the prioritization criteria explained in chapter 5 this column indicates which
are the most critical parameters to be measured for every disability.
Methodology: a brief introduction of the test protocol that should be followed for the
measurement of every metric.
Simulation parameter: for every prioritized metric, it is specified if the measurement can be
simulated by the VERITAS Avatar. In case we find YES on the table it means it makes
sense to measure. In case of NO it does not make sense to measure.
The information from the Extended AUM is implemented in the VUM tables and is given in ANNEX
C: Generic Physical Virtual User Model.
6.3. Links to Task analysis

An end user of a physical VUM has to be able to set up a virtual model of a disabled or elderly
person and use this virtual human model to simulate different tasks specific to different application
sectors (Automotive, Healthcare, etc.). Consequently a generic physical virtual user model has to
link disability related information to information related to different tasks within the different sectors.
The information about the tasks related to different application sectors can be found in the task
analysis tables within ID1.7.1. The list of sectors covered in ID1.7.1 comprises the following:
automotive, workplace, smart living places, infotainment, personal healthcare and wellbeing.
An example screenshot of such a task analysis table is presented in Figure 6-3 for illustrating the
information contained in the task analysis tables.
Figure 6-3 - Task analysis table information

As it can be noticed in Figure 6-3 the task analysis table defines the link between application
sectors, tasks, subtasks, and primitive tasks. We can define a task as a group of basic actions taken
by the user. Entering a car or changing gear can be examples of tasks for a specific sector
(automotive in this case).

With the aim of defining a closer link between the tasks and metrics every task is substructured in
subtasks: a subtask can be defined as a list of primary physical actions needed to perform one task.
For example for the task of changing gear in a car the list of subtasks would be: pushing (left foot),
reach (left arm), position (left hand), grasp (right hand), push (right hand) and lift (left foot).
Following the red circles and lines from the figure one can see an example how the task of entering
the car is linked to different subtasks, like opening the left door, further linking to several primitive
tasks, which may consider different impairments, like for example upper limb impairments.
In some cases it can happen that the list of metrics affected by some specific disability will not affect
the performance of a specific task. For example if the virtual dummy is performing a change of gear
action, parameters related to human gait and lower body will not affect the results, in this case the
important parameters would be strength and upper body metrics.
The information described above is merged in the Generic Physical VUM establishing a link
between the different tasks, subtasks, primitive tasks and the information contained in the AUM:
disabilities, metrics and parameters. Combining these two sets of information one will be able to
start for example from a task related to a specific sector, choose a subtask, and for the related
primitive tasks find information regarding the affected metrics and parameters as a function of
disabilities.
6.4. Experimental Data collection

One of the main innovations in VERITAS with respect to virtual user modeling is the introduction
and use of a Multisensorial Platform (as described in Chapter 4) for the training of parameterized
user models based on real user measurements in real testing conditions. The multisensorial
platform is adapted to the VERITAS application areas and is able to capture user feedback while
executing a number of tasks that will be mapped in the VERITAS virtual user models.
Special sensors, as presented in Chapter 4, are used for data capturing ranging from trace
monitoring cameras for driver monitoring to wearable sensors for body motion analysis, to motion
trackers and gait analysis sensors for analyzing user kinematic patterns while executing specific
activities and tasks and also environmental sensors for monitoring the interaction of users with the
real environment.
While developing the final list of metrics to be measured with the MP different aspects had to be
considered:
MP limitations: considering only those metrics which can be measured with the MP
(prioritization of metrics)
Availability of test subjects: the measurement campaign involves measurements at different
sites with different subjects having different disabilities, however one should take into
consideration that only a limited set of patients can be recruited covering a limited set of
disabilities
Bearing in mind what was mentioned above a final list of metrics was developed considering the
prioritization of metrics, available recruited patients and their disability categories. This information
is summarized in Table 6-1 which contains information about the prioritization of metrics
accomplished in the Extended Abstract User Model related to disabilities for which test subjects
could be recruited during the measurements. This table links all considered metrics to every
considered disability following the prioritization criteria as presented in Chapter 5.
Note: one can notice that also some parameters with lower prioritization were measured. The
reason behind it is to obtain as much information with the MP as physically possible within the
available time frame in order to be able to validate the testing procedures and to provide as much
useful information to the VUM as possible.

Table 6-1- Final Prioritization of metrics measured with the MP
Hand Osteoarthritis
Multiple Sclerosis
Cerebral Palsy
Gonarthritis
Coxarthritis
Parkinson
Elderly
PARAMETERS
Stroke
(QUANTITATIVE Only metrics measurable with MP
METRICS)
Weight shift [deg] L L L L L L L L
Step length [m] H H L H H H H H
Step width [m] H H L H H H H H
Stride length [m] H H L H H H H H
Gait parameters Step Asymmetries [%] H H L H H H H H
Double Support Duration [s] H H L H H H H H
Gait cycle [s] H H L H H H H H
Cadence [steps/minute] H H L H H H H H
Velocity [cm/s] H H L H H H H H
Neck Extension / Flexion [deg] H H L L L L L L
Neck Lateral Bend [deg] H H L L L L L L
Elbow flexion/extension [deg] H H L L L L H L
Upper body
Wrist ulnar bend/radial bend [deg] H H H L L L H L
parameters
Wrist flexion/extension [deg] H H H L L L H L
Phalanges ROM [deg] H H H L L H H L
Wrist pron/supination [deg] L H L L L H H H
Knee flexion/extension [deg] H H L H H H H H
Lower body Hip flexion/extension [deg] H H L L H H H H
parameters Hip adduction/abduction [deg] H H L L H H H H
Lower body Joint angular velocity [deg /s] H H L H H H H H
Video Sensing Reach envelope [m] H H L L L H H H
Pull/Push force [N] H H H L L H L
H
Strength In/Out force [N] H H H L L H L
parameters Elbow Joint Torque [Nm] H H L L L H L H
Shoulder Joint Torque [Nm] H H L L L H L H
Percentage time in target (PTT) [%] H H L L L H H H
Mean Deviation to Trajectory (MD2T ) [mm] H H L L L H H H
Standard deviation of Deviation to Trajectory (STD_D2T) [mm] H H L L L H H H
Continuous Mean Deviation to Path (MD2P) [mm] H H L L L H H H
tracking tasks Standard deviation of Deviation to Path (STD_D2P) [mm] H H L L L H H H
Mean Speed Target (MST) [rad/s] H H L L L H H H
Mean Speed (MS) [mm / s] H H L L L H H H
Standard deviation speed (STD_S) [mm/s] H H L L L H H H
tau [s] H H L L L H H H
wZ [rad/s] H H L L L H H H
Human Transfer wP [rad/s] H H L L L H H H
Function Csi [s] H H L L L H H H
wN [rad/s] H H L L L H H H
rms [mm] H H L L L H H H
A [ms] H H L L L H H H
Fittss law
B [ms] H H L L L H H H
Sagittal flexion of torso [deg] H L L L L L L H
Torso parameters
Lateral flexion of torso [deg] H L L L L L L H

In Table 6-1 the following notation convention was used for prioritization:
H No data found in literature High priority has been assigned to parameters which are:
measurable (with the current version of the MP) and
H Related data found in literature affected by the selected disabilities.
H Data found in literature
L Low priority parameter Low priority has been assigned to parameters which are:
not affected by the disability or for which no cause-effect
relationship was found in medical literature or are not
measurable with the Multisensorial Platform.
For the experimental campaign it is critical to measure the red and yellow parameters. Those
parameters are characterized by a lack of data in available literature and it is necessary to obtain
them for the avatar simulation since it is certainly known that they are affected by that specific
disability.
Table 6-2 presents the final list of test sites, considered disabilities and test subjects considered for
the measurement campaign with the Multisensorial Platform.
Table 6-2- Final list of test sites, considered disabilities and patients
Sites and dates (2011) ITI UniTN I+ MCA UNEW
12-16/12 21-25/11 3-7/10 17-23/12 5-9/12
Disability TOTAL
Parkinson 3 + 2 3 9 12 + 2 = 14
Multiple Sclerosis 8 + 1 11 11 + 1 = 12
Stroke (specific degree) 9 + 1 10 16 26 + 1 = 27
Cerebral Palsy 6 + 4 7 7 + 4 = 11
Hand Osteoarthritis
Coxarthritis 7 7 7
Gonarthritis 5 5 5
Elderly 13 + 1 7 10 10 18 45 + 1 = 46
Visual Impairment 27 27 27
Hearing Impairment 9 11 20 20
160 + 9 = 169
The final list of sensors used in the measurement campaign with the Multisensorial Platform is given
in Table 6-3.
Table 6-3- Final list of sensors used in the Multisensorial Platform
Sensor Developer
Motion Tracking Certh
Electrogoniometer Smartex
Inertial Platforms Smartex
Human Glove Smartex
Motion Capture UniTN
Force Panel UniTN
Load cell UniTN
Video sensing CAF
Vicon UNEW

After the measurements were carried out, the measured data was collected and processed to be
able to extract the numerical values of the considered metrics for the generic Physical VUM.
The procedure followed to process the data received from the measurement campaign with the
multisensorial platform is presented in the block diagram in Figure 6-4. According to this diagram,
the data collected from the measurements with the multisensorial platform is restructured by
disabilities and statistically processed to derive the final values of all the measured metrics related
to the specific disabilities. The aim is to obtain the final mean and standard deviation for all the
metrics for each disability as presented in the rightmost part of Figure 6-5. Next, the final values will
be imported into the physical VUM table in their correct location for each disability and affected
metric.
Figure 6-4 - Data processing procedure

Below, the equations of mean value (equation 6.1) and standard deviation (equation 6.2) are
presented:
(6.1)
(6.2)
The collected numerical data from the tested persons is included in the generic Physical VUM
linking them to the specific disabilities. A large data set is produced by the measurement campaign
with the multisensorial platform which needs processing to derive a final value for each specific
metrics. A snapshot of such a table containing data measured by the multisensorial platform is
presented in the upper part of Figure 6-5.
The physical VUM table will contain all the final means and standard deviations calculated which
are shown on the bottom in green color in the lower part of Figure 6-5.
Some metrics have more than one parameter like for example hip flexion/extension for which during
the measurements data for left and right side of the subject was measured separately, moreover
data was retrieved for flexion and extension separately. The final list of values gives the mean and
standard deviations for the flexion and separately for the extension, taking the mean of the left and
right side.

Figure 6-5 - Data statistical results

The lower part of Figure 6-5 summarizes the final values for all the disabilities. This information can
be more easily linked with the generic physical VUM table where all the numerical data will be
imported.
Information about the raw experimental data is provided in ANNEX A: Measurements: Raw data.
The tables with the processed data can be found in ANNEX B: Measurements: Processed data.

6.5. Virtual User Model

As already outlined in Figure 6-1 the Physical Virtual User Model merges together the information
contained in the Abstract User Model, the numerical data retrieved from the measurements with the
Multisensorial Platform and the tasks derived from the task analysis tables from ID1.7.1.
The above mentioned constituent parts were described in detail in the present chapter in the
previous subchapters. In this subchapter a snapshot of the Physical VUM table is given as seen in
Figure 6-6, describing in detail the information contained in it.
Figure 6-6 - Relevant information in the Generic Physical Virtual User Model table
The structure of the Generic Physical VUM table is presented in Figure 6-6 and contains the
following information (from left to right):
information stored in the Extended AUM
the final mean and standard deviations of measured parameters with the multisensorial
platform and
tasks, subtasks and primitive tasks
The specific information related to the above mentioned are highlighted with different colors:
AUM in blue
measured data in red and
tasks in green
The information derived from the AUM, as described in the previous subchapters is the following:
disabilities, metrics, affected parameters and numerical values from the literature survey (for
parameters for which such data exists in literature). The data contained in the section marked with
red (Measured data) is the result of the gathered and processed data during the measurement
campaign with the multisensorial platform focusing on the prioritization criteria presented in Table
6-1. As described in the previous subchapter (6.4) the mean and standard deviation was included in
the Generic Physical Virtual User Model. Last but not least, in the region marked with green, tasks,
subtasks and affected primitive tasks were included.
The final table of the Generic Physical Virtual User Model is given in ANNEX C: Generic Physical
Virtual User Model.

7. Conclusions
The present document describes the Parameterized Human Physical Models, detailing how
information about disabilities, related metrics, measured data obtained with the Multisensorial
Platform during the measurement campaign, tasks, subtasks and primitive tasks are merged
together to obtain the Generic Physical Virtual User Model. A detailed description of the above
mentioned process and the constituting elements is given in the 6 chapters as follows:
Chapter 1: is a short overview of how the current deliverable links to the different activities and
deliverables of the VERITAS project.
Chapter 2: gives a review of the considered Metrics. A broad classification of motor impairments is
given in this chapter. Motor, speech, hearing and visual metrics are detailed.
Chapter 3: is a brief explanation of the disabilities subdivided in four groups: motor, speech, visual
and hearing. This chapter provides general information about every disability and gives some
backup to the prioritization of metrics.
Chapter 4: describes the Multisensorial Platform. Sensors which compose the Multisensorial
Platform are presented in this chapter, relating these to the measured parameters, describing briefly
also how the sensors can be used in the measurements. The Multisensorial Platform is used to
measure specific metrics with subjects having different disabilities.
Chapter 5: presents the Prioritization of metrics. Starting from the disabilities and metrics (presented
in Chapter 3 and Chapter 2 respectively), 15 Motor Disabilities, 5 Speech impairments, 6 Visual and
5 Hearing impairments have been successfully prioritized. The process followed three main points
of view: literature survey, compatibility with the sensors present in the Multisensorial Platform and a
biomechanical analysis.
Chapter 6: presents the Generic Physical Virtual User Model, describing the different information
merged together. This chapter gives an overview how the information described in previous
chapters (Metrics, Disabilities, Multisensorial Platform and Prioritization of the parameters) is built in
the Physical Virtual User Model. Subchapters of this chapter describe the extended Abstract User
Model, the obtained and processed numerical data delivered by the measurements with the
Multisensorial Platform based on a final list of metrics considered for the measurements, tasks and
how these relate to the Generic Physical Virtual User Model. Finally a description of the Generic
Physical Virtual User Model is given.
The tables containing numerical data are given in the Annexes as follows:

8. References
[1]. http://thcc.or.th/ICD-10TM/
[2]. WHO-World Health Organization [Online] http://www.who.int
[3]. http://www.xsens.com/
[4]. http://www.biometricsltd.com/gonio.htm
[5]. http://www.cyberglovesystems.com/
[6]. De Cecco M., Pertile M., Baglivo L., Lunardelli M., Setti F., Tavernini M., A Unified
Framework for Uncertaintly, Compatibility Analysis and Data Fusion for Multiple Stereo 3D
Shape Estimation, IEEE Trans. Instrum. Meas,,vol: 59, Issue: 11, pp 2834-2842, 2010.
[7]. Yan, J. and Pollefeys, M. A factorization-based approach for articulated non-rigid shape,
motion and kinematic chain recovery from video. IEEE Transactions on Pattern Analysis and
Machine Intelligence, 30(5), 2008.
[8]. Setti F., De Cecco M., Del Blue A., A multi view stereo system for articulated motion
analysis, International conference on computer vision theory and applications- VISAPP,
Angers-France, 17-21 May 2010.
[9]. S Sarkar, P.J. Philips. Z. Liu, I. Robledo-Vega, P. Grother, and K.W. Bowyer, The Human
ID Gait Challenge Problem: Data Sets, Performance and Analysis, IEE Trans. Pattern
Analysis and Machine Intelligence, vol.27, no.2,pp. 162-177. Feb. 2005.
8.1. Rheumatoid arthritis

[10]. Arja Hakkinen at al., Decreased Muscle Strength and Mobility of the Neck in Patients
With Rheumatoid Arthritis and Atlantoaxial Disorders, Arch Phys Med Rehabil, vol. 86, pp.
1603-1608, 2005.
[11]. , J.J. Dias, M. Smith, H.P. Singh, and A.S. Ullah, The Working Space of the Hand in
Rheumatoid Arthritis: Its Impact on Disability, The Journal of Hand Surgery, vol. 34E, pp.
465-470, 2009.
[12]. Kevin C. Chung, Sandra V. Kotsis, Kim H. Myra, and Ann Arbor, A Prospective
Outcomes Study of Swanson Metacarpophalngeal Joint Arthroplasty for the Rheumatoid
Hand, The Journal oh Hand Surgery, vol. 29A, pp. 645-652, 2004.
[13]. Marie Martine Lefevre-Colau et al. Reliability, Validity, and Responsiveness of the
Modified Kapandji Index for Assessment of Functional Mobility of the Rheumatoid Hand,
Arch Phys Med Rehabil, vol. 84, pp 1032-1038, 2003.
[14]. S.M. Meireles, L.M. Oliveira, M.S. Andrade, A.C. Silva, and Jamil Natour, Isokinetic
evaluation of the knee in patients with rheumatoid arthritis, Joint Bone Spine, vol. 69, pp.
566-573, 2002.
[15]. James R. Brinkmann and Jacquelin Perry, Rate and Range of Knee Motion During
Ambulation in Healthy and Arthritic Subjects, Physical Therapy, vol. 65, 1985.
[16]. Michael Khazzam, Jason T.Long, Richard M. Marks, and Gerald F. Harris, Kinematic
Changes of the Foot and Ankle in Patients with Systemic Rheumatoid Arthritis and Forefoot
Deformity, Journal of Orthopaedic Research, vol. 25, pp. 319-329, 2007.

8.2. Gout
[17]. Michael E. Zychowicz, Richard S. Pope, and Elke Graser, The current state of care
in gout: Addressing the need for better understanding on an ancient disease, American
Academy of Nurse Practioners, vol.22, pp. 623-636, 2010.
[18]. Alexander So, Thibaut De Smedt, Sylvie Revaz and Jurg Tschopp A pilot study of
IL-1 inhibition by anakinra in acute gout ,Arthitis Research & Therapy, vol. 9, no.2, 2007.
[19]. Keith Rome et al. Functional and biomechanical characteristics of foot disease in
chronic gout: A case-control study, Clinical Biomechanics, 2010.
8.3. Kyphosis
[20]. Alison M. Greiga, Kim L. Bennella, Briggsa Andrew M., and Paul W. Hodgesc,
Postural taping decreases thoracic kyphosis but does not influence trunk muscle
electromyographic activity or balance in women with osteoporosis Manual Therapy, vol. 13,
pp. 249-257, 2008.
[21]. Saha Devjani, Gard Steven, and Fatone Stefania, The effect of trunk flexion on able-
bodied gait, Gait &Posture, no. 27, pp. 653-660, 2008.
[22]. Maria Grazia Benedetti, Lisa Berti, Chiara Presti, Antonio Frizziero, and Sandro
Giannini, Effects of an adapted physical activity program in a group of elderly subjects with
flexed posture: clinical and instrumental assessment, Journal of NeuroEngineering and
Rehabilitation, vol.5, 2008.
8.4. Lordosis
[23]. Calkir Balkan, Richter Marcus, Kafer Wolfram, Puhl Wolfhart and Schmidt Rene, The
impact of total lumbar disc replacement on segmental and total lumbar lordosis, Clinical
Biomechanics, no. 20, pp. 357-364, 2005.
8.5. Ankylosis spondilytis

[24]. A. Guiotto et al., Kinematics and kinetics analysis of gait in ankylosing spondylitis
subjects, Gait and Posture, vol. 30, Supplement 1, p. S42, 2009.
[25]. Kyllikki Widberg, Hossein Karimi, and Ingiald Hafstrom, Self- And manual
mobilization improves spine mobility in men with ankylosing spondylitis a randomized
study, Clinical Rehabilitation, vol. 23, pp. 559-608, 2009.
[26]. K.L. Haywood, A. M. Garratt, K. Jordan, K. Dziedzic, and P.T. Dawes, Spinal
mobility in ankylosing spondylitis: reliability, vality and responsiveness, Rheumatology,
vol.43, pp. 750-757, 2004.
[27]. Romain Debarge, Guillaume Demey, and Pierre Roussouly, Radiological
analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle
subtraction osteotomy, European Spine Journal, vol.19, pp. 65-70, 2010.
[28]. Ennio Lumbrano and Philip Helliwell, Deterioration in Anthropometric Measures over
Six Years in Patients with Ankylosing Spondylitis, Physiotherapy, vol.85, p. 138, 1999.
[29]. A. Spoorenberg et al., Measuring disease activity in ankylosing spondylitis: patient
and physician have different perspectives, Rheumatology, vol. 44, pp. 789-795, 2005.
8.6. Hand Ostearthiris

[30]. I. Kjeken, H. Dagfinrud, B Slatkowsky-Christensen, P Mowinckel, T Uhlig, T K Kvien,
A Finset, Activity limitations and participation restrictions in women with hand osteoarthritis:
patients descriptions and associations between dimensions of functioning, Ann Rheum Dis
2005 64: 1633-1638.
8.7. Gonarthrosis
[31]. Ken Endo and Hugh Herr, A Model of Muscle-Tendon Function in Human Walking,
2009.
[32]. Zoltan Bejek, Robert Paroczai, Arpad IIIyes, Laszlo Kocsis, and Rita M. Kiss, Gait
Parameters of Patients with Osteoarthiritis of the Knee Joint of the Knee Joint, Physical
Education and Sport, vol. 4, pp. 9-16, 2006.
[33]. M.P.M. Steultjens and J. Dekker, Range of joint motion and disability in patients with
osteoarthritis of the knee or hip, Rheumatology, vol. 39, pp. 955-961, 2000.
8.8. Coxarthrosis
[34]. M.P.M. Steultjens and J. Dekker, Range of joint motion and disability in patients with
osteoarthritis of the knee or hip, Rheumatology, vol. 39, pp. 955-961, 2000.
8.9. Shoulder adhesive capsulitis

[35]. Jadran Lenaric, Michael M. Stanisic, and Vincenzo Parenti-Castelli, Kinematic
design of a humanoid robotic shoulder complex, International Conference on Robotics/&
Automation, 2000.
[36]. Nilu Fer Baci and Mustafa Kemal Balci, Shoulder Adhesive Capsulitis and Shoulder
Range of Motion in Type II Diabetes Mellitus: Association with Diabetic Complications,
Journal Diab Comp, vol 13, 1999.
8.10. Parkinsons
[37]. J. Jankovic, Parkinsons disease: clinical features and diagnosis, vol.4, no.79, pp.
368-76, April 2008.
[38]. Samii A., Nutt J.G., and Ransom B.R., Parkinsons disease, Lancet, vol. 9423, no.
363, pp. 1783-93, May 2004.
[39]. Berardelli A., Rothwell J.C., Thompson P.D., and Hallett M., Pathophysiology of
bradykinesia in Parkinsons disease , Brain, a Journal of Neurology, vol. 124, no. 11, pp.
2131-2146, November 2001.
[40]. Fahn S. and Elton R.L., UPDRS program members. Unified Parkinsons disease
Rating Scale. In: Fahn S, Marsden CD, Goldstein M, Calne DB, editors. Recent
developments in Parkinsons disease, Vol. 2 Florhan Park, NJ: Macmillan Healhcare
Information, pp. 153-163, 293-304.
[41]. Siderowf A. et al., Parkinson study group. Test-retest reliability of the United
Parkinsons Disease Rating Scale in patients with early Parkinsons disease: results from a
multicenter clinical trial, Mov Disord, no. 17, pp. 758-763, 2002.
[42]. Stebbins G.T. and Goetz C.G., Factor structure of the Unified Parkinsons Disease
Rating Scale: motor examination section, Mov Disord, no. 13, pp. 633-636, 1998.
[43]. Martinez Martin P., Gil Nagel A., Gracial L.M., Gomez J.B., and Martinez Sarries J.,
Unified Parkinsons Disease Rating Scale characteristic and structure. The cooperative
Multicentric Group, Mov Disord, no. 9, pp. 76-83, 1994.

[44]. Metman L.V., Myre B., and Verwey N., Test-retest reliability of UPDRS-III,
dyskinesia scales, and timed motor tests in patients with advanced Parkinsons disease: an
argument against multiple baseline assessment, Mov Disord., no. 19, pp. 1079-1084, 2004.
[45]. P. Madeley, J.L. Hulley, H. Wildgust, and R.H. Mindham, Parkinsons disease and
driving ability, J Neurol Neurosurg Psychiatry, vol. 53, no. 7, 1990.
[46]. G. Deuschl, P.G. Bain, and M. Brin, Ad hoc Scientific Committee. Con-sensus
statement of the Movement Disorders Society on tremor, Mov. Disord, vol.3, no. 13, pp. 2-
23, 1998.
[47]. Rocco Agostino et al., Impairment of individual fingers movements in Parkinson;s
disease, Mov Disord, vol. 18, no.5, pp 560-5, 2003.
[48]. Camicioli R., Wang Y., Powell C., Mitnitski A., and Rockwood K., Gait and posture
impairment, parkinson and cognitive decline in older people, Journal of Neural
Transmission, no. 10, October 2007.
[49]. Meg Morris, Robert lansek, Jennifer McGinley, Thomas Matyas, and Frances
Huxman, Three-Dimensional Gait Biomechanics in Parkinsons Disease: Evidence for a
Centrally Mediated Amplitude Regulation Disorder, Movement Disorders, vol.20, no.1, pp.
40-50, 2005.\
[50]. Camicioli R. Wang Y., Powell C., Mitniski A., and Rockwood K., Gait and posture
impairment, parkinsonism and cognitive decline in older people, Journal of Neural
Transmission, no. 10, October 2007.
[51]. James L. Robinson and Cary L. Smidt, Quantitative Gait Evaluation in the Clinic,
Physical Therapy, vol. 61, no.3, March 1981.
[52]. Meg Norris, Robert lansek, Jennifer McGinley, Thomas Matyas, and Frances
Huxman, Three-Dimensional Gait Biomechanics in Parkinsons disease: Evidence for a
Centrally Mediated Amplitude Regulation Disorder, Movement Disorders, vol. 20, no. 1, pp.
40-50, 2005.
8.11. Dystonia
[53]. Maria K. Lebiedowska, Deborah Gaebler-Spira, Richard S. Burns, and John R. Fisk,
Biomechanic Characteristics of patients With Spastic and Dystonic Hypertonia in Cerebral
Palsy, Arch Phys Med Rehabil, vol. 85, June 2004.
[54]. Snaith Alisa and Wade Derick, Dystonia, Clinical Evidence, no. 09, 2008.
[55]. Tanabe Lauren M., Kim Connie E., Alagem Noga, and Dauer William T., Primary
dystonia: molecules and mechanisms, Nat Rev Neurol, vol. 11, no. 5, pp. 598-609,
November 2009.
[56]. Timmermann L.,Pauls K.A.M, Wieland K., Jech R., and Kurlemann G., Dystonia in
neurodegeneration with brain iron accumulation: outcome of bilateral pallidal stimulation,
Brain, no. 133, pp. 701-712, 2010.
[57]. Torres-Russotto Diego and Perlmutter Joel S., Task-specific dystonias, Ann N Y
Acad Sci, no. 1142,pp. 179-199, October 2008.
[58]. J. Carpentato et al., A protocol for the assessment of 3D movements of the head in
persons with cervical dystonia, Clinical Biomechanics, vol. 19, pp. 659-663, 2004.
[59]. Cristina Boccagni, Jacopo Carpaneto, Silvestro Micera, Sergio Bagnato, and
Giuseppe Galardi, Motion analysis in cervical dystonia, Neurol Sci, vol. 29, pp. 375-381,
2008.

[60]. Veronique Marchard-Pauvert and Caroline Iglesias, Properties of human spinal

interneurones: normal and dystonic control, J Physiol, pp. 1247-1256, 2008.
8.12. Multiple sclerosis

[61]. Multiple Sclerosis International Federation [Online]
http://www.msif.org/en/about_ms/index.html
[62]. Ringold Sarah, Lym Cassio, and Glass Richard M., Multiple Sclerosis, JAMA,
no.296, 2006.
[63]. Koch Marcus, Mostert Jop, Heersema Dorothea, and De Keyser Jacques, Tremor in
Multiple Sclerosis, J. Neurol., no.245, pp.133-145, 2007.
[64]. Pryce G. and Baker D., Control of Spasticity in a Multiple Sclerosis Model is
mediated by CB1, not CB2, Cannabinoid Receptors, British Journal of Pharmacology, no.
150, pp. 519-525, 2007.
[65]. Matthew H. Sutliff et al. Efficacy and Safety of Hip Flexion Assist Orthosis in
Ambulatory Multiple Sclerosis Patients, Arch Phys Med Rehabil, vol. 89, August 2008.
[66]. Gregory M. Gutierrez et al., Resistance Training Improves Gait Kinematics in
Persons with Multiple Sclerosis, Arch Phys Med Rehabil, vol. 86, September 2005.
[67]. K.J. Kelleher, W. D. Spence, S. E. Solomonidis, and D. Apatsidis, The
characterization of gait patterns in multiple sclerosis, Journal of Biomechanics, vol.40,
no.S2, 2007.
[68]. Louisa S. DeBolt and Jeffrey A. McCubbin, The Effects of Home-Based Resistance
Exercise on Balance, Power , and Mobility in Adults With Multiple Sclerosis, Arch Phys Med
Rehabil, vol.85, pp. 290-297, February 2004.
[69]. P. Hoang, J.P. Saboisky, S.C. Gandevia, and R.D. Herbert, Passive mechanical
properties of gastrocnemius in people with multiple sclerosis, Clinical Biomechanics, vol.24,
pp.291-298, 2009.
[70]. S.H. Alusi, S. Glickman, N. Patel, J. Worthington and P.G. Bain, Target board test
for the quantification of ataxia in tremulous patients, Clin Rehabil, vol.17,pp.140-149, 2003.
8.13. Cerebral palsy

[71]. Garr Lucinda J., Definition and Classification of Cerebral Palsy, Developmental
Medicine & Child Neurology, no. 47, p.508, 2005.
[72]. M. Kyllerman et al. Dyskinetic Cerebral Palsy, Acta Paediatrica, vol. 71, no. 4, pp.
543-550, Jan 2008.
[73]. Masaharu et al., Cerebral palsy in adults: Independent effects of muscle strength
and muscle tone, Arch Phys Med Rehab, vol. 338, April 2009
[74]. Margaret Maruishi et al., Sensory deficit in the hands of children with cerebral palsy:
a new look at assessment and prevalence, Developmental Medicine & Child Neurology, vol.
36, no.7, pp. 619-624.
[75]. Patricia A. Burtner, Amanda Manhke Medora, Joanne Keene, and Clifford Qualls,
Effect of Wrist Hand Splints on Grip, Pinch, Manual Dexterity, and Muscle Activation in
Children with Spastic Hemiplegia: A Preliminary Study, Journal of Hand Therapy, January-
March 2008.
[76]. D.J. Russell, P.L. Rosenbaum, and D.T. Cadman, The gross motor function
measure: a means to evaluate the effects of physical therapy, Dev Med Child Neurol.,
vol.31, no.341-352, 1989.
[77]. H.Kerr Graham and P.Selber, Musculosketal aspects of cerebral palsy, The Journal
of Bone & Joint Surgery (Br), vol.85-B, no.2,March 2003.
[78]. Chang Jyh-Jong, Wu Tung-I, and Wu, Fong-Chin, Su Wen-Lan, Kinematical
measure for spastic reaching in children with cerebral palsy, Clinical Biomechanics, vol. 20,
pp. 381-388, 2005.
[79]. T.F. Winters, J.R. Gage, and R. Hicks, Gait patterns in spastic hemiplegia in children
and young adults, J. Bone Joint Surg (Am), vol. 69-A, pp. 437-41, 1987.
[80]. J. Harlaar, J.G. Becher, C.J. Snijders, and G.J. Lankhorst, Passive stiffness
characteristics of ankle plantar flexors in hemiplexia, Clinical Biomechanics, vol. 15, pp.
261-270, 2000.
[81]. Laura A. Prosser, Richard T. Lauer, Ann F. VanSant Mary F. Barbe, and Samuel
C.K. Lee, Variability and simmetry of gait in early walkers with and without bilateral cerebral
palsy, Gait & Posture, vol. 31, pp. 522-526, 2010.
[82]. National center on Physical Activity and disability [Online] http://www.ncpad.org/
8.14. Hereditary and idiopathic neuropathies

[83]. Healthline [Online] http://www.healthline.com/galecontent/idiopathic-neuropathy
[84]. Smith A. Gordon and Singleton J. Robinson, Idiopathic neuropathy, prediabetes and
the metabolic syndrome, Journal of the Neurological Sciences, no. 242, pp. 9-14, 2006.
[85]. Anouti A. and Koller W.C., Tremor disorders. Diagnosis and management, West J
Med, vol.6, no. 162, pp.510-513, June 1995.
[86]. A.J Videler, A. Beelen, G. Aufdemkampe, IJ de Groot, and M. van Leemputte, Hand
strength and fatigue in patients with Hereditary Motor and Sensory Neuropathy (Type I and
II), Archives of Physical Medicine & Rehabilitation, vol. 83, no.9,pp. 1274-1278, 2002.
[87]. V. Mathiowetz, K. Webwer, G. Volland, and N. Kashman, Reliability and validity of
hand strength evaluation, J. Hand Surg., vol.9A, pp. 222-226, 1984.
[88]. Gita M. Ramdharry, Brian L. Day, Mary M. Reilly, and Jonathan F. Marsden, Hip
flexor fatigue limits walking in Charcot-Marie-Tooth Disease, Muscle Nerve, vol. 40, pp.
103-111, 2009.
[89]. Cristopher John Newman et al., The characteristics of gait in Charcot-Marie-Tooth
disease types I and II, Gait and Posture, vol.26, pp. 120-127, 2007.
8.15. Stroke
[90]. Hamilton B.B., A uniform national data system for medical rehabilitation,
Rehabilitation outcomes: analysis and measurement, pp. 137-147, 2007.
[91]. Feng Xin and Jack M. Winters, A pilot study evaluating use of computer-assisted
neurorehabilitation platform for upper-extremity stroke assessment, Journal of
NeuroEngineering and Rehabilitation, vol.6, no.15, 2009.
[92]. Spiros Prassas, Michael Thaut, Gerald Mclntosh, and Ruth Rice, Effect of auditory
rhythmic curing on gait kinematic parameters of stroke patients, Gait and Posture, vol. 6,
pp. 218-223, 1997.
[93]. Terry S. Horn, Stuart A. Yablon, John W. Chow, Jae E. Lee, and Dobrivoje S. Stokic,
Effect of Intrathecal Baclofen Bolus Injection on Lower Extremity Joint Range of Motion
During Gait in Patients With Aquired Brain Injury, Arch Phys Med Rehabil, vol. 91, January
2010.

[94]. Fan Gao, Thomas H. Grant, Elliot J. Roth, and Li-Qun Zhang, Changes in Passive
Mechanical Properties of the Gastrocnemius Muscle at the Muscle Fascicle and Joint Level
in Stroke Survivors, Arch Phys Med Rehabil, vol.90, May 2009.
[95]. Feng Xin and Jack M. Winters, A pilot study evaluating use of a computer-assisted
neurorehabilitation platform for upper-extremity stroke assessment, Journal of
NeuroEngineering and Rehabilitation, vol. 6, no. 15, 2009.
[96]. Yitshal N. Berner, Orit Lif Kimchi, Varda Spokoiny, and Bronia Finkeltov, The effect
of electric stimulation treatment on the functional rehabilitation of acute geriatric patients with
stroke- a preliminary study, Archives of Gerontology and Geriatrics, vol. 39, pp. 125-132,
2004.
8.16. Elderly
[97]. S.A. Black and R.D. Rush, Cognitive and functional decline in adults aged 75and
older, J Am Geriatr Soc, vol.50, pp. 1978-1986, 2002.
[98]. National Institute of Aging. (2010, September) Baltimore Lngitudinal Study of Aging
[Online]. http://www.grc.nia.nih.gov/branches/blsa/blsanew.htm
[99]. Nathan W. Shock, Normal Human Aging: The Baltimore Longitudinal Study of Aging.
Washington, DC 20402: Superintendent of Documents, U.S. Government Printing Office,
1984.
[100]. Ralf Th. Krampe, Aging, expertise and fine motor movement, Neuroscience and
Biobehavioural Reviews, vol. 26, pp. 767-776, 2002.
[101]. A.M. Wing and A.B. Kristofferson, Response delays and the timing of discrete motor
responses, Percept Psychophys, vol. 14, pp. 5-12, 1973.
[102]. A.T. Welford, Aging and human skill. Oxford: Oxford University Press for the Nuffield
Foundation, 1958.
[103]. P.C. Amrhein, G.E. Stelmach, and N.L. Goggin, Age differences in the maintenance
and restructuring of movement preparation, Psychol Aging, vol. 6, pp. 451-66, 1991.
[104]. M.J. Liao, R. J. Jagacinski, and N. Greenberg, Quantifying the performance
limitations of older and young adults in a target acquisition task, J Exp Psychol: Hum
Percept Perform, vol. 23, pp. 1644-64, 1997.
[105]. Maxim Bakaev, Fittss Law for Older Adults: Considering Factor of Age, IHC
Proceedings of the VIII Brazilian Symposium on Human Factors in Computing Systems, pp.
21-24, 2008.
[106]. T.J. Doherti, Aging and sarcopenia, J Appl Physiol, vol. 95, pp. 1717-1727, 2003.
[107]. S. Giampaoli, L. Ferrucci, and F. Cecchi, Hand-grip strength predicts incident
disability in non-disabled older man, Age Aging, vol. 28, pp. 283-288, 1999.
[108]. T. Rantanen, J. M. Guralik, and D. Foley, Midlife hand grip strength as a predictor of
old age disability, JAMA, vol. 281, pp. 558-560, 1999.
[109]. Nathan, K. LeBrasseur, Shalender Bhasin, Renee Miciek, and Thomas W. Storer,
Test of Muscle Strength and Physical Function: Reliability and Discrimination of
Performance in Younger and Older Men and Older Men with Mobility Limitations, JAGS,
vol. 56, pp. 2118-2123, 2008.x
[110]. J.O. Judge, R.B. Davis, and S. Ounpuu, Step length reductions in advanced age: the
role of ankle and hip kinetics, J Gerontol A Biol Sci, vol. 51, pp. M303-M312, 1996.

[111]. Seung-Uk Ko, Jeffrey M. Hausdorff, and Luigi Ferrucci, Age-associated differences
in the gait pattern changes of older adults during fast speed and fatigue conditions: results
from Baltimore longitudinal study of ageing, Age and Ageing, vol. 39, pp. 688-694, 2010.
8.17. Glaucoma
[112]. AGIS, The Advanced Glaucoma Intervention Study: 1. Study design and methods
and baseline characteristics of study patients, Control Clin Trials, vol. 5, pp. 299-325, 1994.
[113]. M. Wilson, Progression of visual field loss in untreated glaucoma patients and
suspects in St Lucia, West Indies, Trans. Am. Ophthalmol. Soc, vol. 100, p.365, 2002.
8.18. METRICS
8.18.1. Fittss law

[114]. MacKenzie I. Scott, Fittss law as a research and design and design tool in human-
computer interaction, Human Computer Interaction, vol.7, pp. 91-139, 1992.
[115]. Fittss law demonstration [Online] http://fww.few.vu.nl/hci/interactive/fitts/
8.18.2. PCC
[116]. L.D. Shriberg and J.Kwiatkowski, Phonologic disorders III: A procedure for
assessing severity of involvement. Journal of Speech and Hearing Disorders, 1982.
[117]. Ken Mitchell Beile, Manual of Articulation and Phonological Disorders, Second
Edition ed.
8.19. Hearing Impairments

[118]. American Speech-Language-Hearing Association. Type, Degree and Configuration of
Hearing Loss. [Online] http://www.asha.org/public/hearing/disorders/types.htm


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Accessible and Assistive ICT

Parameterized human physical models

Deliverable No. D1.3.2

SubProject No. SP1 SubProject Title User Modelling

Workpackage No. W1.3 Workpackage Title Physical models

Activity No. A1.3.4 Activity Title Parameterized human

Authors: Hunor Erdelyi, Nicola Cofelice, Oriol Marin, Stijn

Status (F: final; D: draft; RD: revised D

Dissemination level: PU (Public)

File Name: D132_2012-01-26_FINAL

Project start date and duration: 01 January 2010, 48 Months

December 2011 2 LMS

Version History table

December 2011 3 LMS

December 2011 4 LMS

3.2.13. Cerebral palsy ...................................................................................... 30

4.3.9. Step width ............................................................................................ 47

5.1.14. Shoulder Capsulitis .............................................................................. 59

December 2011 7 LMS

Figure 4-24 - Neck Extension.......................................................................................................... 54

December 2011 9 LMS

December 2011 10 LMS

ROM Range of motion

December 2011 12 LMS

December 2011 13 LMS

1. VERITAS project structure

2.1. Description of the metrics of motor impairments

2.1.1. Gait parameters

December 2011 15 LMS

Figure 2-1 - Gait metrics

2.1.2. Upper body parameters

2.1.3. Video sensing

December 2011 16 LMS

2.1.4. Lower body parameters

2.1.5. Strength parameters

2.1.6. Dexterity/control parameters

December 2011 17 LMS

Test Term Description

2.1.7. Torso parameters

2.2. Description of the metrics of speech impairments

2.2.1. Percentage of consonants correct (PCC)

December 2011 18 LMS

50%-65% = Moderate to severe disorder

2.2.2. Articulation Competence Index (ACI)

2.3. Metrics of hearing impairments Decibel as function of the

December 2011 19 LMS

Level of hearing loss dB Functional limitations

2.4. Description of the metrics of visual impairments

December 2011 20 LMS

3.1. Classification (2010 ICD CODE)

Table 3-2 - ICD classification for speech

Table 3-3 - ICD visual disabilities

Table 3-4 - Hearing disabilities

3.2. Motor disabilities

December 2011 22 LMS

3.2.1. Parkinson disease

December 2011 23 LMS

3.2.3. Multiple sclerosis

December 2011 24 LMS

Figure 3-1 - Stroke

3.2.5. Rheumatoid arthritis

December 2011 25 LMS

Figure 3-2 - Examples of hand in extension and flexion