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Developing a Simulation-Based Training Program for Non-Traditional Caregivers

Simulation-based training enables learning in controlled environments which nevertheless mimic real-world scenarios. It has proven effective in the training of medical personnel and affords rapid assimilation and integration of necessary skills. Non-traditional caregivers often operate in austere environments, where resource and personnel limitations preclude more standard provision of care by highly trained and fully equipped health care teams. In these settings, training time for the caregivers may be limited, with long gaps between time of the training and use of the skills, a limited grasp of the underlying physiology, and unfamiliarity with "medical English" which can render it difficult to communicate concepts to more advanced practitioners when such interaction can take place, as for example, when telemedicine can be used to project medical skills further forward . Methods: Simulation-based training can assist in the familiarization of caregivers to the environment, ensure adequate execution of skills at the appropriate time(s), and allow practice of telemedicine communication patterns between the mentor and caregiver. Results: Scenario-based training can and has been used for initial and sustainment training modules, including self-taught modules for use in the field. Strict identification of the critical concepts is vital, as is development and practice of technically simple procedures wherever possible. Medical devices can off-load tasks from caregivers, as well as to minimize the necessary level of caregiver knowledge, while integrated simulations among all members of the mission team can improve communication and efficiency. Discuss ion: Nontraditional caregivers face unique challenges when learning to provide medical care. Scenario-based curricula allow lesson plans to be tailored to each group's individual needs, as well as being suited for the participation of numerous groups, including the caregiver, evacuation/transport staff, decision-makers, and hospital-based physician.

Bacal, Kira↗

Rapid Analysis, Self-Calibrating Array for Air Monitoring

Human space missions have critical needs for monitoring and control for life support systems. These systems have monitoring needs that include feedback for closed loop processes and quality control for environmental factors. Sensors and monitoring technologies assure that the air environment and water supply for the astronaut crew habitat fall within acceptable limits, and that the life support system is functioning properly and efficiently. The longer the flight duration and the more distant the destination, the more critical it becomes to have carefully monitored and automated control systems for life support. Past experiments with the JPL ENose have demonstrated a lifetime of the sensor array, with the software, of around 18 months. The lifetime of the calibration, for some analytes, was as long as 24 months. We are working on a sensor array and new algorithms that will include sensor response time in the analysis. The preliminary array analysis for two analytes shows that the analysis time, of an event, can be dropped from 45 minutes to less than10 minutes and array training time can be cut substantially. We will describe the lifetime testing of an array and show lifetime data on individual sensors. This progress will lead to more rapid identification of analytes, and faster training time of the array.

Self Calibrating↗

Ultrasound Fracture Diagnosis in Space

Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

Dulchavsky, Scott A.↗

Helicopter Human Factors

Even under optimal conditions, helicopter flight is a most demanding form of human-machine interaction, imposing continuous manual, visual, communications, and mental demands on pilots. It is made even more challenging by small margins for error created by the close proximity of terrain in NOE flight and missions flown at night and in low visibility. Although technology advances have satisfied some current and proposed requirements, hardware solutions alone are not sufficient to ensure acceptable system performance and pilot workload. However, human factors data needed to improve the design and use of helicopters lag behind advances in sensor, display, and control technology. Thus, it is difficult for designers to consider human capabilities and limitations when making design decisions. This results in costly accidents, design mistakes, unrealistic mission requirements, excessive training costs, and challenge human adaptability. NASA, in collaboration with DOD, industry, and academia, has initiated a program of research to develop scientific data bases and design principles to improve the pilot/vehicle interface, optimize training time and cost, and maintain pilot workload and system performance at an acceptable level. Work performed at Ames, and by other research laboratories, will be reviewed to summarize the most critical helicopter human factors problems and the results of research that has been performed to: (1) Quantify/model pilots use of visual cues for vehicle control; (2) Improve pilots' performance with helmet displays of thermal imagery and night vision goggles for situation awareness and vehicle control; (3) Model the processes by which pilots encode maps and compare them to the visual scene to develop perceptually and cognitively compatible electronic map formats; (4) Evaluate the use of spatially localized auditory displays for geographical orientation, target localization, radio frequency separation; (5) Develop and flight test control/display concepts; (6) Quantify, model, predict, and improve pilots, workload-management strategies; and (7) Design computer-game trainers to reduce training time and cost.

Hart, Sandra G.↗

Evaluation of shoulder integrity in space: first report of musculoskeletal US on the International Space Station

Investigative procedures were approved by Henry Ford Human Investigation Committee and NASA Johnson Space Center Committee for Protection of Human Subjects. Informed consent was obtained. Authors evaluated ability of nonphysician crewmember to obtain diagnostic-quality musculoskeletal ultrasonographic (US) data of the shoulder by following a just-in-time training algorithm and using real-time remote guidance aboard the International Space Station (ISS). ISS Expedition-9 crewmembers attended a 2.5-hour didactic and hands-on US training session 4 months before launch. Aboard the ISS, they completed a 1-hour computer-based Onboard Proficiency Enhancement program 7 days before examination. Crewmembers did not receive specific training in shoulder anatomy or shoulder US techniques. Evaluation of astronaut shoulder integrity was done by using a Human Research Facility US system. Crew used special positioning techniques for subject and operator to facilitate US in microgravity environment. Common anatomic reference points aided initial probe placement. Real-time US video of shoulder was transmitted to remote experienced sonologists in Telescience Center at Johnson Space Center. Probe manipulation and equipment adjustments were guided with verbal commands from remote sonologists to astronaut operators to complete rotator cuff evaluation. Comprehensive US of crewmember's shoulder included transverse and longitudinal images of biceps and supraspinatus tendons and articular cartilage surface. Total examination time required to guide astronaut operator to acquire necessary images was approximately 15 minutes. Multiple arm and probe positions were used to acquire dynamic video images that were of excellent quality to allow evaluation of shoulder integrity. Postsession download and analysis of high-fidelity US images collected onboard demonstrated additional anatomic detail that could be used to exclude subtle injury. Musculoskeletal US can be performed in space by minimally trained operators by using remote guidance. This technique can be used to evaluate shoulder integrity in symptomatic crewmembers after strenuous extravehicular activities or to monitor microgravity-associated changes in musculoskeletal anatomy. Just-in-time training, combined with remote experienced physician guidance, may provide a useful approach to complex medical tasks performed by nonexperienced personnel in a variety of remote settings, including current and future space programs. (c) RSNA, 2004.

Space Flight/education↗

Acute Hemodynamic Effects of the Braslet-M Device on the International Space Station

The Braslet-M occlusion device is prescribed for cosmonauts as a countermeasure for early phases of spaceflight to temporarily alleviate symptoms associated with the cephalad fluid shift. Using a multipurpose ultrasound (US) device onboard, we assessed the acute hemodynamic effects of the Bracelet-M device on a long duration International Space Station (ISS) crewmember. Methods A combination of just-in-time training and real-time remote expert assistance was used to conduct the imaging procedures. An HDI-5000 imager (Philips, Bothell, WA) was used, provided by the ISS Human Research Facility. Superficial femoral artery (SFA), femoral vein (FV) flow spectra were obtained at mid-thigh level. Left ventricle was imaged through the apical 4-chamber view, with Color M-Mode to measure propagation velocity (V (p)). After 10 minutes of Bracelet-M use, data collection was repeated. All data were transmitted in DICOM format to ground for analysis. Results With Braslet-M, cardiac V(p) slope decreased (56ms to 42ms). A stagnation signature in the FV was seen suggesting impeded flow (rouleaux formation, too-low-to-measure velocity, and increase in diameter). Quadri-phasic flow in SFA was seen both before and after Braslet-M application. Velocities in the SFA decreased with Braslet-M (65cm/sec to 52cm/sec) and so did the time velocity integrals (16.97 to 12.4); the flow pattern spoke of resistivity increase in the vascular bed. Conclusion In the long duration ISS crewmember we observed effects of lower extremity venous occlusion through both central and peripheral indicators. A part of circulating volume transferred to peripheral potential vascular space. Impediment to venous outflow was demonstrated objectively, with a commensurate change in the flow pattern of the main feeding artery. Central volume reduction caused lower V(p). Additional studies are warranted to determine the time course of the changes and the dynamics in interstitial fluid sequestration, as well as the safe levels and duration of the compression forces.

Hamilton, Douglas R.↗

Clinical Core Competency Training for NASA Flight Surgeons

Introduction: The cohort of NASA flight surgeons (FS) is a very accomplished group with varied clinical backgrounds; however, the NASA Flight Surgeon Office has identified that the extremely demanding schedule of this cohort prevents many of these physicians from practicing clinical medicine on a regular basis. In an effort to improve clinical competency, the NASA FS Office has dedicated one day a week for the FS to receive clinical training. Each week, an FS is assigned to one of five clinical settings, one being medical patient simulation. The Medical Operations Support Team (MOST) was tasked to develop curricula using medical patient simulation that would meet the clinical and operational needs of the NASA FS Office. Methods: The MOST met with the Lead FS and Training Lead FS to identify those core competencies most important to the FS cohort. The MOST presented core competency standards from the American Colleges of Emergency Medicine and Internal Medicine as a basis for developing the training. Results: The MOST identified those clinical areas that could be best demonstrated and taught using medical patient simulation, in particular, using high fidelity human patient simulators. Curricula are currently being developed and additional classes will be implemented to instruct the FS cohort. The curricula will incorporate several environments for instruction, including lab-based and simulated microgravity-based environments. Discussion: The response from the NASA FS cohort to the initial introductory class has been positive. As a result of this effort, the MOST has identified three types of training to meet the clinical needs of the FS Office; clinical core competency training, individual clinical refresher training, and just-in-time training (specific for post-ISS Expedition landings). The MOST is continuing to work with the FS Office to augment the clinical training for the FS cohort, including the integration of Web-based learning.

Polk, J. D.↗

On-Orbit Prospective Echocardiography on International Space Station

A number of echocardiographic research projects and experiments have been flown on almost every space vehicle since 1970, but validation of standard methods and the determination of Space Normal cardiac function has not been reported to date. Advanced Diagnostics in Microgravity (ADUM) -remote guided echocardiographic technique provides a novel and effective approach to on-board assessment of cardiac physiology and structure using a just-in-time training algorithm and real-time remote guidance aboard the International Space Station (ISS). The validation of remotely guided echocardiographic techniques provides the procedures and protocols to perform scientific and clinical echocardiography on the ISS and the Moon. The objectives of this study were: 1.To confirm the ability of non-physician astronaut/cosmonaut crewmembers to perform clinically relevant remotely guided echocardiography using the Human Research Facility on board the ISS. 2.To compare the preflight, postflight and in-flight echocardiographic parameters commonly used in clinical medicine.

Hamilton, Douglas R.↗

Training for Long-Duration Space Missions: A Literature Review into Skill Retention and Generalizability

In long-duration space missions, skill retention and generalizability become ever more important as mission length increases, for it is through these capabilities that astronaut crews achieve autonomy. A framework is proposed for future research based on three types of training commonly found in operational scenarios: initial training, refresher training, and just-in-time training. One of the key points of interest identified from the body of literature is the need for a structured and quantifiable approach to characterize skill decay. Such an approach would allow gaining a deeper understanding of the mechanisms through which skill decay operates. Because simulators are used extensively in all types of training, the effects of simulator fidelity on skill retention and generalizability are paramount to understand. Some common fidelity types are defined and their effects on the human operator are discussed. From a review of the literature on all these topics, several research gaps were identified that led to three key opportunities for future research: (1) developing skill decay functions provides theoretical insights into skill decay and allows for several practical applications, such as planning refresher training, (2) the effects of simulator fidelity on skill decay functions should be investigated empirically, and (3) investigating the generalizability of skills learned in initial training to other tasks could provide space crews with greater autonomy. A cybernetic approach might give new insights.

training↗

Training for Long-Duration Space Missions: A Literature Review into Skill Retention and Generalizatility

In long-duration space missions, skill retention and generalizability become ever more important as mission length increases, for it is through these capabilities that astronaut crews achieve autonomy. A framework is proposed for future research based on three types of training commonly found in operational scenarios: initial training, refresher training, and just-in-time training. One of the key points of interest identified from the body of literature is the need for a structured and quantifiable approach to characterize skill decay. Such an approach would allow gaining a deeper understanding of the mechanisms through which skill decay operates. Because simulators are used extensively in all types of training, the effects of simulator fidelity on skill retention and generalizability are paramount to understand. Some common fidelity types are defined and their effects on the human operator are discussed. From a review of the literature on all these topics, several research gaps were identified that led to three key opportunities for future research: (1) developing skill decay functions provides theoretical insights into skill decay and allows for several practical applications, such as planning refresher training, (2) the effects of simulator fidelity on skill decay functions should be investigated empirically, and (3) investigating the generalizability of skills learned in initial training to other tasks could provide space crews with greater autonomy. A cybernetic approach might give new insights.

Pieters, Marc A.↗

Balanced Expertise Distribution in Remote Ultrasound Imaging Aboard The International Space Station (ISS)

Astronaut training for ISS operations usually ensures independent performance. With small crew size same crews also conduct all science work onboard. With diverse backgrounds, a good "match" between the existing and required skills can only be anecdotal. Furthermore, full proficiency in most of the complex tasks can be attained only through long training and practice, which may not be justified and may be impossible given the scarcity of training time. To enable a number of operational and science advancements, authors have developed a new approach to expertise distribution in time and among the space and ground personnel. Methods: As part of NASA Operational Ultrasound Project (1998-2003) and the NASA-solicited experiment "Advanced Diagnostic Ultrasound in Microgravity-ADUM" (P.I. -S.D., ongoing), the authors have created a "Balanced Expertise Distribution" approach to perform complex ultrasound imaging tasks on ISS for both operational and science use. The four components of expertise are a) any pre-existing pertinent expertise; b) limited preflight training c) adaptive onboard proficiency enhancement tools; d) real-time ' guidance from the ground. Throughout the pre-flight training and flight time preceding the experiments, the four components are shaped in a dynamic fashion to meet in an optimum combination during the experiment sessions. Results: Procedure validation sessions and feasibility studies have given encouraging results. While several successful real-time remote guidance sessions have been conducted on ISS, Expedition 8 is the first to use an "on-orbit proficiency enhancement" tool. Conclusions: In spite of severely limited training time, daring peer-reviewed research and operational enhancements are feasible through a balanced distribution of expertise in time, as well as among the crewmembers and ground personnel. This approach shows great promise for biomedical research, but may be applicable for other areas of micro gravity-based science

Sargsyan, Ashot↗

Training effectiveness of an intelligent tutoring system for a propulsion console trainer

A formative evaluation was conducted on an Intelligent Tutoring System (ITS) developed for tasks performed on the Propulsion Console. The ITS, which was developed primarily as a research tool, provides training on use of the Manual Select Keyboard (MSK). Three subjects completed three phases of training using the ITS: declarative, speed, and automaticity training. Data were collected on several performance dimensions, including training time, number of trials performed in each training phase, and number of errors. Information was also collected regarding the user interface and content of training. Suggestions for refining the ITS are discussed. Further, future potential uses and limitations of the ITS are discussed. The results provide an initial demonstration of the effectiveness of the Propulsion Console ITS and indicate the potential benefits of this form of training tool for related tasks.

Johnson, Debra Steele↗

Quantitative analysis of volatile organic compounds using ion mobility spectra and cascade correlation neural networks

Ion Mobility Spectrometry (IMS) is a powerful technique for trace organic analysis in the gas phase. Quantitative measurements are difficult, because IMS has a limited linear range. Factors that may affect the instrument response are pressure, temperature, and humidity. Nonlinear calibration methods, such as neural networks, may be ideally suited for IMS. Neural networks have the capability of modeling complex systems. Many neural networks suffer from long training times and overfitting. Cascade correlation neural networks train at very fast rates. They also build their own topology, that is a number of layers and number of units in each layer. By controlling the decay parameter in training neural networks, reproducible and general models may be obtained.

Harrington, Peter DEB.↗

Common Habitat Design for Microgravity, Artificial Gravity and Partial Gravity in a Safe Haven Configuration

As space exploration efforts advance towards the returning to Lunar surface and later to Mars, new challenges emerge, and habitation becomes one of them. Having a custom manufacturing line for deep space transit and surface habitats (the Moon or Mars) implies a longer design and production line. Instead of spending great amounts of money and time on custom designs a common development has been explored where the interior architectural functions can be multifunctional, capable of being adapted into distinct gravity conditions. The concept developed for a common design is capable of being adapted to two (2) different layout configurations for a common habitat in a safe haven design: (#1) a habitat that could be used both as a deep space transport in micro gravity and on Mars surface partial gravity; and (#2) a habitat that could be used both as a deep space transport in artificial gravity and on Mars surface partial gravity. These designs have the potential to diminish manufacturing time and cost, but also reducing crew training time increasing crew adaptability to their habitation and gravity condition.

Paola M Gonzalez Marquez↗

Spacelab mission dependent training parametric resource requirements study

Training flows were developed for typical missions, resource relationships analyzed, and scheduling optimization algorithms defined. Parametric analyses were performed to study the effect of potential changes in mission model, mission complexity and training time required on the resource quantities required to support training of payload or mission specialists. Typical results of these analyses are presented both in graphic and tabular form.

Ogden, D. H.↗

Communicating Medical Needs to Non-Medical Managers

Differences in communication styles and languages between groups often lead to miscommunication, confusion, and/or frustration. Engineers, computer specialists, clinicians, and managers often utilize the English language in very different ways, with different groups using the same words to represent different concepts ("complaint" is a typical example). In addition, medical issues are often perceived as "off-nominal" and not "primary mission tasks" by managers, which can cause them to assign lower priorities to medical training time and resources. Knowledge bases differ due to variations in training and skill sets, and the goals (both immediate and long-term) of the communicators may also vary, with managers being primarily concerned with overall mission objectives, while clinicians focus on individual or group health issues. Furthermore, true communication is only possible when clinicians possess a deep understanding of mission requirements as well as the ability to communicate medical requirements on a priority basis using risk assessment, added value, and cost benefit analysis. These understandable differences may contribute to difficulties in expressing concerns and ideas in an efficient manner, particularly in projects, such as the space program or many military operations, where these varied groups must collaborate, and where the final decisions must be made by fully informed mission commanders. Methods: Three scenario-based approaches were developed utilizing decision trees and problem based learning, to help define and integrate these concepts. Results: Use of these techniques by NASA and military personnel will be presented. Discussion: To enhance communication, particularly of medical needs, one must identify the concerns and motivating factors for the other groups; for example, members of management may focus on financial concerns, a desire for risk mitigation, public perceptions, mission objectives, etc. Training clinicians to frame issues in these terms may lead to better understanding of the medical concerns by other groups.

Bacal, Kira↗

Limitations and Feasibility of Mini X-Ray Devices in Space Environments

LIMITATIONS AND FEASIBILITY OF MINI X-RAY DEVICES IN SPACE ENVIRONMENTS As space exploration advances toward long-duration missions, reliable medical diagnostic tools become increasingly critical. The miniature x-ray (XR) technology demonstrations by the Exploration Medical Capability (ExMC) and the Exploration Medical Integrated Product Team (XMIPT) aim to assess the feasibility and utility of miniature XR devices in spaceflight. This abstract explores the limitations of current miniature XR systems, the challenges of training crew members, the potential role of clinical decision support systems (CDSS), and the feasibility of ground-based image interpretation. We also propose the integration of miniature XR into other ExMC efforts aimed at identifying the capabilities and resources needed for future exploration class missions. One of the primary challenges with miniature XR devices is the ability to achieve specific anatomical views, particularly in the confined and weightless conditions of a spacecraft. Operators may struggle to acquire diagnostic-quality images when space is limited for proper patient positioning and the volume of the imaging device. Since space radiation and detector limitations may further impact image quality, the flexibility of the operating procedures of these devices will be critical for their success in space applications. CHALLENGES IN TRAINING CREW TO OPERATE IMAGING DEVICES Training in the skills necessary to acquire diagnostic-quality scans may be a barrier for non-clinician crewmembers. The curriculum developed for crew medical officers (CMOs) will require simplification and adaptation to fit into the highly truncated pre-flight training period. Therefore, hands-on familiarization and simulation, both pre-flight and just-in-time training during missions, will be crucial to ensuring the crew can operate the devices in real-life situations. The ability to adjust acquisition parameters must be simplified or made automatic through exam selections on equipment user interfaces, and subject and operator positioning should be assisted with laser guidance and pictorial guides. POTENTIAL FOR CDSS OR ARTIFICIAL INTELLIGENCE (AI)-ASSISTED CDSS CDSS and AI-assisted CDSS offer significant promise in assisting crew members with limited medical training. These systems could provide real-time feedback on image quality and interpretation, helping to mitigate the risks of human error during space missions. Integrating procedural guidance tools, such as virtual and augmented reality, will support crewmembers in accurately positioning patients and obtaining high-quality images. However, the success of such systems will depend on the development of robust training datasets, integration with spaceflight-rated hardware, and the medical decision-making capabilities of operators. FEASIBILITY OF GROUND INTERPRETATION AND DATA TRANSMISSION Reliance on ground-based interpretation may prove difficult for acute care during exploration class-missions due to delays in transmission with increasing distance from Earth or complete communication blackout periods. In such instances where immediate interpretation for clinical intervention is required, crew must be able to interpret the images independently or utilize AI-based assistance to do so. File sizes for XR exams can also be large if numerous images are acquired and bandwidth constraints may limit data transmissions for both radiography and ultrasound exams. FUTURE WORK AND INTEGRATION INTO THE EVIDENCE LIBRARY Future work proposes integrating miniature XR devices into NASA’s Evidence Library to address medical conditions identified as significant contributors to crew morbidity and mortality. The possibility of combining miniature XR with other imaging modalities, such as ultrasound devices, is also under investigation. In conclusion, while miniature XR technology holds potential for extraterrestrial medical systems, there are significant challenges to overcome. Training, integration of AI tools, dedicated exam protocols for microgravity, and improved data transmission systems will be key to realizing the full benefits of miniature XR technology in space.

A M Nelson↗

Locomotion training of legged robots using hybrid machine learning techniques

In this study artificial neural networks and fuzzy logic are used to control the jumping behavior of a three-link uniped robot. The biped locomotion control problem is an increment of the uniped locomotion control. Study of legged locomotion dynamics indicates that a hierarchical controller is required to control the behavior of a legged robot. A structured control strategy is suggested which includes navigator, motion planner, biped coordinator and uniped controllers. A three-link uniped robot simulation is developed to be used as the plant. Neurocontrollers were trained both online and offline. In the case of on-line training, a reinforcement learning technique was used to train the neurocontroller to make the robot jump to a specified height. After several hundred iterations of training, the plant output achieved an accuracy of 7.4%. However, when jump distance and body angular momentum were also included in the control objectives, training time became impractically long. In the case of off-line training, a three-layered backpropagation (BP) network was first used with three inputs, three outputs and 15 to 40 hidden nodes. Pre-generated data were presented to the network with a learning rate as low as 0.003 in order to reach convergence. The low learning rate required for convergence resulted in a very slow training process which took weeks to learn 460 examples. After training, performance of the neurocontroller was rather poor. Consequently, the BP network was replaced by a Cerebeller Model Articulation Controller (CMAC) network. Subsequent experiments described in this document show that the CMAC network is more suitable to the solution of uniped locomotion control problems in terms of both learning efficiency and performance. A new approach is introduced in this report, viz., a self-organizing multiagent cerebeller model for fuzzy-neural control of uniped locomotion is suggested to improve training efficiency. This is currently being evaluated for a possible patent by NASA, Johnson Space Center. An alternative modular approach is also developed which uses separate controllers for each stage of the running stride. A self-organizing fuzzy-neural controller controls the height, distance and angular momentum of the stride. A CMAC-based controller controls the movement of the leg from the time the foot leaves the ground to the time of landing. Because the leg joints are controlled at each time step during flight, movement is smooth and obstacles can be avoided. Initial results indicate that this approach can yield fast, accurate results.

Simon, William E.↗