Muscle Synergies Facilitate Computational Prediction of Subject-Specific Walking Motions.

Researchers have explored a variety of neurorehabilitation approaches to restore normal walking function following a stroke. However, there is currently no objective means for prescribing and implementing treatments that are likely to maximize recovery of walking function for any particular patient. As a first step toward optimizing neurorehabilitation effectiveness, this study develops and evaluates a patient-specific synergy-controlled neuromusculoskeletal simulation framework that can predict walking motions for an individual post-stroke. The main question we addressed was whether driving a subject-specific neuromusculoskeletal model with muscle synergy controls (5 per leg) facilitates generation of accurate walking predictions compared to a model driven by muscle activation controls (35 per leg) or joint torque controls (5 per leg). To explore this question, we developed a subject-specific neuromusculoskeletal model of a single high-functioning hemiparetic subject using instrumented treadmill walking data collected at the subject's self-selected speed of 0.5 m/s. The model included subject-specific representations of lower-body kinematic structure, foot-ground contact behavior, electromyography-driven muscle force generation, and neural control limitations and remaining capabilities. Using direct collocation optimal control and the subject-specific model, we evaluated the ability of the three control approaches to predict the subject's walking kinematics and kinetics at two speeds (0.5 and 0.8 m/s) for which experimental data were available from the subject. We also evaluated whether synergy controls could predict a physically realistic gait period at one speed (1.1 m/s) for which no experimental data were available. All three control approaches predicted the subject's walking kinematics and kinetics (including ground reaction forces) well for the model calibration speed of 0.5 m/s. However, only activation and synergy controls could predict the subject's walking kinematics and kinetics well for the faster non-calibration speed of 0.8 m/s, with synergy controls predicting the new gait period the most accurately. When used to predict how the subject would walk at 1.1 m/s, synergy controls predicted a gait period close to that estimated from the linear relationship between gait speed and stride length. These findings suggest that our neuromusculoskeletal simulation framework may be able to bridge the gap between patient-specific muscle synergy information and resulting functional capabilities and limitations

Nonlinear modeling of FES-supported standing-up in paraplegia for selection of feedback sensors

This paper presents analysis of the standing-up manoeuvre in paraplegia considering the body supportive forces as a potential feedback source in functional electrical stimulation (FES)-assisted standing-up. The analysis investigates the significance of arm, feet, and seat reaction signals to the human body center-of-mass (COM) trajectory reconstruction. The standing-up behavior of eight paraplegic subjects was analyzed, measuring the motion kinematics and reaction forces to provide the data for modeling. Two nonlinear empirical modeling methods are implemented-Gaussian process (GP) priors and multilayer perceptron artificial neural networks (ANN)-and their performance in vertical and horizontal COM component reconstruction is compared. As the input, ten sensory configurations that incorporated different number of sensors were evaluated trading off the modeling performance for variables chosen and ease-of-use in everyday application. For the purpose of evaluation, the root-mean-square difference was calculated between the model output and the kinematics-based COM trajectory. Results show that the force feedback in COM assessment in FES assisted standing-up is comparable alternative to the kinematics measurement systems. It was demonstrated that the GP provided better modeling performance, at higher computational cost. Moreover, on the basis of averaged results, the use of a sensory system incorporating a six-dimensional handle force sensor and an instrumented foot insole is recommended. The configuration is practical for realization and with the GP model achieves an average accuracy of COM estimation 16 /spl plusmn/ 1.8 mm in horizontal and 39 /spl plusmn/ 3.7 mm in vertical direction. Some other configurations analyzed in the study exhibit better modeling accuracy, but are less practical for everyday usage

Predicting muscle forces of individuals with hemiparesis following stroke

<p>Abstract</p> <p>Background</p> <p>Functional electrical stimulation (FES) has been used to improve function in individuals with hemiparesis following stroke. An ideal functional electrical stimulation (FES) system needs an accurate mathematical model capable of designing subject and task-specific stimulation patterns. Such a model was previously developed in our laboratory and shown to predict the isometric forces produced by the quadriceps femoris muscles of able-bodied individuals and individuals with spinal cord injury in response to a wide range of clinically relevant stimulation frequencies and patterns. The aim of this study was to test our isometric muscle force model on the quadriceps femoris, ankle dorsiflexor, and ankle plantar-flexor muscles of individuals with post-stroke hemiparesis.</p> <p>Methods</p> <p>Subjects were seated on a force dynamometer and isometric forces were measured in response to a range of stimulation frequencies (10 to 80-Hz) and 3 different patterns. Subject-specific model parameter values were obtained by fitting the measured force responses from 2 stimulation trains. The model parameters thus obtained were then used to obtain predicted forces for a range of frequencies and patterns. Predicted and measured forces were compared using intra-class correlation coefficients, r²values, and model error relative to the physiological error (variability of measured forces).</p> <p>Results</p> <p>Results showed excellent agreement between measured and predicted force-time responses (r²>0.80), peak forces (ICCs>0.84), and force-time integrals (ICCs>0.82) for the quadriceps, dorsiflexor, and plantar-fexor muscles. The <it>model error </it>was within or below the +95% confidence interval of the <it>physiological error </it>for >88% comparisons between measured and predicted forces.</p> <p>Conclusion</p> <p>Our results show that the model has potential to be incorporated as a feed-forward controller for predicting subject-specific stimulation patterns during FES.</p

Switching Adaptive Concurrent Learning Control for Powered Rehabilitation Machines with FES

Interfacing robotic devices with humans presents significant control challenges, as the control algorithms governing these machines must accommodate for the inherent variability among individuals. This requirement necessitates the system’s ability to adapt to changes in the environment, particularly in the context of human-in-the-loop applications, wherein the system must identify specific features of the human interacting with the machine. In the field of rehabilitation, one promising approach for exercise-based rehabilitation involves the integration of hybrid rehabilitation machines, combining robotic devices such as motorized bikes and exoskeletons with functional electrical stimulation (FES) applied on lower-limb muscles. This integrated approach offers the potential for repetitive training, reduced therapist workload, improved range of motion, and therapeutic benefits. However, conducting prolonged rehabilitation sessions to maximize functional recovery using these hybrid machines imposes several difficulties. Firstly, the design and analysis of adaptive controllers are motivated, but challenges exist in coping with the inherent switching effects associated with hybrid machines. Notably, the transitions between gait phases and the dynamic switching of inputs between active lower-limb muscles and electric motors and their incorporation in the control design remain an open problem for the research community. Secondly, the system must effectively compensate for the influence of human input, which can be viewed as an external disturbance in the closed-loop system during rehabilitation. Robust methods for understanding and adapting to the variations in human input are critical for ensuring stability and accurate control of the human-robot closed-loop system. Lastly, FES-induced muscle fatigue diminishes the human torque contribution to the rehabilitation task, leading to input saturation and potential instabilities as the duration of the exercise extends. Overcoming this challenge requires the development of control algorithms that can adapt to variations in human performance by dynamically adjusting the control parameters accordingly. Consequently, the development of rehabilitative devices that effectively interface with humans requires the design and implementation of control algorithms capable of adapting to users with varying muscle and kinematic characteristics. In this regard, adaptive-based control methods provide tools for addressing the uncertainties in human-robot dynamics within exercise-based rehabilitation using FES, while ensuring stability and robustness in the human-robot closed-loop system. This dissertation develops adaptive controllers to enhance the effectiveness of exercise-based rehabilitation using FES. The objectives include the design and evaluation of adaptive control algorithms that effectively handle the switching effects inherent in hybrid machines, adapt to compensate for human input, and account for input saturation due to muscle fatigue. The control designs leverage kinematic and torque feedback and ensure the stability of the human-robot closed-loop system. These controllers have the potential to significantly enhance the practicality and effectiveness of assistive technologies in both clinical and community settings. In Chapter 1, the motivation to design switching adaptive closed-loop controllers for motorized FES-cycling and powered exoskeletons is described. A survey of closed-loop kinematic control methods related to the tracking objectives in the subsequent chapters of the dissertation is also introduced. In Chapter 2, the dynamic models for cycling and bipedal walking are described: (i) a stationary FES-cycling model with nonlinear dynamics and switched control inputs are introduced based on published literature. The muscle stimulation pattern is defined based on the kinematic effectiveness of the rider, which depends on the crank angle. (ii) A phase-dependent bipedal walking system model with switched dynamics is introduced to control a 4-degrees-of-freedom (DoF) lower-limb exoskeleton assuming single stance support. Moreover, the experimental setup of the cycle-rider and lower-limb exoskeleton system are described. Chapter 3 presents a switched concurrent learning adaptive controller for cadence tracking using the cycle-rider model. The control design is decoupled for the muscles and electric motor. An FES controller is developed with minimal parameters, capable of generating bounded muscle responses with an adjustable saturation limit. The electric motor controller employs an adaptive-based method that estimates uncertain parameters in the cycle-rider system and leverages the muscle input as a feedforward term to improve the tracking of crank trajectories. The adaptive motor controller and saturated muscle controller are implemented in able-bodied individuals and people with movement disorders. Three cycling trials were conducted to demonstrate the feasibility of tracking different crank trajectories with the same set of control parameters across all participants. The developed adaptive controller requires minimal tuning and handles rider uncertainty while ensuring predictable and satisfactory performance. This result has the potential to facilitate the widespread implementation of adaptive closed-loop controllers for FES-cycling systems in real clinical and home-based scenarios. Chapter 4 presents an integral torque tracking controller with anti-windup compensation, which achieves the dual objectives of kinematic and torque tracking (i.e., power tracking) for FES cycling. Designing an integral torque tracking controller to avoid feedback of high-order derivatives poses a significant challenge, as the integration action in the muscle loop can induce error buildup; demanding high FES input on the muscle. This can cause discomfort and accelerate muscle fatigue, thereby limiting the practical utility of the power tracking controller. To address this issue, this chapter builds upon the adaptive control for cadence tracking developed in Chapter 3 and integrates a novel torque tracking controller that allows for input saturation in the FES controller. By doing so, the controller achieves cadence and torque tracking while preventing error buildup. The analysis rigorously considers the saturation effect, and preliminary experimental results in able-bodied individuals demonstrate its feasibility. In Chapter 5, a switched concurrent learning adaptive controller is developed to achieve kinematic tracking throughout the step cycle for treadmill-based walking with a 4-DoF lower-limb hybrid exoskeleton. The developed controller leverages a phase-dependent human-exoskeleton model presented in Chapter 2. A multiple-Lyapunov stability analysis with a dwell time condition is developed to ensure exponential kinematic tracking and parameter estimation. The controller is tested in two able-bodied individuals for a six-minute walking trial and the performance of the controller is compared with a gradient descent classical adaptive controller. Chapter 6 highlights the contributions of the developed control methods and provides recommendations for future research directions

Motor control-based assessment of therapy effects in individuals post-stroke: implications for prediction of response and subject-specific modifications

Producing a coordinated motion such as walking is, at its root, the result of healthy communication pathways between the central nervous system and the musculoskeletal system. The central nervous system produces an electrical signal responsible for the excitation of a muscle, and the musculoskeletal system contains the necessary equipment for producing a movement-driving force to achieve a desired motion. Motor control refers to the ability an individual has to produce a desired motion, and the complexity of motor control is a mathematical concept stemming from how the electrical signals from the central nervous system translate to muscle activations. Exercising a high-level complexity of motor control is critical to producing a smooth motion. However, the occurrence of a sudden, detrimental neurological event like a stroke damages these connecting pathways between these two systems, and the result is a motion that is uncoordinated and energy-inefficient due to diminished motor control complexity. Stroke is a leading cause of disability with nearly 800,000 stroke victims each year in the U.S. alone, amounting to an estimated cost of $45.5B. Impaired mobility following a stroke is a widespread effect, with more than half of survivors over the age of 65 affected in this way, and up to 80% of survivors at some point experiencing hemiparesis during post-stroke recovery. As such, given the importance of independent mobility for quality of life, improving gait mechanics and mobility of stroke survivors has been the goal of rehabilitation efforts for decades. In this work, we mold together the forefronts of statistics and computational physics-based modeling to obtain insight and information about post-stroke hemiparetic gait mechanics and what drives them that would otherwise be unavailable. We expand upon previous work to quantify motor control complexity as it relates to the health of the neuromuscular system and analyze the effect of a specific therapy on motor control of individuals post-stroke. Secondly, we aim to develop a predictive model to conclude whether an individual will respond to the therapy based on kinematic and dynamic features from pre-therapy recordings. Lastly, we will determine how to individually tailor this therapy in order to achieve maximum improvement in motor control complexity in order to improve gait mechanics in individuals post-stroke

Simulation And Control At the Boundaries Between Humans And Assistive Robots

Human-machine interaction has become an important area of research as progress is made in the fields of rehabilitation robotics, powered prostheses, and advanced exercise machines. Adding to the advances in this area, a novel controller for a powered transfemoral prosthesis is introduced that requires limited tuning and explicitly considers energy regeneration. Results from a trial conducted with an individual with an amputation show self-powering operation for the prosthesis while concurrently attaining basic gait fidelity across varied walking speeds. Experience in prosthesis development revealed that, though every effort is made to ensure the safety of the human subject, limited testing of such devices prior to human trials can be completed in the current research environment. Two complementary alternatives are developed to fill that gap. First, the feasibility of implementing impulse-momentum sliding mode control on a robot that can physically replace a human with a transfemoral amputation to emulate weight-bearing for initial prototype walking tests is established. Second, a more general human simulation approach is proposed that can be used in any of the aforementioned human-machine interaction fields. Seeking this general human simulation method, a unique pair of solutions for simulating a Hill muscle-actuated linkage system is formulated. These include using the Lyapunov-based backstepping control method to generate a closed-loop tracking simulation and, motivated by limitations observed in backstepping, an optimal control solver based on differential flatness and sum of squares polynomials in support of receding horizon controlled (e.g. model predictive control) or open-loop simulations. v The backstepping framework provides insight into muscle redundancy resolution. The optimal control framework uses this insight to produce a computationally efficient approach to musculoskeletal system modeling. A simulation of a human arm is evaluated in both structures. Strong tracking performance is achieved in the backstepping case. An exercise optimization application using the optimal control solver showcases the computational benefits of the solver and reveals the feasibility of finding trajectories for human-exercise machine interaction that can isolate a muscle of interest for strengthening

Combining brain-computer interfaces and assistive technologies: state-of-the-art and challenges

In recent years, new research has brought the field of EEG-based Brain-Computer Interfacing (BCI) out of its infancy and into a phase of relative maturity through many demonstrated prototypes such as brain-controlled wheelchairs, keyboards, and computer games. With this proof-of-concept phase in the past, the time is now ripe to focus on the development of practical BCI technologies that can be brought out of the lab and into real-world applications. In particular, we focus on the prospect of improving the lives of countless disabled individuals through a combination of BCI technology with existing assistive technologies (AT). In pursuit of more practical BCIs for use outside of the lab, in this paper, we identify four application areas where disabled individuals could greatly benefit from advancements in BCI technology, namely,“Communication and Control”, “Motor Substitution”, “Entertainment”, and “Motor Recovery”. We review the current state of the art and possible future developments, while discussing the main research issues in these four areas. In particular, we expect the most progress in the development of technologies such as hybrid BCI architectures, user-machine adaptation algorithms, the exploitation of users’ mental states for BCI reliability and confidence measures, the incorporation of principles in human-computer interaction (HCI) to improve BCI usability, and the development of novel BCI technology including better EEG devices