Doctor of Philosophy

dissertationParalysis due to spinal cord injury or stroke can leave a person with intact peripheral nerves and muscles, but deficient volitional motor control, thereby reducing their health and quality of life. Functional neuromuscular stimulation (FNS) has been widely studied and employed in clinical devices to aid and restore lost or deficient motor function. Strong, selective, and fatigue-resistant muscle forces can be evoked by asynchronously stimulating small independent groups of motor neurons via multiple intrafascicular electrodes on an implanted Utah slanted electrode array (USEA). Determining the parameters of asynchronous intrafascicular multi-electrode stimulation (aIFMS), i.e., the per-electrode stimulus intensities and the interelectrode stimulus phasing, to evoke precise muscle force or joint motion presents unique challenges because this system has multiple-inputs, the n independently stimulated electrodes, but only one measurable output, the evoked endpoint isometric force or joint position. This dissertation presents three studies towards developing robust real-time control of aIFMS. The first study developed an adaptive feedforward algorithm for selecting aIFMS per-electrode stimulus intensities and interelectrode stimulus phasing to evoke a variety of isometric ankle plantar-flexion force trajectories. In simulation and experiments, desired step, sinusoidal, and more-complex time-varying isometric forces were successfully evoked. The second study developed a closed-loop feedback control method for determining aIFMS per-electrode stimulus intensities to evoke precise single-muscle isometric ankle plantar-flexion force trajectories, in real-time. Using a proportional closed-loop force-feedback controller, desired step, sinusoid, and more complex time-varying forces were evoked with good response characteristics, even in the presence of nonlinear system dynamics, such as muscle fatigue. The third study adapted and extended the closed-loop feedback controller to the more demanding task of controlling joint position in the presence of opposing joint torques. A proportional-plus-velocity-plus-integral (PIV) joint-angle feedback controller evoked and held desired steps in position with responses th a t were stable, consistent, and robust to disturbances. The controller evoked smooth ramp-up (concentric) and ramp-down (eccentric) motion, as well as precise slow moving sinusoidal motion. The control methods developed in this dissertation provide a foundation for new lower-limb FNS-based neuroprostheses that can generate sustained and coordinated muscle forces and joint motions that will be desired by paralyzed individuals on a daily basis. proportional-plus-velocity-plus-integral (PIV) joint-angle feedback controller evoked and held desired steps in position with responses th a t were stable, consistent, and robust to disturbances. The controller evoked smooth ramp-up (concentric) and ramp-down (eccentric) motion, as well as precise slow moving sinusoidal motion. The control methods developed in this dissertation provide a foundation for new lower-limb FNS-based neuroprostheses that can generate sustained and coordinated muscle forces and joint motions that will be desired by paralyzed individuals on a daily basis

Neuro-fuzzy modeling of multi-field surface neuroprostheses for hand grasp

154 p.Las neuroprótesis aplican pulsos eléctricos a los nervios periféricos con el objetivo de sustituir funciones motrices/sensoriales perdidas, dando asistencia e influyendo positivamente en la rehabilitación motriz de personas con disfunciones motrices causadas por trastornos neurológicos. La complejidad de la neuroanatomía del antebrazo y la mano, su dimensionalidad, las diversas tareas no-cíclicas, la variabilidad de movimientos entre sujetos y la reducida selectividad de las neuroprótesis superficiales, ha dado lugar al diseño de un número reducido de neuroprótesis orientadas a agarres básicos. La posibilidad de hacer más selectiva la estimulación mediante los electrodos multi-campo, junto con el conocimiento sobre la incomodidad y los movimientos que genera la aplicación de la estimulación eléctrica funcional (FES por sus siglas en inglés) en miembro superior, podrían ser base fundamental para el desarrollo de neuroprótesis de agarre más avanzadas. La presente tesis describe un análisis de incomodidad como resultado de FES en el miembro superior, y propone modelos neuro-difusos para neuroprótesis de agarre tanto para personas sanas como para personas con trastornos neurológicos. El conocimiento generado respecto a la incomodidad puede ser utilizado como guía para desarrollar aplicaciones de FES de miembro superior más cómodas. Del mismo modo, los modelos propuestos en esta tesis pueden ser utilizados para apoyar el diseño y la validación de sistemas de control avanzados en neuroprótesis dirigidas a la función de agarre.Tecnalia; Intelligent Control Research Grou

Multi-Muscle FES Force Control of the Human Arm for Arbitrary Goals

We present a method for controlling a neuroprosthesis for a paralyzed human arm using functional electrical stimulation (FES) and characterize the errors of the controller. The subject has surgically implanted electrodes for stimulating muscles in her shoulder and arm. Using input/output data, a model mapping muscle stimulations to isometric endpoint forces measured at the subject’s hand was identified. We inverted the model of this redundant and coupled multiple-input multiple-output system by minimizing muscle activations and used this inverse for feedforward control. The magnitude of the total root mean square error over a grid in the volume of achievable isometric endpoint force targets was 11% of the total range of achievable forces. Major sources of error were random error due to trial-to-trial variability and model bias due to nonstationary system properties. Because the muscles working collectively are the actuators of the skeletal system, the quantification of errors in force control guides designs of motion controllers for multi-joint, multi-muscle FES systems that can achieve arbitrary goals

Advancing Medical Technology for Motor Impairment Rehabilitation: Tools, Protocols, and Devices

Excellent motor control skills are necessary to live a high-quality life. Activities such as walking, getting dressed, and feeding yourself may seem mundane, but injuries to the neuromuscular system can render these tasks difficult or even impossible to accomplish without assistance. Statistics indicate that well over 100 million people are affected by diseases or injuries, such as stroke, Parkinson’s Disease, Multiple Sclerosis, Cerebral Palsy, peripheral nerve injury, spinal cord injury, and amputation, that negatively impact their motor abilities. This wide array of injuries presents a challenge to the medical field as optimal treatment paradigms are often difficult to implement due to a lack of availability of appropriate assessment tools, the inability for people to access the appropriate medical centers for treatment, or altogether gaps in technology for treating the underlying impairments causing the disability. Addressing each of these challenges will improve the treatment of movement impairments, provide more customized and continuous treatment to a larger number of patients, and advance rehabilitative and assistive device technology. In my research, the key approach was to develop tools to assess and treat upper extremity movement impairment. In Chapter 2.1, I challenged a common biomechanical[GV1] modeling technique of the forearm. Comparing joint torque values through inverse dynamics simulation between two modeling platforms, I discovered that representing the forearm as a single cylindrical body was unable to capture the inertial parameters of a physiological forearm which is made up of two segments, the radius and ulna. I split the forearm segment into a proximal and distal segment, with the rationale being that the inertial parameters of the proximal segment could be tuned to those of the ulna and the inertial parameters of the distal segment could be tuned to those of the radius. Results showed a marked increase in joint torque calculation accuracy for those degrees of freedom that are affected by the inertial parameters of the radius and ulna. In Chapter 2.2, an inverse kinematic upper extremity model was developed for joint angle calculations from experimental motion capture data, with the rationale being that this would create an easy-to-use tool for clinicians and researchers to process their data. The results show accurate angle calculations when compared to algebraic solutions. Together, these chapters provide easy-to-use models and tools for processing movement assessment data. In Chapter 3.1, I developed a protocol to collect high-quality movement data in a virtual reality task that is used to assess hand function as part of a Box and Block Test. The goal of this chapter is to suggest a method to not only collect quality data in a research setting but can also be adapted for telehealth and at home movement assessment and rehabilitation. Results indicate that the data collected in this protocol are good and the virtual nature of this approach can make it a useful tool for continuous, data driven care in clinic or at home. In Chapter 3.2 I developed a high-density electromyography device for collecting motor unit action potentials of the arm. Traditional surface electromyography is limited by its ability to obtain signals from deep muscles and can also be time consuming to selectively place over appropriate muscles. With this high-density approach, muscle coverage is increased, placement time is decreased, and deep muscle activity can potentially be collected due to the high-density nature of the device[GV2] . Furthermore, the high-density electromyography device is built as a precursor to a high-density electromyography-electrical stimulation device for functional electrical stimulation. The customizable nature of the prototype in Chapter 3.2 allows for the implementation both recording and stimulating electrodes. Furthermore, signal results show that the electromyography data obtained from the device are of high quality and are correlated with gold standard surface electromyography sensors. One key factor in a device that can record and then stimulate based on the information from the recorded signals is an accurate movement intent decoder. High-quality movement decoders have been designed by closed-loop device controllers in the past, but they still struggle when the user interacts with objects of varying weight due to underlying alterations in muscle signals. In Chapter 4, I investigate this phenomenon by administering an experiment where participants perform a Box and Block Task with objects of 3 different weights, 0 kg, 0.02 kg, and 0.1 kg. Electromyography signals of the participants right arm were collected and co-contraction levels between antagonistic muscles were analyzed to uncover alterations in muscle forces and joint dynamics. Results indicated contraction differences between the conditions and also between movement stages (contraction levels before grabbing the block vs after touching the block) for each condition. This work builds a foundation for incorporating object weight estimates into closed-loop electromyography device movement decoders. Overall, we believe the chapters in this thesis provide a basis for increasing availability to movement assessment tools, increasing access to effective movement assessment and rehabilitation, and advance the medical device and technology field

Description of motor control using inverse models

Humans can perform complicated movements like writing or running without giving them much thought. The scientific understanding of principles guiding the generation of these movements is incomplete. How the nervous system ensures stability or compensates for injury and constraints – are among the unanswered questions today. Furthermore, only through movement can a human impose their will and interact with the world around them. Damage to a part of the motor control system can lower a person’s quality of life. Understanding how the central nervous system (CNS) forms control signals and executes them helps with the construction of devices and rehabilitation techniques. This allows the user, at least in part, to bypass the damaged area or replace its function, thereby improving their quality of life. CNS forms motor commands, for example a locomotor velocity or another movement task. These commands are thought to be processed through an internal model of the body to produce patterns of motor unit activity. An example of one such network in the spinal cord is a central pattern generator (CPG) that controls the rhythmic activation of synergistic muscle groups for overground locomotion. The descending drive from the brainstem and sensory feedback pathways initiate and modify the activity of the CPG. The interactions between its inputs and internal dynamics are still under debate in experimental and modelling studies. Even more complex neuromechanical mechanisms are responsible for some non-periodic voluntary movements. Most of the complexity stems from internalization of the body musculoskeletal (MS) system, which is comprised of hundreds of joints and muscles wrapping around each other in a sophisticated manner. Understanding their control signals requires a deep understanding of their dynamics and principles, both of which remain open problems. This dissertation is organized into three research chapters with a bottom-up investigation of motor control, plus an introduction and a discussion chapter. Each of the three research chapters are organized as stand-alone articles either published or in preparation for submission to peer-reviewed journals. Chapter two introduces a description of the MS kinematic variables of a human hand. In an effort to simulate human hand motor control, an algorithm was defined that approximated the moment arms and lengths of 33 musculotendon actuators spanning 18 degrees of freedom. The resulting model could be evaluated within 10 microseconds and required less than 100 KB of memory. The structure of the approximating functions embedded anatomical and functional features of the modelled muscles, providing a meaningful description of the system. The third chapter used the developments in musculotendon modelling to obtain muscle activity profiles controlling hand movements and postures. The agonist-antagonist coactivation mechanism was responsible for producing joint stability for most degrees of freedom, similar to experimental observations. Computed muscle excitations were used in an offline control of a myoelectric prosthesis for a single subject. To investigate the higher-order generation of control signals, the fourth chapter describes an analytical model of CPG. Its parameter space was investigated to produce forward locomotion when controlled with a desired speed. The model parameters were varied to produce asymmetric locomotion, and several control strategies were identified. Throughout the dissertation the balance between analytical, simulation, and phenomenological modelling for the description of simple and complex behavior is a recurrent theme of discussion

Down-Conditioning of Soleus Reflex Activity using Mechanical Stimuli and EMG Biofeedback

Spasticity is a common syndrome caused by various brain and neural injuries, which can severely impair walking ability and functional independence. To improve functional independence, conditioning protocols are available aimed at reducing spasticity by facilitating spinal neuroplasticity. This down-conditioning can be performed using different types of stimuli, electrical or mechanical, and reflex activity measures, EMG or impedance, used as biofeedback variable. Still, current results on effectiveness of these conditioning protocols are incomplete, making comparisons difficult. We aimed to show the within-session task- dependent and across-session long-term adaptation of a conditioning protocol based on mechanical stimuli and EMG biofeedback. However, in contrast to literature, preliminary results show that subjects were unable to successfully obtain task-dependent modulation of their soleus short-latency stretch reflex magnitude

On the Utility of Representation Learning Algorithms for Myoelectric Interfacing

Electrical activity produced by muscles during voluntary movement is a reflection of the firing patterns of relevant motor neurons and, by extension, the latent motor intent driving the movement. Once transduced via electromyography (EMG) and converted into digital form, this activity can be processed to provide an estimate of the original motor intent and is as such a feasible basis for non-invasive efferent neural interfacing. EMG-based motor intent decoding has so far received the most attention in the field of upper-limb prosthetics, where alternative means of interfacing are scarce and the utility of better control apparent. Whereas myoelectric prostheses have been available since the 1960s, available EMG control interfaces still lag behind the mechanical capabilities of the artificial limbs they are intended to steer—a gap at least partially due to limitations in current methods for translating EMG into appropriate motion commands. As the relationship between EMG signals and concurrent effector kinematics is highly non-linear and apparently stochastic, finding ways to accurately extract and combine relevant information from across electrode sites is still an active area of inquiry.This dissertation comprises an introduction and eight papers that explore issues afflicting the status quo of myoelectric decoding and possible solutions, all related through their use of learning algorithms and deep Artificial Neural Network (ANN) models. Paper I presents a Convolutional Neural Network (CNN) for multi-label movement decoding of high-density surface EMG (HD-sEMG) signals. Inspired by the successful use of CNNs in Paper I and the work of others, Paper II presents a method for automatic design of CNN architectures for use in myocontrol. Paper III introduces an ANN architecture with an appertaining training framework from which simultaneous and proportional control emerges. Paper Iv introduce a dataset of HD-sEMG signals for use with learning algorithms. Paper v applies a Recurrent Neural Network (RNN) model to decode finger forces from intramuscular EMG. Paper vI introduces a Transformer model for myoelectric interfacing that do not need additional training data to function with previously unseen users. Paper vII compares the performance of a Long Short-Term Memory (LSTM) network to that of classical pattern recognition algorithms. Lastly, paper vIII describes a framework for synthesizing EMG from multi-articulate gestures intended to reduce training burden

Development of a hybrid robotic system based on an adaptive and associative assistance for rehabilitation of reaching movement after stroke

Stroke causes irreversible neurological damage. Depending on the location and the size of this brain injury, different body functions could result affected. One of the most common consequences is motor impairments. The level of motor impairment affectation varies between post-stroke subjects, but often, it hampers the execution of most activities of daily living. Consequently, the quality of life of the stroke population is severely decreased. The rehabilitation of the upper-limb motor functions has gained special attention in the scientific community due the poor reported prognosis of post-stroke patients for recovering normal upper-extremity function after standard rehabilitation therapy. Driven by the advance of technology and the design of new rehabilitation methods, the use of robot devices, functional electrical stimulation and brain-computer interfaces as a neuromodulation system is proposed as a novel and promising rehabilitation tools. Although the uses of these technologies present potential benefits with respect to standard rehabilitation methods, there still are some milestones to be addressed for the consolidation of these methods and techniques in clinical settings. Mentioned evidences reflect the motivation for this dissertation. This thesis presents the development and validation of a hybrid robotic system based on an adaptive and associative assistance for rehabilitation of reaching movements in post-stroke subjects. The hybrid concept refers the combined use of robotic devices with functional electrical stimulation. Adaptive feature states a tailored assistance according to the users’ motor residual capabilities, while the associative term denotes a precise pairing between the users’ motor intent and the peripheral hybrid assistance. The development of the hybrid platform comprised the following tasks: 1. The identification of the current challenges for hybrid robotic system, considering twofold perspectives: technological and clinical. The hybrid systems submitted in literature were critically reviewed for such purpose. These identified features will lead the subsequent development and method framed in this work. 2. The development and validation of a hybrid robotic system, combining a mechanical exoskeleton with functional electrical stimulation to assist the execution of functional reaching movements. Several subsystems are integrated within the hybrid platform, which interact each other to cooperatively complement the rehabilitation task. Complementary, the implementation of a controller based on functional electrical stimulation to dynamically adjust the level of assistance is addressed. The controller is conceived to tackle one of the main limitations when using electrical stimulation, i.e. the highly nonlinear and time-varying muscle response. An experimental procedure was conducted with healthy and post-stroke patients to corroborate the technical feasibility and the usability evaluation of the system. 3. The implementation of an associative strategy within the hybrid platform. Three different strategies based on electroencephalography and electromyography signals were analytically compared. The main idea is to provide a precise temporal association between the hybrid assistance delivered at the periphery (arm muscles) and the users’ own intention to move and to configure a feasible clinical setup to be use in real rehabilitation scenarios. 4. Carry out a comprehensive pilot clinical intervention considering a small cohort of patient with post-stroke patients to evaluate the different proposed concepts and assess the feasibility of using the hybrid system in rehabilitation settings. In summary, the works here presented prove the feasibility of using the hybrid robotic system as a rehabilitative tool with post-stroke subjects. Moreover, it is demonstrated the adaptive controller is able to adjust the level of assistance to achieve successful tracking movement with the affected arm. Remarkably, the accurate association in time between motor cortex activation, represented through the motor-related cortical potential measured with electroencephalography, and the supplied hybrid assistance during the execution of functional (multidegree of freedom) reaching movement facilitate distributed cortical plasticity. These results encourage the validation of the overall hybrid concept in a large clinical trial including an increased number of patients with a control group, in order to achieve more robust clinical results and confirm the presented herein.Programa Oficial de Doctorado en Ingeniería Eléctrica, Electrónica y AutomáticaPresidente: Ramón Ceres Ruiz.- Secretario: Luis Enrique Moreno Lorente.- Vocal: Antonio Olivier