Achieving Practical Functional Electrical Stimulation-driven Reaching Motions In An Individual With Tetraplegia

Functional electrical stimulation (FES) is a promising technique for restoring the ability to complete reaching motions to individuals with tetraplegia due to a spinal cord injury (SCI). FES has proven to be a successful technique for controlling many functional tasks such as grasping, standing, and even limited walking. However, translating these successes to reaching motions has proven difficult due to the complexity of the arm and the goaldirected nature of reaching motions. The state-of-the-art systems either use robots to assist the FES-driven reaching motions or control the arm of healthy subjects to complete planar motions. These controllers do not directly translate to controlling the full-arm of an individual with tetraplegia because the muscle capabilities of individuals with spinal cord injuries are unique and often limited due to muscle atrophy and the loss of function caused by lower motor neuron damage. This dissertation aims to develop a full-arm FES-driven reaching controller that is capable of achieving 3D reaching motions in an individual with a spinal cord injury. Aim 1 was to develop a complete-arm FES-driven reaching controller that can hold static hand positions for an individual with high tetraplegia due to SCI. We developed a combined feedforward-feedback controller which used the subject-specific model to automatically determine the muscle stimulation commands necessary to hold a desired static hand position. Aim 2 was to develop a subject-specific model-based control strategy to use FES to drive the arm of an individual with high tetraplegia due to SCI along a desired path in the subject’s workspace. We used trajectory optimization to find feasible trajectories which explicitly account for the unique muscle characteristics and the simulated arm dynamics of our subject with tetraplegia. We then developed a model predictive control controller to iii control the arm along the desired trajectory. The controller developed in this dissertation is a significant step towards restoring full arm reaching function to individuals with spinal cord injuries

Control Methods for Compensation and Inhibition of Muscle Fatigue in Neuroprosthetic Devices

For individuals that suffer from paraplegia activities of daily life are greatly inhibited. With over 5,000 new cases of paraplegia each year in the United States alone there is a clear need to develop technologies to restore lower extremity function to these individuals. One method that has shown promise for restoring functional movement to paralyzed limbs is the use of functional electrical stimulation (FES), which is the application of electrical stimulation to produce a muscle contraction and create a functional movement. This technique has been shown to be able to restore numerous motor functions in persons with disability; however, the application of the electrical stimulation can cause rapid muscle fatigue, limiting the duration that these devices may be used. As an alternative some research has developed fully actuated orthoses to restore motor function via electric motors. These devices have been shown to be capable of achieving greater walking durations than FES systems; however, these systems can be significantly larger and heavier. To develop smaller and more efficient systems some research has explored hybrid neuroprostheses that use both FES and electric motors. However, these hybrid systems present new research challenges. In this dissertation novel control methods to compensate/inhibit muscle fatigue in neuroprosthetic and hybrid neuroprosthetic devices are developed. Some of these methods seek to compensate for the effects of fatigue by using fatigue dynamics in the control development or by minimizing the amount of stimulation used to produce a desired movement. Other control methods presented here seek to inhibit the effects of muscle fatigue by adding an electric motor as additional actuation. These control methods use either switching or cooperative control of FES and an electric motor to achieve longer durations of use than systems that strictly use FES. Finally, the necessity for the continued study of hybrid gait restoration systems is facilitated through simulations of walking with a hybrid neuroprosthesis. The results of these simulations demonstrate the potential for hybrid neuroprosthesis gait restoration devices to be more efficient and achieve greater walking durations than systems that use strictly FES or strictly electric motors

Adaptation Strategies for Personalized Gait Neuroprosthetics

Personalization of gait neuroprosthetics is paramount to ensure their efficacy for users, who experience severe limitations in mobility without an assistive device. Our goal is to develop assistive devices that collaborate with and are tailored to their users, while allowing them to use as much of their existing capabilities as possible. Currently, personalization of devices is challenging, and technological advances are required to achieve this goal. Therefore, this paper presents an overview of challenges and research directions regarding an interface with the peripheral nervous system, an interface with the central nervous system, and the requirements of interface computing architectures. The interface should be modular and adaptable, such that it can provide assistance where it is needed. Novel data processing technology should be developed to allow for real-time processing while accounting for signal variations in the human. Personalized biomechanical models and simulation techniques should be developed to predict assisted walking motions and interactions between the user and the device. Furthermore, the advantages of interfacing with both the brain and the spinal cord or the periphery should be further explored. Technological advances of interface computing architecture should focus on learning on the chip to achieve further personalization. Furthermore, energy consumption should be low to allow for longer use of the neuroprosthesis. In-memory processing combined with resistive random access memory is a promising technology for both. This paper discusses the aforementioned aspects to highlight new directions for future research in gait neuroprosthetics.AK is funded by a faculty endowment by adidas AG. MA, SKH, NM, MN, RJQ, R-DR, RJT are supported by NSF CPS grant 1739800, VA Merit Reviews A2275-R and 3056, and the NIH (5T32EB004314-15, R01 NS040547-13). MS and AG are funded by the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (Grant agreement No. 803035). AJd-A, JMF-L, and JCM are supported by coordinated grants RTI2018-097290-B-C31/C32/C33 (TAILOR project) funded by MCIN/AEI/10.13039/501100011033 and by “ERDF A way of making Europe”. MR is funded by the Lo3-ML project by the Federal Ministry for Education, Science and Technology (BMBF) (Funding No. 16ES1142K). AC, SS, and MV were supported by the European Research Council (ERC) under the project NGBMI (759370), the Einstein Stiftung Berlin, the ERA-NET NEURON project HYBRIDMIND (BMBF, 01GP2121A and -B) and the BMBF project NEO (13GW0483C)

Adaptation Strategies for Personalized Gait Neuroprosthetics

Personalization of gait neuroprosthetics is paramount to ensure their efficacy for users, who experience severe limitations in mobility without an assistive device. Our goal is to develop assistive devices that collaborate with and are tailored to their users, while allowing them to use as much of their existing capabilities as possible. Currently, personalization of devices is challenging, and technological advances are required to achieve this goal. Therefore, this paper presents an overview of challenges and research directions regarding an interface with the peripheral nervous system, an interface with the central nervous system, and the requirements of interface computing architectures. The interface should be modular and adaptable, such that it can provide assistance where it is needed. Novel data processing technology should be developed to allow for real-time processing while accounting for signal variations in the human. Personalized biomechanical models and simulation techniques should be developed to predict assisted walking motions and interactions between the user and the device. Furthermore, the advantages of interfacing with both the brain and the spinal cord or the periphery should be further explored. Technological advances of interface computing architecture should focus on learning on the chip to achieve further personalization. Furthermore, energy consumption should be low to allow for longer use of the neuroprosthesis. In-memory processing combined with resistive random access memory is a promising technology for both. This paper discusses the aforementioned aspects to highlight new directions for future research in gait neuroprosthetics.Peer ReviewedPostprint (published version

Switched Kinematic and Force Control for Lower-Limb Motorized Exoskeletons and Functional Electrical Stimulation

Millions of people experience movement deficits from neurological conditions (NCs) that impair their walking ability and leg function. Exercise-based rehabilitation procedures have shown the potential to facilitate neurological reorganization and functional recovery. Lower-limb powered exoskeletons and motorized ergometers have been combined with functional electrical stimulation (FES) to provide repetitive movement, partially reduce the burden of therapists, improve range of motion, and induce therapeutic benefits. FES evokes artificial muscles contractions and can improve muscle mass and strength, and bone density in people with NCs. Stationary cycling is recommended for individuals who cannot perform load-bearing activities or have increased risks of falling. Cycling has been demonstrated to impart physiological and cardiovascular benefits. Motorized FES-cycling combines an electric motor and electrical stimulation of lower-limb muscles to facilitate coordinated, long-duration exercise, while mitigating the inherent muscle fatigue due to FES. Lower-limb exoskeletons coupled with FES, also called neuroprostheses or hybrid exoskeletons, can facilitate continuous, repetitive motion to improve gait function and build muscle capacity. The human-robot interaction during rehabilitative cycling and walking yield a mix of discrete effects (i.e., foot impact, input switching to engage lower-limb muscles and electric motors, etc.) and continuous nonlinear, uncertain, time-varying dynamics. Switching control is necessary to allocate the control inputs to lower-limb muscle groups and electric motors involved during assisted cycling and walking. Kinematic tracking has been the primary control objective for devices that combine FES and electric motors. However, there are force interactions between the machine and the human during cycling and walking that motivate the design of torque-based controllers (i.e., exploit torque or force feedback) to shape the leg dynamics through controlling joint kinematics and kinetics. Technical challenges exist to develop closed-loop feedback control strategies that integrate kinematic and force feedback in the presence of switching and discontinuous effects. The motivation in this dissertation is to design, analyze and implement switching controllers for assisted cycling and walking leveraging kinematic and force feedback while guaranteeing the stability of the human-robot closed-loop system. In Chapter 1, the motivation to design closed-loop controllers for motorized FES-cycling and powered exoskeletons is described. A survey of closed-loop kinematic and force feedback control methods is also introduced related to the tracking objectives presented in the subsequent chapters of the dissertation. In Chapter 2, the dynamics models for walking and assisted cycling are described. First, a bipedal walking system model with switched dynamics is introduced to control a powered lower-limb exoskeleton. Then, a stationary FES-cycling model with nonlinear dynamics and switched control inputs is 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. The experimental setup for lower-limb exoskeleton and FES-cycling are described. In Chapter 3, a hierarchical control strategy is developed to interface a cable-driven lower-limb exoskeleton. A two-layer control system is developed to adjust cable tensions and apply torque about the knee joint using a pair of electric motors that provide knee flexion and extension. The control design is segregated into a joint-level control loop and a low-level loop using feedback of the angular positions of the electric motors to mitigate cable slacking. A Lyapunov-based stability analysis is developed to ensure exponential tracking for both control objectives. Moreover, an average dwell time analysis computes an upper bound on the number of motor switches to preserve exponential tracking. Preliminary experimental results in an able-bodied individual are depicted. The developed control strategy is extended and applied to the control of both knee and hip joints in Chapter 4 for treadmill walking. In Chapter 4, a cable-driven lower-limb exoskeleton is integrated with FES for treadmill walking at a constant speed. A nonlinear robust controller is used to activate the quadriceps and hamstrings muscle groups via FES to achieve kinematic tracking about the knee joint. Moreover, electric motors adjust the knee joint stiffness throughout the gait cycle using an integral torque feedback controller. A Lyapunov-based stability analysis is developed to ensure exponential tracking of the kinematic and torque closed-loop error systems, while guaranteeing that the control input signals remain bounded. The developed controllers were tested in real-time walking experiments on a treadmill in three able-bodied individuals at two gait speeds. The experimental results demonstrate the feasibility of coupling a cable-driven exoskeleton with FES for treadmill walking using a switching-based control strategy and exploiting both kinematic and force feedback. In Chapter 5, input-output data is exploited using a finite-time algorithm to estimate the target desired torque leveraging an estimate of the active torque produced by muscles via FES. The convergence rate of the finite-time algorithm can be adjusted by tuning selectable parameters. To achieve cadence and torque tracking for FES-cycling, nonlinear robust tracking controllers are designed for muscles and motor. A Lyapunov-based stability analysis is developed to ensure exponential tracking of the closed-loop cadence error system and global uniformly ultimate bounded (GUUB) torque tracking. A discrete-time Lyapunov-based stability analysis leveraging a recent tool for finite-time systems is developed to ensure convergence and guarantee that the finite-time algorithm is Holder continuous. The developed tracking controllers for the muscles and electric motor and finite-time algorithm to compute the desired torque are implemented in real-time during cycling experiments in seven able-bodied individuals. Multiple cycling trials are implemented with different gain parameters of the finite-time torque algorithm to compare tracking performance for all participants. Chapter 6 highlights the contributions of the developed control methods and provides recommendations for future research extensions

Orthotic and Prosthetic Management in Brachial Plexus Injury: Recent Trends

The brachial plexus is a network of intertwined nerve that controls movement and sensation in arm and hand. Any injury to the brachial plexus can result in partial or complete damage of arm and hand. The surgery is a common indicative procedure in brachial plexus injury in case of non-spontaneous recovery. The loss of function of hand due to injury can be replaced by using body powered or externally powered devices. Recent development in treatment protocol of prosthetic and orthotic science using artificial intelligence helps in rehabilitating the persons with brachial plexus injury to regain his confidence and perform daily activities. Combination of advancement in surgical procedure along with artificially intelligent devices opens a new array to rehabilitate the person with brachial plexus injury

Real-time simulation of three-dimensional shoulder girdle and arm dynamics

Electrical stimulation is a promising technology for the restoration of arm function in paralyzed individuals. Control of the paralyzed arm under electrical stimulation, however, is a challenging problem that requires advanced controllers and command interfaces for the user. A real-time model describing the complex dynamics of the arm would allow user-in-the-loop type experiments where the command interface and controller could be assessed. Real-time models of the arm previously described have not included the ability to model the independently controlled scapula and clavicle, limiting their utility for clinical applications of this nature. The goal of this study therefore was to evaluate the performance and mechanical behavior of a real-time, dynamic model of the arm and shoulder girdle. The model comprises seven segments linked by eleven degrees of freedom and actuated by 138 muscle elements. Polynomials were generated to describe the muscle lines of action to reduce computation time, and an implicit, first-order Rosenbrock formulation of the equations of motion was used to increase simulation step-size. The model simulated flexion of the arm faster than real time, simulation time being 92% of actual movement time on standard desktop hardware. Modeled maximum isometric torque values agreed well with values from the literature, showing that the model simulates the moment-generating behavior of a real human arm. The speed of the model enables experiments where the user controls the virtual arm and receives visual feedback in real time. The ability to optimize potential solutions in simulation greatly reduces the burden on the user during development

A Human Motor Control-Inspired Control System for a Walking Hybrid Neuroprosthesis

The purpose of this research is to develop a human motor control-inspired control system for a hybrid neuroprosthesis that combines functional electrical stimulation (FES) with electric motors. This device is intended to reproduce gait for persons with spinal cord injuries (SCI). Each year approximately 17,000 people suffer from an SCI in the U.S. alone, of which about 20% of them are diagnosed with complete paraplegia. Currently, there is a lot of interest in gait restoration for subjects with paraplegia but the existing technologies use either solely FES or electric motors. These two sources of actuation both have their own limitation when used alone. Recently, there have been efforts to provide a combination of the two means of actuation, FES and motors, into gait restoration devices called hybrid neuroprostheses. In this dissertation the derivation and experimental demonstration of control systems for the hybrid neuroprosthesis are presented. Particularly, the dissertation addresses technical challenges associated with the real-time control of a FES such as nonlinear muscle dynamics, actuator dynamics, muscle fatigue, and electromechanical delays (EMD). In addition, when FES is combined with electric motors in hybrid neuroprostheses, an actuator redundancy problem is introduced. To address the actuator redundancy issue, a synergy-based control framework is derived. This synergy-based framework is inspired from the concept of muscle synergies in human motor control theory. Dynamic postural synergies are developed and used in the feedforward path of the control system for the walking hybrid neuroprosthesis. To address muscle fatigue, the stimulation levels are gradually increased based on a model-based fatigue estimate. A dynamic surface control technique, modified with a delay compensation term, is used to address the actuator dynamics and EMD in the control derivation. A Lyapunov-based stability approach is used to derive the controllers and guarantee their stability. The outcome of this research is the development of a human motor control-inspired control framework for the hybrid neuroprosthesis where both FES and electric motors can be simultaneously coordinated to reproduce gait. Multiple experiments were conducted on both able-bodied subjects and persons with SCI to validate the derived controllers

A Review of Control Strategies in Closed-Loop Neuroprosthetic Systems

It has been widely recognized that closed-loop neuroprosthetic systems achieve more favourable outcomes for users then equivalent open-loop devices. Improved performance of tasks, better usability and greater embodiment have all been reported in systems utilizing some form of feedback. However the interdisciplinary work on neuroprosthetic systems can lead to miscommunication due to similarities in well established nomenclature in different fields. Here we present a review of control strategies in existing experimental, investigational and clinical neuroprosthetic systems in order to establish a baseline and promote a common understanding of different feedback modes and closed loop controllers. The first section provides a brief discussion of feedback control and control theory. The second section reviews the control strategies of recent Brain Machine Interfaces, neuromodulatory implants, neuroprosthetic systems and assistive neurorobotic devices. The final section examines the different approaches to feedback in current neuroprosthetic and neurorobotic systems

Closed-loop approaches for innovative neuroprostheses

The goal of this thesis is to study new ways to interact with the nervous system in case of damage or pathology. In particular, I focused my effort towards the development of innovative, closed-loop stimulation protocols in various scenarios: in vitro, ex vivo, in vivo