Artificial Motor Control For Electrically Stimulated Upper Limbs Of Plegic Or Paretic People

Functional Electrical Stimulation (FES) is a technique used in the restoration and generation of movements performed by subjects with neuromuscular disorders such as spinal cord injury (SCI). The purpose of this article is to outline the state of the art and perspectives of the use of FES in artificial motor control of the upper limbs in paretic or plegic people. Methods: The databases used in papers selection were Google Scholar and Capes’ Portals as well as proceedings of the Annual Conference of the International Functional Electrical Stimulation Society (IFESS). Results: Approximately 85% of the reviewed studies showed FES profile with pulse duration ranging from 1 to 300 μs and modulating (burst) frequency between 10 and 40 Hz. Regarding the type of electrodes, 88% of the studies employed transcutaneous electrodes. Conclusion: We concluded that FES with closed-loop feedback and feedforward are the most used and most viable systems for upper limbs motor control, because they perform self-corrections slowing neuromuscular adaptation, allowing different planes and more range of movement and sensory-motor integration. One of the difficulties found in neuroprosthesis systems are electrical wires attached to the user, becoming uninteresting in relation to aesthetics and break. The future perspectives lead to a trend to miniaturization of the stimulation equipment and the availability of wireless networks, which allow the attachment of modules to other components without physical contact, and will become more attractive for daily use. © 2016, Sociedade Brasileira de Engenharia Biomedica. All rights reserved.32219921

Passive reach and grasp with functional electrical stimulation and robotic arm support

Rehabilitation of arm and hand function is crucial to increase functional independence of stroke subjects. Here, we investigate the technical feasibility of an integrated training system combining robotics and functional electrical stimulation (FES) to support reach and grasp during functional manipulation of objects. To support grasp and release, FES controlled the thumb and fingers using Model Predictive Control (MPC), while a novel 3D robotic manipulator provided reach support. The system's performance was assessed in both stroke and blindfolded healthy subjects, where the subject's passive arm and hand made functional reach, grasp, move and release movements while manipulating objects. The success rate of complete grasp, move and release tasks with different objects ranged from 33% to 87% in healthy subjects. In severe chronic stroke subjects especially the hand opening had a low success rate (<;25%) and no complete movements could be made. We demonstrated that our developed integrated training system can move the passive arm and hand for functional pick and place movements. In the current setup, the positioning accuracy of the robot with respect to the object position was critical for the overall performance. The use of a higher virtual stiffness and including feedback of object position in the robot control would likely improve the relative position accuracy. The system has potential for post-stroke rehabilitation, where support could be reduced based on patient performance which is needed to aid motor relearning of reach, grasp and release

Boosting brain–computer interfaces with functional electrical stimulation: potential applications in people with locked-in syndrome

Individuals with a locked-in state live with severe whole-body paralysis that limits their ability to communicate with family and loved ones. Recent advances in brain–computer interface (BCI) technology have presented a potential alternative for these people to communicate by detecting neural activity associated with attempted hand or speech movements and translating the decoded intended movements to a control signal for a computer. A technique that could potentially enrich the communication capacity of BCIs is functional electrical stimulation (FES) of paralyzed limbs and face to restore body and facial movements of paralyzed individuals, allowing to add body language and facial expression to communication BCI utterances. Here, we review the current state of the art of existing BCI and FES work in people with paralysis of body and face and propose that a combined BCI-FES approach, which has already proved successful in several applications in stroke and spinal cord injury, can provide a novel promising mode of communication for locked-in individuals

簡易的パラメータ推定を用いたモデル予測制御に基づく閉ループ型機能的電気刺激制御器の計算機シミュレーション研究

Tohoku University渡邉高志課

Development of computer vision based control of functional electrical stimulation.

Sistemi za funkcionalnu električnu stimulaciju (FES) se u terapiji gornjih ekstremiteta, kod osoba koje su usled oštećenja centralnog nervnog sistema uzrokovanog povredom kičmene moždine ili moždanim udarom delimično izgubili moć voljne kontrole pokreta, izdvajaju kao potencijalno najadekvatnija rehabilitaciona tehnika. Putem sistema za FES se električni impulsi odgovarajućih oblika (amplitude, trajanja i frekvencije) dovode do motornog sistema (mišića) koji su zaduženi za pokrete koje subjekat nije u stanju samostalno da uradi, sa ciljem da se datoj osobi omogući izvršavanje nekog funkcionalnog zadataka. Da bi to bilo moguće, sam FES sistem u sebi mora da uključi interpretaciju komandi pacijenta ili terapeuta, regulaciju stimulacionih parametara, generisanje strujnih impulsa i interfejs za prenos energije do senzorno-motornog sistema subjekta koristeći implantibilne ili površinske elektrode...Functional electrical stimulation (FES) based systems for the treatment of upper extremity in people who have, due to the central nervous system leasion, caused by spinal cord injury or stroke, to some extent lost the voluntary control offer great potential as a rehabilitation technique to improve the lost functionality. In a FES system electrical pulses of appropriate electrical parameters (shape, amplitude, duration and frequency) are transmitted to the motor system (muscles) that are responsible for the movements that the subject is not able to perform in a satisfactory manner, with an aim to enable the person perform some functional task with the help of this external muscle activation. In order to function, FES system needs to include a mechanism for interpretation of the patient or therapist commands, control of stimulation parameters, generation of adequate electrical pulses and an interface for transfer of electrical energy to the sensory-motor system of the subject through the implantable or surface electrodes..

SISTEMA ROBÓTICO HÍBRIDO PARA REABILITAÇÃO DE MEMBRO SUPERIOR DE INDIVÍDUOS PÓS- ACIDENTE VASCULAR ENCEFÁLICO:Design Centrado no Usuário

Post-stroke individuals have upper limb motor limitations that interfere with their ability to independently perform activities of daily living, compromising functionality, affecting social participation and quality of life. Innovative rehabilitation alternatives consist of Robot- Assisted Therapy (RT) and Hybrid Robotic Rehabilitation Systems (HRRS), an approach that combines repetitive muscle practice provided by robotic therapy with muscle activation provided by Functional Electrical Stimulation (FES). Despite the proven benefits of these technologies, a lack of uptake and limited implementation in clinical practice is still observed. This is because most hybrid devices are only in the early stages of development and the robotic equipment available today, presents several disadvantages related to the difficulty of control, little functionality, aesthetics and high cost, compromising their results and applicability. The objective of this study was to develop a hybrid robotic system for use in individuals with upper limb motor impairment due to stroke with advantages over the ones currently available. The competitive differentials concern its aesthetics, structure, drive and control system, portability, joint concomitance, and low cost. An exploratory study was conducted in two stages. The first stage consisted of developing the robotic orthosis prototype and validating the biomechanical functioning through a pilot study with four participants. The second stage consisted in improving the structure and control system, adding FES to the drive, transforming it into a hybrid robotic system. A multicenter pilot study was conducted with 10 participants in order to identify the needs and preferences of users to increase the acceptance and implementation of this technology. The correct functioning of the device was verified through standardized bench tests, resulting in the acquisition of a new and promising equipment for upper limb rehabilitation, capable of aiding in the recovery of functional abilities of individuals with loss of upper limb motor function.Les personnes ayant subi un AVC présentent des limitations motrices dans le membre supérieur qui interfèrent avec la capacité d'effectuer de manière autonome les activités de la vie quotidienne, compromettant la fonctionnalité, affectant la participation sociale et la qualité de vie. Les alternatives innovantes en matière de réadaptation sont la thérapie assistée par robot (RT) et les systèmes de réadaptation hybrides robotiques (SRHR), une approche qui combine la pratique musculaire répétitive fournie par la thérapie robotique avec l'activation musculaire fournie par la stimulation électrique fonctionnelle (FES). Malgré les avantages avérés de ces technologies, on observe encore un manque d'adhésion et une mise en œuvre limitée dans la pratique clinique. En effet, la plupart des dispositifs hybrides n'en sont qu'aux premiers stades de développement et les équipements robotiques disponibles aujourd'hui présentent plusieurs inconvénients liés à la difficulté du contrôle, au peu de fonctionnalité, à l'esthétique et au coût élevé, ce qui compromet leurs résultats et leur applicabilité. L'objectif de cette étude était de développer un système robotique hybride pour les personnes souffrant d'une déficience motrice des membres supérieurs due à une AVC, avec des avantages par rapport aux systèmes actuellement disponibles. Les différentiels concurrentiels concernent son esthétique, sa structure, son système d'entraînement et de contrôle, sa portabilité et la concomitance de ses articulations. Une étude exploratoire a été réalisée en deux étapes. La première étape a consisté à développer le prototype d'orthèse robotique et à valider le fonctionnement de la partie biomécanique par une étude pilote avec quatre participants. La deuxième étape a consisté à améliorer la structure et le système de contrôle, en ajoutant le FES à l'entraînement, le transformant en un système robotique hybride. Une étude pilote multicentrique a été menée auprès de 10 participants afin d'identifier les besoins et les préférences des utilisateurs de manière à accroître l'acceptation et la mise en œuvre de cette technologie. Le bon fonctionnement de l'appareil a été vérifié au moyen d'essais au banc standardisés, ce qui a permis d'acquérir un nouvel équipement prometteur pour la rééducation des membres supérieurs, capable de contribuer à la récupération des capacités fonctionnelles des personnes ayant perdu la fonction motrice des membres supérieurs.Indivíduos pós-acidente vascular encefálico (AVE) apresentam limitações motoras no membro superior que interferem na capacidade de realizar de forma independente as atividades de vida diária, comprometendo a funcionalidade, afetando a participação social e qualidade de vida. Alternativas inovadoras de reabilitação consistem na Terapia Assistida por Robô (RT) e nos Sistemas Robóticos Híbridos de Reabilitação (SRHR), abordagem que combina a prática muscular repetitiva fornecida pela terapia robótica com a ativação muscular proporcionada pela Estimulação Elétrica Funcional (FES). Apesar dos benefícios comprovados dessas tecnologias, observa-se ainda uma falta de adesão e implementação limitada na prática clínica. Isso porque a maioria dos dispositivos híbridos estão apenas nos estágios iniciais de desenvolvimento e os equipamentos robóticos hoje disponíveis, apresentam diversas desvantagens relacionadas à dificuldade de controle, pouca funcionalidade, estética e custo elevado, comprometendo seus resultados e aplicabilidade. O objetivo deste estudo foi desenvolver um sistema robótico híbrido para uso em pessoas com comprometimento motor de membro superior decorrente de AVE com vantagens em relação aos disponíveis atualmente. Os diferenciais competitivos dizem respeito a sua estética, estrutura, sistema de acionamento e de controle, portabilidade e concomitância de articulação. Foi realizado um estudo exploratório em duas etapas. A primeira etapa consistiu no desenvolvimento do protótipo de órtese robótica e validação do funcionamento da parte biomecânica por meio de estudo piloto com quatro participantes. A segunda etapa consistiu no aprimoramento da estrutura e sistema de controle, acrescentando a FES ao acionamento, transformando-o em um sistema robótico híbrido. Foi realizado um estudo piloto multicêntrico com 10 participantes a fim de identificar as necessidades e preferências dos usuários de forma a aumentar a aceitação e implementação dessa tecnologia. Foi verificado correto funcionamento do dispositivo por meio de testes padronizados de bancada, resultando na aquisição de um novo e promissor equipamento para reabilitação de membro superior, capaz de auxiliar na recuperação das habilidades funcionais de pessoas com perda da função motora de membro superior