Control of posture with FES systems

One of the major obstacles in restoration of functional FES supported standing in paraplegia is the lack of knowledge of a suitable control strategy. The main issue is how to integrate the purposeful actions of the non-paralysed upper body when interacting with the environment while standing, and the actions of the artificial FES control system supporting the paralyzed lower extremities. In this paper we provide a review of our approach to solving this question, which focuses on three inter-related areas: investigations of the basic mechanisms of functional postural responses in neurologically intact subjects; re-training of the residual sensory-motor activities of the upper body in paralyzed individuals; and development of closed-loop FES control systems for support of the paralyzed joints

Low-level finite state control of knee joint in paraplegic standing

Low-level finite state (locked-unlocked) control is compared with open-loop stimulation of the knee extensor muscles in functional electrical stimulation (FES) induced paraplegic standing. The parameters were: duration of standing, relative torque loss in knee extensor muscles, knee angle stability, average stimulus output and average arm effort during standing. To investigate the impact of external mechanical conditions on controller performance, experiments were performed both under the condition of a freely moving ankle joint and of a mechanically stabilized ankle joint. Finite state control resulted in a 2.5 to 12 times increase of standing duration or in a 1.5 to 5 times decrease of relative torque loss in comparison with open-loop stimulation. Finite state control induced a limit cycle oscillation in the knee joint. Average maximum knee flexion was 6.2° without ankle bracing, and half that value with ankle bracing. Average arm support was 13.9 and 7.5% of the body weight without and with ankle bracing respectively

Vibration as an exercise modality: how it may work, and what its potential might be

Whilst exposure to vibration is traditionally regarded as perilous, recent research has focussed on potential benefits. Here, the physical principles of forced oscillations are discussed in relation to vibration as an exercise modality. Acute physiological responses to isolated tendon and muscle vibration and to whole body vibration exercise are reviewed, as well as the training effects upon the musculature, bone mineral density and posture. Possible applications in sports and medicine are discussed. Evidence suggests that acute vibration exercise seems to elicit a specific warm-up effect, and that vibration training seems to improve muscle power, although the potential benefits over traditional forms of resistive exercise are still unclear. Vibration training also seems to improve balance in sub-populations prone to fall, such as frail elderly people. Moreover, literature suggests that vibration is beneficial to reduce chronic lower back pain and other types of pain. Other future indications are perceivable

Orthostatic-induced Hypotension Attenuates Cold Pressor Pain Perception

In recent years, numerous studies have established a connection between blood pressure and nocioception. While this connection is well documented in the literature, its underlying physiological mechanisms have yet to be elucidated. Much attention has focused on the relationship between cardiovascular regulatory centers and nocioception, yet the intricacies of this relationship have not been fully explored. Therefore, the purpose of this investigation was to examine the role of the baroreflex system as a modulator of pain perception. Twenty normotensive males participated in two laboratory sessions. Time to cold pain threshold and pain tolerance was measured at rest during the first visit. On visit two, blood pressure was orthostatically manipulated via tilt table at postures 90o, 120o, and 180o. Orthostatic manipulation significantly lowered systolic blood pressure (SBP), pain threshold, and pain tolerance from seated baseline at 120o and 180o. The regression models for baroreceptor reflex sensitivity (BRS) assessed during seated baseline and at 120o and 180o revealed a significant negative beta weight for the effect of SBP. A significant negative beta weight for the effects of BRS, SBP, and their interaction was observed at 90o. In conclusion, orthostatic baroreceptor activation appears to exert an inhibitory effect on the brain that decreases pain sensitivity

Cardiovascular Adjustments to Gravitational Stress

The effects of gravity on the cardiovascular system must be taken into account whenever a hemodynamic assessment is made. All intravascular pressure have a gravity-dependent hydrostatic component. The interaction between the gravitational field, the position of the body, and the functional characteristics of the blood vessels determines the distribution of intravascular volume. In turn this distribution largely determines cardiac pump function. Multiple control mechanisms are activated to preserve optimal tissue perfusion when the magnitude of the gravitational field or its direction relative to the body changes. Humans are particularly sensitive to such changes because of the combination of their normally erect posture and the large body mass and blood volume below the level of the heart. Current aerospace technology also exposes human subjects to extreme variations in the gravitational forces that range from zero during space travel to as much an nine-times normal during operation of high-performance military aircraft. This chapter therefore emphasizes human physiology

A 3D biomechanical vocal tract model to study speech production control: How to take into account the gravity?

This paper presents a modeling study of the way speech motor control can deal with gravity to achieve steady-state tongue positions. It is based on simulations carried out with the 3D biomechanical tongue model developed at ICP, which is now controlled with the Lambda model (Equilibrium-Point Hypothesis). The influence of short-delay orosensory feedback on posture stability is assessed by testing different muscle force/muscle length relationships (Invariant Characteristics). Muscle activation patterns necessary to maintain the tongue in a schwa position are proposed, and the relations of head position, tongue shape and muscle activations are analyzed

M.I.T./Canadian Vestibular Experiments on the Spacelab-1 Mission. Part 1: Sensory Adaptation to Weightlessness and Readaptation to One-G: An Overview

Experiments on human spatial orientation were conducted on four crewmembers of Space Shuttle Spacelab Mission 1. The conceptual background of the project, the relationship among the experiments, and their relevance to a 'sensory reinterpretation hypothesis' are presented. Detailed experiment procedures and results are presented in the accompanying papers in this series. The overall findings are discussed as they pertain to the following aspects of hypothesized sensory reinterpretation in weightlessness: (1) utricular otolith afferent signals are reinterpreted as indicating head translation rather than tilt, (2) sensitivity of reflex responses to footward acceleration is reduced, and (3) increased weighting is given to visual and tactile cues in orientation perception and posture control. Results suggest increased weighting of visual cues and reduced weighting of graviceptor signals in weightlessness

Impaired H-Reflex Adaptations Following Slope Walking in Individuals With Post-stroke Hemiparesis

Background and Purpose: Short term adaptations in the Ia afferent-motoneuron pathway, as measured using the H-reflex, in response to altered ground reaction forces (GRFs) applied at the feet during slope walking have been observed in the non-impaired nervous system. The ability of the stroke-impaired nervous system to adapt to altered GRFs have not been examined. The purpose of this study was to examine the acute effects of altered propulsive and braking forces applied at the feet, which naturally occurs when walking on different slopes, on adaptations of the H-reflex pathway in individuals with chronic post-stroke hemiparesis

A physical model suggests that hip-localized balance sense in birds improves state estimation in perching: implications for bipedal robots

In addition to a vestibular system, birds uniquely have a balance-sensing organ within the pelvis, called the lumbosacral organ (LSO). The LSO is well developed in terrestrial birds, possibly to facilitate balance control in perching and terrestrial locomotion. No previous studies have quantified the functional benefits of the LSO for balance. We suggest two main benefits of hip-localized balance sense: reduced sensorimotor delay and improved estimation of foot-ground acceleration. We used system identification to test the hypothesis that hip-localized balance sense improves estimates of foot acceleration compared to a head-localized sense, due to closer proximity to the feet. We built a physical model of a standing guinea fowl perched on a platform, and used 3D accelerometers at the hip and head to replicate balance sense by the LSO and vestibular systems. The horizontal platform was attached to the end effector of a 6 DOF robotic arm, allowing us to apply perturbations to the platform analogous to motions of a compliant branch. We also compared state estimation between models with low and high neck stiffness. Cross-correlations revealed that foot-to-hip sensing delays were shorter than foot-to-head, as expected. We used multi-variable output error state-space (MOESP) system identification to estimate foot-ground acceleration as a function of hip- and head-localized sensing, individually and combined. Hip-localized sensors alone provided the best state estimates, which were not improved when fused with head-localized sensors. However, estimates from head-localized sensors improved with higher neck stiffness. Our findings support the hypothesis that hip-localized balance sense improves the speed and accuracy of foot state estimation compared to head-localized sense. The findings also suggest a role of neck muscles for active sensing for balance control: increased neck stiffness through muscle co-contraction can improve the utility of vestibular signals. Our engineering approach provides, to our knowledge, the first quantitative evidence for functional benefits of the LSO balance sense in birds. The findings support notions of control modularity in birds, with preferential vestibular sense for head stability and gaze, and LSO for body balance control,respectively. The findings also suggest advantages for distributed and active sensing for agile locomotion in compliant bipedal robots