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Lim D, Pei W, Lee JW, Musselman KE, Masani K. Feasibility of using a depth camera or pressure mat for visual feedback balance training with functional electrical stimulation. Biomed Eng Online 2024; 23:19. [PMID: 38347584 PMCID: PMC10863251 DOI: 10.1186/s12938-023-01191-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 12/07/2023] [Indexed: 02/15/2024] Open
Abstract
Individuals with incomplete spinal-cord injury/disease are at an increased risk of falling due to their impaired ability to maintain balance. Our research group has developed a closed-loop visual-feedback balance training (VFBT) system coupled with functional electrical stimulation (FES) for rehabilitation of standing balance (FES + VFBT system); however, clinical usage of this system is limited by the use of force plates, which are expensive and not easily accessible. This study aimed to investigate the feasibility of a more affordable and accessible sensor such as a depth camera or pressure mat in place of the force plate. Ten able-bodied participants (7 males, 3 females) performed three sets of four different standing balance exercises using the FES + VFBT system with the force plate. A depth camera and pressure mat collected centre of mass and centre of pressure data passively, respectively. The depth camera showed higher Pearson's correlation (r > 98) and lower root mean squared error (RMSE < 10 mm) than the pressure mat (r > 0.82; RMSE < 4.5 mm) when compared with the force plate overall. Stimulation based on the depth camera showed lower RMSE than that based on the pressure mat relative to the FES + VFBT system. The depth camera shows potential as a replacement sensor to the force plate for providing feedback to the FES + VFBT system.
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Affiliation(s)
- Derrick Lim
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - William Pei
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Jae W Lee
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Kristin E Musselman
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Rehabilitation Science Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Kei Masani
- Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada.
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
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Canny E, Vansteensel MJ, van der Salm SMA, Müller-Putz GR, Berezutskaya J. Boosting brain-computer interfaces with functional electrical stimulation: potential applications in people with locked-in syndrome. J Neuroeng Rehabil 2023; 20:157. [PMID: 37980536 PMCID: PMC10656959 DOI: 10.1186/s12984-023-01272-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/23/2023] [Indexed: 11/20/2023] Open
Abstract
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.
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Affiliation(s)
- Evan Canny
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mariska J Vansteensel
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Sandra M A van der Salm
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gernot R Müller-Putz
- Institute of Neural Engineering, Laboratory of Brain-Computer Interfaces, Graz University of Technology, Graz, Austria
| | - Julia Berezutskaya
- Department of Neurology and Neurosurgery, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
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Eslami M, Pirmoradian M, Mokhtarian A, Baghaei S. Design and manufacture of a soft robot with dual-interaction in virtual reality. Heliyon 2023; 9:e19997. [PMID: 37809862 PMCID: PMC10559669 DOI: 10.1016/j.heliyon.2023.e19997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Revised: 05/29/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
This paper examines the design and fabrication of a soft robot that can connect to a virtual reality environment. This study's primary objective is to utilize these technologies concurrently and demonstrate their applicability in various applications, particularly rehabilitation. Therefore, the process of designing and modeling the soft robot is carried out, and an applied model is created using a 3D printer and silicon material, which is then installed on gloves. Using Unity software, a virtual reality environment is created in which programs, commands, and Arduino processors control the movements of the soft robot, allowing the user to move and pick up an object in a real environment while wearing gloves, and to adjust the amount of pressure and angle of its motion based on the size of each virtual object. During the system evaluation phase, a delay in the performance and reaction time of the soft robot installed on the gloves is observed. This delay is reduced by modifying the programming structure, resulting in optimal system functionality. This capability is used to create proper mobility conditions and rehabilitation for the majority of patients with wrist injuries resulting from strokes and accidents, and it may be effective in accelerating patients' recoveries.
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Affiliation(s)
- Majid Eslami
- Department of Mechanical Engineering, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran
| | - Mostafa Pirmoradian
- Department of Mechanical Engineering, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran
| | - Ali Mokhtarian
- Department of Mechanical Engineering, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran
| | - Shaghayegh Baghaei
- Department of Mechanical Engineering, Khomeinishahr Branch, Islamic Azad University, Khomeinishahr, Isfahan, Iran
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Höhler C, Wild L, de Crignis A, Jahn K, Krewer C. Contralaterally EMG-triggered functional electrical stimulation during serious gaming for upper limb stroke rehabilitation: a feasibility study. Front Neurorobot 2023; 17:1168322. [PMID: 37304665 PMCID: PMC10248145 DOI: 10.3389/fnbot.2023.1168322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023] Open
Abstract
Introduction Virtual Reality/serious games (SG) and functional electrical stimulation (FES) therapies are used in upper limb stroke rehabilitation. A combination of both approaches seems to be beneficial for therapy success. The feasibility of a combination of SG and contralaterally EMG-triggered FES (SG+FES) was investigated as well as the characteristics of responders to such a therapy. Materials and methods In a randomized crossover trial, patients performed two gaming conditions: SG alone and SG+FES. Feasibility of the therapy system was assessed using the Intrinsic Motivation Inventory (IMI), the Nasa Task Load Index, and the System Usability Scale (SUS). Gaming parameters, fatigue level and a technical documentation was implemented for further information. Results In total, 18 patients after stroke (62.1 ± 14.1 years) with a unilateral paresis of the upper limb (MRC ≤4) were analyzed in this study. Both conditions were perceived as feasible. Comparing the IMI scores between conditions, perceived competence was significantly increased (z = -2.88, p = 0.004) and pressure/tension during training (z = -2.13, p = 0.034) was decreased during SG+FES. Furthermore, the task load was rated significantly lower for the SG+FES condition (z = -3.14, p = 0.002), especially the physical demand (z = -3.08, p = 0.002), while the performance was rated better (z = -2.59, p = 0.010). Responses to the SUS and the perceived level of fatigue did not differ between conditions (SUS: z = -0.79, p = 0.431; fatigue: z = 1.57, p = 0.115). For patients with mild to moderate impairments (MRC 3-4) the combined therapy provided no or little gaming benefit. The additional use of contralaterally controlled FES (ccFES), however, enabled severely impaired patients (MRC 0-1) to play the SG. Discussion The combination of SG with ccFES is feasible and well-accepted among patients after stroke. It seems that the additional use of ccFES may be more beneficial for severely impaired patients as it enables the execution of the serious game. These findings provide valuable implications for the development of rehabilitation systems by combining different therapeutic interventions to increase patients' benefit and proposes system modifications for home use. Clinical trial registration https://drks.de/search/en, DRKS00025761.
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Affiliation(s)
- Chiara Höhler
- Faculty of Sport and Health Science, Chair of Human Movement Science, Technical University Munich, Munich, Germany
- Department of Neurology, Research Group, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Laura Wild
- Faculty of Sport and Health Science, Chair of Human Movement Science, Technical University Munich, Munich, Germany
| | - Alexandra de Crignis
- Department of Neurology, Research Group, Schoen Clinic Bad Aibling, Bad Aibling, Germany
| | - Klaus Jahn
- Department of Neurology, Research Group, Schoen Clinic Bad Aibling, Bad Aibling, Germany
- Ludwig-Maximilians University of Munich (LMU), German Center for Vertigo and Balance Disorders (DSGZ), Munich, Germany
| | - Carmen Krewer
- Faculty of Sport and Health Science, Chair of Human Movement Science, Technical University Munich, Munich, Germany
- Department of Neurology, Research Group, Schoen Clinic Bad Aibling, Bad Aibling, Germany
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Mercado-Gutierrez JA, Dominguez R, Hernandez-Popo I, Quinzaños-Fresnedo J, Vera-Hernandez A, Leija-Salas L, Gutierrez-Martinez J. A Flexible Pulse Generator Based on a Field Programmable Gate Array Architecture for Functional Electrical Stimulation. Front Neurosci 2022; 15:702781. [PMID: 35126033 PMCID: PMC8814338 DOI: 10.3389/fnins.2021.702781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 12/09/2021] [Indexed: 11/15/2022] Open
Abstract
Non-invasive Functional Electrical Stimulation (FES) is a technique applied for motor rehabilitation of patients with central nervous system injury. This technique requires programmable multichannel systems to configure the stimulation parameters (amplitude, frequency, and pulse width). Most FES systems are based on microcontrollers with fixed architecture; this limits the control of the parameters and the scaling to multiple channels. Although field programmable gate arrays (FPGA) have been used in FES systems as alternative to microcontrollers, most of them focus on signal acquisition, processing, or communication functions, or are for invasive stimulation. A few FES systems report using FPGAs for parameter configuration and pulse generation in non-invasive FES. However, generally they limit the value of the frequency or amplitude parameters to enable multichannel operation. This restricts free selection of parameters and implementation of modulation patterns, previously reported to delay FES-induced muscle fatigue. To overcome those limitations, this paper presents a proof-of-concept (technology readiness level three-TRL 3) regarding the technical feasibility and potential use of an FPGA-based pulse generator for non-invasive FES applications (PG-nFES). The main aims were: (1) the development of a flexible pulse generator for FES applications and (2) to perform a proof-of-concept of the system, comprising: electrical characterization of the stimulation parameters, and verification of its potential for upper limb FES applications. Biphasic stimulation pulses with high linearity (r2 > 0.9998) and repeatability (>0.81) were achieved by combining the PG-nFES with a current-controlled output stage. Average percentage error in the characterizations was under 3% for amplitude (1–48 mA) and pulse width (20–400 μs), and 0% for frequency (10–150 Hz). A six-channel version of the PG-nFES was implemented to demonstrate the scalability feature. The independence of parameters was tested with three patterns of co-modulation of two parameters. Moreover, two complete FES channels were implemented and the claimed features of the PG-nFES were verified by performing upper limb functional movements involving the hand and the arm. Finally, the system enabled implementation of a stimulation pattern with co-modulation of frequency and pulse width, applied successfully for efficient elbow during repetitions of a functional movement.
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Affiliation(s)
- Jorge A. Mercado-Gutierrez
- Departamento de Ingeniería Eléctrica, Sección Bioelectrónica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
- División de Investigación en Ingeniería Médica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Ricardo Dominguez
- Departamento de Ingeniería Eléctrica, Universidad Autónoma Metropolitana — Iztapalapa, Mexico City, Mexico
| | - Ignacio Hernandez-Popo
- CONACYT — Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Jimena Quinzaños-Fresnedo
- División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Arturo Vera-Hernandez
- Departamento de Ingeniería Eléctrica, Sección Bioelectrónica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Lorenzo Leija-Salas
- Departamento de Ingeniería Eléctrica, Sección Bioelectrónica, Centro de Investigación y de Estudios Avanzados del Instituto Politécnico Nacional, Mexico City, Mexico
| | - Josefina Gutierrez-Martinez
- División de Investigación en Ingeniería Médica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
- *Correspondence: Josefina Gutierrez-Martinez,
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Control of a hybrid upper-limb orthosis device based on a data-driven artificial neural network classifier of electromyography signals. Biomed Signal Process Control 2021. [DOI: 10.1016/j.bspc.2021.102624] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Chou CH, Wang T, Sun X, Niu CM, Hao M, Xie Q, Lan N. Automated functional electrical stimulation training system for upper-limb function recovery in poststroke patients. Med Eng Phys 2020; 84:174-183. [PMID: 32977916 DOI: 10.1016/j.medengphy.2020.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND This paper describes the design and test of an automated functional electrical stimulation (FES) system for poststroke rehabilitation training. The aim of automated FES is to synchronize electrically induced movements to assist residual movements of patients. METHODS In the design of the FES system, an accelerometry module detected movement initiation and movement performed by post-stroke patients. The desired movement was displayed in visual game module. Synergy-based FES patterns were formulated using a normal pattern of muscle synergies from a healthy subject. Experiment 1 evaluated how different levels of trigger threshold or timing affected the variability of compound movements for forward reaching (FR) and lateral reaching (LR). Experiment 2 explored the effect of FES duration on compound movements. RESULTS Synchronizing FES-assisted movements with residual voluntary movements produced more consistent compound movements. Matching the duration of synergy-based FES to that of patients could assist slower movements of patients with reduced RMS errors. CONCLUSIONS Evidence indicated that synchronization and matching duration with residual voluntary movements of patients could improve the consistency of FES assisted movements. Automated FES training can reduce the burden of therapists to monitor the training process, which may encourage patients to complete the training.
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Affiliation(s)
- Chih-Hong Chou
- Laboratory of Neurorehabilitaiton Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, China
| | - Tong Wang
- Laboratory of Neurorehabilitaiton Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, China
| | - Xiaopei Sun
- Department of Rehabilitation Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Chuanxin M Niu
- Laboratory of Neurorehabilitaiton Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, China; Department of Rehabilitation Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Manzhao Hao
- Laboratory of Neurorehabilitaiton Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, China
| | - Qing Xie
- Department of Rehabilitation Medicine, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Ning Lan
- Laboratory of Neurorehabilitaiton Engineering, School of Biomedical Engineering, Shanghai Jiao Tong University, China.
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8
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Artificially induced joint movement control with musculoskeletal model-integrated iterative learning algorithm. Biomed Signal Process Control 2020. [DOI: 10.1016/j.bspc.2019.101843] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Smith C, Kenney L, Howard D, Waring K, Sun M, Luckie H, Hardiker N, Cotterill S. Prediction of setup times for an advanced upper limb functional electrical stimulation system. J Rehabil Assist Technol Eng 2019; 5:2055668318802561. [PMID: 31191957 PMCID: PMC6531802 DOI: 10.1177/2055668318802561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 08/24/2018] [Indexed: 11/16/2022] Open
Abstract
Introduction Rehabilitation devices take time to don, and longer or unpredictable setup time impacts on usage. This paper reports on the development of a model to predict setup time for upper limb functional electrical stimulation. Methods Participants' level of impairment (Fugl Meyer-Upper Extremity Scale), function (Action Research Arm Test) and mental status (Mini Mental Scale) were measured. Setup times for each stage of the setup process and total setup times were recorded. A predictive model of setup time was devised using upper limb impairment and task complexity. Results Six participants with stroke were recruited, mean age 60 (±17) years and mean time since stroke 9.8 (±9.6) years. Mean Fugl Meyer-Upper Extremity score was 31.1 (±6), Action Research Arm Test 10.4 (±7.9) and Mini Mental Scale 26.1 (±2.7). Linear regression analysis showed that upper limb impairment and task complexity most effectively predicted setup time (51% as compared with 39%) (F(2,21) = 12.782, adjusted R2 = 0.506; p < .05). Conclusions A model to predict setup time based on upper limb impairment and task complexity accounted for 51% of the variation in setup time. Further studies are required to test the model in real-world settings and to identify other contributing factors.
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Affiliation(s)
- Christine Smith
- Department of Allied Health Professions, Sheffield Hallam University, Sheffield, UK
| | - Laurence Kenney
- School of Health Sciences, University of Salford, Salford, UK
| | - David Howard
- School of Computing, Science and Engineering, University of Salford, Salford, UK
| | - Karen Waring
- School of Health Sciences, University of Salford, Salford, UK
| | - Minxgu Sun
- School of Health Sciences, University of Salford, Salford, UK
| | - Helen Luckie
- School of Health Sciences, University of Salford, Salford, UK
| | - Nicholas Hardiker
- School of Nursing, Midwifery, Social Work & Social Sciences, University of Salford, Salford, UK
| | - Sarah Cotterill
- Research & Development Department, Salford Royal NHS Foundation Trust, Salford, UK
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Valkenborghs SR, Callister R, Visser MM, Nilsson M, van Vliet P. Interventions combined with task-specific training to improve upper limb motor recovery following stroke: a systematic review with meta-analyses. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1597439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sarah R. Valkenborghs
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Biomedical Science and Pharmacy, Faculty of Health, University of Newcastle, Newcastle, NSW, Australia
| | - Milanka M. Visser
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Michael Nilsson
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
| | - Paulette van Vliet
- Priority Research Centre for Stroke and Brain Injury, University of Newcastle, Newcastle, NSW, Australia
- Centre for Research Excellence in Stroke Rehabilitation and Recovery, Hunter Medical Research Institute, Newcastle, NSW, Australia
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Ghaffari MS, Shariat A, Honarpishe R, Hakakzadeh A, Cleland JA, Haghighi S, Barghi TS. Concurrent Effects of Dry Needling and Electrical Stimulation in the Management of Upper Extremity Hemiparesis. J Acupunct Meridian Stud 2019; 12:90-94. [PMID: 31026521 DOI: 10.1016/j.jams.2019.04.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Revised: 03/24/2019] [Accepted: 04/03/2019] [Indexed: 02/02/2023] Open
Abstract
Stroke is one of the leading causes of disability in western countries. A variety of rehabilitation programs for the treatment of patients after stroke have been proposed. We describe the outcomes of a 49-year-old female patient with a 5-year history of right upper extremity hemiparesis after stroke. Physical examination revealed a right wrist extensor strength grade of 1 according to the Medical Research Council Manual Muscle Testing scale, Stage 4 according to the Brunnstrom hand functional recovery, and Grade 1 in finger flexor and in wrist flexor according to the Modified Modified Ashworth Scale system of muscle spasticity. Magnetic resonance imaging taken immediately after the stroke was indicative of an abnormal signal in the left paraventricular and lentiform nucleus. After receiving a single session of dry needling and electrical stimulation, the patient had significant improvement including a strength grade of 3 for the right wrist extensor muscles, Stage 6 according to the Brunnstrom hand functional recovery, and Grade 0 in finger flexor and in wrist flexor according to the Modified Modified Ashworth Scale system of muscle spasticity. This case report found that dry needling combined with electrical stimulation may be effective in hand function recovery, wrist extensor muscles strength, and decreased wrist and finger spasticity.
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Affiliation(s)
- Maryam S Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ardalan Shariat
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Roshanak Honarpishe
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Hakakzadeh
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sepehr Haghighi
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Tohid S Barghi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Rodgers MM, Alon G, Pai VM, Conroy RS. Wearable technologies for active living and rehabilitation: Current research challenges and future opportunities. J Rehabil Assist Technol Eng 2019; 6:2055668319839607. [PMID: 31245033 PMCID: PMC6582279 DOI: 10.1177/2055668319839607] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Accepted: 02/20/2019] [Indexed: 12/28/2022] Open
Abstract
This paper presents some recent developments in the field of wearable sensors and systems that are relevant to rehabilitation and provides examples of systems with evidence supporting their effectiveness for rehabilitation. A discussion of current challenges and future developments for selected systems is followed by suggestions for future directions needed to advance towards wider deployment of wearable sensors and systems for rehabilitation.
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Affiliation(s)
- Mary M Rodgers
- Department of Physical Therapy & Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gad Alon
- Department of Physical Therapy & Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | - Richard S Conroy
- Office of Strategic Coordination, National Institutes of Health, Bethesda, MD, USA
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13
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Gad* A. Functional Electrical Stimulation (FES): Clinical successes and failures to date. ACTA ACUST UNITED AC 2018. [DOI: 10.29328/journal.jnpr.1001022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gonzalez EJ, Downey RJ, Rouse CA, Dixon WE. Influence of Elbow Flexion and Stimulation Site on Neuromuscular Electrical Stimulation of the Biceps Brachii. IEEE Trans Neural Syst Rehabil Eng 2018; 26:904-910. [PMID: 29641395 DOI: 10.1109/tnsre.2018.2807762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Functional electrical stimulation (FES) can help individuals with physical disabilities by assisting limb movement; however, the change in muscle geometry associated with limb movement may affect the response to stimulation. The aim of this paper was to quantify the effects of elbow flexion and stimulation site on muscle torque production. Contraction torque about the elbow was measured in 12 healthy individuals using a custom elbow flexion testbed and a transcutaneous electrode array. Stimulation was delivered to six distinct sites along the biceps brachii over 11 elbow flexion angles. Flexion angle was found to significantly influence the optimal (i.e., torque-maximizing) stimulation site ( ), with post hoc analysis indicating a proximal shift in optimal stimulation site with increased flexion. Similarly, the biceps stimulation site was found to significantly influence the flexion angle at which peak torque occurred ( ), with post hoc analysis indicating an increase in peak-torque flexion angle as stimulation site is moved proximally up the biceps. Since maximizing muscle force per unit stimulation is a common goal in rehabilitative FES, future efforts could examine methods which compensate for the shift in optimal stimulation site during FES-induced limb movement.
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Abstract
The article presents examples of rehabilitation solutions in which textiles play an important role. They are a fully functional garment, an element of clothing adapted to a given part of the body or a product intended for use in improving health. They are designed with the use of modern production technologies that utilize various raw materials to support the health aspects of the user with their structure and properties.
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Capecci M, Ceravolo MG, Ferracuti F, Grugnetti M, Iarlori S, Longhi S, Romeo L, Verdini F. An instrumental approach for monitoring physical exercises in a visual markerless scenario: A proof of concept. J Biomech 2018; 69:70-80. [DOI: 10.1016/j.jbiomech.2018.01.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 12/01/2017] [Accepted: 01/08/2018] [Indexed: 11/27/2022]
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Arnin J, Yamsa-Ard T, Triponyuwasin P, Wongsawat Y. Development of practical functional electrical stimulation cycling systems based on an electromyography study of the Cybathlon 2016. Eur J Transl Myol 2017; 27:7111. [PMID: 29333223 PMCID: PMC5758952 DOI: 10.4081/ejtm.2017.7111] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 11/28/2017] [Accepted: 11/28/2017] [Indexed: 02/06/2023] Open
Abstract
The purpose of this study was to develop a functional electrical stimulation (FES) system based on the motor driving concept for use by spinal cord injury patients participating in the FES Cycling competition at the Cybathlon 2016. The proposed FES system consists of a low-power control system, a precise processor unit, and a 4-channel stimulation unit. Self-adhesive carbon conductive electrodes were utilized for stimulation. A 26-year-old SCI patient was qualified to participate in the competition. The pilot patient underwent training for 16 months, which included experience with FES stimulation, performing FES cycling, and reducing spasticity, to practice using the FES system. In addition, using surface electromyography (EMG) during cycling, the muscle activation pattern for generating the stimulation profile was applied and resulted in good performance. The best FES cycling performance the pilot achieved was 1000 meters translation with the cycling system during twelve minutes of using the FES system. The pilot achieved an 1000 meters translation mobility within an average of 16 minutes of cycling. Nevertheless, the system must be further investigated regarding muscle fatigue and other factors that may affect the stimulation conditions.
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Affiliation(s)
- Jetsada Arnin
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University
| | - Traisak Yamsa-Ard
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University
| | | | - Yodchanan Wongsawat
- Department of Biomedical Engineering, Faculty of Engineering, Mahidol University
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Meadmore KL, Exell TA, Burridge JH, Hughes AM, Freeman CT, Benson V. Upper limb and eye movement coordination during reaching tasks in people with stroke. Disabil Rehabil 2017; 40:2424-2432. [PMID: 28597701 DOI: 10.1080/09638288.2017.1336649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To enhance understanding of the relationship between upper limb and eye movements during reaching tasks in people with stroke. METHODS Eye movements were recorded from 10 control participants and 8 chronic stroke participants during a visual orienting task (Experiment 1) and a series of reaching tasks (Experiment 2). Stroke participants completed the reaching tasks using (i) their less impaired upper limb, (ii) their more impaired upper limb without support, and (iii) their more impaired upper limb, with support (SaeboMAS gravitational support and/or electrical stimulation). Participants were tested individually and completed both experiments in the same session. RESULTS Oculomotor control and the coordination between the upper limb and the oculomotor system were found to be intact in stroke participants when no limb movements were required, or when the less impaired upper limb was used. However, when the more impaired upper limb was used, success and accuracy in reaching decreased and patterns of eye movements changed, with an observed increase in eye movements to the limb itself. With upper limb support, patterns of hand-eye coordination were found to more closely resemble those of the control group. CONCLUSION Deficits in upper limb motor systems result in changes in patterns of eye movement behavior during reaching tasks. These changes in eye movement behavior can be modulated by providing upper limb support. Implications for Rehabilitation Deficits in upper limb motor systems can result in changes in patterns of eye movement behavior during reaching tasks. Upper limb support can reduce deficits in hand-eye coordination. Stroke rehabilitation outcomes should consider motor and oculomotor performance.
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Affiliation(s)
- Katie L Meadmore
- a Psychology, Faculty of Social, Human and Mathematical Sciences , University of Southampton , Southampton , UK.,b Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - Timothy A Exell
- c Faculty of Science , University of Portsmouth , Portsmouth , UK.,d Department of Electronics and Computer Science, Faculty of Physical Sciences and Engineering , University of Southampton , Southampton , UK
| | - Jane H Burridge
- b Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - Ann-Marie Hughes
- b Centre for Innovation and Leadership in Health Sciences, Faculty of Health Sciences , University of Southampton , Southampton , UK
| | - Christopher T Freeman
- d Department of Electronics and Computer Science, Faculty of Physical Sciences and Engineering , University of Southampton , Southampton , UK
| | - Valerie Benson
- a Psychology, Faculty of Social, Human and Mathematical Sciences , University of Southampton , Southampton , UK
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Kutlu M, Freeman C, Spraggs M. Functional electrical stimulation for home-based upper-limb stroke rehabilitation. CURRENT DIRECTIONS IN BIOMEDICAL ENGINEERING 2017. [DOI: 10.1515/cdbme-2017-0006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract:Functional electrical stimulation (FES) therapies have shown effectiveness in restoring movement post-stroke, especially when applied functionally to assist participants’ voluntary intention during repeated, motivating tasks. Recent development in non-contact sensors allows feedback to advanced controllers that precisely adjust FES via an electrode array to assist functional reach and grasp tasks. This has given rise to significant reduction in impairment, as measured in clinical trials. This paper describes the recent developments of a compact system suitable for transference to patients’ homes, with the intention of reducing upper-limb impairment following chronic stroke.
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Affiliation(s)
- Mustafa Kutlu
- 1Electronics and Computer Science, University of Southampton, UK
| | - Chris Freeman
- 1Electronics and Computer Science, University of Southampton, UK
| | - Matthew Spraggs
- 1Electronics and Computer Science, University of Southampton, UK
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