Electrotactile stimulator for artificial proprioception

Applicability and tolerability of electrical stimulation applied to the upper and lower leg skin surface for cueing applications in Parkinson's disease

Due to possible sensory impairments in people with Parkinson's disease, several methodological aspects of electrical stimulation as a potential cueing method remain to be explored. This study aimed to investigate the applicability and tolerability of sensory and motor electrical stimulation in 10 people with Parkinson's disease. The study focused on assessing the electrical stimulation voltages and visual analogue scale discomfort scores at the electrical sensory, motor, discomfort, and pain thresholds. Results show that sensory electrical stimulation at the tibialis anterior, soleus, hamstrings, and quadriceps stimulation sites was applicable and tolerable for 6/10, 10/10, 9/10, and 10/10 participants, respectively. Furthermore, motor electrical stimulation at the tibialis anterior, soleus, hamstrings, and quadriceps stimulation sites were applicable and tolerable for 7/10, 7/10, 7/10, and 8/10 participants, respectively. Interestingly, the thresholds for the lower leg were higher than those of the upper leg. The data presented in this paper indicate that sensory and motor electrical stimulation is applicable and tolerable for cueing applications in people with Parkinson's disease. Sensory electrical stimulation was applicable and tolerable at the soleus and quadriceps sites. Motor electrical stimulation was not tolerable for two participants at any of the proposed stimulation sites. Therefore, future studies investigating motor electrical stimulation cueing, should apply it with caution in people with Parkinson's disease.

An Epidermal Stimulation and Sensing Platform for Sensorimotor Prosthetic Control, Management of Lower Back Exertion, and Electrical Muscle Activation

The design of an ultrathin, conformal electronic device that integrates electrotactile stimulation with electromyography, temperature, and strain sensing in a single, simple platform is reported. Experiments demonstrate simultaneous use of multiple modes of operation of this type of device in the sensorimotor control of robotic systems, in the monitoring of lower back exertion and in muscle stimulation.

Haptic feedback enhances grip force control of sEMG-controlled prosthetic hands in targeted reinnervation amputees

In this study, we hypothesized that haptic feedback would enhance grip force control of surface electromyography (sEMG)-controlled prosthetic hands for targeted reinnervation (TR) amputees. A new miniature haptic device, a tactor, that can deliver touch, pressure, shear, and temperature sensation, allows modality-matching haptic feedback. TR surgery that creates sensory regions on the patient's skin that refer to the surface of the missing limb allows somatotopic-matching haptic feedback. This paper evaluates the hypothesis via an sEMG-controlled virtual prosthetic arm operated by TR amputees under diverse haptic feedback conditions. The results indicate that the grip force control is significantly enhanced via the haptic feedback. However, the simultaneous display of two haptic channels (pressure and shear) does not enhance, but instead degrades, grip force control.

Perception of electrical and mechanical stimulation of the skin: implications for electrotactile feedback

Spinal cord injury is often accompanied by impaired tactile and proprioceptive sensations. Normally, somatosensensory information derived from such sensations is important in the formation of voluntary motor commands. Therefore, as a preliminary step toward the development of an electrotactile feedback system to restore somatosensation, psychophysical methods were used to characterize perceptual attributes associated with electrical stimulation of the skin on the back of the neck in human subjects. These data were compared to mechanical stimulation of the skin on the back of neck and on the distal pad of the index finger. Spatial acuity of the neck, evaluated using two-point thresholds, was not significantly different for electrical (37 +/- 14 mm) or mechanical stimulation (39 +/- 10 mm). The exponent (beta) of the best fitting power function relating perceived intensity to applied stimulus strength was used to characterize perceptual sensitivity to mechanical and electrical stimuli. For electrical stimuli, both current amplitude-modulated and frequency-modulated trains of pulses were tested. Perceptual sensitivity was significantly greater for current amplitude modulation (beta = 1.14 +/- 0.37) compared to frequency modulation (beta = 0.57 +/- 0.24) and mechanical stimulation (0.51 +/- 0.12). Finally, based on the data gathered here, we derive a transfer function that could be used in the future to convert mechanical stimuli detected with artificial sensors placed on the fingers into electrotactile signals that evoke perceptions similar to those arising from normal mechanical stimulation of the skin.

Tendências em biomecânica ortopédica aplicadas à reabilitação

Conceitos de Biomecânica são constantemente utilizados nas mais diversas áreas. Tais conceitos são entretanto primordiais na área de Engenharia de Reabilitação. Este artigo pretende divulgar alguns estudos realizados e em andamento nas áreas de biomecânica e bioengenharia com o intuito de desenvolver novas técnicas para reabilitação de pacientes com algum tipo de deficiência motora. Estas deficiências podem ser de âmbito neurológico ou músculo-esquelético. Dentre as deficiências causadas por problemas neurológicos, pode-se mencionar os casos oriundos de lesões medulares, como a paraplégica e a tetraplegia, e os causados por lesões crânio-encefálicas. No campo das deficiências músculo-esqueléticas incluem-se amputações de membros inferiores ou superiores, doenças congênitas, e algumas doenças degenerativas, como a osteoporose.

A. Estimulação elétrica neuromuscular e estimulação eletrotáctil na restauração artificial da preensão e da propriocepção em tetraplégicos

Esse trabalho discute o uso da estimulação elétrica na reabilitação sensoriomotora de membros superiores paralisados. A restauração da função motora de preensão foi obtida pela aplicação da estimulação elétrica neuromuscular, em seqüências de ativação adequadas a realização de atividades do cotidiano como comer, beber, escrever e digitar. Uma luva instrumentalizada com sensores de força possibilitou quantificar o padrão de movimento exercido artificialmente. Esse sistema foi utilizado como alça de realimentação para a restauração de uma propriocepção através da aplicação da estimulação eletrotáctil, possibilitando a evocação de sensações tácteis codificadas, relacionadas ao movimento artificial. A integração sensoriomotora se deu pela aplicação simultânea dos sistemas desenvolvidos, possibilitando desde a restauração de padrões funcionais de preensão, até o reconhecimento do padrão de movimento exercido através das sensações evocadas artificialmente.

Artificial sensorimotor integration in spinal cord injured subjects through neuromuscular and electrotactile stimulation

Spinal cord injured (SCI) subjects lack sensorimotor functions. Neuromuscular electrical stimulation (NMES) systems have been used to artificially restore motor functions, but without proprioceptive feedback, SCI subjects can control NMES systems only when they can see their limbs. In a gait restoration system, the subject looks down to the ground to be aware of where his foot is while in a grasping activity, maximum grip strength is employed regardless of the force that is required to perform tasks. This report focuses on artificial sensorimotor integration. Multichannel stimulation was used to restore motor functions while encoded tactile sensation (moving fused phantom images) relating to artificially generated movements was provided by electrotactile stimulation during walking and grasping activities. The results showed that the sensorimotor integration attained yielded both the recognition of artificial grasp force patterns and a technique to be used by paraplegics allowing spatial awareness of their limb while walking.

An artificial grasping evaluation system for the paralysed hand

Neuromuscular electrical stimulation (NMES) has been used in upper limb rehabilitation towards restoring motor hand function. Quantitative evaluation of the artificially generated movement is necessary to achieve proper muscle activation. Custom-made gloves instrumented with force and position transducers were used to evaluate artificial quadriplegic grasping for a drinking activity. In spite of different sensor position, stimulation parameter dependence and lack of repeatability, grasp patterns achieved with the application of NMES follow the same patterns previously obtained with normal subjects, regarding force distribution among fingers and the shape of force curves. Larger forces were exerted by the thumb (average ranged from 2.8 to 4.5 N) following by index or long finger (average ranged from 1.8 to 3 N). The forces exerted ranged within the same interval as those previously measured and were sufficient to grasp an object of 10 N. Finger position achieved by interphalangeal joint status indicated the opening size of the hand throughout the range of movement. The instrumented gloves offer an alternative force and position feedback system for use in cylindrical grasp evaluation. The gloves can be used in a closed-loop control system, allowing on-line adjustment or in a clinical application to evaluate the results of a rehabilitation programme.

A solution for linearity, stability and frequency bandwidth in PAM electrocutaneous stimulators' isolation interface

This paper introduces a novel method to isolate low-level from high-voltage circuits and/or channels of PAM electrocutaneous stimulators in neuromuscular electrical stimulation (NMES). The method avoids problems of linearity and polarization stability of optocouplers and narrow bandwidth of isolation amplifiers. Its main parameters are: carrier frequency of rectangular pulses up to 1 MHz and maximum modulating signal (elliptical or triangular envelopes) of 50 kHz. The circuit has low drift, high-voltage isolation, low-power consumption, requires few components, is battery-operated and ideal for microcomputer interface-based applications.