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Buckmire AJ, Lockwood DR, Doane CJ, Fuglevand AJ. Distributed stimulation increases force elicited with functional electrical stimulation. J Neural Eng 2019; 15:026001. [PMID: 29099387 DOI: 10.1088/1741-2552/aa9820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The maximum muscle forces that can be evoked using functional electrical stimulation (FES) are relatively modest. The reason for this weakness is not fully understood but could be partly related to the widespread distribution of motor nerve branches within muscle. As such, a single stimulating electrode (as is conventionally used) may be incapable of activating the entire array of motor axons supplying a muscle. Therefore, the objective of this study was to determine whether stimulating a muscle with more than one source of current could boost force above that achievable with a single source. APPROACH We compared the maximum isometric forces that could be evoked in the anterior deltoid of anesthetized monkeys using one or two intramuscular electrodes. We also evaluated whether temporally interleaved stimulation between two electrodes might reduce fatigue during prolonged activity compared to synchronized stimulation through two electrodes. MAIN RESULTS We found that dual electrode stimulation consistently produced greater force (~50% greater on average) than maximal stimulation with single electrodes. No differences, however, were found in the fatigue responses using interleaved versus synchronized stimulation. SIGNIFICANCE It seems reasonable to consider using multi-electrode stimulation to augment the force-generating capacity of muscles and thereby increase the utility of FES systems.
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Affiliation(s)
- Alie J Buckmire
- Department of Physiology, University of Arizona, Tucson, AZ, United States of America.,Department of Neuroscience, University of Arizona, Tucson, AZ, United States of America
| | - Danielle R Lockwood
- Department of Physiology, University of Arizona, Tucson, AZ, United States of America
| | - Cynthia J Doane
- University Animal Care, University of Arizona, Tucson, AZ, United States of America
| | - Andrew J Fuglevand
- Department of Physiology, University of Arizona, Tucson, AZ, United States of America.,Department of Neuroscience, University of Arizona, Tucson, AZ, United States of America
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Wiest MJ, Bergquist AJ, Heffernan MG, Popovic M, Masani K. Fatigue and Discomfort During Spatially Distributed Sequential Stimulation of Tibialis Anterior. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1566-1573. [PMID: 31265401 DOI: 10.1109/tnsre.2019.2923117] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Neuromuscular electrical stimulation is conventionally applied through a single pair of electrodes over the muscle belly, denominated single electrode stimulation (SES). SES is limited by discomfort and incomplete motor-unit recruitment, restricting electrically-evoked torque and promoting premature fatigue-induced torque-decline. Sequential stimulation involving rotation of pulses between multiple pairs of electrodes has been proposed as an alternative, denominated spatially distributed sequential stimulation (SDSS). The present aim was to compare discomfort, maximal-tolerated torque, and fatigue-related outcomes between SES and SDSS of tibialis anterior. Ten healthy participants completed two experimental sessions. The self-reported discomfort at sub-maximal torque, the maximal-tolerated torque, fatigue-induced torque-decline during, and doublet-twitch torque at 10- and 100-Hz before and after, 300 intermittent (0.6-s-ON-0.6-s-OFF) isokinetic contractions were compared between SES and SDSS. SDSS stimulation improved fatigue-related outcomes, whereas increased discomfort and reduced maximal-tolerated torque. SDSS holds promise for reducing fatigue. However, limited torque production and associated discomfort may limit its utility for rehabilitation/training.
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Buckmire AJ, Arakeri TJ, Reinhard JP, Fuglevand AJ. Mitigation of excessive fatigue associated with functional electrical stimulation. J Neural Eng 2018; 15:066004. [PMID: 30168443 DOI: 10.1088/1741-2552/aade1c] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Restoration of motor function in paralyzed limbs using functional electrical stimulation (FES) is undermined by rapid fatigue associated with artificial stimulation. Typically, single electrodes are used to activate muscles with FES. However, due to the highly distributed branching of muscle nerves, a single electrode may not be able to activate the entire array of motor axons supplying a muscle. Therefore, stimulating muscle with multiple electrodes might enable access to a larger volume of muscle and thereby reduce fatigue. APPROACH Accordingly, we compared the endurance times that ankle dorsiflexion could be sustained at 20% maximum voluntary force using feedback controlled stimulation (25 Hz) of human tibialis anterior (TA) using one or four percutaneous intramuscular electrodes. In addition, we measured endurance times in response to direct stimulation of the nerve supplying TA and during voluntary contraction. In all sessions involving electrical stimulation, an anesthetic nerve block proximal to the site of stimulation was used to isolate the effects of stimulation and alleviate discomfort. MAIN RESULTS Endurance time associated with stimuli delivered by a single intramuscular electrode (84 ± 19 s) was significantly smaller than that elicited by four intramuscular electrodes (232 ± 123 s). Moreover, endurance time in response to nerve stimulation (787 ± 201 s) was not significantly different that that produced during voluntary contraction (896 ± 272 s). SIGNIFICANCE Therefore, excessive fatigue associated with FES is probably due to the inability of conventional FES systems to enlist the full complement of motor axons innervating muscle and can be mitigated using multiple electrodes or nerve-based electrodes.
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Affiliation(s)
- Alie J Buckmire
- Department of Physiology, College of Medicine, University of Arizona, Tucson, AZ, United States of America. Graduate Program in Neuroscience, College of Medicine, University of Arizona, Tucson, AZ, United States of America
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Potvin JR, Fuglevand AJ. A motor unit-based model of muscle fatigue. PLoS Comput Biol 2017; 13:e1005581. [PMID: 28574981 PMCID: PMC5473583 DOI: 10.1371/journal.pcbi.1005581] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 06/16/2017] [Accepted: 05/15/2017] [Indexed: 11/18/2022] Open
Abstract
Muscle fatigue is a temporary decline in the force and power capacity of skeletal muscle resulting from muscle activity. Because control of muscle is realized at the level of the motor unit (MU), it seems important to consider the physiological properties of motor units when attempting to understand and predict muscle fatigue. Therefore, we developed a phenomenological model of motor unit fatigue as a tractable means to predict muscle fatigue for a variety of tasks and to illustrate the individual contractile responses of MUs whose collective action determines the trajectory of changes in muscle force capacity during prolonged activity. An existing MU population model was used to simulate MU firing rates and isometric muscle forces and, to that model, we added fatigue-related changes in MU force, contraction time, and firing rate associated with sustained voluntary contractions. The model accurately estimated endurance times for sustained isometric contractions across a wide range of target levels. In addition, simulations were run for situations that have little experimental precedent to demonstrate the potential utility of the model to predict motor unit fatigue for more complicated, real-world applications. Moreover, the model provided insight into the complex orchestration of MU force contributions during fatigue, that would be unattainable with current experimental approaches.
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Affiliation(s)
- Jim R. Potvin
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Andrew J. Fuglevand
- Department of Physiology, College of Medicine, University of Arizona, Tucson, Arizona, United States of America
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Downey RJ, Cheng TH, Bellman MJ, Dixon WE. Switched Tracking Control of the Lower Limb During Asynchronous Neuromuscular Electrical Stimulation: Theory and Experiments. IEEE TRANSACTIONS ON CYBERNETICS 2017; 47:1251-1262. [PMID: 27076479 DOI: 10.1109/tcyb.2016.2543699] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Neuromuscular electrical stimulation (NMES) induces muscle contractions via electrical stimuli. NMES can be used for rehabilitation and to enable functional movements; however, a fundamental limitation is the early onset of fatigue. Asynchronous stimulation is a method that can reduce fatigue by utilizing multiple stimulation channels to segregate and switch between different sets of recruited motor units. However, switching between stimulation channels is challenging due to each channel's differing response to stimulation. To address this challenge, a switched systems analysis is used in the present work to design a controller that allows for instantaneous switching between stimulation channels. The developed controller yields semi-global exponential tracking of a desired angular trajectory for a person's knee-joint. Experiments were conducted in six able-bodied individuals. Compared to conventional stimulation, the results indicate that asynchronous stimulation with the developed controller yields longer durations of successful tracking despite different responses between the stimulation channels.
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Frankel MA, Mathews VJ, Clark GA, Normann RA, Meek SG. Control of Dynamic Limb Motion Using Fatigue-Resistant Asynchronous Intrafascicular Multi-Electrode Stimulation. Front Neurosci 2016; 10:414. [PMID: 27679557 PMCID: PMC5020091 DOI: 10.3389/fnins.2016.00414] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 08/25/2016] [Indexed: 11/28/2022] Open
Abstract
Asynchronous intrafascicular multi-electrode stimulation (aIFMS) of small independent populations of peripheral nerve motor axons can evoke selective, fatigue-resistant muscle forces. We previously developed a real-time proportional closed-loop control method for aIFMS generation of isometric muscle force and the present work extends and adapts this closed-loop controller to the more demanding task of dynamically controlling joint position in the presence of opposing joint torque. A proportional-integral-velocity controller, with integrator anti-windup strategies, was experimentally validated as a means to evoke motion about the hind-limb ankle joint of an anesthetized feline via aIFMS stimulation of fast-twitch plantar-flexor muscles. The controller was successful in evoking steps in joint position with 2.4% overshoot, 2.3-s rise time, 4.5-s settling time, and near-zero steady-state error. Controlled step responses were consistent across changes in step size, stable against external disturbances, and reliable over time. The controller was able to evoke smooth eccentric motion at joint velocities up to 8 deg./s, as well as sinusoidal trajectories with frequencies up to 0.1 Hz, with time delays less than 1.5 s. These experiments provide important insights toward creating a robust closed-loop aIFMS controller that can evoke precise fatigue-resistant motion in paralyzed individuals, despite the complexities introduced by aIFMS.
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Affiliation(s)
- Mitchell A Frankel
- Department of Mechanical Engineering, University of Utah Salt Lake City, UT, USA
| | - V John Mathews
- School of Electrical Engineering and Computer Science, Oregon State University Corvallis, OR, USA
| | - Gregory A Clark
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
| | - Richard A Normann
- Department of Bioengineering, University of Utah Salt Lake City, UT, USA
| | - Sanford G Meek
- Department of Mechanical Engineering, University of Utah Salt Lake City, UT, USA
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Downey RJ, Cheng TH, Bellman MJ, Dixon WE. Closed-Loop Asynchronous Neuromuscular Electrical Stimulation Prolongs Functional Movements in the Lower Body. IEEE Trans Neural Syst Rehabil Eng 2015; 23:1117-27. [PMID: 25935038 DOI: 10.1109/tnsre.2015.2427658] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Yaşar E, Yılmaz B, Göktepe S, Kesikburun S. The effect of functional electrical stimulation cycling on late functional improvement in patients with chronic incomplete spinal cord injury. Spinal Cord 2015; 53:866-9. [PMID: 25687513 DOI: 10.1038/sc.2015.19] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Revised: 01/09/2015] [Accepted: 01/14/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Prospective single-arm study. OBJECTIVES To investigate the effect of functional electrical stimulation (FES) cycling on late functional recovery, spasticity, gait parameters and oxygen consumption during walking in patients with chronic incomplete spinal cord injury (SCI). SETTING Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. METHODS Ten patients with chronic (duration of more than 2 years) incomplete SCI who could ambulate at least 10 m independently or with the assistance of a cane or walker, but no hip-knee-ankle-foot orthosis. The subjects underwent 1-h FES cycling sessions three times a week for 16 weeks. Outcome measures including the total motor score, the Functional Independence Measure (FIM) score, the Modified Ashworth Scale for knee spasticity, temporal spatial gait parameters and oxygen consumption rate during walking were assessed at baseline, 3 and 6 months after the baseline. RESULTS There were statistically significant improvements in total motor scores, the FIM scores and spasticity level at the 6-month follow-up (P<0.01). The changes in gait parameters reached no significant level (P>0.05). Oxygen consumption rate of the patients showed significant reduction at only 6 months compared with baseline (P<0.01). CONCLUSION The results suggest that FES cycling may provide some functional improvements in the late period of SCI. SPONSORSHIP The study was supported by The Scientific and Technological Research Council of Turkey (TUBITAK).
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Affiliation(s)
- E Yaşar
- Gülhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey
| | - B Yılmaz
- Gülhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey
| | - S Göktepe
- Gülhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey
| | - S Kesikburun
- Gülhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey
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Downey RJ, Bellman MJ, Kawai H, Gregory CM, Dixon WE. Comparing the Induced Muscle Fatigue Between Asynchronous and Synchronous Electrical Stimulation in Able-Bodied and Spinal Cord Injured Populations. IEEE Trans Neural Syst Rehabil Eng 2014; 23:964-72. [PMID: 25350934 DOI: 10.1109/tnsre.2014.2364735] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Neuromuscular electrical stimulation (NMES) has been shown to impart a number of health benefits and can be used to produce functional outcomes. However, one limitation of NMES is the onset of NMES-induced fatigue. Multi-channel asynchronous stimulation has been shown to reduce NMES-induced fatigue compared to conventional single-channel stimulation. However, in previous studies in man, the effect of stimulation frequency on the NMES-induced fatigue has not been examined for asynchronous stimulation. Low stimulation frequencies are known to reduce fatigue during conventional stimulation. Therefore, the aim of this study was to examine the fatigue characteristics of high- and low-frequency asynchronous stimulation as well as high- and low-frequency conventional stimulation. Experiments were performed in both able-bodied and spinal cord injured populations. Low frequency asynchronous stimulation is found to have significant fatigue benefits over high frequency asynchronous stimulation as well as high- and low-frequency conventional stimulation, motivating its use for rehabilitation and functional electrical stimulation (FES).
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Downey RJ, Tate M, Kawai H, Dixon WE. Comparing the force ripple during asynchronous and conventional stimulation. Muscle Nerve 2014; 50:549-55. [DOI: 10.1002/mus.24186] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 01/07/2014] [Accepted: 01/20/2014] [Indexed: 11/07/2022]
Affiliation(s)
- Ryan J. Downey
- Department of Mechanical and Aerospace Engineering; University of Florida; Gainesville Florida 32611-6250 USA
| | - Mark Tate
- Department of Mechanical and Aerospace Engineering; University of Florida; Gainesville Florida 32611-6250 USA
| | - Hiroyuki Kawai
- Department of Robotics; Kanazawa Institute of Technology; Ishikawa Japan
| | - Warren E. Dixon
- Department of Mechanical and Aerospace Engineering; University of Florida; Gainesville Florida 32611-6250 USA
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11
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Thomas CK, Bakels R, Klein CS, Zijdewind I. Human spinal cord injury: motor unit properties and behaviour. Acta Physiol (Oxf) 2014; 210:5-19. [PMID: 23901835 DOI: 10.1111/apha.12153] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 05/31/2013] [Accepted: 07/29/2013] [Indexed: 01/03/2023]
Abstract
Spinal cord injury (SCI) results in widespread variation in muscle function. Review of motor unit data shows that changes in the amount and balance of excitatory and inhibitory inputs after SCI alter management of motoneurons. Not only are units recruited up to higher than usual relative forces when SCI leaves few units under voluntary control, the force contribution from recruitment increases due to elevation of twitch/tetanic force ratios. Force gradation and precision are also coarser with reduced unit numbers. Maximal unit firing rates are low in hand muscles, limiting voluntary strength, but are low, normal or high in limb muscles. Unit firing rates during spasms can exceed voluntary rates, emphasizing that deficits in descending drive limit force production. SCI also changes muscle properties. Motor unit weakness and fatigability seem universal across muscles and species, increasing the muscle weakness that arises from paralysis of units, motoneuron death and sensory impairment. Motor axon conduction velocity decreases after human SCI. Muscle contractile speed is also reduced, which lowers the stimulation frequencies needed to grade force when paralysed muscles are activated with patterned electrical stimulation. This slowing does not necessarily occur in hind limb muscles after cord transection in cats and rats. The nature, duration and level of SCI underlie some of these species differences, as do variations in muscle function, daily usage, tract control and fibre-type composition. Exploring this diversity is important to promote recovery of the hand, bowel, bladder and locomotor function most wanted by people with SCI.
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Affiliation(s)
- C. K. Thomas
- The Miami Project to Cure Paralysis, Departments of Neurological Surgery, and Physiology and Biophysics; University of Miami; Miami FL USA
| | - R. Bakels
- Department of Neuroscience; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - C. S. Klein
- Rehabilitation Institute of Chicago; Chicago IL USA
| | - I. Zijdewind
- Department of Neuroscience; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
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Normann RA, Dowden BR, Frankel MA, Wilder AM, Hiatt SD, Ledbetter NM, Warren DA, Clark GA. Coordinated, multi-joint, fatigue-resistant feline stance produced with intrafascicular hind limb nerve stimulation. J Neural Eng 2012; 9:026019. [PMID: 22414699 DOI: 10.1088/1741-2560/9/2/026019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The production of graceful skeletal movements requires coordinated activation of multiple muscles that produce torques around multiple joints. The work described herein is focused on one such movement, stance, that requires coordinated activation of extensor muscles acting around the hip, knee and ankle joints. The forces evoked in these muscles by external stimulation all have a complex dependence on muscle length and shortening velocities, and some of these muscles are biarticular. In order to recreate sit-to-stand maneuvers in the anesthetized feline, we excited the hind limb musculature using intrafascicular multielectrode stimulation (IFMS) of the muscular branch of the sciatic nerve, the femoral nerve and the main branch of the sciatic nerve. Stimulation was achieved with either acutely or chronically implanted Utah Slanted Electrode Arrays (USEAs) via subsets of electrodes (1) that activated motor units in the extensor muscles of the hip, knee and ankle joints, (2) that were able to evoke large extension forces and (3) that manifested minimal coactivation of the targeted motor units. Three hind limb force-generation strategies were investigated, including sequential activation of independent motor units to increase force, and interleaved or simultaneous IFMS of three sets of six or more USEA electrodes that excited the hip, knee and ankle extensors. All force-generation strategies evoked stance, but the interleaved IFMS strategy also reduced muscle fatigue produced by repeated sit-to-stand maneuvers compared with fatigue produced by simultaneous activation of different motor neuron pools. These results demonstrate the use of interleaved IFMS as a means to recreate coordinated, fatigue-resistant multi-joint muscle forces in the unilateral hind limb. This muscle activation paradigm could provide a promising neuroprosthetic approach for the restoration of sit-to-stand transitions in individuals who are paralyzed by spinal cord injury, stroke or disease.
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Affiliation(s)
- R A Normann
- Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA.
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Dowden BR, Frankel MA, Normann RA, Clark GA. Non-invasive method for selection of electrodes and stimulus parameters for FES applications with intrafascicular arrays. J Neural Eng 2011; 9:016006. [PMID: 22173566 DOI: 10.1088/1741-2560/9/1/016006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
High-channel-count intrafascicular electrode arrays provide comprehensive and selective access to the peripheral nervous system. One practical difficulty in using several electrode arrays to evoke coordinated movements in paralyzed limbs is the identification of the appropriate stimulation channels and stimulus parameters to evoke desired movements. Here we present the use of a six degree-of-freedom load cell placed under the foot of a feline to characterize the muscle activation produced by three 100-electrode Utah Slanted Electrode Arrays (USEAs) implanted into the femoral nerves, sciatic nerves, and muscular branches of the sciatic nerves of three cats. Intramuscular stimulation was used to identify the endpoint force directions produced by 15 muscles of the hind limb, and these directions were used to classify the forces produced by each intrafascicular USEA electrode as flexion or extension. For 451 USEA electrodes, stimulus intensities for threshold and saturation muscle forces were identified, and the 3D direction and linearity of the force recruitment curves were determined. Further, motor unit excitation independence for 198 electrode pairs was measured using the refractory technique. This study demonstrates the utility of 3D endpoint force monitoring as a simple and non-invasive metric for characterizing the muscle-activation properties of hundreds of implanted peripheral nerve electrodes, allowing for electrode and parameter selection for neuroprosthetic applications.
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Affiliation(s)
- B R Dowden
- Department of Bioengineering, University of Utah, Salt Lake City, UT 84112, USA
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Frankel MA, Dowden BR, Mathews VJ, Normann RA, Clark GA, Meek SG. Multiple-input single-output closed-loop isometric force control using asynchronous intrafascicular multi-electrode stimulation. IEEE Trans Neural Syst Rehabil Eng 2011; 19:325-32. [PMID: 21385670 DOI: 10.1109/tnsre.2011.2123920] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although asynchronous intrafascicular multi-electrode stimulation (IFMS) can evoke fatigue-resistant muscle force, a priori determination of the necessary stimulation parameters for precise force production is not possible. This paper presents a proportionally-modulated, multiple-input single-output (MISO) controller that was designed and experimentally validated for real-time, closed-loop force-feedback control of asynchronous IFMS. Experiments were conducted on anesthetized felines with a Utah Slanted Electrode Array implanted in the sciatic nerve, either acutely or chronically ( n = 1 for each). Isometric forces were evoked in plantar-flexor muscles, and target forces consisted of up to 7 min of step, sinusoidal, and more complex time-varying trajectories. The controller was successful in evoking steps in force with time-to-peak of less than 0.45 s, steady-state ripple of less than 7% of the mean steady-state force, and near-zero steady-state error even in the presence of muscle fatigue, but with transient overshoot of near 20%. The controller was also successful in evoking target sinusoidal and complex time-varying force trajectories with amplitude error of less than 0.5 N and time delay of approximately 300 ms. This MISO control strategy can potentially be used to develop closed-loop asynchronous IFMS controllers for a wide variety of multi-electrode stimulation applications to restore lost motor function.
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Affiliation(s)
- Mitchell A Frankel
- Department of Mechanical Engineering, University of Utah, Salt Lake City, UT 84112, USA.
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15
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Abstract
Weakness is a characteristic of muscles influenced by the postpolio syndrome (PPS), amyotrophic lateral sclerosis (ALS), and spinal cord injury (SCI). The strength deficits relate to changes in muscle use and to the chronic denervation that can follow the spinal motoneuron death common to these disorders. PPS, ALS, and SCI also involve variable amounts of supraspinal neuron death, the effects of which on muscle weakness remains unclear. Nevertheless, weakness of muscle itself defines the functional consequences of these disorders. A weaker muscle requires an individual to work that muscle at higher than usual intensities relative to its maximal capacity, inducing progressive fatigue and an increased sense of effort. Little evidence is available to suggest that the fatigue commonly experienced by individuals with these disorders relates to an increase in the intrinsic fatigability of the muscle fibers. The only exception is when SCI induces chronic muscle paralysis. To reduce long-term functional deficits in these disorders, studies must identify the signaling pathways that influence neuron survival and determine the factors that encourage and limit sprouting of motor axons. This may ensure that a greater proportion of the fibers in each muscle remain innervated and available for use.
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Affiliation(s)
- Christine K Thomas
- The Miami Project to Cure Paralysis, Lois Pope LIFE Center, 1095 NW 14th Terrace (R-48), Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Morgan DL, Gregory JE, Proske U. The influence of fatigue on damage from eccentric contractions in the gastrocnemius muscle of the cat. J Physiol 2004; 561:841-50. [PMID: 15486022 PMCID: PMC1665381 DOI: 10.1113/jphysiol.2004.069948] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Eccentric exercise is unique in that it can lead to muscle damage and soreness. Concentric exercise is not accompanied by evidence of damage. There are reports in the literature that muscle fatigue is a factor determining the amount of damage from eccentric exercise. Our theory for the damage process predicts that susceptibility for damage is independent of fatigue. Experiments were carried out to test this prediction as well as to seek other evidence in support of our theory. Comparisons were made between the effects of eccentric and concentric contractions. The nerve supply to the medial gastrocnemius muscle of the anaesthetized cat was divided into three equal portions in terms of the tension they generated. In the first experiment a muscle portion was fatigued by giving it 200 shortening contractions over 12 mm at a shortening speed of 50 mm s(-1). This led to a mean fall in isometric tension (37 +/- 4%) without a significant shift in the optimum length for peak active tension. Giving the fatigued muscle 10 eccentric contractions, active stretches over 6 mm at 50 mm s(-1), beginning from the muscle's optimum length led to a further fall in tension (11% +/- 7%) and a significant shift in optimum length (3.7 mm +/- 0.6 mm) in the direction of longer muscle lengths. The shift in optimum was taken as an indicator of muscle damage. This shift was not significantly different from that seen after eccentric contractions carried out on an unfatigued muscle. After a series of eccentric or concentric contractions, tension at the end of a ramp shortening of 6 mm at 10 mm s(-1) fell more than isometric tension, and by near equal amounts for the two kinds of contractions. In an unfatigued muscle, if tension was altered by changing the rate of stimulation, the fall in shortening tension was greater than after either concentric or eccentric contractions. These observations were seen to be consistent with predictions of the proposed mechanism for the damage process.
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Affiliation(s)
- D L Morgan
- Department of Physiology, Monash University, Clayton, VIC 3800, Australia
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Kalezic I, Bugaychenko LA, Kostyukov AI, Pilyavskii AI, Ljubisavljevic M, Windhorst U, Johansson H. Fatigue-related depression of the feline monosynaptic gastrocnemius-soleus reflex. J Physiol 2004; 556:283-96. [PMID: 14645451 PMCID: PMC1664889 DOI: 10.1113/jphysiol.2003.053249] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2003] [Accepted: 11/21/2003] [Indexed: 12/21/2022] Open
Abstract
In decerebrate cats, changes in the monosynaptic reflex (MSR) of gastrocnemius-soleus (G-S) motoneurones were studied after fatiguing stimulation (FST) of the G-S muscles. Monosynaptic reflexes were evoked by stimulation of Ia fibres in the G-S nerve and recorded from a filament of ventral root (VR) L7. FST (intermittent 40 s(-1) stimulation for 10-12 min) was applied to the distal part of the cut VR S1. FST reduced MSR amplitudes to 0.64 +/- 0.04 (mean +/-s.e.m.) of the prefatigue values. The suppression remained stable for approximately 25 min and then MSR amplitudes gradually returned towards the normal. To test for the involvement of presynaptic and recurrent inhibition, MSRs were conditioned by stimulation of the nerve to the posterior biceps and semitendinosus (PBSt) muscles or a filament of VR L7, respectively. The intensity of presynaptic inhibition (reduction of the normalized value of MSR amplitude during conditioning) increased from 0.19 +/- 0.02 in prefatigue to 0.44 +/- 0.04 within a 5.3-18.2 min interval after FST, followed by a recovery. In contrast, the intensity of recurrent inhibition first diminished from 0.23 +/- 0.02 in prefatigue to 0.15 +/- 0.01 within 15.6-30.1 min after FST and then gradually recovered. Both primary afferent depolarization and the intensity of antidromic discharges in primary afferents increased with the presynaptic inhibition intensity. These results demonstrate a fatigue-related suppression of Ia excitation of synergistic motoneurones, probably arising from the activation of group III and IV afferents. The effects could in part be due to increased presynaptic inhibition, while recurrent inhibition plays a minor role.
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Affiliation(s)
- Ivana Kalezic
- Centre for Musculoskeletal Research, University of Gävle, PO Box 7629, S-907 12 Umeå, Sweden.
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Whitehead NP, Morgan DL, Gregory JE, Proske U. Rises in whole muscle passive tension of mammalian muscle after eccentric contractions at different lengths. J Appl Physiol (1985) 2003; 95:1224-34. [PMID: 12740312 DOI: 10.1152/japplphysiol.00163.2003] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This is a report of experiments carried out on the medial gastrocnemius muscle of the anesthetized cat, investigating the effects of eccentric contractions carried out at different muscle lengths on the passive and active length-tension relationships. In one series of experiments, the motor supply to the muscle was divided into three approximately equal parts; in the other, whole muscles were used. Fifty eccentric contractions were carried out over different regions of the active length-tension curve for each partial or whole muscle. Active and passive length-tension curves were measured before and after the eccentric contractions. When eccentric contractions were carried out at longer lengths, there was a larger shift of the optimum length for active tension in the direction of longer muscle lengths and a larger fall in peak isometric tension. Passive tension was higher immediately after the eccentric contractions, and if the muscle was left undisturbed for 40 min, it increased further to higher values, particularly after contractions at longer lengths. A series of 20 passive stretches of the same speed and amplitude and covering the same length range as the active stretches, reduced the passive tension which redeveloped over a subsequent 40-min period. It is hypothesized that there are two factors influencing the level of passive tension in a muscle after a series of eccentric contractions. One is injury contractures in damaged muscle fibers tending to raise passive tension; the other is the presence of disrupted sarcomeres in series with still-functioning sarcomeres tending to reduce it.
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Affiliation(s)
- N P Whitehead
- Department of Physiology, Monash University, Melbourne, Victoria 3800, Australia
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19
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Duchateau J, Balestra C, Carpentier A, Hainaut K. Reflex regulation during sustained and intermittent submaximal contractions in humans. J Physiol 2002; 541:959-67. [PMID: 12068054 PMCID: PMC2290373 DOI: 10.1113/jphysiol.2002.016790] [Citation(s) in RCA: 115] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
To investigate whether the intensity and duration of a sustained contraction influences reflex regulation, we compared sustained fatiguing contractions at 25 % and 50 % of maximal voluntary contraction (MVC) force in the human abductor pollicis brevis (APB) muscle. Because the activation of motoneurones during fatigue may be reflexively controlled by the metabolic status of the muscle, we also compared reflex activities during sustained and intermittent (6 s contraction, 4 s rest) contractions at 25 % MVC for an identical duration. The short-latency Hoffmann(H) reflex and the long-latency reflex (LLR) were recorded during voluntary contractions, before, during and after the fatigue tests, with each response normalised to the compound muscle action potential (M-wave). The results showed that fatigue during sustained contractions was inversely related to the intensity, and hence the duration, of the effort. The MVC force and associated surface electromyogram (EMG) declined by 26.2 % and 35.2 %, respectively, after the sustained contraction at 50 % MVC, and by 34.2 % and 44.2 % after the sustained contraction at 25 % MVC. Although the average EMG increased progressively with time during the two sustained fatiguing contractions, the amplitudes of the H and LLR reflexes decreased significantly. Combined with previous data (Duchateau & Hainaut, 1993), the results show that the effect on the H reflex is independent of the intensity of the sustained contraction, whereas the decline in the LLR is closely related to the duration of the contraction. Because there were no changes in the intermittent test at 25 % MVC, the results indicate that the net excitatory spinal and supraspinal reflex-mediated input to the motoneurone pool is reduced. This decline in excitation to the motoneurones, however, can be temporarily compensated by an enhancement of the central drive.
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Affiliation(s)
- Jacques Duchateau
- Laboratory of Biology, Université Libre de Bruxelles, 28 avenue P. Héger, CP 168, Belgium
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20
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Brockett CL, Morgan DL, Gregory JE, Proske U. Damage to different motor units from active lengthening of the medial gastrocnemius muscle of the cat. J Appl Physiol (1985) 2002; 92:1104-10. [PMID: 11842046 DOI: 10.1152/japplphysiol.00479.2001] [Citation(s) in RCA: 58] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Slow-twitch motor units in the medial gastrocnemius muscle of the anesthetized cat were found to have an average optimum length for active tension that was 0.8 +/- 0.5 (SE) mm longer than the whole muscle optimum. For fast-twitch units (time to peak < 50 ms), the average optimum was 1.3 +/- 0.3 mm shorter than the whole muscle optimum. After the muscle had been subjected to 10 stretches while maximally activated, beginning at the whole muscle optimum length, the optimum lengths of the 27 fast-twitch motor units shifted significantly further in the direction of longer muscle lengths (mean 4.3 +/- 0.3 mm) than for the eight slow-twitch units (2.1 +/- 0.4 mm). A shift in the muscle's length-tension relation was interpreted as being due to sarcomere disruption. Statistical analysis showed that a motor unit's optimum length for a contraction, relative to the whole muscle optimum, was a better indicator of the unit's susceptibility to damage from active lengthenings than was motor unit type.
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Affiliation(s)
- C L Brockett
- Department of Physiology, Monash University, Melbourne, Victoria 3800, Australia
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21
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Gregory JE, Brockett CL, Morgan DL, Whitehead NP, Proske U. Effect of eccentric muscle contractions on Golgi tendon organ responses to passive and active tension in the cat. J Physiol 2002; 538:209-18. [PMID: 11773329 PMCID: PMC2290032 DOI: 10.1113/jphysiol.2001.012785] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
To investigate the possibility of a peripheral contribution to the perturbations of force sensation reported to occur after eccentric exercise, responses to passive and active tension were recorded from Golgi tendon organs in the medial gastrocnemius muscle of the anaesthetised cat, before and after a series of eccentric contractions. After the eccentric contractions, nearly all tendon organs commenced firing at a shorter muscle length during slow passive stretch than before, probably because of a rise in whole muscle passive tension. There was a small drop in the sensitivity to incremental tension, but no mean change in tension threshold. Following the eccentric contractions, there was a small, but not significant, increase in tendon organ sensitivity to active tension, which was graded using a method of optimised, distributed stimulation of divided ventral roots. Sensitivity was estimated as the mean response over a range of tensions and as the change in discharge rate in response to incremental tension. The experiments provided the opportunity of comparing tendon organ sensitivities to graded passive and active whole muscle tension. In agreement with previous work in which whole muscle nerve stimulation was employed, little difference was found. It was concluded that the peripheral contribution to perturbations of force perception after eccentric exercise is likely to be small and that the centrally derived sense of effort plays the dominant role. Tendon organs appear to be remarkably reliable in signalling whole muscle tension, whether passive or active, and even after the muscle's force production has been disturbed by fatigue or eccentric exercise.
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Affiliation(s)
- J E Gregory
- Department of Physiology, Monash University, Victoria 3800, Australia.
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Whitehead NP, Weerakkody NS, Gregory JE, Morgan DL, Proske U. Changes in passive tension of muscle in humans and animals after eccentric exercise. J Physiol 2001; 533:593-604. [PMID: 11389215 PMCID: PMC2278643 DOI: 10.1111/j.1469-7793.2001.0593a.x] [Citation(s) in RCA: 121] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
1. This is a report of experiments on ankle extensor muscles of human subjects and a parallel series on the medial gastrocnemius of the anaesthetised cat, investigating the origin of the rise in passive tension after a period of eccentric exercise. 2. Subjects exercised their triceps surae of one leg eccentrically by walking backwards on an inclined, forward-moving treadmill. Concentric exercise required walking forwards on a backwards-moving treadmill. For all subjects the other leg acted as a control. 3. Immediately after both eccentric and concentric exercise there was a significant drop in peak active torque, but only after eccentric exercise was this accompanied by a shift in optimum angle for torque generation and a rise in passive torque. In the eccentrically exercised group some swelling and soreness developed but not until 24 h post-exercise. 4. In the animal experiments the contracting muscle was stretched by 6 mm at 50 mm s(-1) over a length range symmetrical about the optimum length for tension generation. Measurements of passive tension were made before and after the eccentric contractions, using small stretches to a range of muscle lengths, or with large stretches covering the full physiological range. 5. After 150 eccentric contractions, passive tension was significantly elevated over most of the range of lengths. Measurements of work absorption during stretch-release cycles showed significant increases after the contractions. 6. It is suggested that the rise in passive tension in both human and animal muscles after eccentric contractions is the result of development of injury contractures in damaged muscle fibres.
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Affiliation(s)
- N P Whitehead
- Department of Physiology, Monash University, Clayton, Victoria 3168, Australia
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