User-centered practicability analysis of two identification strategies in electrode arrays for FES induced hand motion in early stroke rehabilitation

Transcutaneous auricular vagus nerve stimulation in the treatment of disorders of consciousness: mechanisms and applications

This review provides an in-depth exploration of the mechanisms and applications of transcutaneous auricular vagus nerve stimulation (taVNS) in treating disorders of consciousness (DOC). Beginning with an exploration of the vagus nerve's role in modulating brain function and consciousness, we then delve into the neuroprotective potential of taVNS demonstrated in animal models. The subsequent sections assess the therapeutic impact of taVNS on human DOC, discussing the safety, tolerability, and various factors influencing the treatment response. Finally, the review identifies the current challenges in taVNS research and outlines future directions, emphasizing the need for large-scale trials, optimization of treatment parameters, and comprehensive investigation of taVNS's long-term effects and underlying mechanisms. This comprehensive overview positions taVNS as a promising and safe modality for DOC treatment, with a focus on understanding its intricate neurophysiological influence and optimizing its application in clinical settings.

Modeling Ankle Torque and Stiffness Induced by Functional Electrical Stimulation

Functional electrical stimulation (FES) is commonly used for individuals with neuromuscular impairments to generate muscle contractions. Both joint torque and stiffness play important roles in maintaining stable posture and resisting external disturbance. However, most previous studies only focused on the modulation of joint torque using FES while ignoring the joint stiffness. A model that can simultaneously modulate both ankle torque and stiffness induced by FES was investigated in this study. This model was composed of four subparts including an FES-to-activation model, a musculoskeletal geometry model, a Hill-based muscle-tendon model, and a joint stiffness model. The model was calibrated by the maximum voluntary contraction test of the tibialis anterior (TA) and gastrocnemius medial (GAS) muscles. To validate the model, the estimated torque and stiffness by the model were compared with the measured torque and stiffness induced by FES, respectively. The results showed that the proposed model can estimate torque and stiffness with electrically stimulated TA or/and GAS, which was significantly correlated to the measured torque and stiffness. The proposed model can modulate both joint torque and stiffness induced by FES in the isometric condition, which can be potentially extended to modulate the joint torque and stiffness during FES-assisted walking.

Multichannel Nerve Stimulation for Diverse Activation of Finger Flexors

OBJECTIVE

Neuromuscular electrical stimulation (NMES) is a common approach to restore muscle strength of individuals with a neurological injury but restoring hand dexterity is still a challenge. This study sought to quantify the diversity of finger movements elicited by a multichannel nerve stimulation technique.

METHODS

A 2 × 8 stimulation grid, placed on the upper arm along the ulnar and median nerves, was used to activate different finger flexors by automatically switching between randomized bipolar electrodes. The forces from each individual finger as well as the high-density electromyogram (HDEMG) of the intrinsic and extrinsic flexors were recorded. The elicited finger forces were categorized using hierarchical clustering, and the 2D correlation of the spatial patterns of muscle activation was also calculated.

RESULTS

A wide range of movement patterns were identified, including multi-finger and single-digit movements. Additionally, a number of electrode pairs elicited similar finger movements. The muscle activation patterns showed similar and distinct spatial patterns, signifying activation redundancy.

CONCLUSION

These results revealed the diversity of elicitable finger movements and muscle activations. The system redundancy can be explored to compensate for system instability due to fatigue or electrode shift. The outcomes can also enable the development of an automatic calibration of the stimulation.

A Tangible Solution for Hand Motion Tracking in Clinical Applications

Objective real-time assessment of hand motion is crucial in many clinical applications including technically-assisted physical rehabilitation of the upper extremity. We propose an inertial-sensor-based hand motion tracking system and a set of dual-quaternion-based methods for estimation of finger segment orientations and fingertip positions. The proposed system addresses the specific requirements of clinical applications in two ways: (1) In contrast to glove-based approaches, the proposed solution maintains the sense of touch. (2) In contrast to previous work, the proposed methods avoid the use of complex calibration procedures, which means that they are suitable for patients with severe motor impairment of the hand. To overcome the limited significance of validation in lab environments with homogeneous magnetic fields, we validate the proposed system using functional hand motions in the presence of severe magnetic disturbances as they appear in realistic clinical settings. We show that standard sensor fusion methods that rely on magnetometer readings may perform well in perfect laboratory environments but can lead to more than 15 cm root-mean-square error for the fingertip distances in realistic environments, while our advanced method yields root-mean-square errors below 2 cm for all performed motions.