Effect of different terrains on onset timing, duration and amplitude of tibialis anterior activation

Hybrid and adaptive control of functional electrical stimulation to correct hemiplegic gait for patients after stroke

Introduction: Gait, as a fundamental human movement, necessitates the coordination of muscles across swing and stance phases. Functional electrical stimulation (FES) of the tibialis anterior (TA) has been widely applied to foot drop correction for patients with post-stroke during the swing phase. Although the gastrocnemius (GAS) during the stance phase is also affected, the Functional electrical stimulation of the gastrocnemius received less attention. Methods: To address this limitation, a timing- and intensity-adaptive Functional electrical stimulation control strategy was developed for both the TA and GAS. Each channel incorporates a speed-adaptive (SA) module to control stimulation timing and an iterative learning control (ILC) module to regulate the stimulation intensity. These modules rely on real-time kinematic or kinetic data during the swing or stance phase, respectively. The orthotic effects of the system were evaluated on eight patients with post-stroke foot drop. Gait kinematics and kinetics were assessed under three conditions: no stimulation (NS), Functional electrical stimulation to the ankle dorsiflexor tibialis anterior (SA-ILC DS) and FES to the tibialis anterior and the ankle plantarflexor gastrocnemius (SA-ILC DPS). Results: The ankle plantarflexion angle, the knee flexion angle, and the anterior ground reaction force (AGRF) in the SA-ILC DPS condition were significantly larger than those in the NS and SA-ILC DS conditions (p < 0.05). The maximum dorsiflexion angle during the swing phase in the SA-ILC DPS condition was similar to that in the SA-ILC DS condition, with both being significantly larger than the angle observed in the NS condition (p < 0.05). Furthermore, the angle error and force error relative to the set targets were minimized in the SA-ILC DPS condition. Discussion: The observed improvements can be ascribed to the appropriate stimulation timing and intensity provided by the SA-ILC DPS strategy. This study demonstrates that the hybrid and adaptive control strategy of functional electrical stimulation system offers a significant orthotic effect, and has considerable potential for future clinical application.

EMG-Centered Multisensory Based Technologies for Pattern Recognition in Rehabilitation: State of the Art and Challenges

In the field of rehabilitation, the electromyography (EMG) signal plays an important role in interpreting patients' intentions and physical conditions. Nevertheless, utilizing merely the EMG signal suffers from difficulty in recognizing slight body movements, and the detection accuracy is strongly influenced by environmental factors. To address the above issues, multisensory integration-based EMG pattern recognition (PR) techniques have been developed in recent years, and fruitful results have been demonstrated in diverse rehabilitation scenarios, such as achieving high locomotion detection and prosthesis control accuracy. Owing to the importance and rapid development of the EMG centered multisensory fusion technologies in rehabilitation, this paper reviews both theories and applications in this emerging field. The principle of EMG signal generation and the current pattern recognition process are explained in detail, including signal preprocessing, feature extraction, classification algorithms, etc. Mechanisms of collaborations between two important multisensory fusion strategies (kinetic and kinematics) and EMG information are thoroughly explained; corresponding applications are studied, and the pros and cons are discussed. Finally, the main challenges in EMG centered multisensory pattern recognition are discussed, and a future research direction of this area is prospected.

A Smart Terrain Identification Technique Based on Electromyography, Ground Reaction Force, and Machine Learning for Lower Limb Rehabilitation

Automatic terrain classification in lower limb rehabilitation systems has gained worldwide attention. In this field, a simple system architecture and high classification accuracy are two desired attributes. In this article, a smart neuromuscular–mechanical fusion and machine learning-based terrain classification technique utilizing only two electromyography (EMG) sensors and two ground reaction force (GRF) sensors is reported for classifying three different terrains (downhill, level, and uphill). The EMG and GRF signals from ten healthy subjects were collected, preprocessed and segmented to obtain the EMG and GRF profiles in each stride, based on which twenty-one statistical features, including 9 GRF features and 12 EMG features, were extracted. A support vector machine (SVM) machine learning model is established and trained by the extracted EMG features, GRF features and the fusion of them, respectively. Several methods or statistical metrics were used to evaluate the goodness of the proposed technique, including a paired-t-test and Kruskal–Wallis test for correlation analysis of the selected features and ten-fold cross-validation accuracy, confusion matrix, sensitivity and specificity for the performance of the SVM model. The results show that the extracted features are highly correlated with the terrain changes and the fusion of the EMG and GRF features produces the highest accuracy of 96.8%. The presented technique allows simple system construction to achieve the precise detection of outcomes, potentially advancing the development of terrain classification techniques for rehabilitation.