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Gunnarsson E, Rödby K, Seoane F. Seamlessly integrated textile electrodes and conductive routing in a garment for electrostimulation: design, manufacturing and evaluation. Sci Rep 2023; 13:17408. [PMID: 37833440 PMCID: PMC10575854 DOI: 10.1038/s41598-023-44622-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 10/10/2023] [Indexed: 10/15/2023] Open
Abstract
Electro-stimulation to alleviate spasticity, pain and to increase mobility has been used successfully for years. Usually, gelled electrodes are used for this. In a garment intended for repeated use such electrodes must be replaced. The Mollii-suit by the company Inerventions utilises dry conductive rubber electrodes. The electrodes work satisfactory, but the garment is cumbersome to fit on the body. In this paper we show that knitted dry electrodes can be used instead. The knitted electrodes present a lower friction against the skin and a garment is easily fitted to the body. The fabric is stretchable and provides a tight fit to the body ensuring electrical contact. We present three candidate textrodes and show how we choose the one with most favourable features for producing the garment. We validate the performance of the garment by measuring three electrical parameters: rise time (10-90%) of the applied voltage, net injected charge and the low frequency value of the skin-electrode impedance. It is concluded that the use of flat knitting intarsia technique can produce a garment with seamlessly integrated conductive leads and electrodes and that this garment delivers energy to the body as targeted and is beneficial from manufacturing and comfort perspectives.
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Affiliation(s)
- Emanuel Gunnarsson
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, Borås, Sweden.
| | - Kristian Rödby
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, Borås, Sweden
| | - Fernando Seoane
- Textile Materials Technology, Department of Textile Technology, Faculty of Textiles, Engineering and Business Swedish School of Textiles, University of Borås, Borås, Sweden
- Institute for Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Care Technology, Karolinska University Hospital, 14157, Huddinge, Sweden
- Department of Clinical Physiology, Karolinska University Hospital, 14157, Huddinge, Sweden
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Dujović SD, Malešević J, Malešević N, Vidaković AS, Bijelić G, Keller T, Konstantinović L. Novel multi-pad functional electrical stimulation in stroke patients: A single-blind randomized study. NeuroRehabilitation 2018; 41:791-800. [PMID: 29254111 DOI: 10.3233/nre-172153] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Foot drop is common gait impairment after stroke. Functional electrical stimulation (FES) of the ankle dorsiflexor muscles during the swing phase of gait can help correcting foot drop. OBJECTIVE To evaluate efficacy of additional novel FES system to conventional therapy in facilitating motor recovery in the lower extremities and improving walking ability after stroke. METHODS Sixteen stroke patients were randomly allocated to the FES group (FES therapy plus conventional rehabilitation program) (n = 8), and control group (conventional rehabilitation program) n = 8. FES was delivered for 30 min during gait to induce ankle plantar and dorsiflexion. MAIN OUTCOME MEASURES gait speed using 10 Meter Walk Test (10 MWT), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI). RESULTS Results showed a significant increase in gait speed in FES group (p < 0.001), higher than the minimal detected change. The FES group showed improvement in functional independence in the activities of daily living, motor recovery and gait performance. CONCLUSIONS The findings suggest that novel FES therapy combined with conventional rehabilitation is more effective on walking speed, mobility of the lower extremity, balance disability and activities of daily living compared to a conventional rehabilitation program only.
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Affiliation(s)
- Suzana Dedijer Dujović
- The University of Belgrade, Serbia and Clinic for rehabilitation "Dr M.Zotovic", Belgrade, Serbia
| | - Jovana Malešević
- The University of Belgrade and Tecnalia Serbia Ltd., Belgrade, Serbia
| | - Nebojša Malešević
- Department of Biomedical Engineering, Lund University, Belgrade, Serbia
| | - Aleksandra S Vidaković
- Faculty of Medicine, University of Belgrade and Clinic for rehabilitation "Dr M.Zotovic", Belgrade, Serbia
| | - Goran Bijelić
- Neurorehabilitation Area at the Health Division of TECNALIA, San Sebastian, Spain
| | - Thierry Keller
- Neurorehabilitation Area at the Health Division of TECNALIA, San Sebastian, Spain
| | - Ljubica Konstantinović
- Faculty of Medicine, University of Belgrade and Clinic for rehabilitation "Dr M.Zotovic", Belgrade, Serbia
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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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Electrode placement on the forearm for selective stimulation of finger extension/flexion. PLoS One 2018; 13:e0190936. [PMID: 29324829 PMCID: PMC5764314 DOI: 10.1371/journal.pone.0190936] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Accepted: 12/22/2017] [Indexed: 12/17/2022] Open
Abstract
It is still challenging to achieve a complex grasp or fine finger control by using surface functional electrical stimulation (FES), which usually requires a precise electrode configuration under laboratory or clinical settings. The goals of this study are as follows: 1) to study the possibility of selectively activating individual fingers; 2) to investigate whether the current activation threshold and selective range of individual fingers are affected by two factors: changes in the electrode position and forearm rotation (pronation, neutral and supination); and 3) to explore a theoretical model for guidance of the electrode placement used for selective activation of individual fingers. A coordinate system with more than 400 grid points was established over the forearm skin surface. A searching procedure was used to traverse all grid points to identify the stimulation points for finger extension/flexion by applying monophasic stimulation pulses. Some of the stimulation points for finger extension and flexion were selected and tested in their respective two different forearm postures according to the number and the type of the activated fingers and the strength of finger action response to the electrical stimulation at the stimulation point. The activation thresholds and current ranges of the selectively activated finger at each stimulation point were determined by visual analysis. The stimulation points were divided into three groups (“Low”, “Medium” and “High”) according to the thresholds of the 1st activated fingers. The angles produced by the selectively activated finger within selective current ranges were measured and analyzed. Selective stimulation of extension/flexion is possible for most fingers. Small changes in electrode position and forearm rotation have no significant effect on the threshold amplitude and the current range for the selective activation of most fingers (p > 0.05). The current range is the largest (more than 2 mA) for selective activation of the thumb, followed by those for the index, ring, middle and little fingers. The stimulation points in the “Low” group for all five fingers lead to noticeable finger angles at low current intensity, especially for the index, middle, and ring fingers. The slopes of the finger angle variation in the “Low” group for digits 2~4 are inversely proportional to the current intensity, whereas the slopes of the finger angle variation in other groups and in all groups for the thumb and little finger are proportional to the current intensity. It is possible to selectively activate the extension/flexion of most fingers by stimulating the forearm muscles. The physiological characteristics of each finger should be considered when placing the negative electrode for selective stimulation of individual fingers. The electrode placement used for the selective activation of individual fingers should not be confined to the location with the lowest activation threshold.
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Malešević J, Dedijer Dujović S, Savić AM, Konstantinović L, Vidaković A, Bijelić G, Malešević N, Keller T. A decision support system for electrode shaping in multi-pad FES foot drop correction. J Neuroeng Rehabil 2017; 14:66. [PMID: 28673311 PMCID: PMC5496361 DOI: 10.1186/s12984-017-0275-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 06/18/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Functional electrical stimulation (FES) can be applied as an assistive and therapeutic aid in the rehabilitation of foot drop. Transcutaneous multi-pad electrodes can increase the selectivity of stimulation; however, shaping the stimulation electrode becomes increasingly complex with an increasing number of possible stimulation sites. We described and tested a novel decision support system (DSS) to facilitate the process of multi-pad stimulation electrode shaping. The DSS is part of a system for drop foot treatment that comprises a custom-designed multi-pad electrode, an electrical stimulator, and an inertial measurement unit. METHODS The system was tested in ten stroke survivors (3-96 months post stroke) with foot drop over 20 daily sessions. The DSS output suggested stimulation pads and parameters based on muscle twitch responses to short stimulus trains. The DSS ranked combinations of pads and current amplitudes based on a novel measurement of the quality of the induced movement and classified them based on the movement direction (dorsiflexion, plantar flexion, eversion and inversion) of the paretic foot. The efficacy of the DSS in providing satisfactory pad-current amplitude choices for shaping the stimulation electrode was evaluated by trained clinicians. The range of paretic foot motion was used as a quality indicator for the chosen patterns. RESULTS The results suggest that the DSS output was highly effective in creating optimized FES patterns. The position and number of pads included showed pronounced inter-patient and inter-session variability; however, zones for inducing dorsiflexion and plantar flexion within the multi-pad electrode were clearly separated. The range of motion achieved with FES was significantly greater than the corresponding active range of motion (p < 0.05) during the first three weeks of therapy. CONCLUSIONS The proposed DSS in combination with a custom multi-pad electrode design covering the branches of peroneal and tibial nerves proved to be an effective tool for producing both the dorsiflexion and plantar flexion of a paretic foot. The results support the use of multi-pad electrode technology in combination with automatic electrode shaping algorithms for the rehabilitation of foot drop. TRIAL REGISTRATION This study was registered at the Current Controlled Trials website with ClinicalTrials.gov ID NCT02729636 on March 29, 2016.
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Affiliation(s)
- Jovana Malešević
- Tecnalia Serbia Ltd., Belgrade, Serbia. .,University of Belgrade, Belgrade, Serbia.
| | - Suzana Dedijer Dujović
- University of Belgrade, Belgrade, Serbia.,Clinic for Rehabilitation "Dr Miroslav Zotović", Belgrade, Serbia
| | - Andrej M Savić
- Tecnalia Serbia Ltd., Belgrade, Serbia.,University of Belgrade, School of Electrical Engineering, Belgrade, Serbia
| | - Ljubica Konstantinović
- Clinic for Rehabilitation "Dr Miroslav Zotović", Belgrade, Serbia.,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Aleksandra Vidaković
- Clinic for Rehabilitation "Dr Miroslav Zotović", Belgrade, Serbia.,University of Belgrade, Faculty of Medicine, Belgrade, Serbia
| | - Goran Bijelić
- Tecnalia Research & Innovation - Health Division, Donostia-San Sebastián, Spain
| | - Nebojša Malešević
- University of Belgrade, School of Electrical Engineering, Belgrade, Serbia.,Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Thierry Keller
- Tecnalia Research & Innovation - Health Division, Donostia-San Sebastián, Spain
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Mufti T, Slovak M, Barker AT, Farrow TF. 24-channel transcutaneous electrical sensory stimulation of the forearm: Effects on cognitive performance and autonomic arousal compared with single-electrode stimulation. COGENT MEDICINE 2016. [DOI: 10.1080/2331205x.2016.1149992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Affiliation(s)
- Tabitha Mufti
- SCANLab (Sheffield Cognition and Neuroimaging Laboratory), Academic Clinical Psychiatry, University of Sheffield, Sheffield, UK
| | - Martin Slovak
- Department of Medical Physics and Clinical Engineering, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Anthony T. Barker
- Department of Medical Physics and Clinical Engineering, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tom F.D. Farrow
- Academic Clinical Neurology, University of Sheffield, Rm. N129, N-Floor, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, UK
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Laubacher M, Aksöz EA, Binder-Macleod S, Hunt KJ. Comparison of Proximally Versus Distally Placed Spatially Distributed Sequential Stimulation Electrodes in a Dynamic Knee Extension Task. Eur J Transl Myol 2016; 26:6016. [PMID: 27478563 PMCID: PMC4942706 DOI: 10.4081/ejtm.2016.6016] [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] [Indexed: 11/23/2022] Open
Abstract
Spatially distributed sequential stimulation (SDSS) has demonstrated substantial power output and fatigue benefits compared to single electrode stimulation (SES) in the application of functional electrical stimulation (FES). This asymmetric electrode setup brings new possibilities but also new questions since precise placement of the electrodes is one critical factor for good muscle activation. The aim of this study was to compare the power output, fatigue and activation properties of proximally versus distally placed SDSS electrodes in an isokinetic knee extension task simulating knee movement during recumbent cycling. M. vastus lateralis and medialis of seven able-bodied subjects were stimulated with rectangular bi-phasic pulses of constant amplitude of 40 mA and at an SDSS frequency of 35 Hz for 6 min on both legs with both setups (i.e. n=14). Torque was measured during knee-extension movement by a dynamometer at an angular velocity of 110 deg/s. Mean power, peak power and activation time were calculated and compared for the initial and final stimulation phases, together with an overall fatigue index. Power output values (Pmean, Ppeak) were scaled to a standardised reference input pulse width of 100 μs (Pmean,s, Ppeak,s). The initial evaluation phase showed no significant differences between the two setups for all outcome measures. Ppeak and Ppeak,s were both significantly higher in the final phase for the distal setup (25.4 ± 8.1 W vs. 28.2 ± 6.2 W, p=0.0062 and 34.8 ± 9.5 W vs. 38.9 ± 6.7 W, p=0.021, respectively). With distal SDSS, there was modest evidence of higher Pmean and Pmean,s (p=0.071, p=0.14, respectively) but of longer activation time (p=0.096). The rate of fatigue was similar for both setups. For practical FES applications, distal placement of the SDSS electrodes is preferable.
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Affiliation(s)
- Marco Laubacher
- Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland; Sensory Motor Systems Lab, ETH Zurich, Zürich, Switzerland
| | - Efe A Aksöz
- Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences, Burgdorf, Switzerland; Sensory Motor Systems Lab, ETH Zurich, Zürich, Switzerland
| | - Stuart Binder-Macleod
- Department of Physical Therapy, University of Delaware , Newark, United States of America
| | - Kenneth J Hunt
- Institute for Rehabilitation and Performance Technology, Bern University of Applied Sciences , Burgdorf, Switzerland
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Koutsou AD, Moreno JC, del Ama AJ, Rocon E, Pons JL. Advances in selective activation of muscles for non-invasive motor neuroprostheses. J Neuroeng Rehabil 2016; 13:56. [PMID: 27296478 PMCID: PMC4907085 DOI: 10.1186/s12984-016-0165-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 06/07/2016] [Indexed: 11/10/2022] Open
Abstract
Non-invasive neuroprosthetic (NP) technologies for movement compensation and rehabilitation remain with challenges for their clinical application. Two of those major challenges are selective activation of muscles and fatigue management. This review discusses how electrode arrays improve the efficiency and selectivity of functional electrical stimulation (FES) applied via transcutaneous electrodes. In this paper we review the principles and achievements during the last decade on techniques for artificial motor unit recruitment to improve the selective activation of muscles. We review the key factors affecting the outcome of muscle force production via multi-pad transcutaneous electrical stimulation and discuss how stimulation parameters can be set to optimize external activation of body segments. A detailed review of existing electrode array systems proposed by different research teams is also provided. Furthermore, a review of the targeted applications of existing electrode arrays for control of upper and lower limb NPs is provided. Eventually, last section demonstrates the potential of electrode arrays to overcome the major challenges of NPs for compensation and rehabilitation of patient-specific impairments.
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Affiliation(s)
- Aikaterini D. Koutsou
- />Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council, Madrid, Spain
| | - Juan C. Moreno
- />Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council, Madrid, Spain
| | | | - Eduardo Rocon
- />Neural and Cognitive Engineering group, Centro de Automática y Robótica, CAR, Spanish National Research Council, CSIC-UPM, Madrid, Spain
| | - José L. Pons
- />Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council, Madrid, Spain
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Salchow C, Valtin M, Seel T, Schauer T. A New Semi-Automatic Approach to Find Suitable Virtual Electrodes in Arrays Using an Interpolation Strategy. Eur J Transl Myol 2016; 26:6029. [PMID: 27478567 PMCID: PMC4942710 DOI: 10.4081/ejtm.2016.6029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Functional Electrical Stimulation via electrode arrays enables the user to form virtual electrodes (VEs) of dynamic shape, size, and position. We developed a feedback-control-assisted manual search strategy which allows the therapist to conveniently and continuously modify VEs to find a good stimulation area. This works for applications in which the desired movement consists of at least two degrees of freedom. The virtual electrode can be moved to arbitrary locations within the array, and each involved element is stimulated with an individual intensity. Meanwhile, the applied global stimulation intensity is controlled automatically to meet a predefined angle for one degree of freedom. This enables the therapist to concentrate on the remaining degree(s) of freedom while changing the VE position. This feedback-control-assisted approach aims to integrate the user’s opinion and the patient’s sensation. Therefore, our method bridges the gap between manual search and fully automatic identification procedures for array electrodes. Measurements in four healthy volunteers were performed to demonstrate the usefulness of our concept, using a 24-element array to generate wrist and hand extension.
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Affiliation(s)
- Christina Salchow
- Control Systems Group, Technische Universität Berlin , Berlin, Germany
| | - Markus Valtin
- Control Systems Group, Technische Universität Berlin , Berlin, Germany
| | - Thomas Seel
- Control Systems Group, Technische Universität Berlin , Berlin, Germany
| | - Thomas Schauer
- Control Systems Group, Technische Universität Berlin , Berlin, Germany
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Krenn M, Hofstoetter US, Danner SM, Minassian K, Mayr W. Multi-Electrode Array for Transcutaneous Lumbar Posterior Root Stimulation. Artif Organs 2015; 39:834-40. [DOI: 10.1111/aor.12616] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Matthias Krenn
- Center for Medical Physics and Biomedical Engineering; Medical University of Vienna; Vienna Austria
| | - Ursula S. Hofstoetter
- Center for Medical Physics and Biomedical Engineering; Medical University of Vienna; Vienna Austria
| | - Simon M. Danner
- Center for Medical Physics and Biomedical Engineering; Medical University of Vienna; Vienna Austria
- Institute of Analysis and Scientific Computing; Vienna University of Technology; Vienna Austria
- Department of Neurobiology and Anatomy; Drexel College of Medicine; Philadelphia PA USA
| | - Karen Minassian
- Center for Medical Physics and Biomedical Engineering; Medical University of Vienna; Vienna Austria
| | - Winfried Mayr
- Center for Medical Physics and Biomedical Engineering; Medical University of Vienna; Vienna Austria
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Malešević NM, Popović Maneski LZ, Ilić V, Jorgovanović N, Bijelić G, Keller T, Popović DB. A multi-pad electrode based functional electrical stimulation system for restoration of grasp. J Neuroeng Rehabil 2012; 9:66. [PMID: 23009589 PMCID: PMC3547757 DOI: 10.1186/1743-0003-9-66] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2012] [Accepted: 09/19/2012] [Indexed: 11/10/2022] Open
Abstract
Background Functional electrical stimulation (FES) applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions. To improve the stimulation effectiveness of conventional FES, we introduce multi-pad electrodes and a new stimulation paradigm. Methods The new FES system comprises an electrode composed of small pads that can be activated individually. This electrode allows the targeting of motoneurons that activate synergistic muscles and produce a functional movement. The new stimulation paradigm allows asynchronous activation of motoneurons and provides controlled spatial distribution of the electrical charge that is delivered to the motoneurons. We developed an automated technique for the determination of the preferred electrode based on a cost function that considers the required movement of the fingers and the stabilization of the wrist joint. The data used within the cost function come from a sensorized garment that is easy to implement and does not require calibration. The design of the system also includes the possibility for fine-tuning and adaptation with a manually controllable interface. Results The device was tested on three stroke patients. The results show that the multi-pad electrodes provide the desired level of selectivity and can be used for generating a functional grasp. The results also show that the procedure, when performed on a specific user, results in the preferred electrode configuration characteristics for that patient. The findings from this study are of importance for the application of transcutaneous stimulation in the clinical and home environments.
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12
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Doheny EP, Caulfield BM, Minogue CM, Lowery MM. Effect of subcutaneous fat thickness and surface electrode configuration during neuromuscular electrical stimulation. Med Eng Phys 2010; 32:468-74. [PMID: 20417145 DOI: 10.1016/j.medengphy.2010.03.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 03/10/2010] [Accepted: 03/13/2010] [Indexed: 10/19/2022]
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13
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Kuhn A, Keller T, Lawrence M, Morari M. The Influence of Electrode Size on Selectivity and Comfort in Transcutaneous Electrical Stimulation of the Forearm. IEEE Trans Neural Syst Rehabil Eng 2010; 18:255-62. [PMID: 20071267 DOI: 10.1109/tnsre.2009.2039807] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Andreas Kuhn
- Automatic Control Laboratory, ETH Zurich, 8092 Zurich, Switzerland
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Doheny EP, Caulfield BM, Minogue CM, Lowery MM. The effect of subcutaneous fat thickness on the efficacy of transcutaneous electrical stimulation. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2008:5684-7. [PMID: 19164007 DOI: 10.1109/iembs.2008.4650504] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Transcutaneous electrical stimulation is a widely used technique to relieve the symptoms of various neuromuscular disorders and to improve muscle strength. It is currently being investigated in the treatment of obesity to physically enable and encourage increased levels of voluntary exercise. Due to the high resistivity of subcutaneous fat tissue, higher stimulus currents are required to evoke muscle contraction in obese subjects than in subjects of a healthy weight, which can lead to patient discomfort. In this study, a three-dimensional finite element model of the human thigh, including skin, fat, muscle and bone, was developed to examine the relationship between fat thickness and evoked muscle activation. The effects of fat thickness, electrode size and inter-electrode distance on the activating function were investigated during monopolar and bipolar stimulation. The amplitude of the activating function was found to reduce as electrode size increased, however, this effect was relatively less at higher fat thicknesses. The activating function was also less sensitive to inter-electrode distance as fat thickness increased. These results indicate that by increasing electrode size, the current density at the skin surface can be reduced, thereby reducing patient discomfort while maintaining the efficacy of the electrical stimulation in obese patient populations.
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Affiliation(s)
- Emer P Doheny
- School of Electrical, Electronic and Mechanical Engineering, University College Dublin, Dublin 4, Ireland.
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