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Chaikho L, Clark E, Raison M. Transcutaneous Functional Electrical Stimulation Controlled by a System of Sensors for the Lower Limbs: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:9812. [PMID: 36560179 PMCID: PMC9780889 DOI: 10.3390/s22249812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/30/2022] [Accepted: 12/11/2022] [Indexed: 06/17/2023]
Abstract
In the field of transcutaneous functional electrical stimulation (FES), open-loop and closed-loop control strategies have been developed to restore functions of the lower limbs: walking, standing up, maintaining posture, and cycling. These strategies require sensors that provide feedback information on muscle activity or biomechanics of movement. Since muscle response induced by transcutaneous FES is nonlinear, time-varying, and dependent on muscle fatigue evolution, the choice of sensor type and control strategy becomes critical. The main objective of this review is to provide state-of-the-art, emerging, current, and previous solutions in terms of control strategies. Focus is given on transcutaneous FES systems for the lower limbs. Using Compendex and Inspec databases, a total of 135 review and conference articles were included in this review. Recent studies mainly use inertial sensors, although the use of electromyograms for lower limbs has become more frequent. Currently, several researchers are opting for nonlinear controllers to overcome the nonlinear and time-varying effects of FES. More development is needed in the field of systems using inertial sensors for nonlinear control. Further studies are needed to validate nonlinear control systems in patients with neuromuscular disorders.
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Affiliation(s)
- Layal Chaikho
- Lab of Intelligent Biomechanics, Robotics, and Rehab Technology (LIBRTy), Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079 Station Centre-Ville, Montréal, QC H3C 3A7, Canada
- Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079 Station Centre-Ville, Montréal, QC H3C 3A7, Canada
| | | | - Maxime Raison
- Lab of Intelligent Biomechanics, Robotics, and Rehab Technology (LIBRTy), Department of Mechanical Engineering, Polytechnique Montréal, P.O. Box 6079 Station Centre-Ville, Montréal, QC H3C 3A7, Canada
- Institute of Biomedical Engineering, Polytechnique Montreal, P.O. Box 6079 Station Centre-Ville, Montréal, QC H3C 3A7, Canada
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Kim J, Moon JH, Kim J. Impedance Control of Human Ankle Joint With Electrically Stimulated Antagonistic Muscle Co-Contraction. IEEE Trans Neural Syst Rehabil Eng 2021; 29:1593-1603. [PMID: 34379593 DOI: 10.1109/tnsre.2021.3104091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Functional electrical stimulation (FES) is often used, typically in an open-loop manner, to restore paralyzed motor function for daily living activities. Several feedback control strategies have been developed to improve the performance and usability of FES-evoked movement. However, most of them have been position controllers, while the control strategy for human movement has been known as impedance modulation. Moreover, few studies have attempted to use antagonistic co-contraction for FES feedback control despite its expected benefits, such as enhanced stability and performance and better rehabilitation outcome. In this paper, we propose a robust impedance controller for FES that can adjust the intrinsic joint stiffness using co-contraction. It consists of an impedance control law based on time-delay estimation to compensate for the nonlinear uncertain joint dynamics and an antagonistic muscle co-contraction allocator to address the intrinsic joint stiffness caused by the co-contraction. The proposed controller was implemented on the ankle joints of five healthy subjects to simulate a standing balance situation. The results verified that the proposed controller can achieve desired impedance accurately by adjusting the intrinsic stiffness that stems from the change in the amount of co-contraction (up to 48.4% better impedance achievement with high desired stiffness).
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Rouhani H, Same M, Masani K, Li YQ, Popovic MR. PID Controller Design for FES Applied to Ankle Muscles in Neuroprosthesis for Standing Balance. Front Neurosci 2017; 11:347. [PMID: 28676739 PMCID: PMC5476782 DOI: 10.3389/fnins.2017.00347] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 06/06/2017] [Indexed: 11/23/2022] Open
Abstract
Closed-loop controlled functional electrical stimulation (FES) applied to the lower limb muscles can be used as a neuroprosthesis for standing balance in neurologically impaired individuals. The objective of this study was to propose a methodology for designing a proportional-integral-derivative (PID) controller for FES applied to the ankle muscles toward maintaining standing balance for several minutes and in the presence of perturbations. First, a model of the physiological control strategy for standing balance was developed. Second, the parameters of a PID controller that mimicked the physiological balance control strategy were determined to stabilize the human body when modeled as an inverted pendulum. Third, this PID controller was implemented using a custom-made Inverted Pendulum Standing Apparatus that eliminated the effect of visual and vestibular sensory information on voluntary balance control. Using this setup, the individual-specific FES controllers were tested in able-bodied individuals and compared with disrupted voluntary control conditions in four experimental paradigms: (i) quiet-standing; (ii) sudden change of targeted pendulum angle (step response); (iii) balance perturbations that simulate arm movements; and (iv) sudden change of targeted angle of a pendulum with individual-specific body-weight (step response). In paradigms (i) to (iii), a standard 39.5-kg pendulum was used, and 12 subjects were involved. In paradigm (iv) 9 subjects were involved. Across the different experimental paradigms and subjects, the FES-controlled and disrupted voluntarily-controlled pendulum angle showed root mean square errors of <1.2 and 2.3 deg, respectively. The root mean square error (all paradigms), rise time, settle time, and overshoot [paradigms (ii) and (iv)] in FES-controlled balance were significantly smaller or tended to be smaller than those observed with voluntarily-controlled balance, implying improved steady-state and transient responses of FES-controlled balance. At the same time, the FES-controlled balance required similar torque levels (no significant difference) as voluntarily-controlled balance. The implemented PID parameters were to some extent consistent among subjects for standard weight conditions and did not require prolonged individual-specific tuning. The proposed methodology can be used to design FES controllers for closed-loop controlled neuroprostheses for standing balance. Further investigation of the clinical implementation of this approach for neurologically impaired individuals is needed.
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Affiliation(s)
- Hossein Rouhani
- Department of Mechanical Engineering, University of AlbertaEdmonton, AB, Canada
| | - Michael Same
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health NetworkToronto, ON, Canada.,Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada
| | - Kei Masani
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health NetworkToronto, ON, Canada.,Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada
| | - Ya Qi Li
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health NetworkToronto, ON, Canada.,Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada
| | - Milos R Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health NetworkToronto, ON, Canada.,Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of TorontoToronto, ON, Canada
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Restoring standing capabilities with feedback control of functional neuromuscular stimulation following spinal cord injury. Med Eng Phys 2017; 42:13-25. [PMID: 28215399 DOI: 10.1016/j.medengphy.2017.01.023] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 01/15/2017] [Accepted: 01/31/2017] [Indexed: 11/20/2022]
Abstract
This paper reviews the field of feedback control for neuroprosthesis systems that restore advanced standing function to individuals with spinal cord injury. Investigations into closed-loop control of standing by functional neuromuscular stimulation (FNS) have spanned three decades. The ultimate goal for FNS standing control systems is to facilitate hands free standing and enabling the user to perform manual functions at self-selected leaning positions. However, most clinical systems for home usage currently only provide basic upright standing using preprogrammed stimulation patterns. To date, online modulation of stimulation to produce advanced standing functions such as balance against postural disturbances or the ability to assume leaning postures have been limited to simulation and laboratory investigations. While great technological advances have been made in biomechanical sensing and interfaces for neuromuscular stimulation, further progress is still required for finer motor control by FNS. Another major challenge is the development of sophisticated control schemes that produce the necessary postural adjustments, adapt against accelerating muscle fatigue, and consider volitional actions of the intact upper-body of the user. Model-based development for novel control schemes are proven and sensible approaches to prototype and test the basic operating efficacy of potentially complex and multi-faceted control systems. The major considerations for further innovation of such systems are summarized in this paper prior to describing the evolution of closed-loop FNS control of standing from previous works. Finally, necessary emerging technologies to for implementing FNS feedback control systems for standing are identified. These technological advancements include novel electrodes that more completely and selectively activate paralyzed musculature and implantable sensors and stimulation modules for flexible neuroprosthesis system deployment.
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Rouhani H, Popovic MR, Same M, Li YQ, Masani K. Identification of ankle plantar-flexors dynamics in response to electrical stimulation. Med Eng Phys 2016; 38:1166-1171. [PMID: 27544922 DOI: 10.1016/j.medengphy.2016.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 05/16/2016] [Accepted: 07/30/2016] [Indexed: 10/20/2022]
Abstract
Modeling the muscle response to functional electrical stimulation (FES) is an essential step in the design of closed-loop controlled neuroprostheses. This study was aimed at identifying the dynamic response of ankle plantar-flexors to FES during quiet standing. Thirteen healthy subjects stood in a standing frame that locked the knee and hip joints. The ankle plantar-flexors were stimulated bilaterally through surface electrodes and the generated ankle torque was measured. The pulse amplitude was sinusoidally modulated at five different frequencies. The pulse amplitude and the measured ankle torque fitted by a sine function were considered as input and output, respectively. First-order and critically-damped second-order linear models were fitted to the experimental data. Both models fitted similarly well to the experimental data. The coefficient of variation of the time constant among subjects was smaller in the case of the second-order model compared to the first-order model (18.1%vs. 79.9%, p<0.001). We concluded that the critically-damped second-order model more consistently described the relationship between isometric ankle torque and surface FES pulse amplitude, which was applied to the ankle plantar-flexors during quiet standing.
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Affiliation(s)
- Hossein Rouhani
- Department of Mechanical Engineering, University of Alberta, 10-368 Donadeo Innovation Centre for Engineering, Edmonton, Alberta, T6G 1H9, Canada.
| | - Milos R Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, Ontario, M4G 3V9, Canada; Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, M5S 3G9, Canada
| | - Michael Same
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, Ontario, M4G 3V9, Canada; Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, M5S 3G9, Canada
| | - Ya Qi Li
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, Ontario, M4G 3V9, Canada; Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, M5S 3G9, Canada
| | - Kei Masani
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network, 520 Sutherland Drive, Toronto, Ontario, M4G 3V9, Canada; Rehabilitation Engineering Laboratory, Institute of Biomaterials and Biomedical Engineering, University of Toronto, 164 College Street, Toronto, Ontario, M5S 3G9, Canada
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