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王 瑶, 李 雨, 崔 红, 李 萌, 陈 小. [A review of functional electrical stimulation based on brain-computer interface]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2024; 41:650-655. [PMID: 39218589 PMCID: PMC11366473 DOI: 10.7507/1001-5515.202311036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 05/28/2024] [Indexed: 09/04/2024]
Abstract
Individuals with motor dysfunction caused by damage to the central nervous system are unable to transmit voluntary movement commands to their muscles, resulting in a reduced ability to control their limbs. However, traditional rehabilitation methods have problems such as long treatment cycles and high labor costs. Functional electrical stimulation (FES) based on brain-computer interface (BCI) connects the patient's intentions with muscle contraction, and helps to promote the reconstruction of nerve function by recognizing nerve signals and stimulating the moving muscle group with electrical impulses to produce muscle convulsions or limb movements. It is an effective treatment for sequelae of neurological diseases such as stroke and spinal cord injury. This article reviewed the current research status of BCI-based FES from three aspects: BCI paradigms, FES parameters and rehabilitation efficacy, and looked forward to the future development trend of this technology, in order to improve the understanding of BCI-based FES.
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Affiliation(s)
- 瑶 王
- 天津工业大学 生命科学学院(天津 300387)School of Life Sciences, Tianjin Polytechnic University, Tianjin 300387, P. R. China
| | - 雨涵 李
- 天津工业大学 生命科学学院(天津 300387)School of Life Sciences, Tianjin Polytechnic University, Tianjin 300387, P. R. China
| | - 红岩 崔
- 天津工业大学 生命科学学院(天津 300387)School of Life Sciences, Tianjin Polytechnic University, Tianjin 300387, P. R. China
| | - 萌 李
- 天津工业大学 生命科学学院(天津 300387)School of Life Sciences, Tianjin Polytechnic University, Tianjin 300387, P. R. China
| | - 小刚 陈
- 天津工业大学 生命科学学院(天津 300387)School of Life Sciences, Tianjin Polytechnic University, Tianjin 300387, P. R. China
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Singh RK, Nayak NP, Behl T, Arora R, Anwer MK, Gulati M, Bungau SG, Brisc MC. Exploring the Intersection of Geophysics and Diagnostic Imaging in the Health Sciences. Diagnostics (Basel) 2024; 14:139. [PMID: 38248016 PMCID: PMC11154438 DOI: 10.3390/diagnostics14020139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
To develop diagnostic imaging approaches, this paper emphasizes the transformational potential of merging geophysics with health sciences. Diagnostic imaging technology improvements have transformed the health sciences by enabling earlier and more precise disease identification, individualized therapy, and improved patient care. This review article examines the connection between geophysics and diagnostic imaging in the field of health sciences. Geophysics, which is typically used to explore Earth's subsurface, has provided new uses of its methodology in the medical field, providing innovative solutions to pressing medical problems. The article examines the different geophysical techniques like electrical imaging, seismic imaging, and geophysics and their corresponding imaging techniques used in health sciences like tomography, magnetic resonance imaging, ultrasound imaging, etc. The examination includes the description, similarities, differences, and challenges associated with these techniques and how modified geophysical techniques can be used in imaging methods in health sciences. Examining the progression of each method from geophysics to medical imaging and its contributions to illness diagnosis, treatment planning, and monitoring are highlighted. Also, the utilization of geophysical data analysis techniques like signal processing and inversion techniques in image processing in health sciences has been briefly explained, along with different mathematical and computational tools in geophysics and how they can be implemented for image processing in health sciences. The key findings include the development of machine learning and artificial intelligence in geophysics-driven medical imaging, demonstrating the revolutionary effects of data-driven methods on precision, speed, and predictive modeling.
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Affiliation(s)
- Rahul Kumar Singh
- Energy Cluster, University of Petroleum and Energy Studies, Dehradun 248007, Uttarakhand, India; (R.K.S.); (N.P.N.)
| | - Nirlipta Priyadarshini Nayak
- Energy Cluster, University of Petroleum and Energy Studies, Dehradun 248007, Uttarakhand, India; (R.K.S.); (N.P.N.)
| | - Tapan Behl
- Amity School of Pharmaceutical Sciences, Amity University, Mohali 140306, Punjab, India
| | - Rashmi Arora
- Chitkara College of Pharmacy, Chitkara University, Rajpura 140401, Punjab, India;
| | - Md. Khalid Anwer
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia;
| | - Monica Gulati
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 1444411, Punjab, India;
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW 20227, Australia
| | - Simona Gabriela Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
- Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania
| | - Mihaela Cristina Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
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Hwang S, Song CS. Rehabilitative effects of electrical stimulation on gait performance in stroke patients: A systematic review with meta-analysis. NeuroRehabilitation 2024; 54:185-197. [PMID: 38306066 DOI: 10.3233/nre-230360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
BACKGROUND Electrical stimulation techniques are widely utilized for rehabilitation management in individuals with stroke patients. OBJECTIVES This review aims to summarize the rehabilitative effects of electrical stimulation therapy on gait performance in stroke patients. METHODS This review included randomized controlled trials (RCT) investigating the therapeutic effects of electrical stimulation in stroke patients throughout five databases. This review qualitatively synthesized 20 studies and quantitatively analyzed 11 RCTs. RESULTS Functional electrical stimulation (FES) was the most commonly used electrical stimulation type to improve postural stability and gait performance in stroke patients. The clinical measurement tools commonly used in the three studies to assess the therapeutic effects of FES were Berg balance scale (BBS), 10-meter walk test (10MWT), 6-minute walk test (6mWT), and gait velocity. The BBS score and gait velocity had positive effects in the FES group compared with the control group, but the 10MWT and 6mWT showed the same effects between the two groups. The heterogeneity of BBS scores was also high. CONCLUSION The results of this review suggest that electrical stimulation shows little evidence of postural stability and gait performance in stroke patients, although some electrical stimulations showed positive effects on postural stability and gait performance.
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Affiliation(s)
- Sujin Hwang
- Department of Physical Therapy, Division of Health Science, Baekseok University, Cheonan, South Korea
- Graduate School of Health and Welfare, Baekseok University, Seoul, South Korea
| | - Chiang-Soon Song
- Department of Occupational Therapy, College of Natural Science and Public Health and Safety, Chosun University, Gwangju, South Korea
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Moroder P, Karpinski K, Akgün D, Danzinger V, Gerhardt C, Patzer T, Tauber M, Wellmann M, Scheibel M, Boileau P, Lambert S, Porcellini G, Audige L. Neuromuscular Electrical Stimulation-Enhanced Physical Therapist Intervention for Functional Posterior Shoulder Instability (Type B1): A Multicenter Randomized Controlled Trial. Phys Ther 2024; 104:pzad145. [PMID: 37870503 PMCID: PMC10824628 DOI: 10.1093/ptj/pzad145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 05/26/2023] [Accepted: 10/18/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE Functional posterior shoulder instability (FPSI) (type B1) is a severe type of instability, mainly in teenagers and young adults, that leads to loss of function, pain, and stigmatization among peers. An experimental nonsurgical treatment protocol based on neuromuscular electrical stimulation (NMES) showed very promising early results in the treatment of FPSI. The hypothesis of this study was that NMES-enhanced physical therapy leads to better outcomes than physical therapy alone as the current gold standard of treatment in patients with FPSI. METHODS In this multicenter randomized controlled trial, patients with FPSI were randomly allocated in a 1:1 ratio to either 6 weeks of physical therapy or 6 weeks of physical therapy with simultaneous motion-triggered NMES. Baseline scores as well as outcome scores at 6 weeks, 3 months, 6 months, and 12 months after the intervention were obtained. The predefined primary outcome of this trial was the Western Ontario Shoulder Instability Index (WOSI) at the 3-month time point. RESULTS Forty-nine patients were randomized and eligible for the trial. The group that received physical therapy with simultaneous motion-triggered NMES showed a significantly better main outcome measurement in terms of the 3-month WOSI score (64% [SD = 16%] vs 51% [SD = 24%]). Two-thirds of the patients from the physical therapist group crossed over to the group that received physical therapy with simultaneous motion-triggered NMES due to dissatisfaction after the 3-month follow-up and showed a significant increase in their WOSI score from 49% [SD = 8%] to 67% [SD = 24%]. The frequency of instability episodes showed a significant improvement in the group that received physical therapy with simultaneous motion-triggered NMES at the 3-month follow-up and beyond, while in the physical therapist group, no significant difference was observed. CONCLUSION The current study shows that NMES-enhanced physical therapy led to statistically significant and clinically relevant improvement in outcomes in the treatment of FPSI compared to conventional physical therapy alone-from which even patients with prior unsatisfactory results after conventional physical therapy can benefit. IMPACT Based on the results of this study, NMES-enhanced physical therapy is an effective new treatment option for FPSI, a severe type of shoulder instability. NMES-enhanced physical therapy should be preferred over conventional physical therapy for the treatment of patients with FPSI.
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Affiliation(s)
- Philipp Moroder
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
| | - Katrin Karpinski
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Doruk Akgün
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Victor Danzinger
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Christian Gerhardt
- Department of Traumatology, Hand Surgery and Sports Medicine, ViDia Clinics Karlsruhe, Karlsruhe, Germany
| | - Thilo Patzer
- Department of Orthopaedics and Trauma Surgery, Schoenklinik Düsseldorf, Düsseldorf, Germany
| | - Mark Tauber
- Deutsches Schulterzentrum, ATOS Klinik, Munich, Germany
| | | | - Markus Scheibel
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
- Department for Shoulder and Elbow Surgery, Charité - Centrum für Muskuloskeletale Chirurgie, Berlin, Germany
| | - Pascal Boileau
- Institute for Sports & Reconstructive Surgery, Groupe Kantys, Nice, France
| | - Simon Lambert
- Department of Trauma and Orthopedics, University College London Hospital NHS Foundation Trust, London, UK
| | - Giuseppe Porcellini
- Department of Orthopedics and Traumatology, University of Modena and Reggio Emilia, Modena, Italy
| | - Laurent Audige
- Department of Shoulder and Elbow Surgery, Schulthess Clinic, Zurich, Switzerland
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Khan MA, Fares H, Ghayvat H, Brunner IC, Puthusserypady S, Razavi B, Lansberg M, Poon A, Meador KJ. A systematic review on functional electrical stimulation based rehabilitation systems for upper limb post-stroke recovery. Front Neurol 2023; 14:1272992. [PMID: 38145118 PMCID: PMC10739305 DOI: 10.3389/fneur.2023.1272992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Background Stroke is one of the most common neurological conditions that often leads to upper limb motor impairments, significantly affecting individuals' quality of life. Rehabilitation strategies are crucial in facilitating post-stroke recovery and improving functional independence. Functional Electrical Stimulation (FES) systems have emerged as promising upper limb rehabilitation tools, offering innovative neuromuscular reeducation approaches. Objective The main objective of this paper is to provide a comprehensive systematic review of the start-of-the-art functional electrical stimulation (FES) systems for upper limb neurorehabilitation in post-stroke therapy. More specifically, this paper aims to review different types of FES systems, their feasibility testing, or randomized control trials (RCT) studies. Methods The FES systems classification is based on the involvement of patient feedback within the FES control, which mainly includes "Open-Loop FES Systems" (manually controlled) and "Closed-Loop FES Systems" (brain-computer interface-BCI and electromyography-EMG controlled). Thus, valuable insights are presented into the technological advantages and effectiveness of Manual FES, EEG-FES, and EMG-FES systems. Results and discussion The review analyzed 25 studies and found that the use of FES-based rehabilitation systems resulted in favorable outcomes for the stroke recovery of upper limb functional movements, as measured by the FMA (Fugl-Meyer Assessment) (Manually controlled FES: mean difference = 5.6, 95% CI (3.77, 7.5), P < 0.001; BCI-controlled FES: mean difference = 5.37, 95% CI (4.2, 6.6), P < 0.001; EMG-controlled FES: mean difference = 14.14, 95% CI (11.72, 16.6), P < 0.001) and ARAT (Action Research Arm Test) (EMG-controlled FES: mean difference = 11.9, 95% CI (8.8, 14.9), P < 0.001) scores. Furthermore, the shortcomings, clinical considerations, comparison to non-FES systems, design improvements, and possible future implications are also discussed for improving stroke rehabilitation systems and advancing post-stroke recovery. Thus, summarizing the existing literature, this review paper can help researchers identify areas for further investigation. This can lead to formulating research questions and developing new studies aimed at improving FES systems and their outcomes in upper limb rehabilitation.
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Affiliation(s)
- Muhammad Ahmed Khan
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
- Department of Electrical Engineering, Stanford University, Palo Alto, CA, United States
- Department of Health Technology, Technical University of Denmark, Lyngby, Denmark
| | - Hoda Fares
- Department of Electrical, Electronic, Telecommunication Engineering and Naval Architecture (DITEN), University of Genoa, Genoa, Italy
| | - Hemant Ghayvat
- Department of Computer Science, Linnaeus University, Växjö, Sweden
| | | | | | - Babak Razavi
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
| | - Maarten Lansberg
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
| | - Ada Poon
- Department of Electrical Engineering, Stanford University, Palo Alto, CA, United States
| | - Kimford Jay Meador
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA, United States
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Melnikova EA, Starkova EY, Razumov AN. [Modern view on upper limb physical rehabilitation after stroke. Literature review]. VOPROSY KURORTOLOGII, FIZIOTERAPII, I LECHEBNOI FIZICHESKOI KULTURY 2023; 100:42-53. [PMID: 36971671 DOI: 10.17116/kurort202310001142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
Stroke is the world's second leading cause of death and the first cause of disability among all diseases. The most common complication of a stroke is a violation of the motor function of the limbs, which significantly worsens the quality of life and the level of self-care and independence of patients. Restoring the function of the upper limb is one of the priority tasks of rehabilitation after a stroke. A large number of factors, such as the location and size of the primary brain lesion, the presence of complications in the form of spasticity, impaired skin and proprioceptive sensitivity, and comorbidities, determine the patient's rehabilitation potential and the prognosis of ongoing rehabilitation measures. Of particular note are the timing of the start of rehabilitation measures, the duration and regularity of the treatment methods. A number of authors propose scales for assessing the rehabilitation prognosis, as well as algorithms for compiling rehabilitation programs for restoring the function of the upper limb. A fairly large number of rehabilitation methods and their combinations have been proposed, including special methods of kinesitherapy, robotic mechanotherapy with biofeedback, the use of physiotherapeutic factors, manual and reflex effects, as well as ready-made programs that include sequential and combined use of various methods. Dozens of studies have been devoted to comparative analysis and evaluation of the effectiveness of these methods. The purpose of this work is to review current research on a given topic and draw up our own conclusion on the appropriateness of using and combining these methods at various stages of rehabilitation in stroke patients.
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Affiliation(s)
- E A Melnikova
- Moscow Regional Scientific Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia
| | - E Yu Starkova
- Moscow Regional Scientific Research Clinical Institute named after M.F. Vladimirsky, Moscow, Russia
| | - A N Razumov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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Zhou D, Hayakawa W, Nakajima Y, Tadano K. Development of a Wearable Haptic Glove Presenting Haptic Sensation by Electrical Stimulation. SENSORS (BASEL, SWITZERLAND) 2022; 23:431. [PMID: 36617027 PMCID: PMC9823645 DOI: 10.3390/s23010431] [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: 12/02/2022] [Revised: 12/23/2022] [Accepted: 12/27/2022] [Indexed: 06/17/2023]
Abstract
Most haptic devices generate haptic sensation using mechanical actuators. However, the workload and limited workspace handicap the operator from operating freely. Electrical stimulation is an alternative approach to generate haptic sensations without using mechanical actuators. The light weight of the electrodes adhering to the body brings no limitations to free motion. Because a real haptic sensation consists of feelings from several areas, mounting the electrodes to several different body areas can make the sensations more realistic. However, simultaneously stimulating multiple electrodes may result in "noise" sensations. Moreover, the operators may feel tingling because of unstable stimulus signals when using the dry electrodes to help develop an easily mounted haptic device using electrical stimulation. In this study, we first determine the appropriate stimulation areas and stimulus signals to generate a real touch sensation on the forearm. Then, we propose a circuit design guideline for generating stable electrical stimulus signals using a voltage divider resistor. Finally, based on the aforementioned results, we develop a wearable haptic glove prototype. This haptic glove allows the user to experience the haptic sensations of touching objects with five different degrees of stiffness.
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Affiliation(s)
- Dongbo Zhou
- Institute of Innovation Research, Tokyo Institute of Technology, Yokohama 226-8503, Kanagawa, Japan
| | - Wataru Hayakawa
- Institute of Innovation Research, Tokyo Institute of Technology, Yokohama 226-8503, Kanagawa, Japan
| | - Yoshikazu Nakajima
- Department of Biomedical Informatics, Institute of Biomaterials and Bioengineering, Tokyo Medical and Dental University, Tokyo 101-0062, Japan
| | - Kotaro Tadano
- Institute of Innovation Research, Tokyo Institute of Technology, Yokohama 226-8503, Kanagawa, Japan
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Alkharji H, Gan QF, Foo CN. Concepts and Application of Tai Ji in Stroke Rehabilitation: A Narrative Review. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2449-2457. [PMID: 36561259 PMCID: PMC9745417 DOI: 10.18502/ijph.v51i11.11162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/11/2022] [Indexed: 11/21/2022]
Abstract
Stroke remains a leading cause of adult disability, and it decreases the health-related quality of life due to functional disability and poor functional recovery in stroke. Tai Ji has been recently introduced to overcome disabilities. This review aims to explain the effects of Tai Ji on functional recovery in stroke patients, linking it to current approaches, concepts and therapies such as Bobath and proprioceptive neuromuscular facilitation techniques. A compilation of recent literature on Tai Ji's use in stroke rehabilitation from Google scholar and PubMed Central (2018 to 2022). The benefits of Tai Ji in stroke functional recovery were studied and explained based on its similarity in concepts to current conventional stroke rehabilitation approaches. There were few randomized controlled trials on Tai Ji in functional recovery among stroke patients. However, all literature identified Tai Ji as beneficial in stroke rehabilitation. However, there was no literature on explaining the Tai Ji movement based on current conventional stroke rehabilitation approaches. Tai Ji carries similar theories to the current neurorehabilitation approach. Tai Ji can be modified and incorporated into stroke rehabilitation programs based on patients' needs to produce promising outcomes.
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Affiliation(s)
- Hamad Alkharji
- Quality and Accreditation Department, Al-Hamra Tower, Ministry of Health, Kuwait, Kuwait
| | - Quan Fu Gan
- Department of Pre-Clinical Science, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, 43000 Kajang, Malaysia
| | - Chai Nien Foo
- Department of Population Medicine, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, 43000 Kajang, Malaysia,Corresponding Author:
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Solomons CD, Shanmugasundaram V, Balasubramanian S. Encoder-Controlled Functional Electrical Stimulator for Bilateral Wrist Activities—Design and Evaluation. Bioengineering (Basel) 2022; 9:bioengineering9100501. [PMID: 36290469 PMCID: PMC9598413 DOI: 10.3390/bioengineering9100501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 09/04/2022] [Accepted: 09/11/2022] [Indexed: 11/16/2022] Open
Abstract
Upper limb impairment following stroke is often characterized by limited voluntary control in the affected arm. In addition, significant motor coordination problems occur on the unaffected arm due to avoidance of performing bilateral symmetrical activities. Rehabilitation strategies should, therefore, not only aim at improving voluntary control on the affected arm, but also contribute to synchronizing activity from both upper limbs. The encoder-controlled functional electrical stimulator, described in this paper, implements precise contralateral control of wrist flexion and extension with electrical stimulation. The stimulator is calibrated for each individual to obtain a table of stimulation parameters versus wrist angle. This table is used to set stimulation parameters dynamically, based on the difference in wrist angle between the set and stimulated side, which is continuously monitored. This allows the wrist on the stimulated side to follow flexion and extension patterns on the set side, thereby mirroring wrist movements of the normal side. This device also gives real-time graphical feedback on how the stimulated wrist is performing in comparison to the normal side. A study was performed on 25 normal volunteers to determine how closely wrist movements on the set side were being followed on the stimulated side. Graphical results show that there were minor differences, which were quantified by considering the peak angles of flexion and extension on the set and stimulated side for each participant. The mean difference in peak flexion and extension range of movement was 2.3 degrees and 1.9 degrees, respectively, with a mean time lag of 1 s between the set and the stimulated angle graphs.
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Affiliation(s)
- Cassandra D. Solomons
- Department of Instrumentation and Control, School of Electrical Engineering, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India
| | - Vivekanandan Shanmugasundaram
- Department of Instrumentation and Control, School of Electrical Engineering, Vellore Institute of Technology, Vellore 632014, Tamil Nadu, India
- Correspondence:
| | - Sivakumar Balasubramanian
- Department of Bioengineering, Christian Medical College and Hospital, Bagayam, Vellore 632002, Tamil Nadu, India
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Nicksic PJ, Donnelly DT, Verma N, Setiz AJ, Shoffstall AJ, Ludwig KA, Dingle AM, Poore SO. Electrical Stimulation of Acute Fractures: A Narrative Review of Stimulation Protocols and Device Specifications. Front Bioeng Biotechnol 2022; 10:879187. [PMID: 35721861 PMCID: PMC9201474 DOI: 10.3389/fbioe.2022.879187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Orthopedic fractures have a significant impact on patients in the form of economic loss and functional impairment. Beyond the standard methods of reduction and fixation, one adjunct that has been explored since the late 1970s is electrical stimulation. Despite robust evidence for efficacy in the preclinical arena, human trials have mixed results, and this technology is not widely accepted. The purpose of this review is to examine the body of literature supporting electrical stimulation for the purpose of fracture healing in humans with an emphasis on device specifications and stimulation protocols and delineate a minimum reporting checklist for future studies of this type. We have isolated 12 studies that pertain to the administration of electrical stimulation for the purpose of augmenting fracture healing in humans. Of these, one was a direct current electrical stimulation study. Six studies utilized pulsed electromagnetic field therapy and five used capacitive coupling. When examining these studies, the device specifications were heterogenous and often incomplete in what they reported, which rendered studies unrepeatable. The stimulation protocols also varied greatly study to study. To demonstrate efficacy of electrical stimulation for fractures, the authors recommend isolating a fracture type that is prone to nonunion to maximize the electrical stimulation effect, a homogenous study population so as to not dilute the effect of electrical stimulation, and increasing scientific rigor in the form of pre-registration, blinding, and sham controls. Finally, we introduce the critical components of minimum device specification reporting for repeatability of studies of this type.
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Affiliation(s)
- Peter J. Nicksic
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - D’Andrea T. Donnelly
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Nishant Verma
- Department of Biomedical Engineering, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe), University of Wisconsin—Madison, Madison, WI, United States
| | - Allison J. Setiz
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Andrew J. Shoffstall
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States
- APT Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United States
| | - Kip A. Ludwig
- Department of Biomedical Engineering, University of Wisconsin—Madison, Madison, WI, United States
- Wisconsin Institute for Translational Neuroengineering (WITNe), University of Wisconsin—Madison, Madison, WI, United States
- Department of Neurological Surgery, University of Wisconsin—Madison, Madison, WI, United States
| | - Aaron M. Dingle
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
| | - Samuel O. Poore
- Division of Plastic Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States
- *Correspondence: Samuel O. Poore,
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