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Becerra-Fajardo L, Minguillon J, Krob MO, Rodrigues C, González-Sánchez M, Megía-García Á, Galán CR, Henares FG, Comerma A, Del-Ama AJ, Gil-Agudo A, Grandas F, Schneider-Ickert A, Barroso FO, Ivorra A. First-in-human demonstration of floating EMG sensors and stimulators wirelessly powered and operated by volume conduction. J Neuroeng Rehabil 2024; 21:4. [PMID: 38172975 PMCID: PMC10765656 DOI: 10.1186/s12984-023-01295-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Recently we reported the design and evaluation of floating semi-implantable devices that receive power from and bidirectionally communicate with an external system using coupling by volume conduction. The approach, of which the semi-implantable devices are proof-of-concept prototypes, may overcome some limitations presented by existing neuroprostheses, especially those related to implant size and deployment, as the implants avoid bulky components and can be developed as threadlike devices. Here, it is reported the first-in-human acute demonstration of these devices for electromyography (EMG) sensing and electrical stimulation. METHODS A proof-of-concept device, consisting of implantable thin-film electrodes and a nonimplantable miniature electronic circuit connected to them, was deployed in the upper or lower limb of six healthy participants. Two external electrodes were strapped around the limb and were connected to the external system which delivered high frequency current bursts. Within these bursts, 13 commands were modulated to communicate with the implant. RESULTS Four devices were deployed in the biceps brachii and the gastrocnemius medialis muscles, and the external system was able to power and communicate with them. Limitations regarding insertion and communication speed are reported. Sensing and stimulation parameters were configured from the external system. In one participant, electrical stimulation and EMG acquisition assays were performed, demonstrating the feasibility of the approach to power and communicate with the floating device. CONCLUSIONS This is the first-in-human demonstration of EMG sensors and electrical stimulators powered and operated by volume conduction. These proof-of-concept devices can be miniaturized using current microelectronic technologies, enabling fully implantable networked neuroprosthetics.
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Affiliation(s)
- Laura Becerra-Fajardo
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain
| | - Jesus Minguillon
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain
- Research Centre for Information and Communications Technologies, University of Granada, Granada, 18014, Spain
- Department of Signal Theory, Telematics and Communications, University of Granada, Granada, 18014, Spain
| | - Marc Oliver Krob
- Fraunhofer Institute for Biomedical Engineering IBMT, 66280, Sulzbach, Germany
| | - Camila Rodrigues
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, 28002, Spain
- Systems Engineering and Automation Department, Carlos III University of Madrid, Madrid, 28903, Spain
| | - Miguel González-Sánchez
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | - Álvaro Megía-García
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
| | - Carolina Redondo Galán
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
| | - Francisco Gutiérrez Henares
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
| | - Albert Comerma
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain
| | - Antonio J Del-Ama
- School of Science and Technology, Department of Applied Mathematics, Materials Science and Engineering and Electronic Technology, Rey Juan Carlos University, Móstoles, 28933, Spain
| | - Angel Gil-Agudo
- Biomechanics and Assistive Technology Unit, National Hospital for Paraplegics. Unit of Neurorehabilitation, Biomechanics and Sensory-Motor Function (HNP-SESCAM), Unit associated to the CSIC, Toledo, Spain
- CSIC's Associated RDI Unit 'Unidad De Neurorehabilitación, Biomecánica Y Función Sensitivo-Motora', Madrid, Spain
| | - Francisco Grandas
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, 28007, Spain
| | | | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, 28002, Spain
- CSIC's Associated RDI Unit 'Unidad De Neurorehabilitación, Biomecánica Y Función Sensitivo-Motora', Madrid, Spain
| | - Antoni Ivorra
- Department of Information and Communications Technologies, Universitat Pompeu Fabra, Barcelona, 08018, Spain.
- Serra Húnter Fellow Programme, Universitat Pompeu Fabra, Barcelona, 08018, Spain.
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Carvalho CR, Fernández JM, Del-Ama AJ, Oliveira Barroso F, Moreno JC. Review of electromyography onset detection methods for real-time control of robotic exoskeletons. J Neuroeng Rehabil 2023; 20:141. [PMID: 37872633 PMCID: PMC10594734 DOI: 10.1186/s12984-023-01268-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 10/13/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND Electromyography (EMG) is a classical technique used to record electrical activity associated with muscle contraction and is widely applied in Biomechanics, Biomedical Engineering, Neuroscience and Rehabilitation Robotics. Determining muscle activation onset timing, which can be used to infer movement intention and trigger prostheses and robotic exoskeletons, is still a big challenge. The main goal of this paper was to perform a review of the state-of-the-art of EMG onset detection methods. Moreover, we compared the performance of the most commonly used methods on experimental EMG data. METHODS A total of 156 papers published until March 2022 were included in the review. The papers were analyzed in terms of application domain, pre-processing method and EMG onset detection method. The three most commonly used methods [Single (ST), Double (DT) and Adaptive Threshold (AT)] were applied offline on experimental intramuscular and surface EMG signals obtained during contractions of ankle and knee joint muscles. RESULTS Threshold-based methods are still the most commonly used to detect EMG onset. Compared to ST and AT, DT required more processing time and, therefore, increased onset timing detection, when applied on experimental data. The accuracy of these three methods was high (maximum error detection rate of 7.3%), demonstrating their ability to automatically detect the onset of muscle activity. Recently, other studies have tested different methods (especially Machine Learning based) to determine muscle activation onset offline, reporting promising results. CONCLUSIONS This study organized and classified the existing EMG onset detection methods to create consensus towards a possible standardized method for EMG onset detection, which would also allow more reproducibility across studies. The three most commonly used methods (ST, DT and AT) proved to be accurate, while ST and AT were faster in terms of EMG onset detection time, especially when applied on intramuscular EMG data. These are important features towards movement intention identification, especially in real-time applications. Machine Learning methods have received increased attention as an alternative to detect muscle activation onset. However, although several methods have shown their capability offline, more research is required to address their full potential towards real-time applications, namely to infer movement intention.
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Affiliation(s)
- Camila R Carvalho
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - J Marvin Fernández
- Electronic Technology Department, Rey Juan Carlos University, Madrid, Spain
| | - Antonio J Del-Ama
- Electronic Technology Department, Rey Juan Carlos University, Madrid, Spain
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain.
| | - Juan C Moreno
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
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Ferreira CL, Oliveira Barroso F, Torricelli D, Pons JL, Politti F, Lucareli PRG. Muscle synergies analysis shows altered neural strategies in women with patellofemoral pain during walking. PLoS One 2023; 18:e0292464. [PMID: 37796922 PMCID: PMC10553307 DOI: 10.1371/journal.pone.0292464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/21/2023] [Indexed: 10/07/2023] Open
Abstract
Several studies suggest that the central nervous system coordinates muscle activation by modulating neural commands directed to groups of muscles combined to form muscle synergies. Individuals with patellofemoral pain (PFP) move differently from asymptomatic individuals. Understanding the neural strategies involved in the execution of tasks such as walking can help comprehend how the movement is planned and better understand this clinical condition. The objective of this study was to compare muscle synergies between women with and without PFP during walking. Eleven women with PFP and thirteen asymptomatic women were assessed using three-dimensional kinematics and electromyography (EMG) while walking at self-selected speed. Kinematics of the trunk, pelvis and lower limbs were analyzed through the Movement Deviation Profile. Muscle synergies were extracted from the EMG signals of eight lower limb muscles collected throughout the whole gait cycle. Kinematic differences between the two groups (p<0.001, z-score = 3.06) were more evident during loading response, terminal stance, and pre-swing. PFP group presented a lower number of muscle synergies (p = 0.037), and greater variability accounted for (VAFtotal) when using 3 (p = 0.017), 4 (p = 0.004), and 5 (p = 0.012) synergies to reconstruct all EMG signals. The PFP group also presented higher VAFmuscle for rectus femoris (p = 0.048) and gastrocnemius medialis (p = 0.019) when considering 4 synergies. Our results suggest that women with PFP show lower motor complexity and deficit in muscle coordination to execute gait, indicating that gait in PFP is the result of different neural commands compared to asymptomatic women.
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Affiliation(s)
- Cintia Lopes Ferreira
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - Diego Torricelli
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - José L. Pons
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
- Legs & Walking AbilityLab, Shirley Ryan AbilityLab, Chicago, IL, United States of America
- Department Biomedical Engineering & Dept. Mechanical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, United States of America
- Department of PM&R, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Fabiano Politti
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil
| | - Paulo Roberto Garcia Lucareli
- Department of Rehabilitation Science, Human Motion Analysis Laboratory, Universidade Nove de Julho, São Paulo, Brazil
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Barroso FO, Torricelli D, Moreno JC. Neurorobotics and neuroprostheses: Towards a new anatomy. Anat Rec (Hoboken) 2023; 306:706-709. [PMID: 36715240 DOI: 10.1002/ar.25157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/07/2022] [Accepted: 12/20/2022] [Indexed: 01/31/2023]
Abstract
The idea of this Special Issue arose from the technological advances in bionic, robotic, and neural rehabilitation systems and the common need to comprehend in detail how human anatomical structures can be replicated or controlled. Motor control theories, among others, include the generalized control program theory, the equilibrium point hypothesis, or the optimal control approach in which neural commands to the muscles are a result of the central nervous system solving an optimization problem for a specific cost function. No matter the alternative interpretation selected to replicate biological control of human movements, artificial "anatomies" should consider not only motor capabilities from the central nervous system but integrate bioinspired mechanical features (such as compliance) in artificial limbs. The development of wearable robotics and neuroprosthetic systems for human movement compensation and control is naturally inspired by human anatomy and biology. Cutting-edge technological advances in the field of biomedical and neural engineering are bringing us more and more close to a new artificial anatomy with which humans could augment their motor capabilities or replace them after they are compromised. Either augmentative/assistive or rehabilitation technologies in the near future will require engineering solutions based on novel approaches to create usable neurorobotic and neuroprosthetic systems for the most relevant societal needs.
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Affiliation(s)
| | - Diego Torricelli
- Neural Rehabilitation Group, Cajal Institute, CSIC, Madrid, Spain
| | - Juan C Moreno
- Neural Rehabilitation Group, Cajal Institute, CSIC, Madrid, Spain
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Asín-Prieto G, Oliveira Barroso F, Martínez-Expósito A, Urendes E, Gonzalez-Vargas J, Moreno JC. Mechanical disturbances applied by motorized ankle foot orthosis to adapt ankle muscles activation—A validation study. Front Bioeng Biotechnol 2023; 11:1079027. [PMID: 37008040 PMCID: PMC10060880 DOI: 10.3389/fbioe.2023.1079027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023] Open
Abstract
Background: Reduced function of ankle muscles usually leads to impaired gait. Motorized ankle foot orthoses (MAFOs) have shown potential to improve neuromuscular control and increase volitional engagement of ankle muscles. In this study, we hypothesize that specific disturbances (adaptive resistance-based perturbations to the planned trajectory) applied by a MAFO can be used to adapt the activity of ankle muscles. The first goal of this exploratory study was to test and validate two different ankle disturbances based on plantarflexion and dorsiflexion resistance while training in standing still position. The second goal was to assess neuromuscular adaptation to these approaches, namely, in terms of individual muscle activation and co-activation of antagonists.Methods: Two ankle disturbances were tested in ten healthy subjects. For each subject, the dominant ankle followed a target trajectory while the contralateral leg was standing still: a) dorsiflexion torque during the first part of the trajectory (Stance Correlate disturbance—StC), and b) plantarflexion torque during the second part of the trajectory (Swing Correlate disturbance—SwC). Electromyography was recorded from the tibialis anterior (TAnt) and gastrocnemius medialis (GMed) during MAFO and treadmill (baseline) trials.Results: GMed (plantarflexor muscle) activation decreased in all subjects during the application of StC, indicating that dorsiflexion torque did not enhance GMed activity. On the other hand, TAnt (dorsiflexor muscle) activation increased when SwC was applied, indicating that plantarflexion torque succeeded in enhancing TAnt activation. For each disturbance paradigm, there was no antagonist muscle co-activation accompanying agonist muscle activity changes.Conclusion: We successfully tested novel ankle disturbance approaches that can be explored as potential resistance strategies in MAFO training. Results from SwC training warrant further investigation to promote specific motor recovery and learning of dorsiflexion in neural-impaired patients. This training can potentially be beneficial during intermediate phases of rehabilitation prior to overground exoskeleton-assisted walking. Decreased activation of GMed during StC might be attributed to the unloaded body weight in the ipsilateral side, which typically decreases activation of anti-gravity muscles. Neural adaptation to StC needs to be studied thoroughly in different postures in futures studies.
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Affiliation(s)
- Guillermo Asín-Prieto
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
- Gogoa Mobility Robots, Abadiño, Spain
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
- *Correspondence: Filipe Oliveira Barroso,
| | - Aitor Martínez-Expósito
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
- Universidad Autónoma de Madrid, Madrid, Spain
| | - Eloy Urendes
- Departamento de Tecnologías de la Información, Escuela Politécnica Superior, Escuela Politécnica Superior, Universidad San Pablo-CEU, CEU Universities, Madrid, Spain
| | | | - Juan C. Moreno
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
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Pascual-Valdunciel A, Kurukuti NM, Montero-Pardo C, Barroso FO, Pons JL. Modulation of spinal circuits following phase-dependent electrical stimulation of afferent pathways. J Neural Eng 2023; 20. [PMID: 36603216 DOI: 10.1088/1741-2552/acb087] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 01/05/2023] [Indexed: 01/06/2023]
Abstract
Objective.Peripheral electrical stimulation (PES) of afferent pathways is a tool commonly used to induce neural adaptations in some neural disorders such as pathological tremor or stroke. However, the neuromodulatory effects of stimulation interventions synchronized with physiological activity (closed-loop strategies) have been scarcely researched in the upper-limb. Here, the short-term spinal effects of a 20-minute stimulation protocol where afferent pathways were stimulated with a closed-loop strategy named selective and adaptive timely stimulation (SATS) were explored in 11 healthy subjects.Approach. SATS was applied to the radial nerve in-phase (INP) or out-of-phase (OOP) with respect to the muscle activity of the extensor carpi radialis (ECR). The neural adaptations at the spinal cord level were assessed for the flexor carpi radialis (FCR) by measuring disynaptic Group I inhibition, Ia presynaptic inhibition, Ib facilitation from the H-reflex and estimation of the neural drive before, immediately after, and 30 minutes after the intervention.Main results.SATS strategy delivered electrical stimulation synchronized with the real-time muscle activity measured, with an average delay of 17 ± 8 ms. SATS-INP induced increased disynaptic Group I inhibition (77 ± 23% of baseline conditioned FCR H-reflex), while SATS-OOP elicited the opposite effect (125 ± 46% of baseline conditioned FCR H-reflex). Some of the subjects maintained the changes after 30 minutes. No other significant changes were found for the rest of measurements.Significance.These results suggest that the short-term modulatory effects of phase-dependent PES occur at specific targeted spinal pathways for the wrist muscles in healthy individuals. Importantly, timely recruitment of afferent pathways synchronized with specific muscle activity is a fundamental principle that shall be considered when tailoring PES protocols to modulate specific neural circuits. (NCT number 04501133).
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Affiliation(s)
- Alejandro Pascual-Valdunciel
- Legs & Walking AbilityLab, Shirley Ryan AbilityLab, Chicago, IL, United States of America.,Department of PM&R, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.,Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain.,E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - Nish Mohith Kurukuti
- Legs & Walking AbilityLab, Shirley Ryan AbilityLab, Chicago, IL, United States of America.,Department of Biomedical Engineering and Mechanical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, United States of America
| | - Cristina Montero-Pardo
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain.,Universidad Carlos III de Madrid, Madrid, Spain
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - José Luis Pons
- Legs & Walking AbilityLab, Shirley Ryan AbilityLab, Chicago, IL, United States of America.,Department of PM&R, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.,Department of Biomedical Engineering and Mechanical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, United States of America
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Rodrigues-Carvalho C, Fernández-García M, Pinto-Fernández D, Sanz-Morere C, Barroso FO, Borromeo S, Rodríguez-Sánchez C, Moreno JC, del-Ama AJ. Benchmarking the Effects on Human-Exoskeleton Interaction of Trajectory, Admittance and EMG-Triggered Exoskeleton Movement Control. Sensors (Basel) 2023; 23:791. [PMID: 36679587 PMCID: PMC9867281 DOI: 10.3390/s23020791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/12/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Nowadays, robotic technology for gait training is becoming a common tool in rehabilitation hospitals. However, its effectiveness is still controversial. Traditional control strategies do not adequately integrate human intention and interaction and little is known regarding the impact of exoskeleton control strategies on muscle coordination, physical effort, and user acceptance. In this article, we benchmarked three types of exoskeleton control strategies in a sample of seven healthy volunteers: trajectory assistance (TC), compliant assistance (AC), and compliant assistance with EMG-Onset stepping control (OC), which allows the user to decide when to take a step during the walking cycle. This exploratory study was conducted within the EUROBENCH project facility. Experimental procedures and data analysis were conducted following EUROBENCH's protocols. Specifically, exoskeleton kinematics, muscle activation, heart and breathing rates, skin conductance, as well as user-perceived effort were analyzed. Our results show that the OC controller showed robust performance in detecting stepping intention even using a corrupt EMG acquisition channel. The AC and OC controllers resulted in similar kinematic alterations compared to the TC controller. Muscle synergies remained similar to the synergies found in the literature, although some changes in muscle contribution were found, as well as an overall increase in agonist-antagonist co-contraction. The OC condition led to the decreased mean duration of activation of synergies. These differences were not reflected in the overall physiological impact of walking or subjective perception. We conclude that, although the AC and OC walking conditions allowed the users to modulate their walking pattern, the application of these two controllers did not translate into significant changes in the overall physiological cost of walking nor the perceived experience of use. Nonetheless, results suggest that both AC and OC controllers are potentially interesting approaches that can be explored as gait rehabilitation tools. Furthermore, the INTENTION project is, to our knowledge, the first study to benchmark the effects on human-exoskeleton interaction of three different exoskeleton controllers, including a new EMG-based controller designed by us and never tested in previous studies, which has made it possible to provide valuable third-party feedback on the use of the EUROBENCH facility and testbed, enriching the apprenticeship of the project consortium and contributing to the scientific community.
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Affiliation(s)
- Camila Rodrigues-Carvalho
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), 28002 Madrid, Spain
- Systems Engineering and Automation Department, Carlos III University of Madrid, 28903 Madrid, Spain
| | | | - David Pinto-Fernández
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), 28002 Madrid, Spain
- CAR-UPM Associated Unit, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Clara Sanz-Morere
- Center for Clinical Neuroscience, Hospital Los Madroños, 28690 Madrid, Spain
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), 28002 Madrid, Spain
| | - Susana Borromeo
- Electronic Technology Department, Rey Juan Carlos University, 28933 Móstoles, Spain
| | | | - Juan C. Moreno
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), 28002 Madrid, Spain
| | - Antonio J. del-Ama
- Electronic Technology Department, Rey Juan Carlos University, 28933 Móstoles, Spain
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Pascual-Valdunciel A, Lopo-Martínez V, Beltrán-Carrero AJ, Sendra-Arranz R, González-Sánchez M, Pérez-Sánchez JR, Grandas F, Farina D, Pons JL, Oliveira Barroso F, Gutiérrez Á. Classification of Kinematic and Electromyographic Signals Associated with Pathological Tremor Using Machine and Deep Learning. Entropy (Basel) 2023; 25:114. [PMID: 36673255 PMCID: PMC9858124 DOI: 10.3390/e25010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/23/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Peripheral Electrical Stimulation (PES) of afferent pathways has received increased interest as a solution to reduce pathological tremors with minimal side effects. Closed-loop PES systems might present some advantages in reducing tremors, but further developments are required in order to reliably detect pathological tremors to accurately enable the stimulation only if a tremor is present. This study explores different machine learning (K-Nearest Neighbors, Random Forest and Support Vector Machines) and deep learning (Long Short-Term Memory neural networks) models in order to provide a binary (Tremor; No Tremor) classification of kinematic (angle displacement) and electromyography (EMG) signals recorded from patients diagnosed with essential tremors and healthy subjects. Three types of signal sequences without any feature extraction were used as inputs for the classifiers: kinematics (wrist flexion-extension angle), raw EMG and EMG envelopes from wrist flexor and extensor muscles. All the models showed high classification scores (Tremor vs. No Tremor) for the different input data modalities, ranging from 0.8 to 0.99 for the f1 score. The LSTM models achieved 0.98 f1 scores for the classification of raw EMG signals, showing high potential to detect tremors without any processed features or preliminary information. These models may be explored in real-time closed-loop PES strategies to detect tremors and enable stimulation with minimal signal processing steps.
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Affiliation(s)
- Alejandro Pascual-Valdunciel
- E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), 28002 Madrid, Spain
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - Víctor Lopo-Martínez
- E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | | | - Rafael Sendra-Arranz
- E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel González-Sánchez
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Javier Ricardo Pérez-Sánchez
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Francisco Grandas
- Movement Disorders Unit, Department of Neurology, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
- Department of Medicine, Universidad Complutense, 28040 Madrid, Spain
| | - Dario Farina
- Department of Bioengineering, Imperial College London, London SW7 2AZ, UK
| | - José L. Pons
- Legs & Walking AbilityLab, Shirley Ryan AbilityLab, Chicago, IL 60611, USA
- Department of PM&R, Feinberg School of Medicine, Northwestern University, Evanston, IL 60208, USA
- Department of Biomedical Engineering and Mechanical Engineering, McCormick School of Engineering, Northwestern University, Evanston, IL 60208, USA
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), 28002 Madrid, Spain
| | - Álvaro Gutiérrez
- E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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Pascual-Valdunciel A, Lopo-Martinez V, Sendra-Arranz R, Gonzalez-Sanchez M, Perez-Sanchez JR, Grandas F, Torricelli D, Moreno JC, Barroso FO, Pons JL, Gutierrez A. Prediction of Pathological Tremor Signals Using Long Short-Term Memory Neural Networks. IEEE J Biomed Health Inform 2022; 26:5930-5941. [PMID: 36170410 DOI: 10.1109/jbhi.2022.3209316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Previous implementations of closed-loop peripheral electrical stimulation (PES) strategies have provided evidence about the effect of the stimulation timing on tremor reduction. However, these strategies have used traditional signal processing techniques that only consider phase prediction and might not model the non-stationary behavior of tremor. Here, we tested the use of long short-term memory (LSTM) neural networks to predict tremor signals using kinematic data recorded from Essential Tremor (ET) patients. A dataset comprising wrist flexion-extension data from 12 ET patients was pre-processed to feed the predictors. A total of 180 models resulting from the combination of network (neurons and layers of the LSTM networks, length of the input sequence and prediction horizon) and training parameters (learning rate) were trained, validated and tested. Predicted tremor signals using LSTM-based models presented high correlation values (from 0.709 to 0.998) with the expected values, with a phase delay between the predicted and real signals below 15 ms, which corresponds approximately to 7.5% of a tremor cycle. The prediction horizon was the parameter with a higher impact on the prediction performance. The proposed LSTM-based models were capable of predicting both phase and amplitude of tremor signals outperforming results from previous studies (32-56% decreased phase prediction error compared to the out-of-phase method), which might provide a more robust PES-based closed-loop control applied to PES-based tremor reduction.
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10
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Becerra-Fajardo L, Krob MO, Minguillon J, Rodrigues C, Welsch C, Tudela-Pi M, Comerma A, Oliveira Barroso F, Schneider A, Ivorra A. Floating EMG sensors and stimulators wirelessly powered and operated by volume conduction for networked neuroprosthetics. J Neuroeng Rehabil 2022; 19:57. [PMID: 35672857 PMCID: PMC9171952 DOI: 10.1186/s12984-022-01033-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022] Open
Abstract
Background Implantable neuroprostheses consisting of a central electronic unit wired to electrodes benefit thousands of patients worldwide. However, they present limitations that restrict their use. Those limitations, which are more adverse in motor neuroprostheses, mostly arise from their bulkiness and the need to perform complex surgical implantation procedures. Alternatively, it has been proposed the development of distributed networks of intramuscular wireless microsensors and microstimulators that communicate with external systems for analyzing neuromuscular activity and performing stimulation or controlling external devices. This paradigm requires the development of miniaturized implants that can be wirelessly powered and operated by an external system. To accomplish this, we propose a wireless power transfer (WPT) and communications approach based on volume conduction of innocuous high frequency (HF) current bursts. The currents are applied through external textile electrodes and are collected by the wireless devices through two electrodes for powering and bidirectional digital communications. As these devices do not require bulky components for obtaining power, they may have a flexible threadlike conformation, facilitating deep implantation by injection. Methods We report the design and evaluation of advanced prototypes based on the above approach. The system consists of an external unit, floating semi-implantable devices for sensing and stimulation, and a bidirectional communications protocol. The devices are intended for their future use in acute human trials to demonstrate the distributed paradigm. The technology is assayed in vitro using an agar phantom, and in vivo in hindlimbs of anesthetized rabbits. Results The semi-implantable devices were able to power and bidirectionally communicate with the external unit. Using 13 commands modulated in innocuous 3 MHz HF current bursts, the external unit configured the sensing and stimulation parameters, and controlled their execution. Raw EMG was successfully acquired by the wireless devices at 1 ksps. Conclusions The demonstrated approach overcomes key limitations of existing neuroprostheses, paving the way to the development of distributed flexible threadlike sensors and stimulators. To the best of our knowledge, these devices are the first based on WPT by volume conduction that can work as EMG sensors and as electrical stimulators in a network of wireless devices. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-022-01033-3.
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11
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Jung MK, Muceli S, Rodrigues C, Megia-Garcia A, Pascual-Valdunciel A, Del-Ama AJ, Gil-Agudo A, Moreno JC, Barroso FO, Pons JL, Farina D. Intramuscular EMG-Driven Musculoskeletal Modelling: Towards Implanted Muscle Interfacing in Spinal Cord Injury Patients. IEEE Trans Biomed Eng 2021; 69:63-74. [PMID: 34097604 DOI: 10.1109/tbme.2021.3087137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Surface EMG-driven modelling has been proposed as a means to control assistive devices by estimating joint torques. Implanted EMG sensors have several advantages over wearable sensors but provide a more localized information on muscle activity, which may impact torque estimates. Here, we tested and compared the use of surface and intramuscular EMG measurements for the estimation of required assistive joint torques using EMG driven modelling. METHODS Four healthy subjects and three incomplete spinal cord injury (SCI) patients performed walking trials at varying speeds. Motion capture marker trajectories, surface and intramuscular EMG, and ground reaction forces were measured concurrently. Subject-specific musculoskeletal models were developed for all subjects, and inverse dynamics analysis was performed for all individual trials. EMG-driven modelling based joint torque estimates were obtained from surface and intramuscular EMG. RESULTS The correlation between the experimental and predicted joint torques was similar when using intramuscular or surface EMG as input to the EMG-driven modelling estimator in both healthy individuals and patients. CONCLUSION We have provided the first comparison of non-invasive and implanted EMG sensors as input signals for torque estimates in healthy individuals and SCI patients. SIGNIFICANCE Implanted EMG sensors have the potential to be used as a reliable input for assistive exoskeleton joint torque actuation.
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Pascual-Valdunciel A, Gonzalez-Sanchez M, Muceli S, Adan-Barrientos B, Escobar-Segura V, Perez-Sanchez JR, Jung MK, Schneider A, Hoffmann KP, Moreno JC, Grandas F, Farina D, Pons JL, Barroso FO. Intramuscular Stimulation of Muscle Afferents Attains Prolonged Tremor Reduction in Essential Tremor Patients. IEEE Trans Biomed Eng 2021; 68:1768-1776. [PMID: 32813648 DOI: 10.1109/tbme.2020.3015572] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study proposes and clinically tests intramuscular electrical stimulation below motor threshold to achieve prolonged reduction of wrist flexion/extension tremor in Essential Tremor (ET) patients. The developed system consisted of an intramuscular thin-film electrode structure that included both stimulation and electromyography (EMG) recording electrodes, and a control algorithm for the timing of intramuscular stimulation based on EMG (closed-loop stimulation). Data were recorded from nine ET patients with wrist flexion/extension tremor recruited from the Gregorio Marañón Hospital (Madrid, Spain). Patients participated in two experimental sessions comprising: 1) sensory stimulation of wrist flexors/extensors via thin-film multichannel intramuscular electrodes; and 2) surface stimulation of the nerves innervating the same target muscles. For each session, four of these patients underwent random 60-s trials of two stimulation strategies for each target muscle: 1) selective and adaptive timely stimulation (SATS) - based on EMG of the antagonist muscle; and 2) continuous stimulation (CON) of target muscles. Two patients underwent SATS stimulation trials alone while the other three underwent CON stimulation trials alone in each session. Kinematics of wrist, elbow, and shoulder, together with clinical scales, were used to assess tremor before, right after, and 24 h after each session. Intramuscular SATS achieved, on average, 32% acute (during stimulation) tremor reduction on each trial, while continuous stimulation augmented tremorgenic activity. Furthermore, tremor reduction was significantly higher using intramuscular than surface stimulation. Prolonged reduction of tremor amplitude (24 h after the experiment) was observed in four patients. These results showed acute and prolonged (24 h) tremor reduction using a minimally invasive neurostimulation technology based on SATS of primary sensory afferents of wrist muscles. This strategy might open the possibility of an alternative therapeutic approach for ET patients.
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Pascual-Valdunciel A, Hoo GW, Avrillon S, Barroso FO, Goldman JG, Hernandez-Pavon JC, Pons JL. Peripheral electrical stimulation to reduce pathological tremor: a review. J Neuroeng Rehabil 2021; 18:33. [PMID: 33588841 PMCID: PMC7885254 DOI: 10.1186/s12984-021-00811-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/11/2021] [Indexed: 01/02/2023] Open
Abstract
Interventions to reduce tremor in essential tremor (ET) and Parkinson’s disease (PD) clinical populations often utilize pharmacological or surgical therapies. However, there can be significant side effects, decline in effectiveness over time, or clinical contraindications for these interventions. Therefore, alternative approaches must be considered and developed. Some non-pharmacological strategies include assistive devices, orthoses and mechanical loading of the tremorgenic limb, while others propose peripheral electrical stimulation. Specifically, peripheral electrical stimulation encompasses strategies that activate motor and sensory pathways to evoke muscle contractions and impact sensorimotor function. Numerous studies report the efficacy of peripheral electrical stimulation to alter tremor generation, thereby opening new perspectives for both short- and long-term tremor reduction. Therefore, it is timely to explore this promising modality in a comprehensive review. In this review, we analyzed 27 studies that reported the use of peripheral electrical stimulation to reduce tremor and discuss various considerations regarding peripheral electrical stimulation: the stimulation strategies and parameters, electrodes, experimental designs, results, and mechanisms hypothesized to reduce tremor. From our review, we identified a high degree of disparity across studies with regard to stimulation patterns, experimental designs and methods of assessing tremor. Having standardized experimental methodology is a critical step in the field and is needed in order to accurately compare results across studies. With this review, we explore peripheral electrical stimulation as an intervention for tremor reduction, identify the limitations and benefits of the current state-of-the-art studies, and provide ideas to guide the development of novel approaches based on the neural circuitries and mechanical properties implied in tremor generation.
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Affiliation(s)
- Alejandro Pascual-Valdunciel
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain.,E.T.S. Ingenieros de Telecomunicación, Universidad Politécnica de Madrid, Madrid, Spain
| | - Grace W Hoo
- Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, 60611, USA
| | - Simon Avrillon
- Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, 60611, USA.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council (CSIC), Madrid, Spain
| | - Jennifer G Goldman
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.,Parkinson's Disease and Movement Disorders, Shirley Ryan AbilityLab, Chicago, IL, USA.,Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Julio C Hernandez-Pavon
- Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, 60611, USA.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - José L Pons
- Legs + Walking Lab, Shirley Ryan AbilityLab, Chicago, IL, 60611, USA. .,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. .,Department of Biomedical Engineering and Mechanical Engineering, McCormick School of Engineering, Northwestern University, Chicago, IL, USA.
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14
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Botzheim L, Laczko J, Torricelli D, Mravcsik M, Pons JL, Oliveira Barroso F. Effects of gravity and kinematic constraints on muscle synergies in arm cycling. J Neurophysiol 2021; 125:1367-1381. [PMID: 33534650 DOI: 10.1152/jn.00415.2020] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Arm cycling is a bimanual motor task used in medical rehabilitation and in sports training. Understanding how muscle coordination changes across different biomechanical constraints in arm cycling is a step toward improved rehabilitation approaches. This exploratory study aims to get new insights on motor control during arm cycling. To achieve our main goal, we used the muscle synergies analysis to test three hypotheses: 1) body position with respect to gravity (sitting and supine) has an effect on muscle synergies; 2) the movement size (crank length) has an effect on the synergistic behavior; 3) the bimanual cranking mode (asynchronous and synchronous) requires different synergistic control. Thirteen able-bodied volunteers performed arm cranking on a custom-made device with unconnected cranks, which allowed testing three different conditions: body position (sitting vs. supine), crank length (10 cm vs. 15 cm), and cranking mode (synchronous vs. asynchronous). For each of the eight possible combinations, subjects cycled for 30 s while electromyography of eight muscles (four from each arm) were recorded: biceps brachii, triceps brachii, anterior deltoid, and posterior deltoid. Muscle synergies in this eight-dimensional muscle space were extracted by nonnegative matrix factorization. Four synergies accounted for over 90% of muscle activation variances in all conditions. Results showed that synergies were affected by body position and cranking mode but practically unaffected by movement size. These results suggest that the central nervous system may employ different motor control strategies in response to external constraints such as cranking mode and body position during arm cycling.NEW & NOTEWORTHY Recent studies analyzed muscle synergies in lower limb cycling. Here, we examine upper limb cycling and specifically the effect of body position with respect to gravity, movement size, and cranking mode on muscle coordination during arm cranking tasks. We show that altered body position and cranking mode affects modular organization of muscle activities. To our knowledge, this is the first study assessing motor control through muscle synergies framework during upper limb cycling with different constraints.
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Affiliation(s)
- Lilla Botzheim
- Department of Information Technology and Biorobotics, Institute of Mathematics and Informatics, Faculty of Sciences, University of Pecs, Pecs, Hungary.,Neurorehabilitation and Motor Control Research Group, Department of Computational Sciences, Wigner Research Centre for Physics, Budapest, Hungary
| | - Jozsef Laczko
- Department of Information Technology and Biorobotics, Institute of Mathematics and Informatics, Faculty of Sciences, University of Pecs, Pecs, Hungary.,Neurorehabilitation and Motor Control Research Group, Department of Computational Sciences, Wigner Research Centre for Physics, Budapest, Hungary.,Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Diego Torricelli
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council, Madrid, Spain
| | - Mariann Mravcsik
- Department of Information Technology and Biorobotics, Institute of Mathematics and Informatics, Faculty of Sciences, University of Pecs, Pecs, Hungary.,Neurorehabilitation and Motor Control Research Group, Department of Computational Sciences, Wigner Research Centre for Physics, Budapest, Hungary
| | - Jose L Pons
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council, Madrid, Spain.,Legs & Walking AbilityLab, Shirley Ryan AbilityLab, Chicago, Illinois.,Department of Biomedical Engineering and Mechanical Engineering, McCormick School of Engineering, Northwestern University, Chicago, Illinois.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Council, Madrid, Spain
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15
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Torricelli D, De Marchis C, d'Avella A, Tobaruela DN, Barroso FO, Pons JL. Reorganization of Muscle Coordination Underlying Motor Learning in Cycling Tasks. Front Bioeng Biotechnol 2020; 8:800. [PMID: 32760711 PMCID: PMC7373728 DOI: 10.3389/fbioe.2020.00800] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 06/22/2020] [Indexed: 12/27/2022] Open
Abstract
The hypothesis of modular control, which stands on the existence of muscle synergies as building blocks of muscle coordination, has been investigated in a great variety of motor tasks and species. Yet, its role during learning processes is still largely unexplored. To what extent is such modular control flexible, in terms of spatial structure and temporal activation, to externally or internally induced adaptations, is a debated issue. To address this question, we designed a biofeedback experiment to induce changes in the timing of muscle activations during leg cycling movements. The protocol consisted in delaying the peak of activation of one target muscle and using its electromyography (EMG) envelope as visual biofeedback. For each of the 10 healthy participants, the protocol was repeated for three different target muscles: Tibialis Anterioris (TA), Gastrocnemius Medialis (GM), and Vastus Lateralis (VL). To explore the effects of the conditioning protocol, we analyzed changes in the activity of eight lower limb muscles by applying different models of modular motor control [i.e., fixed spatial components (FSC) and fixed temporal components (FTC)]. Our results confirm the hypothesis that visual EMG biofeedback is able to induce changes in muscle coordination. Subjects were able to shift the peak of activation of the target muscle, with a delay of (49 ± 27°) across subjects and conditions. This time shift generated a reorganization of all the other muscles in terms of timing and amplitude. By using different models of modular motor control, we demonstrated that neither spatially invariant nor temporally invariant muscle synergies alone were able to account for these changes in muscle coordination after learning, while temporally invariant muscle synergies with adjustments in timing could capture most of muscle activity adaptations observed after the conditioning protocol. These results suggest that short-term learning in rhythmic tasks is built upon synergistic temporal commands that are robust to changes in the task demands.
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Affiliation(s)
- Diego Torricelli
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Center (CSIC), Madrid, Spain
| | - Cristiano De Marchis
- Biomedical Engineering Laboratory, Department of Engineering, Università Roma TRE, Rome, Italy
| | - Andrea d'Avella
- Laboratory of Neuromotor Physiology, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Università di Messina, Messina, Italy
| | - Daniel Nemati Tobaruela
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Center (CSIC), Madrid, Spain
| | - Filipe Oliveira Barroso
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Center (CSIC), Madrid, Spain
| | - Jose L Pons
- Neural Rehabilitation Group, Cajal Institute, Spanish National Research Center (CSIC), Madrid, Spain.,Legs and Walking Lab, Shirley Ryan AbilityLab (formerly Rehabilitation Institute of Chicago), Chicago, IL, United States.,Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,Department of Biomedical Engineering, McCormick School of Engineering and Applied Science, Northwestern University, Chicago, IL, United States.,Department of Mechanical Engineering, McCormick School of Engineering and Applied Science, Northwestern University, Chicago, IL, United States
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Muceli S, Poppendieck W, Hoffmann KP, Dosen S, Benito-León J, Barroso FO, Pons JL, Farina D. A thin-film multichannel electrode for muscle recording and stimulation in neuroprosthetics applications. J Neural Eng 2019; 16:026035. [PMID: 30721892 DOI: 10.1088/1741-2552/ab047a] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE We propose, design and test a novel thin-film multichannel electrode that can be used for both recording from and stimulating a muscle in acute implants. APPROACH The system is built on a substrate of polyimide and contains 12 recording and three stimulation sites made of platinum. The structure is 420 µm wide, 20 µm thick and embeds the recording and stimulation contacts on the two sides of the polyimide over an approximate length of 2 cm. We show representative applications in healthy individuals as well as tremor patients. The designed system was tested by a psychometric characterization of the stimulation contacts in six tremor patients and three healthy individuals determining the perception threshold and current limit as well as the success rate in discriminating elicited sensations (electrotactile feedback). Also, we investigated the possibility of using the intramuscular electrode for reducing tremor in one patient by electrical stimulation delivered with timing based on the electromyographic activity recorded with the same electrode. MAIN RESULTS In the tremor patients, the current corresponding to the perception threshold and the current limit were 0.7 ± 0.2 and 1.4 ± 0.7 mA for the wrist flexor muscles and 0.4 ± 0.2 and 1.5 ± 0.7 mA for the extensors. In one patient, closed-loop stimulation resulted in a decrease of the tremor power >50%. In healthy individuals the perception threshold and current limits were 0.9 ± 0.6 and 2.1 ± 0.6 mA for the extensor carpi radialis muscle. The subjects could distinguish four or six stimulation patterns (two or three stimulation sites × two stimulation current amplitudes) with true positive rate >80% (two subjects) and >60% (one subject), respectively. SIGNIFICANCE The proposed electrode provides a compact multichannel interface for recording electromyogram and delivering electrical stimulation in applications such as neuroprostheses for tremor suppression and closed-loop myoelectric prostheses.
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Affiliation(s)
- Silvia Muceli
- Department of Bioengineering, Imperial College London, London, United Kingdom
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Alessandro C, Rellinger BA, Barroso FO, Tresch MC. Adaptation after vastus lateralis denervation in rats demonstrates neural regulation of joint stresses and strains. eLife 2018; 7:38215. [PMID: 30175959 PMCID: PMC6150696 DOI: 10.7554/elife.38215] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/22/2018] [Indexed: 12/14/2022] Open
Abstract
In order to produce movements, muscles must act through joints. The translation from muscle force to limb movement is mediated by internal joint structures that permit movement in some directions but constrain it in others. Although muscle forces acting against constrained directions will not affect limb movements, such forces can cause excess stresses and strains in joint structures, leading to pain or injury. In this study, we hypothesized that the central nervous system (CNS) chooses muscle activations to avoid excessive joint stresses and strains. We evaluated this hypothesis by examining adaptation strategies after selective paralysis of a muscle acting at the rat’s knee. We show that the CNS compromises between restoration of task performance and regulation of joint stresses and strains. These results have significant implications to our understanding of the neural control of movements, suggesting that common theories emphasizing task performance are insufficient to explain muscle activations during behaviors. Although most of us will never achieve the grace and dexterity of professional ballerina Misty Copeland, we each make sophisticated, complex movements every day. Even simple movements often involve coordinating many muscles throughout the body. Moreover, because we have so many muscles, there are often multiple ways that we could use them to make the same movement. So which ones do we use, and why? Many studies into muscle control focus on how the muscles activate to perform a task like kicking a soccer ball. But muscles do more than just move the limbs; they also act on joints. Contracting a muscle exerts strain on bones and the ligaments that hold joints together. If these strains become excessive, they may cause pain and injury, and over a longer time may lead to arthritis. It would therefore make sense if the nervous system factored in the need to protect joints when turning on muscles. The quadriceps are a group of muscles that stretch along the front of the thigh bone and help to straighten the knee. To investigate whether the nervous system selects muscle activations to avoid joint injuries, Alessando et al. studied rats that had one particular quadriceps muscle paralyzed. The easiest way for the rats to adapt to this paralysis would be to increase the activation of a muscle that performs the same role as the paralyzed one, but places more stress on the knee joint. Instead, Alessando et al. found that the rats increase the activation of a muscle that minimizes the stress placed on the knee, even though this made it more difficult for the rats to recover their ability to use the leg in certain tasks. The results presented by Alessando et al. may have important implications for physical therapy. Clinicians usually work to restore limb movements so that a task is performed in a way that is similar to how it was done before the injury. But sometimes repairing the damage can change the mechanical properties of the joint – for example, reconstructive surgery may replace a damaged ligament with a graft that has a different strength or stiffness. In those cases, performing movements in the same way as before the surgery could place abnormal stress on the joint. However, much more research is needed before recommendations can be made for how to rehabilitate rats after injury, let alone humans.
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Affiliation(s)
| | - Benjamin A Rellinger
- Department of Biomedical Engineering, Northwestern University, Evanston, United States
| | | | - Matthew C Tresch
- Department of Physiology, Northwestern University, Chicago, United States.,Department of Biomedical Engineering, Northwestern University, Evanston, United States.,Department of Physical Medicine and Rehabilitation, Northwestern University, Chicago, United States.,Shirley Ryan AbilityLab, Chicago, United States
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Alessandro C, Oliveira Barroso F, Tresch M. Working hard to make a simple definition of synergies: Comment on: "Hand synergies: Integration of robotics and neuroscience for understanding the control of biological and artificial hands" by Marco Santello et al. Phys Life Rev 2016; 17:24-6. [PMID: 27318535 DOI: 10.1016/j.plrev.2016.05.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 05/25/2016] [Indexed: 01/08/2023]
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