Neuromuscular electrical stimulation (NMES) is a promising assistive technology for stroke rehabilitation. Here we present the design and development of a multimuscle stimulation system as an emerging therapy for people with paretic stroke. A network-based multichannel NMES system was integrated based on dual bus architecture of communication and an H-bridge current regulator with a power booster. The structure of the system was a body area network embedded with multiple stimulators and a communication protocol of controlled area network to transmit muscle stimulation parameter information to individual stimulators. A graphical user interface was designed to allow clinicians to specify temporal patterns and muscle stimulation parameters. We completed and tested a prototype of the hardware and communication software modules of the multichannel NMES system. The prototype system was first verified in nondisabled subjects for safety, and then tested in subjects with stroke for feasibility with assisting multijoint movements. Results showed that synergistic stimulation of multiple muscles in subjects with stroke improved performance of multijoint movements with more natural velocity profiles at elbow and shoulder and reduced acromion excursion due to compensatory trunk rotation. The network-based NMES system may provide an innovative solution that allows more physiological activation of multiple muscles in multijoint task training for patients with stroke.
Recent experiments have suggested that the central nervous system (CNS) makes use of muscle synergies as a neural strategy to simplify the control of a variety of movements by using a single pattern of neural command signal. This nature of muscle coordination could have great significance in the treatment and rehabilitation of upper limb impairments for hemiparetic patients post stroke.The use of neuromuscular electrical stimulation (NMES) for neural prosthetics or therapeutic applications has been demonstrated as a promising clinical intervention for stroke patients to recover motor function of the upper extremity. However, the existing NMES systems do not provide control methods for the patient to achieve an individualized and functional rehabilitation training.In this research work, muscle synergies from the flexionextension elbow antagonistic muscles were studied. Using motion information and EMG signals, muscle synergies were extracted using non-negative matrix factorization (NMF) method. Reconstructed signals obtained from the muscle synergies were then applied to the virtual arm (VA) model to test a synergy based NMES strategy. Results show close resemblance to the original elbow trajectory of normal movements and thus the feasibility to control movements in stroke patients for rehabilitation. University,
The lack of reliable sensory feedback has been one of the barriers in prosthetic hand development. Restoring sensory function from prosthetic hand to amputee remains a great challenge to neural engineering. In this paper, we present the development of a sensory feedback system based on the phenomenon of evoked tactile sensation (ETS) at the stump skin of residual limb induced by transcutaneous electrical nerve stimulation (TENS). The system could map a dynamic pattern of stimuli to an electrode placed on the corresponding projected finger areas on the stump skin. A pressure transducer placed at the tip of prosthetic fingers was used to sense contact pressure, and a high performance DSP processor sampled pressure signals, and calculated the amplitude of feedback stimulation in real-time. Biphasic and charge-balanced current pulses with amplitude modulation generated by a multi-channel laboratory stimulator were delivered to activate sensory nerves beneath the skin. We tested this sensory feedback system in amputee subjects. Preliminary results showed that the subjects could perceive different levels of pressure at the tip of prosthetic finger through evoked tactile sensation (ETS) with distinct grades and modalities. We demonstrated the feasibility to restore the perceptual sensation from prosthetic fingers to amputee based on the phenomenon of evoked tactile sensation (ETS) with TENS.
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