A multichannel FES system for the restoration of motor functions in high spinal cord injury patients: a respiration-controlled system for multijoint upper extremity

Hoshimiya, Nozomu; Naito, Akira; Yajima, M.; Handa, Yasunobu

doi:10.1109/10.32108

Cited by 158 publications

(81 citation statements)

References 5 publications

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“…The results of this study support earlier findings 18,20,21,22 suggesting a relatively high tendency for LMN lesions of proximal arm muscles following high tetraplegia, especially C3 and C4 level SCI. In this series of 24 arms, LMN lesions of the elbow¯exors and proximal shoulder muscles were present in 91% and more than 80% of the cases, respectively.…”

Section: Discussionsupporting

confidence: 91%

“…21,23 Both types of orthoses are designed to support the weight of the limb so that weak shoulder muscles (typically innervated at C5) can move the arm through a purposeful range; 31 in the absence of voluntary or FES-excitable muscles both the BFO and overhead sling may simply provide a support to protect the glenohumeral joint. Nevertheless, in our experience, few persons would accept these orthoses on a day-to-day basis because of di culty in set-up and cosmesis.…”

Section: Discussionmentioning

confidence: 99%

“…Reports by Hoshimiya and Nathan support Peckham concerning the need for alternative power sources. Hoshimiya 21 required a balance forearm orthosis (BFO) to provide proximal stability when he employed intramuscular stimulation controlled by sip and pu sensors for hand grasp and release and elbow extension and¯exion. Nathan 22 utilized an overhead sling for shoulder support when he applied surface stimulation activated by voice control for hand and arm function.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury

Mulcahey

1999

Spinal Cord

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Purpose: To evaluate the lower motor neuron (LMN) integrity of upper extremity muscles of persons with high tetraplegia (C1-C4) in order to determine muscles available for stimulation. Methods: Fourteen subjects (23 arms) were evaluated for LMN integrity. Muscles that elicited a functional response (grade 3 or better) to surface electrical stimulation were considered to have intact LMN and good candidates for FES. Strength-duration (S-D) curves were generated on muscles that showed weak (less than grade 3) or no response to surface stimulation. Muscles were considered denervated if S-D curves were discontinuous or depicted steep, increasing amplitude for pulse durations greater than 1 m. Results: Muscles for grasp and release had intact LMN in 19 of 23 (83%) arms. The wrist extensors and¯exors and pronator were excitable in 17 (74%), 20 (87%) and 19 (83%) arms, respectively. The supinator demonstrated LMN lesion in 80% of the arms. Over 90% of the biceps muscles were unresponsive to electrical stimulation and 85% and 87% of the deltoid and supraspinatus muscles, respectively, were not electrically excitable. The latissimus dorsi and triceps muscles were typically innervated (78% and 91%, respectively) and slightly more than half (52%) of the pectoralis major muscles were excitable. Conclusion: These data suggest that application of FES in high tetraplegia for hand and arm function would require augmentation because of the inability to stimulate the elbow¯exors, deltoid and rotator cu muscles. These data also show that several paralyzed proximal muscles with intact LMN that have been historically transferred to address shoulder paralysis in other patient populations are available for transfer and stimulation in the population with high level spinal injuries.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury

Mulcahey

1999

Spinal Cord

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“…FES systems activate the triceps with electrical stimuli, either through surface electrodes [10], percutaneous electrodes [11][12][13][14][15], or implanted electrodes [16,17]. Individuals who are candidates for triceps stimulation generally are already receiving a hand-grasp neuroprosthesis [18].…”

Section: Introductionmentioning

confidence: 99%

Restoration of elbow extension via functional electrical stimulation in individuals with tetraplegia

Memberg¹,

Crago²,

Keith³

2003

JRRD

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Abstract-Functional electrical stimulation of the triceps is a method of restoring elbow extension to individuals with paralyzed triceps. Eleven arms of individuals with cervical-level spinal cord injuries (SCIs) received a triceps electrode as an addition to a hand-grasp neuroprosthesis. Stimulation was controlled either as part of a preprogrammed pattern or via a switch or an accelerometer that was connected to the neuroprosthesis external controller. The outcome measures were (1) elbow extension moments at different elbow positions, (2) performance in controllable workspace experiments, and (3) comparison to an alternative method of providing elbow extension in these individuals-a posterior deltoid (PD) to triceps tendon transfer. Stimulated elbow extension moments in 11 arms ranged from 0.8 to 13.3 N•m. The stimulated elbow extension moments varied with elbow angle in a manner consistent with the length-tension properties of the triceps. Triceps stimulation provided a significantly stronger elbow extension moment than the PD to triceps tendon transfer. The elbow extension moment generated by the tendon transfer and triceps electrode being activated together was always greater than either method used separately. Stimulation of the long head of the triceps should be avoided in persons with weak shoulder abduction, since the long head adducts the shoulder and limits shoulder function in these cases. Statistically, elbow extension neuroprostheses significantly increased the ability to successfully reach and move an object and significantly decreased the time required to acquire an object while reaching.

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“…So far, many FES control strategies have been proposed to control paralyzed limbs: look-up tables [1,2], open-loop artificial neural This work was supported in part by the Ministry of Education, Culture, Sports, Science and Technology of Japan under a Grant-in-Aid for Scientific Research, The Japan society for the Promotion of Science under the Bilateral Program, and Takayanagi Foundation for Electronics Science and Technology. We would like to thank these organizations.…”

Section: Introduction or Individuals With Spinal Cord Injuries Fumentioning

confidence: 99%

Development of a closed-loop fes system using a 3-d magnetic position and orientation measurement system

et al. 2002

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Abstract-We have developed a closed-loop FES system using a magnetic 3-D position and orientation measurement system (FASTRAK, Polhemus Inc.). The purpose of this development was to resolve some experimental difficulties involved in our previous goniometer-based experimental system. The new system enabled us to perform FES control experiments on the multi-joint musculoskeletal system of the upper limbs including forearm pronation/supination. In this paper, we evaluated the system by some single-joint tracking tasks in order to compare its control performance with that of the previous system. Four muscles (ECRL(B), ECU, FCR, and FCU) of neurologically intact subjects were stimulated to control the wrist joint's two degrees of freedom movement. Stimulation currents were determined by a multi-channel PID controller that was designed for a musculoskeletal system with redundancy (i.e. the number of muscles stimulated is more than that of the degree-of-freedom of the movement). The results showed that the system had sufficient control performance on tracking desired trajectories. Moreover, the system could compensate for unwanted external disturbances.

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A multichannel FES system for the restoration of motor functions in high spinal cord injury patients: a respiration-controlled system for multijoint upper extremity

Cited by 158 publications

References 5 publications

Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury

Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury

Restoration of elbow extension via functional electrical stimulation in individuals with tetraplegia

Development of a closed-loop fes system using a 3-d magnetic position and orientation measurement system

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