Cycle Training Using Implanted Neural Prostheses: Team Cleveland

McDaniel, John; Lombardo, Lisa M.; Foglyano, Kevin M.; Marasco, Paul D.; Triolo, Ronald J.

doi:10.4081/ejtm.2017.7087

Cited by 17 publications

(16 citation statements)

References 18 publications

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“…A crank angle encoder (US Digital, Inc.) relayed instantaneous recumbent bike pedal crank position to an external control unit (ECU) [ 38 ] running custom cycling exercise stimulation models as a Simulink real-time xPC target. Crank angle was mapped to the necessary muscle activations and timings for smooth cycling within the ECU stimulation model [ 23 ]. The ECU relayed the desired stimulus based on crank angle via a close coupled inductive radiofrequency communications link to a subcutaneous implanted pulse generator.…”

Section: Methodsmentioning

confidence: 99%

“…Conventional cycling stimulation methods activate large groups of synergistic muscle fibers each pedal rotation. For example, large portions or even multiple heads of the quadriceps are activated concurrently when strong knee extension is needed [ 23 ]. The activated fibers thus have a high duty cycle, or work to rest ratio, as they are all repeatedly activated each pedal stroke.…”

Section: Introductionmentioning

confidence: 99%

“…One potential way to acutely improve electricallyinduced exercise is to reduce the overlap of activated fibers among stimulating electrodes. Current systems stimulate through multiple surface electrode pads [19][20][21][22] or implanted neural electrode contacts [23] at once and at high pulse amplitudes (PA) and/or pulse widths (PW) to engage as many muscle fibers as possible, particularly during knee extension phases of cycling. Though this can result in high initial power production, the large voltage fields produced by each electrode can overlap and limit performance as the exercise goes on.…”

mentioning

confidence: 99%

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Selective neural stimulation methods improve cycling exercise performance after spinal cord injury: a case series

Gelenitis

Foglyano

Lombardo

et al. 2021

J NeuroEngineering Rehabil

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Background Exercise after paralysis can help prevent secondary health complications, but achieving adequate exercise volumes and intensities is difficult with loss of motor control. Existing electrical stimulation-driven cycling systems involve the paralyzed musculature but result in rapid force decline and muscle fatigue, limiting their effectiveness. This study explores the effects of selective stimulation patterns delivered through multi-contact nerve cuff electrodes on functional exercise output, with the goal of increasing work performed and power maintained within each bout of exercise. Methods Three people with spinal cord injury and implanted stimulation systems performed cycling trials using conventional (S-Max), low overlap (S-Low), low duty cycle (C-Max), and/or combined low overlap and low duty cycle (C-Low) stimulation patterns. Outcome measures include total work (W), end power (Pend), power fluctuation indices (PFI), charge accumulation (Q), and efficiency (η). Mann–Whitney tests were used for statistical comparisons of W and Pend between a selective pattern and S-Max. Welch’s ANOVAs were used to evaluate differences in PFIs among all patterns tested within a participant (n ≥ 90 per stimulation condition). Results At least one selective pattern significantly (p < 0.05) increased W and Pend over S-Max in each participant. All selective patterns also reduced Q and increased η compared with S-Max for all participants. C-Max significantly (p < 0.01) increased PFI, indicating a decrease in ride smoothness with low duty cycle patterns. Conclusions Selective stimulation patterns can increase work performed and power sustained by paralyzed muscles prior to fatigue with increased stimulation efficiency. While still effective, low duty cycle patterns can cause inconsistent power outputs each pedal stroke, but this can be managed by utilizing optimized stimulation levels. Increasing work and sustained power each exercise session has the potential to ultimately improve the physiological benefits of stimulation-driven exercise.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Selective neural stimulation methods improve cycling exercise performance after spinal cord injury: a case series

Gelenitis

Foglyano

Lombardo

et al. 2021

J NeuroEngineering Rehabil

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“…This does not indicate that involving a PIL for more than four years is not bene cial for a good performance at the CYBATHLON, but rather that there is no signi cant difference in the positive effect compared to involvements of 2-4 years duration. The re-occurring success stories from teams that participated in both competitions of 2016 and 2020 with the same PIL, like HSR enhanced (WHL), Cleveland (FES), TWIICE (EXO), or IHMC (EXO) con rm this identi ed bene t of long-term PIL involvement [23,26,37,38]. Iterestingly, the quality of PIL involvement, i.e., their role within the ve different development phases, was not found to signi cantly affect race performance.…”

Section: Cybathlon Race Performance Indicatorsmentioning

confidence: 89%

A Survey on the Influence of CYBATHLON on the Development and Acceptance of Advanced Assistive Technologies

Meyer

Weber

Jäger³

et al. 2021

Preprint

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Background: Advanced assistive technologies (AAT) aim to exploit the vast potential of technological developments made in the past decades to improve the quality of life of people with disabilities. Combining complex robotic technologies with the unique needs of people with disabilities requires a strong focus on user-centered design to ensure that the AAT appropriately addresses the daily life struggles of target users. The CYBATHLON aims to promote this mindset by empowering the AAT target users (“pilots”) to compete on race tracks that represent daily life obstacles. The objective of this work was to investigate the influence of the CYABTHALON on AAT technology development, acceptance, and user involvement (i.e., application of user-centered design).Methods: With an online survey targetting the pilots and technical leads of teams preparing for the CYBATHLON 2020 Global Edition, we investigated to what extent the pilots were involved in device development and how this influences the perceived daily life usability of the showcased AAT. Furthermore, the effects of user-centered design variables on the individual race performances were analyzed.Results: A total of 81 responses from 35 pilots and 46 technical leads were collected in the two weeks prior to the event. Of all teams partaking in the included disciplines of the CYBATHLON 2020 Global Edition, 81.8% (36 of 44) were included in the study. User-centered design appeared to be a prevalent practice among the teams, as 85.7% of all pilots reported a certain level of involvement. However, only 25.5% of the pilots reported daily life usage, despite QUEST usability scores of both respondent groups showing moderate to high satisfaction with the respected AAT across all investigated disciplines. An explorative linear mixed model indicated that daily life usage (p < 0.05) and prolonged user involvement (e.g. more than 2 years, p < 0.001) have a significant positive effect on the race performance at the competition.Conclusions: We conclude that the CYBATHLON positively fullfills its conceptual goals of promoting active participation and inclusion of people with disabilities in the design and evaluation of AAT, thereby stimulating the development of promising novel technological solutions. Also, our data could underline the value of the competition as a benchmark, highlighting remaining usability limitations or technology adoption hurdles.

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“…In this article, we aim to analyse the precision and accuracy of three algorithms by comparing their movement event detection results with the desired targets (i.e., relative time points within a cycle at which the onset of stimulation is to be triggered) occurring on a post-calculated reference baseline. In contrast to techniques which track the knee-angle [ 18 ] or control stimulation based on the crank angle [ 10 , 22 , 23 , 24 ], we decided to evaluate algorithms which can directly interpret the thigh inclination (measured by a single IMU) as the common input signal. The selected algorithms allowed us to detect the desired stimulation-triggering events throughout consecutive cycles.…”

Section: Introductionmentioning

confidence: 99%

A Novel Framework for Quantifying Accuracy and Precision of Event Detection Algorithms in FES-Cycling

Guillou

Schmoll

Sijobert

et al. 2021

Sensors

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Functional electrical stimulation (FES) is a technique used in rehabilitation, allowing the recreation or facilitation of a movement or function, by electrically inducing the activation of targeted muscles. FES during cycling often uses activation patterns which are based on the crank angle of the pedals. Dynamic changes in their underlying predefined geometrical models (e.g., change in seating position) can lead to desynchronised contractions. Adaptive algorithms with a real-time interpretation of anatomical segments can avoid this and open new possibilities for the automatic design of stimulation patterns. However, their ability to accurately and precisely detect stimulation triggering events has to be evaluated in order to ensure their adaptability to real-case applications in various conditions. In this study, three algorithms (Hilbert, BSgonio, and Gait Cycle Index (GCI) Observer) were evaluated on passive cycling inertial data of six participants with spinal cord injury (SCI). For standardised comparison, a linear phase reference baseline was used to define target events (i.e., 10%, 40%, 60%, and 90% of the cycle’s progress). Limits of agreement (LoA) of ±10% of the cycle’s duration and Lin’s concordance correlation coefficient (CCC) were used to evaluate the accuracy and precision of the algorithm’s event detections. The delays in the detection were determined for each algorithm over 780 events. Analysis showed that the Hilbert and BSgonio algorithms validated the selected criteria (LoA: +5.17/−6.34% and +2.25/−2.51%, respectively), while the GCI Observer did not (LoA: +8.59/−27.89%). When evaluating control algorithms, it is paramount to define appropriate criteria in the context of the targeted practical application. To this end, normalising delays in event detection to the cycle’s duration enables the use of a criterion that stays invariable to changes in cadence. Lin’s CCC, comparing both linear correlation and strength of agreement between methods, also provides a reliable way of confirming comparisons between new control methods and an existing reference.

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Cycle Training Using Implanted Neural Prostheses: Team Cleveland

Cited by 17 publications

References 18 publications

Selective neural stimulation methods improve cycling exercise performance after spinal cord injury: a case series

Selective neural stimulation methods improve cycling exercise performance after spinal cord injury: a case series

A Survey on the Influence of CYBATHLON on the Development and Acceptance of Advanced Assistive Technologies

A Novel Framework for Quantifying Accuracy and Precision of Event Detection Algorithms in FES-Cycling

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