Paraplegics standing up using multichannel FES and arm support

Abstract

The suitability of multichannel functional electrical stimulation (FES) during the standing-up manoeuvre for therapeutic home use was investigated. Two spinal cord-injured subjects (SCI) participated in the study. Ankle plantar flexors, knee extensors and hip extensors were stimulated. The amplitude of the stimulation pulses depended on the current phase of raising. The sit-to-stand process was divided into three phases by detecting characteristic events in the vertical handle reaction force. It was found that the multichannel FES did not contribute to the decrease of the arm support force when compared with stimulation of knee extensors only. However, stimulation of the hip extensors could speed up the raising process. Increased repeatability and faster standing up were observed when the stimulation began before the start of raising.

Synthesis of standing-up trajectories using dynamic optimization

“…Novel assistive devices are being developed which are intended to help persons with disabilities relearn or improve motor activities such as walking [1][2][3], standing-up [4], and reaching [5]. One approach to obtain the training trajectory for such assistive devices is to measure a physiotherapist's induced motion.…”

The effects of stimulation frequency and fatigue on the force–intensity relationship for human skeletal muscle

“…The use of electrical stimulation to activate paralyzed muscles and restore functional movements for individuals with upper motoneuron lesions is termed Functional Electrical Stimulation (FES). After first being introduced by Liberson and colleagues (Liberson et al, 1961) to prevent foot drop during the swing phase of gait for patients with hemiplegia, FES has been applied to restore functional movements such as grasping (Prochazka et al, 1997;Snoek et al, 2000), standing (Davis et al, 2001;Kuzelicki et al, 2002) and walking (Graupe et al, 1998,Kobetic andMarsolais, 1994) for individuals either post-stroke or with spinal cord injury (SCI).…”

Functional electrical stimulation in neurological disorders

“…Most FES systems today are pre‐programmed to perform tasks specific to the needs of the individual. The major areas of application include: assisted walking in paraplegia [10,12,13], cases of spinal cord injuries [14–16] and in hemiplegic gait training [10,17–19]. The therapeutic effect of FES‐assisted walking may derive from many factors such as plasticity of both the peripheral and central nervous system being the major one.…”