Selective Nerve Cuff Stimulation Strategies for Prolonging Muscle Output

Gelenitis, Kristen; Sanner, Brian M.; Triolo, Ronald J.; Tyler, Dustin J.

doi:10.1109/tbme.2019.2937061

Cited by 9 publications

(6 citation statements)

References 36 publications

(46 reference statements)

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“…Reducing duty cycle with SOPS increased TF and W over constant stimulation (Fig. 3) in our participant, in accordance with several other studies [20][21][22] that reported decreased duty cycles prolong muscle output and delay stimulation-induced fatigue. Duty cycle reduction and rotating activation among separate MUPs is thought to delay glycogen store depletion and metabolite build-up, and create a pumping action to promote blood flow and oxygen delivery to the muscle [23], which may explain the improvements in joint moment maintenance with the SOPS paradigm.…”

Section: Discussionsupporting

confidence: 93%

Sum of phase-shifted sinusoids stimulation prolongs paralyzed muscle output

Gelenitis

Freeberg

Triolo

2020

J NeuroEngineering Rehabil

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Neuroprostheses that activate musculature of the lower extremities can enable standing and movement after paralysis. Current systems are functionally limited by rapid muscle fatigue induced by conventional, non-varying stimulus waveforms. Previous work has shown that sum of phase-shifted sinusoids (SOPS) stimulation, which selectively modulates activation of individual motor unit pools (MUPs) to lower the duty cycle of each while maintaining a high net muscle output, improves joint moment maintenance but introduces greater instability over conventional stimulation. In this case study, implementation of SOPS stimulation with a real-time feedback controller successfully decreased joint moment instability and further prolonged joint moment output with increased stimulation efficiency over open-loop approaches in one participant with spinal cord injury. These findings demonstrate the potential for closed-loop SOPS to improve functionality of neuroprosthetic systems.

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Section: Discussionsupporting

confidence: 93%

Sum of phase-shifted sinusoids stimulation prolongs paralyzed muscle output

Gelenitis

Freeberg

Triolo

2020

J NeuroEngineering Rehabil

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“…C-Max cycling results agree with other studies of similar duty cycle reduction techniques to improve functional outcomes during isometric contractions [ 29 – 31 , 49 , 50 ]. Improvements with duty cycle reduction are often partially credited to the pumping action that is created when activation is rotated among different fiber groups, which can promote blood flow and oxygen delivery to the muscle [ 51 ].…”

Section: Discussionsupporting

confidence: 88%

“…The activated fibers thus have a high duty cycle, or work to rest ratio, as they are all repeatedly activated each pedal stroke. Studies have shown that high duty cycles contribute to rapid muscle fatigue and force decline, whereas lower duty cycles can extend muscle output prior to fatigue [29][30][31]. Duty cycle may be lowered without interrupting cycling motion by alternating between muscles with a "carousel" stimulation pattern through selective, multi-contact electrodes [26,27,32,33].…”

mentioning

confidence: 99%

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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“…Gelenitis et al changed stimulation patterns to the nerve to check muscle fatigue. The sequential stimulation (change the stimulation site in order) showed slower muscle fatigue than the conventional stimulation pattern [ 31 ]. R. J. Downey et al changed the stimulation site on the surface electrodes, and the interleaved stimulation showed lower muscle fatigue than the conventional stimulation [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

A Wirelessly Powered 4-Channel Neurostimulator for Reconstructing Walking Trajectory

Takeuchi

Tokutake

Watanabe

et al. 2022

Sensors

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A wirelessly powered four-channel neurostimulator was developed for applying selective Functional Electrical Stimulation (FES) to four peripheral nerves to control the ankle and knee joints of a rat. The power of the neurostimulator was wirelessly supplied from a transmitter device, and the four nerves were connected to the receiver device, which controlled the ankle and knee joints in the rat. The receiver device had functions to detect the frequency of the transmitter signal from the transmitter coil. The stimulation site of the nerves was selected according to the frequency of the transmitter signal. The rat toe position was controlled by changing the angles of the ankle and knee joints. The joint angles were controlled by the stimulation current applied to each nerve independently. The stimulation currents were adjusted by the Proportional Integral Differential (PID) and feed-forward control method through a visual feedback control system, and the walking trajectory of a rat’s hind leg was reconstructed. This study contributes to controlling the multiple joints of a leg and reconstructing functional motions such as walking using the robotic control technology.

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Selective Nerve Cuff Stimulation Strategies for Prolonging Muscle Output

Cited by 9 publications

References 36 publications

Sum of phase-shifted sinusoids stimulation prolongs paralyzed muscle output

Sum of phase-shifted sinusoids stimulation prolongs paralyzed muscle output

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

A Wirelessly Powered 4-Channel Neurostimulator for Reconstructing Walking Trajectory

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