Control of posture with FES systems

Area of Science:

• Biomedical Engineering
• Neuroscience
• Rehabilitation Technology

Background:

• Restoring functional standing in paraplegia is challenging due to the lack of effective control strategies.
• Integrating voluntary upper body actions with artificial lower limb control via functional electrical stimulation (FES) remains a key issue.

Purpose of the Study:

• To review an integrated approach for achieving functional FES-supported standing in individuals with paraplegia.
• To address the challenge of coordinating upper body purposeful actions with FES control of lower extremities.

Main Methods:

• Investigating fundamental mechanisms of postural responses in neurologically intact individuals.
• Developing methods for re-training residual sensory-motor functions of the upper body in paralyzed individuals.
• Designing and implementing closed-loop FES control systems to support paralyzed lower limb joints.

Main Results:

• The review outlines a multi-faceted strategy addressing critical aspects of FES-supported standing.
• The approach integrates biomechanical, neurorehabilitative, and control system engineering principles.
• Focus is placed on creating synergistic control between voluntary and artificial systems.

Conclusions:

• An integrated strategy involving basic research, targeted retraining, and advanced control systems is crucial for functional FES-supported standing.
• This approach offers a promising direction for improving mobility and independence in individuals with paraplegia.
• Further development and clinical translation of these integrated strategies are warranted.