Feedback control of coronal plane hip angle in paraplegic subjects using functional neuromuscular stimulation

This paper reports on an investigation of feedback control of coronal plane posture in paraplegic subjects who stand using functional neuromuscular stimulation (FNS). A feedback control system directed at regulating coronal plane hip angle in neutral position was designed, implemented, and evaluated in two paraplegic subjects. The control system included sensor mounting and signal processing techniques, a two-stage feedback controller, stimulation hardware, and a set of percutaneous intramuscular electrodes. The feedback controller consisted of two-stages in cascade: a modified discrete-time proportional-integral-derivative (PID) stage and a nonlinear single-input, multiple-output stage to determine the stimulation to be sent to several muscles. The focus of this work was on evaluating the performance of the feedback controller by comparing the response of the feedback-controlled system to that of an open-loop stimulation system. In an evaluation based on temporal response characteristics the controlled system exhibited a 41% reduction in root-mean-squared (rms) error (where error is defined as the deviation from the desired angle), a 52% reduction in steady-state error, and a 22% reduction in hip compliance. In addition, the feedback-controlled system exhibited significant reductions in variability of these measures on several days. These results demonstrate the ability of the feedback controller to improve the temporal response characteristics of the FNS control system.