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    Area of Science:

    • Biomedical Engineering
    • Control Systems
    • Neurorehabilitation

    Background:

    • Upper motor neuron lesions (UMNL) cause significant motor function disabilities.
    • Neuromuscular electrical stimulation (NMES) is a key rehabilitation technique for UMNL.
    • Existing NMES stability analyses often overlook the modulated nature of electrical pulse delivery.

    Purpose of the Study:

    • To develop a muscle activation model that incorporates amplitude-modulated control input, reflecting the discontinuous nature of NMES.
    • To design and analyze an identification-based closed-loop NMES controller for this modulated model.
    • To investigate the relationship between NMES controller gains, pulse frequency, and system stability, particularly concerning muscle fatigue.

    Main Methods:

    • Development of a novel muscle activation model featuring an amplitude-modulated control input.
    • Design and stability analysis of an identification-based closed-loop NMES controller using Lyapunov methods.
    • Experimental validation with able-bodied subjects to assess controller performance and stability under varying pulse frequencies.

    Main Results:

    • The proposed controller guarantees semi-global uniformly ultimately bounded tracking for the modulated muscle activation model.
    • A pulse frequency-dependent gain condition for closed-loop stability was derived.
    • Experimental results confirmed that increased control gains are necessary when decreasing stimulation pulse frequency to mitigate muscle fatigue and maintain stability.

    Conclusions:

    • This work presents the first integrated analysis of NMES controllers and modulation schemes.
    • The findings provide crucial insights for optimizing NMES protocols in UMNL rehabilitation, balancing efficacy and fatigue management.
    • The study establishes a foundation for more robust and adaptive NMES control strategies.