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Stabilizing leaning postures with feedback controlled functional neuromuscular stimulation after trunk paralysis.

Aidan R W Friederich1,2, Lisa M Lombardo2, Kevin M Foglyano2

  • 1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, United States.

Frontiers in Rehabilitation Sciences
|October 16, 2023
PubMed
Summary

Electrical stimulation with feedback controllers helps individuals with spinal cord injury (SCI) achieve stable seated leaning postures. This improves reaching ability and daily activities for paralyzed individuals.

Keywords:
feedback controlfunctional neuromuscular stimulationmuscle synergiesseated balancespinal cord injury

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Area of Science:

  • Neuroscience
  • Rehabilitation Engineering
  • Biomechanics

Background:

  • Spinal cord injury (SCI) impairs trunk and hip muscles, affecting seated balance and environmental interaction.
  • Electrical stimulation can activate paralyzed muscles for posture but lacks stability without feedback.
  • Existing neuroprostheses require enhanced control for dynamic postural adjustments.

Purpose of the Study:

  • To develop and evaluate a feedback controller for enabling stable, non-erect seated postures in individuals with SCI.
  • To assess the impact of these controlled leaning postures on reaching capabilities and stability.
  • To explore the potential of synergy-based control for neuroprosthetic applications.

Main Methods:

  • System identification was used to determine subject-specific muscle synergies for lumbar moment generation.
  • Real-time stimulation parameters were calculated based on these synergies for leaning postures.
  • A proportional, integral, derivative (PID) controller and accelerometer data were integrated for trunk orientation feedback.

Main Results:

  • All three participants with motor complete SCI achieved stable leaning postures (30-40° flexion, 15° lateral bending).
  • Leaning postures significantly increased forward reaching distances (10.2-46.7 cm).
  • The system demonstrated stability against perturbations up to 90 N and was perceived as stable by users.

Conclusions:

  • Synergy-based feedback control enables dynamic, non-erect seated postures for individuals with SCI.
  • This technology has the potential to expand functional workspaces and enhance independence.
  • Implementation in neuroprostheses can facilitate daily activities for people with paralysis.