Above- and below-lesion EMG pattern mapping for controlling electrical stimulation of paraplegics to facilitate unbraced walker-assisted walking |
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| Affiliation: | 1. Department of Electrical Engineering and Computer Science and Department of Biomedical Engineering, University of Illinois, Chicago, IL 60680, USA;2. Department of Rehabilitation Medicine, Michael Reese Hospital, Chicago, IL 60616 USA;3. Department of Physical Medicine and Rehabilitation, University of Illinois, Chicago, IL 60680, USA;4. Intellitech Inc., Northbrook, IL 60062, USA;1. Department of Mechanical Engineering, University of Washington, Seattle, WA;2. Department of Rehabilitation Science, KU Leuven, Leuven, Belgium;3. Clinical Motion Analysis Laboratory, University Hospitals Leuven, Pellenberg, Pellenberg, Belgium;4. James R. Gage Center for Gait & Motion Analysis, Gillette Children’s Specialty Healthcare, St. Paul, MN;5. Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN;1. Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom;2. Department of Exercise and Sports Science, The University of Sydney, Lidcombe, Australia;3. Performance People & Teams, Australian Institute of Sport, Canberra, Australia;4. Department of Applied Mathematics, Liverpool John Moores University, Liverpool, United Kingdom;5. Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium;1. University of Washington, Department of Mechanical Engineering, Seattle, WA 98195, USA;2. KU Leuven, Department of Rehabilitation Science, University of Leuven, Leuven, Belgium;3. James R. Gage Center for Gait & Motion Analysis, Gillette Children''s Specialty Healthcare, St. Paul, MN 55101, USA;4. University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN, USA;1. Department of Veterans Affairs and Veterans Affairs Medical Center Baltimore, Geriatric Research, Education, and Clinical Center (GRECC), Baltimore, MD;2. Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD;3. Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD;1. Mechanical Engineering Department, Sharif University of Technology, Tehran, Iran;2. RCBTR, Tehran University of Medical Sciences, Tehran, Iran;3. Department of Orthotics and Prosthetics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran |
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| Abstract: | ![]()
We describe and evaluate above- and below-lesion EMG control of functional electrical stimulation (FES) in upper motor neuron paraplegics, in order to provide them with a patient-responsive system for walking with a walker support. Control is considered in terms of a combination of above-lesion EMG control and below-lesion response-EMG control. The above-lesion EMG is used to control the activation of limb functions involved in standing up and walking with FES, control being accomplished by analysing raw surface-EMG time-series patterns to discriminate between upper-trunk muscle contraction patterns, which in turn, are correlated with intended lower-limb functions involved in walking, so that natural and instinctive balance changes in paraplegics are controlled by the patient from above the lesion. The below-lesion response-EMG is the EMG produced in response to the FES pulses at the stimulation sites, for adjusting stimulation levels as needed when contractions weaken due to muscle fatigue. Above-lesion EMG is a stochastic (random-like) signal, being a response to unsynchronized motor neuron firings, whereas the below-lesion EMG is a deterministic signal responding to synchronized firings that result solely from the FES pulses. We also discuss the merits and difficulties of EMG control, and evaluate patient performance under such control, noting that FES-activated walking without adequate and patient-responsive control is of very limited use to paraplegics. |
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