Control of prosthetic gait

Recent advances in two types of prosthetic gait are particularly noteworthy, namely work on limb and neural prostheses. Current work on artificial limbs has been oriented towards improving devices, with commercialization as the driving force. Progress has been made in understanding how the compliant properties of the foot, ankle and knee joints of artificial legs affect the energetics and kinematics of gait. Work is continuing on automated systems for fabricating sockets with improved fit to increase the comfort of artificial limbs. Neural prostheses use electrical stimulation to activate paralyzed muscle: Advances have been made in understanding how to model the patterns of neural prosthetic gait and how neural prostheses respond to disturbances. Work in real-time control of stimulated muscle has progressed in the area of system identification and in using natural sensors for feedback signals. There still remains a wide gap, however, between able-bodied gait and the gait that can be achieved using current neural prosthesis systems.     

Modular neuromuscular control of human locomotion by central pattern generator

The central pattern generators (CPG) in the spinal cord are thought to be responsible for producing the rhythmic motor patterns during rhythmic activities. For locomotor tasks, this involves much complexity, due to a redundant system of muscle actuators with a large number of highly nonlinear muscles. This study proposes a reduced neural control strategy for the CPG, based on modular organization of the co-active muscles, i.e., muscle synergies. Four synergies were extracted from the EMG data of the major leg muscles of two subjects, during two gait trials each, using non-negative matrix factorization algorithm. A Matsuoka׳s four-neuron CPG model with mutual inhibition, was utilized to generate the rhythmic activation patterns of the muscle synergies, using the hip flexion angle and foot contact force information from the sensory afferents as inputs. The model parameters were tuned using the experimental data of one gait trial, which resulted in a good fitting accuracy (RMSEs between 0.0491 and 0.1399) between the simulation and experimental synergy activations. The model׳s performance was then assessed by comparing its predictions for the activation patterns of the individual leg muscles during locomotion with the relevant EMG data. Results indicated that the characteristic features of the complex activation patterns of the muscles were well reproduced by the model for different gait trials and subjects. In general, the CPG- and muscle synergy-based model was promising in view of its simple architecture, yet extensive potentials for neuromuscular control, e.g., resolving redundancies, distributed and fast control, and modulation of locomotion by simple control signals.     

Speed adaptation in a powered transtibial prosthesis controlled with a neuromuscular model

Control schemes for powered ankle-foot prostheses would benefit greatly from a means to make them inherently adaptive to different walking speeds. Towards this goal, one may attempt to emulate the intact human ankle, as it is capable of seamless adaptation. Human locomotion is governed by the interplay among legged dynamics, morphology and neural control including spinal reflexes. It has been suggested that reflexes contribute to the changes in ankle joint dynamics that correspond to walking at different speeds. Here, we use a data-driven muscle-tendon model that produces estimates of the activation, force, length and velocity of the major muscles spanning the ankle to derive local feedback loops that may be critical in the control of those muscles during walking. This purely reflexive approach ignores sources of non-reflexive neural drive and does not necessarily reflect the biological control scheme, yet can still closely reproduce the muscle dynamics estimated from biological data. The resulting neuromuscular model was applied to control a powered ankle-foot prosthesis and tested by an amputee walking at three speeds. The controller produced speed-adaptive behaviour; net ankle work increased with walking speed, highlighting the benefits of applying neuromuscular principles in the control of adaptive prosthetic limbs.     

Theories of bipedal walking: an odyssey

In this paper six theories of bipedal walking, and the evidence in support of the theories, are reviewed. They include: evolution, minimising energy consumption, maturation in children, central pattern generators, linking control and effect, and robots on two legs. Specifically, the six theories posit that: (1) bipedalism is the fundamental evolutionary adaptation that sets hominids--and therefore humans--apart from other primates; (2) locomotion is the translation of the centre of gravity along a pathway requiring the least expenditure of energy; (3) when a young child takes its first few halting steps, his or her biomechanical strategy is to minimise the risk of falling; (4) a dedicated network of interneurons in the spinal cord generates the rhythm and cyclic pattern of electromyographic signals that give rise to bipedal gait; (5) bipedal locomotion is generated through global entrainment of the neural system on the one hand, and the musculoskeletal system plus environment on the other; and (6) powered dynamic gait in a bipedal robot can be realised only through a strategy which is based on stability and real-time feedback control. The published record suggests that each of the theories has some measure of support. However, it is important to note that there are other important theories of locomotion which have not been covered in this review. Despite such omissions, this odyssey has explored the wide spectrum of bipedal walking, from its origins through to the integration of the nervous, muscular and skeletal systems.     

An artificial neural network that utilizes hip joint actuations to control bifurcations and chaos in a passive dynamic bipedal walking model

Chaos is a central feature of human locomotion and has been suggested to be a window to the control mechanisms of locomotion. In this investigation, we explored how the principles of chaos can be used to control locomotion with a passive dynamic bipedal walking model that has a chaotic gait pattern. Our control scheme was based on the scientific evidence that slight perturbations to the unstable manifolds of points in a chaotic system will promote the transition to new stable behaviors embedded in the rich chaotic attractor. Here we demonstrate that hip joint actuations during the swing phase can provide such perturbations for the control of bifurcations and chaos in a locomotive pattern. Our simulations indicated that systematic alterations of the hip joint actuations resulted in rapid transitions to any stable locomotive pattern available in the chaotic locomotive attractor. Based on these insights, we further explored the benefits of having a chaotic gait with a biologically inspired artificial neural network (ANN) that employed this chaotic control scheme. Remarkably, the ANN was quite robust and capable of selecting a hip joint actuation that rapidly transitioned the passive dynamic bipedal model to a stable gait embedded in the chaotic attractor. Additionally, the ANN was capable of using hip joint actuations to accommodate unstable environments and to overcome unforeseen perturbations. Our simulations provide insight on the advantage of having a chaotic locomotive system and provide evidence as to how chaos can be used as an advantageous control scheme for the nervous system.     

From diagnostics to therapy--conceptual basis for real-time movement feedback in rehabilitation medicine.

Recently, locomotion therapy on a treadmill has become part of rehabilitation programs for neurological gait disorders (spinal cord injury, hemiplegia). Instrumental gait analysis is an important tool for quantification of therapy progress in terms of functional changes in a patient's gait patterns. Whereas most of current applications focus on diagnostic assessment of gait, the current paper presents an extension of movement analysis offering enhanced therapeutic options. Specifically, the conceptual basis for application of real-time movement feedback in rehabilitation medicine is outlined and is put into context with recent developments in the field. A first technical realization of these concepts is presented and first results are reported. Furthermore, open questions towards a universal environment for movement feedback in rehabilitation medicine are discussed and future lines of research are identified.     

An Electrocorticographic Brain Interface in an Individual with Tetraplegia

Brain-computer interface (BCI) technology aims to help individuals with disability to control assistive devices and reanimate paralyzed limbs. Our study investigated the feasibility of an electrocorticography (ECoG)-based BCI system in an individual with tetraplegia caused by C4 level spinal cord injury. ECoG signals were recorded with a high-density 32-electrode grid over the hand and arm area of the left sensorimotor cortex. The participant was able to voluntarily activate his sensorimotor cortex using attempted movements, with distinct cortical activity patterns for different segments of the upper limb. Using only brain activity, the participant achieved robust control of 3D cursor movement. The ECoG grid was explanted 28 days post-implantation with no adverse effect. This study demonstrates that ECoG signals recorded from the sensorimotor cortex can be used for real-time device control in paralyzed individuals.     

Neural mechanisms generating locomotion studied in mammalian brain stem-spinal cord in vitro

The neural control system for generation of locomotion is an important system for analysis of neural mechanisms underlying complex motor acts. In these studies, a novel experimental model using neonatal rat brain stem and spinal cord in vitro was developed for investigation of the locomotor system in mammals. The in vitro brain stem and spinal cord system was shown to retain functional circuitry for locomotor command generation, motor pattern generation, and sensorimotor integration. This system was exploited to investigate neurochemical mechanisms involved in neurogenesis of locomotion. Evidence was obtained for peptidergic and gamma-amino-butyric acid-mediated mechanisms in brain-stem circuits generating locomotor commands. Cholinergic, dopaminergic, and excitatory amino acid-mediated mechanisms were shown to activate spinal cord circuits for locomotor pattern generation. Endogenous N-methyl-D-aspartic acid receptors in spinal networks were found to play a central role in the generation of locomotion. The chemically induced patterns of motor activity and rhythmic membrane potential oscillations of spinal motoneurons were characteristic of those during locomotion in other mammals in vivo. The in vitro brain stem and spinal cord model provides a versatile and powerful experimental system with potentially broad application for investigation of diverse aspects of the neurobiology of mammalian motor control systems.     

A Brain-Machine-Muscle Interface for Restoring Hindlimb Locomotion after Complete Spinal Transection in Rats

A brain-machine interface (BMI) is a neuroprosthetic device that can restore motor function of individuals with paralysis. Although the feasibility of BMI control of upper-limb neuroprostheses has been demonstrated, a BMI for the restoration of lower-limb motor functions has not yet been developed. The objective of this study was to determine if gait-related information can be captured from neural activity recorded from the primary motor cortex of rats, and if this neural information can be used to stimulate paralysed hindlimb muscles after complete spinal cord transection. Neural activity was recorded from the hindlimb area of the primary motor cortex of six female Sprague Dawley rats during treadmill locomotion before and after mid-thoracic transection. Before spinal transection there was a strong association between neural activity and the step cycle. This association decreased after spinal transection. However, the locomotive state (standing vs. walking) could still be successfully decoded from neural recordings made after spinal transection. A novel BMI device was developed that processed this neural information in real-time and used it to control electrical stimulation of paralysed hindlimb muscles. This system was able to elicit hindlimb muscle contractions that mimicked forelimb stepping. We propose this lower-limb BMI as a future neuroprosthesis for human paraplegics.     

Motor mechanisms in the turtle spinal cord

We reveal the intrinsic motor capacity of the spinal cord by examining motor behaviours produced by spinal segments caudal to a complete transection of the spinal cord. The turtle spinal cord generates three forms of the scratch reflex in the absence of neural inputs from supraspinal structures. Each form exhibits a characteristic motor neuron discharge pattern. We test the ability of the spinal cord to generate organized motor patterns in the absence of movement-related sensory feedback by examining motor neuron discharge patterns in spinal preparations that are immobilized with a neuromuscular blocking agent. The motor neuron discharge pattern associate with each form is observed in the spinal immobilized preparation. Each of these motor patterns is therefore generated centrally within the spinal cord.     

Spinal Mechanisms in the Control of Lamprey Swimming

SYNOPSIS. The lamprey, an anguilliform fish, swims using lateralundulatory movement; a transverse wave passes backward, fromhead to tail, the amplitude of the wave increasing as it movestailward. The wave of muscle activity producing this movementtravels down the body faster than the mechanical wave. The wayin which certain features of anguilliform movement contributeto its efficiency have been described. The neural activity underlyingswimming is characterized by: 1) rhythmical alternation betweenthe two sides of a single segment; 2) a burst duration thatremains a constant proportion of the cycle time and is independentof the cycle frequency; 3) rostrocaudal phase lag that is constantand also independent of the cycle frequency. Local circuitsin the lamprey spinal cord can generate this locomotory patternin the absence of sensory feedback following activation of excitatoryamino acid receptors; the pattern is centrally generated. Ithas been hypothesized that the spinal central pattern generatorfor locomotion consists of a series of segmental burst generatorscoupled together by an intersegmental coordinating system. Theintersegmental coordinating system functions to keep the frequenciesof the oscillators along the cord constant and to provide theappropriate rostrocaudal phase lag. Mechanosensitive units withinthe spinal cord are sensitive to movement of the spinal cord\notochordand movement of the spinal cord/notochord can entrain the burstpattern. Entrainment occurs through movement-related feedbackonto neurons at the local level. The possible roles this movement-relatedfeedback plays during locomotion are discussed.     

Elongation factor 2 and fragile X mental retardation protein control the dynamic translation of Arc/Arg3.1 essential for mGluR-LTD

The initiation and coordination of activity in limb muscles are the main functions of neural circuits that control locomotion. Commissural neurons connect locomotor circuits on the two sides of the spinal cord, and represent the known neural substrate for left-right coordination. Here we demonstrate that a group of ipsilateral interneurons, V2a interneurons, plays an essential role in the control of left-right alternation. In the absence of V2a interneurons, the spinal cord fails to exhibit consistent left-right alternation. Locomotor burst activity shows increased variability, but flexor-extensor coordination is unaffected. Anatomical tracing studies reveal a direct excitatory input of V2a interneurons onto commissural interneurons, including a set of molecularly defined V0 neurons that drive left-right alternation. Our findings imply that the neural substrate for left-right coordination consists of at least two components; commissural neurons and a class of ipsilateral interneurons that activate commissural pathways.     

Spontaneous development of full weight-supported stepping after complete spinal cord transection in the neonatal opossum, Monodelphis domestica

Spinal cord trauma in the adult nervous system usually results in permanent loss of function below the injury level. The immature spinal cord has greater capacity for repair and can develop considerable functionality by adulthood. This study used the marsupial laboratory opossum Monodelphis domestica, which is born at a very early stage of neural development. Complete spinal cord transection was made in the lower-thoracic region of pups at postnatal-day 7 (P7) or P28, and the animals grew to adulthood. Injury at P7 resulted in a dense neuronal tissue bridge that connected the two ends of the cord; retrograde neuronal labelling indicated that supraspinal and propriospinal innervation spanned the injury site. This repair was associated with pronounced behavioural recovery, coordinated gait and an ability to use hindlimbs when swimming. Injury at P28 resulted in a cyst-like cavity encased in scar tissue forming at the injury site. Using retrograde labelling, no labelled brainstem or propriospinal neurons were found above the lesion, indicating that detectable neuronal connectivity had not spanned the injury site. However, these animals could use their hindlimbs to take weight-supporting steps but could not use their hindlimbs when swimming. White matter, demonstrated by Luxol Fast Blue staining, was present in the injury site of P7- but not P28-injured animals. Overall, these studies demonstrated that provided spinal injury occurs early in development, regrowth of supraspinal innervation is possible. This repair appears to lead to improved functional outcomes. At older ages, even without detectable axonal growth spanning the injury site, substantial development of locomotion was still possible. This outcome is discussed in conjunction with preliminary findings of differences in the local propriospinal circuits following spinal cord injury (demonstrated with fluororuby labelling), which may underlie the weight bearing locomotion observed in the apparent absence of axons bridging the lesion site in P28-injured Monodelphis.     

Voltage-sensitive ion channels in rhythmic motor systems

Voltage-sensitive ionic currents shape both the firing properties of neurons and their synaptic integration within neural networks that drive rhythmic motor patterns. Persistent sodium currents underlie rhythmic bursting in respiratory neurons. H-type pacemaker currents can act as leak conductances in spinal motoneurons, and also control long-term modulation of synaptic release at the crayfish neuromuscular junction. Calcium currents travel in rostro-caudal waves with motoneuron activity in the spinal cord. Potassium currents control spike width and burst duration in many rhythmic motor systems. We are beginning to identify the genes that underlie these currents.     

Transplanted embryonic stem cells survive, differentiate and promote recovery in injured rat spinal cord

Transplantation approaches using cellular bridges, fetal central nervous system cells, fibroblasts expressing neurotrophin-3 (ref. 6), hybridoma cells expressing inhibitory protein-blocking antibodies, or olfactory nerves ensheathing glial cells transplanted into the acutely injured spinal cord have produced axonal regrowth or functional benefits. Transplants of rat or cat fetal spinal cord tissue into the chronically injured cord survive and integrate with the host cord, and may be associated with some functional improvements. In addition, rats transplanted with fetal spinal cord cells have shown improvements in some gait parameters, and the delayed transplantation of fetal raphe cells can enhance reflexes. We transplanted neural differentiated mouse embryonic stem cells into a rat spinal cord 9 days after traumatic injury. Histological analysis 2-5 weeks later showed that transplant-derived cells survived and differentiated into astrocytes, oligodendrocytes and neurons, and migrated as far as 8 mm away from the lesion edge. Furthermore, gait analysis demonstrated that transplanted rats showed hindlimb weight support and partial hindlimb coordination not found in 'sham-operated' controls or control rats transplanted with adult mouse neocortical cells.     

Dynamic motion planning for the design of robotic gait rehabilitation

In this paper we examine a method to control the stepping motion of a paralyzed person suspended over a treadmill using a robot attached to the pelvis. A leg swing motion is created by moving the pelvis without contact with the legs. The problem is formulated as an optimal control problem for an underactuated articulated chain. The optimal control problem is converted into a discrete parameter optimization and an efficient gradient-based algorithm is used to solve it. Motion capture data from an unimpaired human subject is compared to the simulation results from the dynamic motion optimization. Our results suggest that it is feasible to drive repetitive stepping on a treadmill by a paralyzed person by assisting in torso movement alone. The optimized, pelvic motion strategies are comparable to "hip-hiking" gait strategies used by people with lower limb prostheses or hemiparesis. The resulting motions can be found at the web site http://ww.eng.uci.edu/-chwang/project/stepper/stepper.html.     

Traveling-wave pattern generator controls movement and organization of sensory feedback in a spinal cord model

 A traveling wave in a two-dimensional spinal cord model constitutes a stable pattern generator for quadruped gaits. In the context of the somatotopic organization of the spinal cord, this pattern generator is sufficient to generate stable locomotive limb trajectories. The elastic properties of muscles alone, providing linear negative feedback, are sufficient to stabilize stance and locomotion in the presence of perturbative forces. We further show that such a pattern generator is capable of organizing sensory processing in the spinal cord. A single-layer perceptron was trained to associate the sensory feedback from the limb (coding force, length, and change of length for each muscle) with the two-dimensional activity profile of the traveling wave. This resulted in a well-defined spatial organization of the connections within the spinal network along a rostrocaudal axis. The spinal network driven by peripheral afferents alone supported autonomous locomotion in the positive feedback mode, whereas in the negative feedback mode stance was stabilized in response to perturbations. Systematic variation of a parameter representing the effect of gamma-motor neurons on muscle spindle activity in our model led to a corresponding shift of limb position during stance and locomotion, resulting in a systematic displacement alteration of foot positions. Received: 30 July 2001 / Accepted in revised form: 17 April 2002 Correspondence to: A. Kaske (e-mails: alexander.kaske@mtc.ki.se, alexander.kaske@vglab.com)     

Disease modifying treatment of spinal cord injury with directly reprogrammed neural precursor cells in non-human primates

BACKGROUNDThe development of regenerative therapy for human spinal cord injury (SCI) is dramatically restricted by two main challenges: the need for a safe source of functionally active and reproducible neural stem cells and the need of adequate animal models for preclinical testing. Direct reprogramming of somatic cells into neuronal and glial precursors might be a promising solution to the first challenge. The use of non-human primates for preclinical studies exploring new treatment paradigms in SCI results in data with more translational relevance to human SCI.AIMTo investigate the safety and efficacy of intraspinal transplantation of directly reprogrammed neural precursor cells (drNPCs).METHODSSeven non-human primates with verified complete thoracic SCI were divided into two groups: drNPC group (n = 4) was subjected to intraspinal transplantation of 5 million drNPCs rostral and caudal to the lesion site 2 wk post injury, and lesion control (n = 3) was injected identically with the equivalent volume of vehicle.RESULTSFollow-up for 12 wk revealed that animals in the drNPC group demonstrated a significant recovery of the paralyzed hindlimb as well as recovery of somatosensory evoked potential and motor evoked potential of injured pathways. Magnetic resonance diffusion tensor imaging data confirmed the intraspinal transplantation of drNPCs did not adversely affect the morphology of the central nervous system or cerebrospinal fluid circulation. Subsequent immunohistochemical analysis showed that drNPCs maintained SOX2 expression characteristic of multipotency in the transplanted spinal cord for at least 12 wk, migrating to areas of axon growth cones.CONCLUSIONOur data demonstrated that drNPC transplantation was safe and contributed to improvement of spinal cord function after acute SCI, based on neurological status assessment and neurophysiological recovery within 12 wk after transplantation. The functional improvement described was not associated with neuronal differentiation of the allogeneic drNPCs. Instead, directed drNPCs migration to the areas of active growth cone formation may provide exosome and paracrine trophic support, thereby further supporting the regeneration processes.