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1. Restoring continuous finger function with temporarily paralyzed nonhuman primates using brain–machine interfaces

   https://doi.org/10.1088/1741-2552/accf36  

   Nason-Tomaszewski, Samuel R; Mender, Matthew J; Kennedy, Eric; Lambrecht, Joris M; Kilgore, Kevin L; Chiravuri, Srinivas; Ganesh Kumar, Nishant; Kung, Theodore A; Willsey, Matthew S; Chestek, Cynthia A; et al (May 2023, Journal of Neural Engineering)

   Abstract Objective. Brain–machine interfaces (BMIs) have shown promise in extracting upper extremity movement intention from the thoughts of nonhuman primates and people with tetraplegia. Attempts to restore a user’s own hand and arm function have employed functional electrical stimulation (FES), but most work has restored discrete grasps. Little is known about how well FES can control continuous finger movements. Here, we use a low-power brain-controlled functional electrical stimulation (BCFES) system to restore continuous volitional control of finger positions to a monkey with a temporarily paralyzed hand. Approach. We delivered a nerve block to the median, radial, and ulnar nerves just proximal to the elbow to simulate finger paralysis, then used a closed-loop BMI to predict finger movements the monkey was attempting to make in two tasks. The BCFES task was one-dimensional in which all fingers moved together, and we used the BMI’s predictions to control FES of the monkey’s finger muscles. The virtual two-finger task was two-dimensional in which the index finger moved simultaneously and independently from the middle, ring, and small fingers, and we used the BMI’s predictions to control movements of virtual fingers, with no FES. Main results. In the BCFES task, the monkey improved his success rate to 83% (1.5 s median acquisition time) when using the BCFES system during temporary paralysis from 8.8% (9.5 s median acquisition time, equal to the trial timeout) when attempting to use his temporarily paralyzed hand. In one monkey performing the virtual two-finger task with no FES, we found BMI performance (task success rate and completion time) could be completely recovered following temporary paralysis by executing recalibrated feedback-intention training one time. Significance. These results suggest that BCFES can restore continuous finger function during temporary paralysis using existing low-power technologies and brain-control may not be the limiting factor in a BCFES neuroprosthesis. 

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2. Hybrid FES-exoskeleton control: Using MPC to distribute actuation for elbow and wrist movements

   https://doi.org/10.3389/fnbot.2023.1127783  

   Dunkelberger, Nathan; Berning, Jeffrey; Schearer, Eric M.; O'Malley, Marcia K. (April 2023, Frontiers in Neurorobotics)

   IntroductionIndividuals who have suffered a cervical spinal cord injury prioritize the recovery of upper limb function for completing activities of daily living. Hybrid FES-exoskeleton systems have the potential to assist this population by providing a portable, powered, and wearable device; however, realization of this combination of technologies has been challenging. In particular, it has been difficult to show generalizability across motions, and to define optimal distribution of actuation, given the complex nature of the combined dynamic system. MethodsIn this paper, we present a hybrid controller using a model predictive control (MPC) formulation that combines the actuation of both an exoskeleton and an FES system. The MPC cost function is designed to distribute actuation on a single degree of freedom to favor FES control effort, reducing exoskeleton power consumption, while ensuring smooth movements along different trajectories. Our controller was tested with nine able-bodied participants using FES surface stimulation paired with an upper limb powered exoskeleton. The hybrid controller was compared to an exoskeleton alone controller, and we measured trajectory error and torque while moving the participant through two elbow flexion/extension trajectories, and separately through two wrist flexion/extension trajectories. ResultsThe MPC-based hybrid controller showed a reduction in sum of squared torques by an average of 48.7 and 57.9% on the elbow flexion/extension and wrist flexion/extension joints respectively, with only small differences in tracking accuracy compared to the exoskeleton alone. DiscussionTo realize practical implementation of hybrid FES-exoskeleton systems, the control strategy requires translation to multi-DOF movements, achieving more consistent improvement across participants, and balancing control to more fully leverage the muscles' capabilities. 

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3. Admittance Trajectory Tracking using a Challenge-Based Rehabilitation Robot with Functional Electrical Stimulation

   https://doi.org/10.23919/ACC.2018.8431750  

   Cousin, Christian A.; Duenas, Victor H.; Rouse, Courtney A.; Dixon, Warren E. (June 2018, American Control Conference)

   In an effort to combine two rehabilitation strategies, Functional Electrical Stimulation (FES) and robotic therapy, a rehabilitation robot was developed to challenge an arm during bicep curls elicited by closed-loop control of FES. The robot is designed to act as an admittance and its robust, sliding mode controller is proven to be passive with respect to the human. The FES controller utilizes a robust, sliding mode control design to then dominate the robot effects and obtain global exponential stability as demonstrated by a Lyapunov-based stability analysis. The two interacting controllers yield arm position and velocity regulation, where the robot challenges this movement with a desired admittance. 

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4. Adaptive Trajectory Tracking During Motorized and FES-Induced Biceps Curls via Integral Concurrent Learning

   https://doi.org/10.1115/DSCC2020-3125  

   Allen, Brendon C.; Stubbs, Kimberly J.; Dixon, Warren E. (October 2020, ASME Dynamic Systems and Control Conference)

   null (Ed.)

   A common rehabilitative technique for those with neuro-muscular disorders is functional electrical stimulation (FES) induced exercise such as FES-induced biceps curls. FES has been shown to have numerous health benefits, such as increased muscle mass and retraining of the nervous system. Closed-loop control of a motorized FES system presents numerous challenges since the system has nonlinear and uncertain dynamics and switching is required between motor and FES control, which is further complicated by the muscle having an uncertain control effectiveness. An additional complication of FES systems is that high gain feedback from traditional robust controllers can be uncomfortable to the participant. In this paper, data-based, opportunistic learning is achieved by implementing an integral concurrent learning (ICL) controller during a motorized and FES-induced biceps curl exercise. The ICL controller uses adaptive feedforward terms to augment the FES controller to reduce the required control input. A Lyapunov-based analysis is performed to ensure exponential trajectory tracking and opportunistic, exponential learning of the uncertain human and machine parameters. In addition to improved tracking performance and robustness, the potential of learning the specific dynamics of a person during a rehabilitative exercise could be clinically significant. Preliminary simulation results are provided and demonstrate an average position error of 0.14 ± 1.17 deg and an average velocity error of 0.004 ± 1.18 deg/s. 

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5. Shared Control of a Powered Exoskeleton and Functional Electrical Stimulation Using Iterative Learning

   https://doi.org/10.3389/frobt.2021.711388  

   Molazadeh, Vahidreza; Zhang, Qiang; Bao, Xuefeng; Dicianno, Brad E.; Sharma, Nitin (November 2021, Frontiers in Robotics and AI)

   A hybrid exoskeleton comprising a powered exoskeleton and functional electrical stimulation (FES) is a promising technology for restoration of standing and walking functions after a neurological injury. Its shared control remains challenging due to the need to optimally distribute joint torques among FES and the powered exoskeleton while compensating for the FES-induced muscle fatigue and ensuring performance despite highly nonlinear and uncertain skeletal muscle behavior. This study develops a bi-level hierarchical control design for shared control of a powered exoskeleton and FES to overcome these challenges. A higher-level neural network–based iterative learning controller (NNILC) is derived to generate torques needed to drive the hybrid system. Then, a low-level model predictive control (MPC)-based allocation strategy optimally distributes the torque contributions between FES and the exoskeleton’s knee motors based on the muscle fatigue and recovery characteristics of a participant’s quadriceps muscles. A Lyapunov-like stability analysis proves global asymptotic tracking of state-dependent desired joint trajectories. The experimental results on four non-disabled participants validate the effectiveness of the proposed NNILC-MPC framework. The root mean square error (RMSE) of the knee joint and the hip joint was reduced by 71.96 and 74.57%, respectively, in the fourth iteration compared to the RMSE in the 1st sit-to-stand iteration. 

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