An official website of the United States government
Functional electrical stimulation (FES) is a potential neurorehabilitative intervention to enable functional movements in persons with neurological conditions that cause mobility impairments. However, the quick onset of muscle fatigue during FES is a significant challenge for sustaining the desired functional movements for more extended periods. Therefore, a considerable interest still exists in the development of sensing techniques that reliably measure FES-induced muscle fatigue. This study proposes to use ultrasound (US) imaging-derived echogenicity signal as an indicator of FES-induced muscle fatigue. We hypothesized that the US-derived echogenicity signal is sensitive to FES-induced muscle fatigue under isometric and dynamic muscle contraction conditions. Eight non-disabled participants participated in the experiments, where FES electrodes were applied on their tibialis anterior (TA) muscles. During a fatigue protocol under either isometric and dynamic ankle dorsiflexion conditions, we synchronously collected the isometric dorsiflexion torque or dynamic dorsiflexion angle on the ankle joint, US echogenicity signals from TA muscle, and the applied stimulation intensity. The experimental results showed an exponential reduction in the US echogenicity relative change (ERC) as the fatigue progressed under the isometric (R2=0.891±0.081) and dynamic (R2=0.858±0.065) conditions. The experimental results also implied a strong linear relationship between US ERC and TA muscle fatigue benchmark (dorsiflexion torque or angle amplitude), with R2 values of 0.840±0.054 and 0.794±0.065 under isometric and dynamic conditions, respectively. The findings in this study indicate that the US echogenicity signal is a computationally efficient signal that strongly represents FES-induced muscle fatigue. Its potential real-time implementation to detect fatigue can facilitate an FES closed-loop controller design that considers the FES-induced muscle fatigue.
more »
« less
Ultrasound-Compatible Electrode for Functional Electrical Stimulation
Functional electrical stimulation (FES) is a vital method in neurorehabilitation used to reanimate paralyzed muscles, enhance the size and strength of atrophied muscles, and reduce spasticity. FES often leads to increased muscle fatigue, necessitating careful monitoring of the patient’s response. Ultrasound (US) imaging has been utilized to provide valuable insights into FES-induced fatigue by assessing changes in muscle thickness, stiffness, and strain. Current commercial FES electrodes lack sufficient US transparency, hindering the observation of muscle activity beneath the skin where the electrodes are placed. US-compatible electrodes are essential for accurate imaging and optimal FES performance, especially given the spatial constraints of conventional US probes and the need to monitor muscle areas directly beneath the electrodes. This study introduces specially designed body-conforming US-compatible FES (US-FES) electrodes constructed with a silver nanowire/polydimethylsiloxane (AgNW/PDMS) composite. We compared the performance of our body-conforming US-FES electrode with a commercial hydrogel electrode. The findings revealed that our US-FES electrode exhibited comparable conductivity and performance to the commercial one. Furthermore, US compatibility was investigated through phantom and in vivo tests, showing significant compatibility even during FES, unlike the commercial electrode. The results indicated that US-FES electrodes hold significant promise for the real-time monitoring of muscle activity during FES in clinical rehabilitative applications.
more »
« less
- PAR ID:
- 10534184
- Publisher / Repository:
- MDPI
- Date Published:
- Journal Name:
- Biomedicines
- Volume:
- 12
- Issue:
- 8
- ISSN:
- 2227-9059
- Page Range / eLocation ID:
- 1741
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
More Like this
-
-
null (Ed.)Objective: Functional electrical stimulation (FES) is a common technique to elicit muscle contraction and help improve muscle strength. Traditional FES over the muscle belly typically only activates superficial muscle regions. In the case of hand FES, this prevents the activation of the deeper flexor muscles which control the distal finger joints. Here, we evaluated whether an alternative transcutaneous nerve-bundle stimulation approach can activate both superficial and deep extrinsic finger flexors using a high-density stimulation grid. Methods: Transverse ultrasound of the forearm muscles was used to obtain cross-sectional images of the underlying finger flexors during stimulated finger flexions and kinematically-matched voluntary motions. Finger kinematics were recorded, and an image registration method was used to capture the large deformation of the muscle regions during each flexion. This deformation was used as a surrogate measure of the contraction of muscle tissue, and the regions of expanding tissue can identify activated muscles. Results: The nerve-bundle stimulation elicited contractions in the superficial and deep finger flexors. Both separate and concurrent activation of these two muscles were observed. Joint kinematics of the fingers also matched the expected regions of muscle contractions. Conclusions: Our results showed that the nerve-bundle stimulation technique can activate the deep extrinsic finger flexors, which are typically not accessible via traditional surface FES. Significance: Our nerve-bundle stimulation method enables us to produce the full range of motion of different joints necessary for various functional grasps, which could benefit future neuroprosthetic applications.more » « less
-
null (Ed.)Functional electrical stimulation (FES) is a potential technique for reanimating paralyzed muscles post neurological injury/disease. Several technical challenges including difficulty in measuring and compensating for delayed muscle activation levels inhibit its satisfactory control performance. In this paper, an ultrasound (US) imaging approach is proposed to measure delayed muscle activation levels under the implementation of FES. Due to low sampling rates of US imaging, a sampled data observer (SDO) is designed to estimate the muscle activation in a continuous manner. The SDO is combined with continuous-time dynamic surface control (DSC) approach that compensates for the electromechanical delay (EMD) in the tibialis anterior (TA) activation dynamics. The stability analysis based on the Lyapunov-Krasovskii function proves that the SDO-based DSC plus delay compensation (SDO-DSC-DC) approach achieves semi-global uniformly ultimately bounded (SGUUB) tracking performance. Simulation results on an ankle dorsiflexion neuromusculoskeletal system show the root mean square error (RMSE) of desired trajectory tracking is reduced by 19.77 % by using the proposed SDO-DSC-DC compared to the DSC-DC without the SDO. The findings provide potentials for rehabilitative devices, like powered exoskeleton and FES, to assist or enhance human limb movement based on the corresponding muscle activities in real-time.more » « less
-
Functional electrical stimulation (FES) is commonly used for people with neurological conditions. As the muscle geometry changes (i.e., muscle lengthening/ shortening), the force induced by static electrode placement may also change. Experimental results indicate that muscle forces can be increased by spatially switching stimulation as the muscle geometry changes with joint angle. In this letter, an electric field is switched between multiple electrodes placed across the biceps brachii to track a desired trajectory. A switched systems approach is used to develop a position-based switching law, including a switched robust sliding mode controller that successfully tracks the desired angular trajectory about the elbow, despite changes in muscle geometry. Lyapunovbased methods for switched systems are used to prove global exponential tracking. Experimental results from nine able-bodied subjects are presented and the developed control system achieves an average position and velocity error of −0.21 ± 1.17 deg and −0.43 ± 5.38 deg/s, respectively, and, on average, reduces fatigue by 13.6%, as compared to traditional single-electrode methods, demonstrating the performance of the uncertain nonlinear switched control system.more » « less
-
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.more » « less
- Free Publicly Accessible Full Text
-
Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.3390/biomedicines12081741
