IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society
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IEEE Trans Neural Syst Rehabil Eng · Mar 2004
Epidural spinal-cord stimulation facilitates recovery of functional walking following incomplete spinal-cord injury.
We investigated a novel treatment paradigm for developing functional ambulation in wheelchair-dependent individuals with chronic, incomplete spinal-cord injury. By coordinating epidural stimulation of the dorsal structures of the spinal cord with partial weight bearing treadmill therapy, we observed improvement in treadmill and over-ground ambulation in an individual with chronic incomplete tetraplegia. The application of partial weight-bearing therapy alone was not sufficient to achieve functional ambulation over ground, though treadmill ambulation improved significantly. ⋯ After several weeks of over ground training, he reached maximum walking speeds of 0.35 m/s, and was able to ambulate over 325 m. We propose that ESCS facilitated locomotor recovery in this patient by augmenting the use-dependent plasticity created by partial weight bearing therapy. Confirmation of these promising results in a controlled study of groups of spinal-cord-injured subjects is warranted.
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IEEE Trans Neural Syst Rehabil Eng · Dec 2003
Clinical TrialVibrotactile display coding for a balance prosthesis.
Preliminary experiments have demonstrated the potential usefulness of a precursor balance prosthesis that displays the tilt of the subject using tactile vibrators (tactors) which are in contact with the subject's skin. The device consists of a motion sensing system mounted on the head or body whose signals are converted into estimates of head or body tilt. Tilt is displayed to the subject by coding the tilt estimate into signals that are sent to the tactors using one of several schemes. ⋯ The prediction of better actual balance performance using position-based relative to interval-based vibrotactile display was validated by a preliminary study of six normal subjects that compared the body sway produced during quiet standing while providing head tilt estimates using both display modes. Our study provides basic characterization using lambda(c) for several vibrotactile display schemes in human subjects. The quantitative CTT measure of performance can logically be extended to other applications of vibrotactile displays and to other kinds of display schemes used for rehabilitation.
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IEEE Trans Neural Syst Rehabil Eng · Dec 2003
Comparative Study Clinical TrialStimulation artifact in surface EMG signal: effect of the stimulation waveform, detection system, and current amplitude using hybrid stimulation technique.
The purpose of this study was to investigate the amplitude properties of the artifact generated on the recorded surface electromyography (EMG) signals during transcutaneous electrical muscle stimulation. The factors which were investigated are the shape of the stimulation waveform, the distance of the stimulating electrode from the recording system, the interelectrode distance of the detection system, the spatial filter used for signal detection, and the stimulation current amplitude. Surface EMG signals were recorded during electrical stimulation of the biceps brachii motor point with a linear adhesive array of eight electrodes. ⋯ The average rectified artifact values (both absolute and normalized with respect to the corresponding M-wave values) were computed to investigate the artifact amplitude properties. Results indicated that, while the artifact average rectified value, normalized with respect to the M-wave amplitude, depended on the distance of the detecting electrodes from the stimulation point, it did not depend on the stimulation waveform, on the current intensity, on the interelectrode distance, and on the spatial filter. It was concluded that, using hybrid stimulation techniques, the selection of particular stimulation waveforms, interelectrode distances, or spatial filters has a minor effect on the reduction of the artifact when recording M-waves.
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IEEE Trans Neural Syst Rehabil Eng · Dec 2003
A model-based approach to stabilizing crutch supported paraplegic standing by artificial hip joint stiffness.
The prerequisites for stable crutch supported standing were analyzed in this paper. For this purpose, a biomechanical model of crutch supported paraplegic stance was developed assuming the patient was standing with extended knees. When using crutches during stance, the crutches will put a position constraint on the shoulder, thus reducing the number of degrees of freedom. ⋯ However, postures in which the hip joint was in extension (C postures) appeared to the most stable postures. Applying at least 60 N x m/rad hip-joint stiffness gave stable equilibrium postures in all cases. Choosing appropriate hip-joint offset angles, the static equilibrium postures changed to more erect postures, without causing instability or excessive arm forces to occur.
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IEEE Trans Neural Syst Rehabil Eng · Sep 2003
Comparative StudyComparison of joint torque evoked with monopolar and tripolar-cuff electrodes.
Using a self-sizing spiral-cuff electrode placed on the sciatic nerve of the cat, the joint torque evoked with stimulation applied to contacts in a monopolar configuration was judged to be the same as the torque evoked by stimulation applied to contacts in a tripolar configuration. Experiments were carried out in six acute cat preparations. In each experiment, a 12-contact electrode was placed on the sciatic nerve and used to effect both the monopolar and tripolar electrode configurations. ⋯ These results indicate that a four contact, monopolar nerve-cuff electrode is a viable substitute for a 12 contact, tripolar nerve-cuff electrode. The results of this study are also consistent with the hypothesis that multicontact self-sizing spiral-cuff electrodes can be used in motor prostheses to provide selective control of many muscles. These findings should also apply to other neuroprostheses employing-cuff electrodes on nerve trunks.