Control of standing balance at leaning postures with functional neuromuscular stimulation following spinal cord injury

Med Biol Eng Comput, 2018 · DOI: https://doi.org/10.1007/s11517-017-1687-x · Published: July 24, 2017

Simple Explanation

This study explores using feedback control of functional neuromuscular stimulation (FNS) to help people with spinal cord injuries (SCI) stand in different positions. The system adjusts stimulation to paralyzed muscles based on the person's center of pressure (CoP) to resist disturbances. The goal is to allow users to lean forward or sideways, reducing reliance on their arms for balance and enabling them to perform daily tasks more easily.

Study Duration

Not specified

Participants

Two subjects with motor complete thoracic level SCI

Evidence Level

Not specified

Key Findings

1
Feedback control reduced the need for upper extremity (UE) force by up to 50% in some leaning postures.
2
Center of pressure (CoP) deviations were reduced by up to 75% with feedback control.
3
The feedback controller can reject destabilizing disturbances in individuals with SCI using FNS.

Research Summary

This study investigated feedback control of FNS for stabilizing standing postures after SCI, including erect and leaning positions. Perturbations were applied to subjects with SCI using FNS, and the effectiveness of feedback control was compared to open-loop stimulation. The results suggest that feedback control can reduce upper extremity force and improve balance control in leaning postures for individuals with SCI using FNS.

Practical Implications

Reduced Upper Extremity Effort

The use of feedback control can significantly reduce the reliance on upper extremities for balance, potentially freeing them for other activities.

Improved Stability in Leaning Postures

The ability to maintain balance in non-erect postures allows for more functional movements and activities of daily living.

Enhanced Safety and Fall Prevention

By reducing CoP deviations, the risk of falls due to disturbances is minimized, especially in leaning postures where stability is already compromised.

Study Limitations

1
The synergistic muscles for a given plane acted simultaneously.
2
The relatively small number of synergistic muscles in the controller group.
3
All perturbations were conducted with the subjects holding onto a support device with both hands.

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