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  4. Feedback control of upright seating with functional neuromuscular stimulation during a reaching task after spinal cord injury: a feasibility study

Feedback control of upright seating with functional neuromuscular stimulation during a reaching task after spinal cord injury: a feasibility study

Journal of NeuroEngineering and Rehabilitation, 2022 · DOI: https://doi.org/10.1186/s12984-022-01113-4 · Published: November 23, 2022

Spinal Cord InjuryAssistive TechnologyNeurorehabilitation

Simple Explanation

This study explores using electrical stimulation to help people with spinal cord injuries sit upright and maintain balance while reaching for objects. Maintaining trunk stability is important for performing daily activities. The researchers used a controller that adjusts the electrical stimulation to trunk and hip muscles based on the person's posture. This aims to counteract internal perturbations (movements) that destabilize seated posture. The results showed that the controller reduced postural sway (how much a person moves while trying to stay still) and improved reach in some participants, suggesting it could be a viable way to improve seated posture and function.

Study Duration
Not specified
Participants
5 subjects with SCI
Evidence Level
Level 2; Feasibility Study

Key Findings

  • 1
    Feedback-controlled stimulation reduced postural sway in two subjects, indicating improved seated stability during the reaching task.
  • 2
    The controller increased mean effective reach in three subjects, suggesting an improved ability to hold objects further from the trunk.
  • 3
    Return to upright movements was quickened by 0.17 to 0.32 seconds in four subjects, showing faster recovery from leaning positions.

Research Summary

This study investigated the feasibility of using feedback-controlled functional neuromuscular stimulation (FNS) to maintain upright seated posture during a functional reaching task in individuals with spinal cord injury (SCI). A proportional, integral, derivative (PID) controller was implemented to modulate trunk and hip muscle stimulation based on trunk pitch and roll angles measured by an accelerometer. The results suggest that feedback control of neural stimulation is a viable method to maintain upright posture by facilitating trunk movements during reaching tasks, with potential for improving functional capabilities and quality of life for individuals with SCI.

Practical Implications

Improved ADL Performance

Enhanced trunk stability can improve the ability to perform activities of daily living (ADLs) that require reaching and object manipulation.

Fall Prevention

Quicker return to upright posture reduces the time spent in unstable positions, potentially decreasing the risk of falls.

Home-Based Application

The controller could be integrated into a home-based neuroprosthesis to improve seated stability and functional independence in everyday life.

Study Limitations

  • 1
    Small sample size limits the generalizability of the findings.
  • 2
    Axial trunk rotation was not addressed by the control system.
  • 3
    A linear PID control law may not be optimal for larger trunk excursions.

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