Simulating the restoration of standing balance at leaning postures with functional neuromuscular stimulation following spinal cord injury

Med Biol Eng Comput, 2016 · DOI: 10.1007/s11517-015-1377-5 · Published: January 1, 2016

Spinal Cord Injury Neurology Biomechanics

Simple Explanation

This study explores using electrical stimulation to help people with spinal cord injuries stand and lean, improving their reach. A computer model was used to test a control system that adjusts muscle stimulation based on body movement. The goal is to reduce how much users need to rely on their arms for balance, freeing them to do more activities.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Level 5, Simulation Study

Key Findings

1
Feedback control of muscle stimulation, guided by body movement data, outperforms constant, maximal stimulation in maintaining balance while leaning.
2
Estimating body movement from simulated implanted sensors is feasible and can be used to control stimulation effectively.
3
Reducing upper extremity loading is possible even at leaning postures using the proposed control system.

Research Summary

This simulation study investigates the potential of restoring leaning postures with FNS following SCI using a 3-D computer model of standing. The results indicate that a control paradigm outputting optimal stimulation patterns according to feedback of center of mass kinematics can notably outperform the conventional usage of constant supramaximal stimulation. The study also demonstrates the potential for improved standing neuroprosthesis performance at leaning postures using novel feedback estimation of center of mass kinematics expected with a currently available sensor-based system.

Practical Implications

Improved Reach and Functionality

Restoring leaning postures can significantly extend the reach and functional capabilities of individuals with SCI using FNS.

Reduced Upper Extremity Strain

The developed control system minimizes the reliance on upper extremities for balance, reducing strain and fatigue during standing.

Advancement of Neuroprosthesis Technology

The study provides a pathway for developing more advanced and adaptable FNS systems for restoring complex standing functions.

Study Limitations

1
Simulation-based results may not directly translate to real-world clinical outcomes.
2
The model assumes fixed feet and may not account for all real-world balance challenges.
3
The study does not address muscle fatigue, which can affect long-term standing performance.

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