C.J. Robinson

Multi-joint movement of the cat hindlimb evoked by microstimulation of the lumbosacral spinal cord.

Microstimulation of the lumbosacral spinal cord may be an effective tool for the restoration of locomotion after spinal cord injury. To examine this possibility, complex coordinated multi-joint hindlimb movements were evoked by electrical stimulation with sine waveform modulation using a single microelectrode positioned in the L5-S1 spinal cord. Four types of hindlimb movement (flexion, extension, abduction, and adduction) were identified, and their stimulation locations were mapped onto cross-sectional drawings of L5-S1 spinal cord following histological examination of electrode tracks in the cord. Hindlimb flexion was evoked without abduction/adduction at many locations in the dorsal part of the L5-S1 spinal cord, whereas extension was evoked with abduction/adduction in the ventral part of the cord. Bilateral reciprocal lifting of the hindlimb was evoked by implanting two microelectrodes (one on each side) in the spinal cord. This study indicates that functional hindlimb movements can be elicited by activating a small number of sites in lumbosacral spinal cord.

Postural control and detection of slip/fall initiation in the elderly population

One of the common causes of morbidity and mortality in workplaces is related to slips or falls. Reaction to external disturbances, such as slips or falls, requires a process of perturbation detection and control of motion changes. Postural control is a common mechanism to compensate unexpected displacements of the body. The ability of postural control diminishes with ageing or neuropathy. In this study, two controlled groups, diabetics and non-diabetics in the elderly population, were investigated to compare how different postural control mechanisms would relate to the detection of perturbation and regain of balance. The ultra-low-vibration Sliding Linear Investigative Platform for Analyzing Lower Limb Stability SYSTEM was used to measure the biomechanical changes of posture and perturbation detection. In phase 1 of the analysis, static measures during quiet standing were considered to investigate the relationship between postural stability and perturbation detection capability. In phase 2 of the analysis, dynamic measures during an occurrence of perturbation were analysed. Statistical tests and linear logistic regression models were applied to find differences of postural control mechanisms and to build a predictive model for perturbation detection quantitatively. It is anticipated that the results of this study will contribute to more comprehensive understanding of postural control mechanisms and design of slip/fall prevention programmes.

Isometric torque about the knee joint generated by microstimulation of the cat L6 spinal cord

Isometric torque was generated about the knee joint by microstimulation of the cat L6 spinal cord using a single microelectrode. The torque responses varied with microstimulation location. Appreciable extension torque was generated by microstimulation in ventrolateral locations of the L6 spinal cord. Stimulation parameters (intensity, frequency and pulse-width) also influenced the extension torque. Specific stimulation parameters (100 microA intensity, 40 Hz frequency and 0.20 ms pulse-width) appear best suited for mapping the spinal cord based on knee joint torque responses. Low levels of cocontraction of the extensor and flexor could be achieved when extension torque was produced, but also varied with the stimulation locations. There are locations in the L6 ventral horn where microstimulation could evoke sustained extension for at least 4 min with only a slight change in torque. This study suggests the possibility of restoring lower limb function in patients with spinal cord injury above the lumbar level.

Multimicroelectrode stimulation within the cat L6 spinal cord: influences of electrode combinations and stimulus interleave time on knee joint extension torque

During multimicroelectrode stimulation within the cat L6 spinal cord, the number of electrodes activated, their separation distance, and the stimulus interleave time all influenced isometric knee joint extension torque. The torque evoked by stimulation with a three electrode combination could be enhanced or suppressed when compared with that evoked by single or paired electrode stimulation. A similar difference was noted when comparing two electrode combination versus single electrode stimulation. Relative fatigue was not improved significantly by interleaving the stimuli from two or three microelectrodes. Compared with the extension torque response evoked by noninterleaved stimulation, torque evoked by interleaved stimulation with the two microelectrode combination was decreased when the electrode distance was 2.0 mm or less and increased when the electrode distance was 3.0 mm. Designing an optimal stimulation strategy for multimicroelectrode spinal cord stimulation will be challenging and complex if a suppression effect among these electrodes is to be avoided. To reduce muscle fatigue, an asynchronous, interleaved strategy of stimulation may be required.

A comparative study of reaction times between type II diabetics and non-diabetics.

BackgroundAging has been shown to slow reflexes and increase reaction time to varied stimuli. However, the effect of Type II diabetes on these same reaction times has not been reported. Diabetes affects peripheral nerves in the somatosensory and auditory system, slows psychomotor responses, and has cognitive effects on those individuals without proper metabolic control, all of which may affect reaction times. The additional slowing of reaction times may affect every-day tasks such as balance, increasing the probability of a slip or fall.MethodsReaction times to a plantar touch, a pure tone auditory stimulus, and rightward whole-body lateral movement of 4 mm at 100 mm/s2 on a platform upon which a subject stood, were measured in 37 adults over 50 yrs old. Thirteen (mean age = 60.6 ± 6.5 years) had a clinical diagnosis of type II diabetes and 24 (mean age = 59.4 ± 8.0 years) did not. Group averages were compared to averages obtained from nine healthy younger adult group (mean age = 22.7 ± 1.2 years).ResultsAverage reaction times for plantar touch were significantly longer in diabetic adults than the other two groups, while auditory reaction times were not significantly different among groups. Whole body reaction times were significantly different among all three groups with diabetic adults having the longest reaction times, followed by age-matched adults, and then younger adults.ConclusionWhole body reaction time has been shown to be a sensitive indicator of differences between young adults, healthy mature adults, and mature diabetic adults. Additionally, the increased reaction time seen in this modality for subjects with diabetes may be one cause of increased slips and falls in this group.

Effects of Diabetic Neuropathy on Body Sway and Slip Perturbation Detection in Older Population

Postural control is a common mechanism to compensate for unexpected displacements of the body. In the older population, a slip or fall due to a failure of postural control is a common cause of morbidity and mortality. The ability of postural control decreases with aging or neuropathy. In this study, 2 groups, diabetics and non-diabetics in the older population, were compared to determine how patterns of postural sway during quiet standing were related to the detection of perturbation. The SLIP-FALLS system was applied to the measurement of sway and detection of perturbation. In phase 1 of the development of the predictive model, neural network algorithms were applied to find determinant variables for perturbation detection. In phase 2, a fuzzy logic inference system was developed to investigate the relationship between sway and perturbation detection. Results of this study may be applied to the design of floor mats or shoe insoles for preventing fatigue in workplaces.

Effect of lateral perturbations on psychophysical acceleration detection thresholds

BackgroundIn understanding how the human body perceives and responds to small slip-like motions, information on how one senses the slip is essential. The effect of aging and plantar sensory loss on detection of a slip can also be studied. Using psychophysical procedures, acceleration detection thresholds of small lateral whole-body perturbations were measured for healthy young adults (HYA), healthy older adults (HOA) and older adults with diabetic neuropathy (DOA). It was hypothesized that young adults would require smaller accelerations than HOAs and DOAs to detect perturbations at a given displacement.MethodsAcceleration detection thresholds to whole-body lateral perturbations of 1, 2, 4, 8, and 16 mm were measured for HYAs, HOAs, and DOAs using psychophysical procedures including a two-alternative forced choice protocol. Based on the subjects detection of the previous trial, the acceleration magnitude of the subsequent trial was increased or decreased according to the parameter estimation by sequential testing methodology. This stair-stepping procedure allowed acceleration thresholds to be measured for each displacement.ResultsResults indicate that for lateral displacements of 1 and 2 mm, HOAs and DOAs have significantly higher acceleration detection thresholds than young adults. At displacements of 8 and 16 mm, no differences in threshold were found among groups or between the two perturbation distances. The relationship between the acceleration threshold and perturbation displacement is of particular interest. Peak acceleration thresholds of approximately 10 mm/s2 were found at displacements of 2, 4, 8, and 16 mm for HYAs; at displacements of 4, 8, and 16 mm for HOAs; and at displacements of 8 and 16 mm for DOAs. Thus, 2, 4, and 8 mm appear to be critical breakpoints for HYAs, HOAs, and DOAs respectively, where the psychometric curve deviated from a negative power law relationship. These critical breakpoints likely indicate a change in the physiology of the system as it responds to the stimuli.ConclusionAs a function of age, the displacement at which the group deviates from a negative power law relationship increases from 2 mm to 4 mm. Additionally, the displacement at which subjects with peripheral sensory deficits deviate from the negative power law relations increases to 8 mm. These increases as a function of age and peripheral sensory loss may help explain the mechanism of falls in the elderly and diabetic populations.

Variations in Anterior-Posterior CoP Patterns in Elderly Adults Between Psychophysically Detected and Non-Detected Short Horizontal Perturbations

Using an ultra-low-vibration sliding linear investigative platform for assessing lower limb stability (SLIP-FALLS), postural responses were evaluated while subjects stood on a platform that was given a short anterior perturbation presented in one of 2 sequential test intervals for a set of 30 trials. An adaptive 2-alternative-forced-choice protocol required the subject to detect platform movement. Anterior-posterior centers-of-pressure (AP CoP) were compared among the detected and non-detected trials for the healthy elderly adults (HEA) and diabetic peripheral neuropathy (DPN) elderly adults. Results indicate that there is a significant difference between the CoP patterns for a detected and non-detected trial. Also, the range of sway is found to be higher in the case of DPN elderly adults when compared to HEA. However, the AP CoP pattern for detected trials in both HEA and DPN were the same

Expanding the scope of the IEEE Transactions on rehabilitation engineering to explicitly include neural engineering

The original scope of this Transactions implicitly gave it wide latitude to include all aspects of biologically based Neural Engineering. The Transactions now has an additional explicit charter to target Neural Engineering and its links to rehabilitation, from the very basic science to the highly engineered design application. This Transactions will become a prime repository for the emerging field of Neural Engineering, without losing its rehabilitation roots.

Using Engineering and Assistive Technologies for Rehabilitation after Electrical Traumaa

ABSTRACT: A framework is presented for judging when, how, and why rehabilitation engineering and its related assistive technologies are appropriate interventions following electrically induced trauma or burns. Instead of relying on the World Health Organizations medically based classification scheme of “Impairment, Disability, and Handicap,” this newer framework is built on a rational demarcation proposed by the National Center for Medical Rehabilitation and Research at the U.S. National Institutes of Health. This latter client‐centered framework encompasses pathophysiology, impairment, functional limitations, “disability”, and societal limitations. This framework is well suited to handle the varied sequelae of electrical trauma and burn injuries and provides guidance towards the most effective use of traditional rehabilitation interventions and of assistive technologies. For electrical injuries, rehabilitative technologies can be classified as those promoting job accommodations (i.e., that help an individual return to active employment, albeit possibly in a different role) or as aids to the other activities of daily living (ADLs) that provide an enhanced quality of life to the individual with disability. While the traditional rehabilitative focus has been on return‐to‐work, especially among professional tradesmen, a more productive rehabilitative effort in some cases may occur through psychosocial adjustments achieved via effective technological interventions that enhance ADLs.