Matthew J. Bellman

Comparing the Induced Muscle Fatigue Between Asynchronous and Synchronous Electrical Stimulation in Able-Bodied and Spinal Cord Injured Populations

Neuromuscular electrical stimulation (NMES) has been shown to impart a number of health benefits and can be used to produce functional outcomes. However, one limitation of NMES is the onset of NMES-induced fatigue. Multi-channel asynchronous stimulation has been shown to reduce NMES-induced fatigue compared to conventional single-channel stimulation. However, in previous studies in man, the effect of stimulation frequency on the NMES-induced fatigue has not been examined for asynchronous stimulation. Low stimulation frequencies are known to reduce fatigue during conventional stimulation. Therefore, the aim of this study was to examine the fatigue characteristics of high- and low-frequency asynchronous stimulation as well as high- and low-frequency conventional stimulation. Experiments were performed in both able-bodied and spinal cord injured populations. Low frequency asynchronous stimulation is found to have significant fatigue benefits over high frequency asynchronous stimulation as well as high- and low-frequency conventional stimulation, motivating its use for rehabilitation and functional electrical stimulation (FES).

A novel modulation strategy to increase stimulation duration in neuromuscular electrical stimulation

Introduction: Neuromuscular electrical stimulation (NMES) has been shown to be an effective treatment for muscular dysfunction. Yet, a fundamental barrier to NMES treatments is the rapid onset of muscle fatigue. The purpose of this study is to examine the effect of feedback‐based frequency modulation on the closed‐loop performance of the quadriceps during repeated dynamic contractions. Methods: In the first experiment, subjects completed four different frequency modulation NMES protocols utilizing the same amplitude modulation control to compare the successful run times (SRTs). A second experiment was performed to determine the change in muscle response to high‐ and low‐frequency stimulation. Results: Compared with constant‐frequency stimulation, results indicate that using an error‐driven strategy to vary the stimulation frequency during amplitude modulation increases the number of successful contractions during non‐isometric conditions. Conclusion: Simultaneous frequency and amplitude modulation increases the SRT during closed‐loop NMES control. Muscle Nerve 44: 382–387, 2011

Stationary cycling induced by switched functional electrical stimulation control

Functional electrical stimulation (FES) is used to activate the dysfunctional lower limb muscles of individuals with neuromuscular disorders to produce cycling as a means of exercise and rehabilitation. In this paper, a stimulation pattern for quadriceps femoris-only FES-cycling is derived based on the effectiveness of knee joint torque in producing forward pedaling. In addition, a switched sliding-mode controller is designed for the uncertain, nonlinear cycle-rider system with autonomous state-dependent switching. The switched controller yields ultimately bounded tracking of a desired trajectory in the presence of an unknown, time-varying, bounded disturbance, provided a reverse dwell-time condition is satisfied by appropriate choice of the control gains and a sufficient desired cadence. Stability is derived through Lyapunov methods for switched systems, and experimental results demonstrate the performance of the switched control system under typical cycling conditions.

Closed-Loop Asynchronous Neuromuscular Electrical Stimulation Prolongs Functional Movements in the Lower Body

Neuromuscular electrical stimulation (NMES) is commonly used in rehabilitative settings and is also used for assistive purposes to create functional movements, where it is termed functional electrical stimulation (FES). One limitation of NMES/FES is early onset of muscle fatigue. NMES-induced fatigue can be reduced by switching between multiple stimulation channels that target different motor units or synergistic muscles (i.e., asynchronous stimulation). However, switching stimulation channels introduces additional complexity due to the need to consider the switching dynamics and differing muscle response to stimulation. The objective of this study was to develop and test a closed-loop controller for asynchronous stimulation. The developed closed-loop controller yields asymptotic tracking of a desired trajectory for a persons knee-shank complex despite switching between stimulation channels. The developed controller was implemented on four able-bodied individuals with four-channel asynchronous stimulation as well as single-channel conventional stimulation. The results indicate that asynchronous stimulation extends the duration that functional movements can be performed during feedback control. This result is promising for the implementation of asynchronous stimulation in closed-loop rehabilitative procedures and in assistive devices as a method to reduce muscle fatigue while maintaining a persons ability to track a desired limb trajectory.

Tracking control for FES-cycling based on force direction efficiency with antagonistic bi-articular muscles

A functional electrical stimulation (FES)-based tracking controller is developed to enable cycling based on a strategy to yield force direction efficiency by exploiting antagonistic bi-articular muscles. Given the input redundancy naturally occurring among multiple muscle groups, the force direction at the pedal is explicitly determined as a means to improve the efficiency of cycling. A model of a stationary cycle and rider is developed as a closed-chain mechanism. A strategy is then developed to switch between muscle groups for improved efficiency based on the force direction of each muscle group. Stability of the developed controller is analyzed through Lyapunov-based methods.

Switched Control of Cadence During Stationary Cycling Induced by Functional Electrical Stimulation

Functional electrical stimulation (FES) can be used to activate the dysfunctional lower limb muscles of individuals with neurological disorders to produce cycling as a means of rehabilitation. However, previous literature suggests that poor muscle control and nonphysiological muscle fiber recruitment during FES-cycling causes lower efficiency and power output at the cycle crank than able-bodied cycling, thus motivating the investigation of improved control methods for FES-cycling. In this paper, a stimulation pattern is designed based on the kinematic effectiveness of the riders hip and knee joints to produce a forward torque about the cycle crank. A robust controller is designed for the uncertain, nonlinear cycle-rider system with autonomous, state-dependent switching. Provided sufficient conditions are satisfied, the switched controller yields ultimately bounded tracking of a desired cadence. Experimental results on four able-bodied subjects demonstrate cadence tracking errors of 0.05 ±1.59 and 5.27 ±2.14 revolutions per minute during volitional and FES-induced cycling, respectively. To establish feasibility of FES-assisted cycling in subjects with Parkinsons disease, experimental results with one subject demonstrate tracking errors of 0.43 ±4.06 and 0.17 ±3.11 revolutions per minute during volitional and FES-induced cycling, respectively.

Cadence control of stationary cycling induced by switched functional electrical stimulation control

Cycling induced by functional electrical stimulation (FES) is an effective means for exercise and rehabilitation of individuals suffering from neurological disorders such as stroke, spinal cord injury, and cerebral palsy. To achieve FES-cycling, potential fields are alternately applied across muscle groups in the lower extremities. Alternating stimulation of various muscle groups according to the crank position makes the FES-cycling system a switched system with autonomous state-dependent switching. This paper examines FES-cycling from a switched systems analysis perspective. Specifically, a switched sliding mode controller is developed to yield approximate tracking of a desired cadence despite an uncertain, nonlinear cycle-rider model. Cadence tracking is proven via a common Lyapunov-like function and experimental results are provided to demonstrate the performance of the switched controller.

Automatic Control of Cycling Induced by Functional Electrical Stimulation With Electric Motor Assistance

Cycling induced by automatic control of functional electrical stimulation provides a means of therapeutic exercise and functional restoration for people affected by paralysis. During cycling induced by functional electrical stimulation, various muscle groups are stimulated according to the cycle crank angle; however, because of kinematic constraints on the cycle-rider system, stimulation is typically only applied in a subsection of the crank cycle. Therefore, these systems can be considered as switched control systems with autonomous, state-dependent switching with potentially unstable modes. Previous studies have included an electric motor in the system to provide additional control authority, but no studies have considered the effects of switched control in the stability analysis of the motorized functional electrical stimulation cycling system. In this paper, a model of the motorized cycle-rider system with functional electrical stimulation is developed that includes the effects of a switched control input. A novel switching strategy for the electric motor is designed to only provide assistance in the regions of the crank cycle where the kinematic effectiveness of the riders muscles is low. A switched sliding-mode controller is designed, and global, exponentially stable tracking of a desired crank trajectory is guaranteed via Lyapunov methods for switched systems, despite parametric uncertainty in the nonlinear model and unknown, time-varying disturbances. Experimental results from five able-bodied, passive riders are presented to validate the control design, and the developed control system achieves an average cadence tracking error of

Switched Tracking Control of the Lower Limb During Asynchronous Neuromuscular Electrical Stimulation: Theory and Experiments

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Identification-Based Closed-Loop NMES Limb Tracking With Amplitude-Modulated Control Input

revolutions per minute for a desired trajectory of 50 revolutions per minute.