Neuromuscular Electrical Stimulation for Mobility Support of Elderly.

The stimulator for neuromuscular electrical stimulation for mobility support of elderly is not very complicated, but for application within "MOBIL" we have some additional demands to fulfill. First we have specific safety issues for this user group. A powerful compliance management system is crucial not only to guide daily application, but for creating hard data for the scientific outcome. We also need to assure easy handling of the stimulator, because the subjects are generally not able to cope with too difficult and complex motor skills. So, we developed five generations of stimulators and optimizing solutions after field tests. We are already planning the sixth generation with wireless control of the stimulation units by the central main handheld control unit. In a prototype, we have implemented a newly available high capacity memory, a breakthrough in "compliance data storage" as they offer the necessary high storage capacity and fast data handling for an affordable prize. The circuit also contains a 3D accelerometer sensor which acts as a further important safety features: if the control unit drops, this event is detected automatically by the sensor and activates an emergency switch-off that disables the stimulation to avoid associated risks. Further, we have implemented a hardware emergence shutdown and other safety measures. Finally, in the last example muscle torque measurements are referenced with compliance data. In the study normalized maximum voluntary contraction (MVC) and maximum stimulation induced contraction (MSC) were assessed in regular check-ups along the training period. With additional consideration of adjusted stimulation intensity for training out of the compliance data records we are able to estimate the induced contraction strength, which turned out to amount in average 11% of MVC. This value may seem on a first sight rather low, and ought to be considered in relation to the results at the end of the training period. Therefore the correlation between normalized MVC and normalized MSC was calculated. It is obvious that MVC can increase to strongly variable extent (3 to 65 %), but in few cases also decrease (-4 to 15 %) over the study period. The correlation suggests that an increase of roughly 1 % of normalized MSC can lead to an increase of about 10 % in MVC in the given training conditions. Overall, we can say that we have a stimulator that has turned out to work sufficiently. The most important feature is the integrated compliance recording because this is very useful for interpretation of the study outcome. The electrical stimulation training has shown that even with relatively small induced contraction intensity we still get some increase in the achievable voluntary extension torque.