National Spinal Injuries Centre, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL, UK.
Buckinghamshire Healthcare Plastics, Stoke Mandeville Hospital, Mandeville Road, Aylesbury, HP21 8AL, UK.
Sci Rep. 2020 Dec 4;10(1):21242. doi: 10.1038/s41598-020-77664-0.
Neurophysiological theories and past studies suggest that intention driven functional electrical stimulation (FES) could be effective in motor neurorehabilitation. Proportional control of FES using voluntary EMG may be used for this purpose. Electrical artefact contamination of voluntary electromyogram (EMG) during FES application makes the technique difficult to implement. Previous attempts to date either poorly extract the voluntary EMG from the artefacts, require a special hardware or are unsuitable for online application. Here we show an implementation of an entirely software-based solution that resolves the current problems in real-time using an adaptive filtering technique with an optional comb filter to extract voluntary EMG from muscles under FES. We demonstrated that unlike the classic comb filter approach, the signal extracted with the present technique was coherent with its noise-free version. Active FES, the resulting EMG-FES system was validated in a typical use case among fifteen patients with tetraplegia. Results showed that FES intensity modulated by the Active FES system was proportional to intentional movement. The Active FES system may inspire further research in neurorehabilitation and assistive technology.
神经生理学理论和过去的研究表明,意图驱动的功能性电刺激(FES)在运动神经康复中可能是有效的。使用自愿肌电图(EMG)进行 FES 的比例控制可用于此目的。在 FES 应用期间,自愿 EMG 中的电伪影污染使得该技术难以实施。迄今为止,以前的尝试要么无法从伪影中很好地提取自愿 EMG,要么需要特殊的硬件,要么不适合在线应用。在这里,我们展示了一种完全基于软件的解决方案的实现,该方案使用自适应滤波技术实时解决当前的问题,并使用可选的梳状滤波器从 FES 下的肌肉中提取自愿 EMG。我们证明,与经典梳状滤波器方法不同,本技术提取的信号与其无噪声版本具有一致性。主动 FES,该结果的 EMG-FES 系统在 15 名四肢瘫痪患者的典型用例中得到了验证。结果表明,由主动 FES 系统调制的 FES 强度与意向运动成正比。主动 FES 系统可能会激发神经康复和辅助技术领域的进一步研究。