Dong Hongtao, Hou Jie, Song Zhaoxi, Xu Rui, Meng Lin, Ming Dong
Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China.
Front Neurosci. 2022 Aug 24;16:944291. doi: 10.3389/fnins.2022.944291. eCollection 2022.
Functional electrical stimulation (FES) neuroprostheses have been regarded as an effective approach for gait rehabilitation and assisting patients with stroke or spinal cord injuries. A multiple-channel FES system was developed to improve the assistance and restoration of lower limbs. However, most neuroprostheses need to be manually adjusted and cannot adapt to individual needs. This study aimed to integrate the purely reflexive FES controller with an iterative learning algorithm while a multiple-channel FES walking assistance system based on an adaptive reflexive control strategy has been established. A real-time gait phase detection system was developed for accurate gait phase detection and stimulation feedback. The reflexive controller generated stimulation sequences induced by the gait events. These stimulation sequences were updated for the next gait cycle through the difference between the current and previous five gait cycles. Ten healthy young adults were enrolled to validate the multiple-channel FES system by comparing participants' gait performance to those with no FES controller and purely reflexive controller. The results showed that the proposed adaptive FES controller enabled the adaption to generate fitted stimulation sequences for each participant during various treadmill walking speeds. The maximum, minimum, and range of motion (ROM) of the hip, knee, and ankle joints were furtherly improved for most participants, especially for the hip and knee flexion and ankle dorsiflexion compared with the purely reflexive FES control strategy. The presented system has the potential to enhance motor relearning and promote neural plasticity.
功能性电刺激(FES)神经假体已被视为一种有效的步态康复方法,可帮助中风或脊髓损伤患者。为了改善下肢的辅助和恢复功能,开发了一种多通道FES系统。然而,大多数神经假体需要手动调整,无法适应个体需求。本研究旨在将纯反射性FES控制器与迭代学习算法相结合,同时建立了一种基于自适应反射控制策略的多通道FES步行辅助系统。开发了一种实时步态相位检测系统,用于准确的步态相位检测和刺激反馈。反射控制器产生由步态事件诱发的刺激序列。这些刺激序列通过当前和前五个步态周期之间的差异为下一个步态周期进行更新。招募了10名健康的年轻人,通过将参与者的步态表现与没有FES控制器和纯反射控制器的参与者进行比较,来验证多通道FES系统。结果表明,所提出的自适应FES控制器能够在各种跑步机行走速度下为每个参与者生成合适的刺激序列。与纯反射性FES控制策略相比,大多数参与者的髋、膝和踝关节的最大、最小和运动范围(ROM)进一步得到改善,尤其是髋和膝的屈曲以及踝关节的背屈。所提出的系统具有增强运动再学习和促进神经可塑性的潜力。