Riener R, Fuhr T
Institute of Automatic Control Engineering (Lehrstuhl für Steuerungs und Regelungstechnik), Technical University of Munich, Germany.
IEEE Trans Rehabil Eng. 1998 Jun;6(2):113-24. doi: 10.1109/86.681177.
To control movements aided by functional electrical stimulation (FES) in paraplegic patients, stimulation of the paralyzed lower limbs might be adjusted in response to voluntary upper body effort. Recently, Donaldson and Yu proposed a theoretical approach, called "control by handle reactions of leg muscle stimulation" (CHRELMS), in which stimulation of the lower limbs depends on upper body effort, i.e., body posture and recorded hand reactions, and is aimed to minimize arm forces during standing up and standing. An alternative strategy is presented in this paper, which accounts for voluntary upper body effort as well, but does not require estimation of hand reactions. The objective of this study is to test both strategies by applying them to a generic two-dimensional (2-D) neuromusculoskeletal model. The model takes into account the major properties of muscle and segmental dynamics during FES-supported standing-up movements of a paraplegic patient. In comparison to standing up without FES-support, both closed-loop strategies yield satisfying standing-up movements although no reference information (e.g., a desired trajectory) is required. Arm forces can be significantly reduced. Using the model to optimize the controller, time-consuming and strenuous trial-and-error experimentation could be avoided. However, final experimental studies are planned to verify the presented strategies.
为了控制截瘫患者借助功能性电刺激（FES）辅助进行的运动，可根据上半身的自主用力情况来调整对瘫痪下肢的刺激。最近，唐纳森和于提出了一种理论方法，称为“通过腿部肌肉刺激的手柄反应进行控制”（CHRELMS），其中下肢的刺激取决于上半身的用力情况，即身体姿势和记录的手部反应，目的是在站立和起身过程中尽量减少手臂用力。本文提出了另一种策略，该策略同样考虑了上半身的自主用力情况，但不需要对手部反应进行估计。本研究的目的是通过将这两种策略应用于一个通用的二维（2-D）神经肌肉骨骼模型来对它们进行测试。该模型考虑了截瘫患者在FES辅助站立运动过程中肌肉和节段动力学的主要特性。与无FES支持的站立相比，尽管不需要参考信息（例如期望轨迹），但两种闭环策略都能产生令人满意的站立运动。手臂用力可显著降低。利用该模型对控制器进行优化，可以避免耗时且费力的试错实验。不过，计划进行最终的实验研究以验证所提出的策略。
