Artificial Sensorimotor Integration in Spinal Cord Injured Subjects Through Neuromuscular and Electrotactile Stimulation

Abstract

Spinal cord injured (SCI) subjects lack sensorimotor functions. Neuromuscular electrical stimulation (NMES) systems have been used to artificially restore motor functions, but without proprioceptive feedback, SCI subjects can control NMES systems only when they can see their limbs. In a gait restoration system, the subject looks down to the ground to be aware of where his foot is while in a grasping activity, maximum grip strength is employed regardless of the force that is required to perform tasks. This report focuses on artificial sensorimotor integration. Multichannel stimulation was used to restore motor functions while encoded tactile sensation (moving fused phantom images) relating to artificially generated movements was provided by electrotactile stimulation during walking and grasping activities. The results showed that the sensorimotor integration attained yielded both the recognition of artificial grasp force patterns and a technique to be used by paraplegics allowing spatial awareness of their limb while walking.

Biofeedback for robotic gait rehabilitation

“…Electromyographic (EMG) recordings [23-26,32,33], kinematic quantities [25-30,34-38], and kinetic measures [37,38] have been processed and displayed visually [29,32], acoustically [27,28,30,37] or in combination [23,26,33,35,38], as well as via vibrotactile stimuli [34,36,37]. The application of biofeedback in stroke rehabilitation improved the patients' gait function according to a recent systematic review [8].…”

Human-centered robotics applied to gait training and assessment

“…As an alternative or extension to EMG recordings, kinematic quantities have also been used [56][57][58][59][60][61][65][66][67][68][69], e.g., joint angles of the ankle [56][57] or the knee [58], the distance between left and right knee joints [59], step length [60,66], and stance duration [61,64,66,[68][69]. Kinetic measures have been used as well, such as ground reaction forces and plantar pressure values [68][69].…”

“…Some research groups also use vibrotactile displays to generate tactile impressions on the skin [65,[67][68].…”

The Cybernetic Rehabilitation Aid: A novel concept for direct rehabilitation

“…Hauschild et al proposed a system to test prosthetic arms using VR with FES and EMG signals [9]. In addition, Phillips et al, Castro and Cliquet, and Batavia et al used VR and tactile feedback for gait analysis in their studies [10,11,12]. The advantages of VR include patient motivation, adaptability and variability based on the patient baseline, transparent data storage, online remote data access, economy of scale and reduced medical costs.…”