Design and Testing of an Advanced Implantable Neuroprosthesis With Myoelectric Control

Hart, Ronald L.; Bhadra, Niloy; Montague, Fred W.; Kilgore, Kevin L.; Peckham, P. Hunter

doi:10.1109/tnsre.2010.2079952

Cited by 62 publications

(43 citation statements)

References 42 publications

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“…This project used a 12-channel implantable stimulator-telemeter (IST-12) 18,19 to apply the stimulation and to record EMG signals for a user interface. The IST-12 (Figure 1A) has a circuit hermetically sealed in a titanium capsule, a coil for power/communication, and leads for 12 stimulating electrodes and two bipolar EMG channels.…”

Section: Methodsmentioning

confidence: 99%

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Implanted Neuroprosthesis for Restoring Arm and Hand Function in People With High Level Tetraplegia

Memberg

Polasek

Hart

et al. 2014

Archives of Physical Medicine and Rehabilitation

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116

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Objective To develop and apply an implanted neuroprosthesis to restore arm and hand function to individuals with high level tetraplegia Design Case study. Setting Clinical research laboratory. Participants Two individuals with spinal cord injuries at or above the C4 motor level. Interventions The individuals were each implanted with two stimulators (24 stimulation channels and 4 myoelectric recording channels total). Stimulating electrodes were placed in the shoulder and arm, including the first chronic application of spiral nerve cuff electrodes to activate a human limb. Myoelectric recording electrodes were placed in the head and neck areas. Main Outcome Measures The successful installation and operation of the neuroprosthesis, along with the electrode performance, range of motion, grasp strength, joint moments, and performance in activities of daily living. Results The neuroprosthesis system was successfully implanted in both individuals. Spiral nerve cuff electrodes were placed around upper extremity nerves and activated the intended muscles. In both individuals, the neuroprosthesis has functioned properly for at least 2.5 years post-implant. Hand, wrist, forearm, elbow and shoulder movements were achieved. A mobile arm support was needed to support the mass of the arm during functional activities. One individual was able to perform several activities of daily living with some limitations due to spasticity. The second individual was able to partially complete two activities of daily living. Conclusions Functional electrical stimulation is a feasible intervention for restoring arm and hand functions to individuals with high tetraplegia. Forces and movements were generated at the hand, wrist, elbow and shoulder that allowed the performance of activities of daily living, with some limitations requiring the use of a mobile arm support to assist the stimulated shoulder forces.

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Section: Methodsmentioning

confidence: 99%

“…EMG signals were filtered, amplified, rectified and integrated before the data was telemetered externally. The IST-12 delivers constant current, charge-balanced, biphasic pulses of varying amplitude (0 to 20 mA) and duration (0 to 255 μsec), and can deliver the 12-16 Hz stimulation rate typical for FES upper extremity systems 18 .…”

Section: Methodsmentioning

confidence: 99%

Implanted Neuroprosthesis for Restoring Arm and Hand Function in People With High Level Tetraplegia

Memberg

Polasek

Hart

et al. 2014

Archives of Physical Medicine and Rehabilitation

Self Cite

124

116

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“…After approval by the Institutional Review Board of the Louis Stokes Cleveland Department of Veterans Affairs Medical Center, informed consent was obtained prior to installation of an EMG-controlled neuroprosthesis consisting of a 12-channel implanted stimulatortelemeter (IST-12), 35 12 stimulating electrodes, 36 and 2 surgically implanted intramuscular EMG recording electrodes. 37 The implanted stimulator-receiver was powered and controlled by a wearable external control unit (ECU) that transmitted information to the IST-12 and recovered signals from the implanted EMG electrodes via an inductive communication link maintained by a coil affixed to the skin. The subject had previously received an 8-channel implanted gait assist system during participation in other studies in our laboratory, 25 which was removed and replaced with the advanced EMG-controlled neuroprosthesis in a single surgical procedure.…”

Section: Methodsmentioning

confidence: 99%

A preliminary comparison of myoelectric and cyclic control of an implanted neuroprosthesis to modulate gait speed in incomplete SCI

Lombardo

Bailey

Foglyano

et al. 2014

The Journal of Spinal Cord Medicine

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Objective: Explore whether electromyography (EMG) control of electrical stimulation for walking after incomplete spinal cord injury (SCI) can affect ability to modulate speed and alter gait spatial-temporal parameters compared to cyclic repetition of pre-programmed stimulation. Design: Single case study with subject acting as own concurrent control. Setting: Hospital-based biomechanics laboratory. Participants: Single subject with C6 AIS D SCI using an implanted neuroprosthesis for walking. Interventions: Lower extremity muscle activation via an implanted system with two different control methods: (1) pre-programmed pattern of stimulation, and (2) EMG-controlled stimulation based on signals from the gastrocnemius and quadriceps. Outcome measures: Gait speed, distance, and subjective rating of difficulty during 2-minute walks. Range of walking speeds and associated cadences, stride lengths, stride times, and double support times during quantitative gait analysis. Results: EMG control resulted in statistically significant increases in both walking speed and distance (P < 0.001) over cyclic stimulation during 2-minute walks. Maximum walking speed with EMG control (0.48 m/second) was significantly (P < 0.001) faster than the fastest automatic pattern (0.39 m/second), with increased cadence and decreased stride and double support times (P < 0.000) but no change in stride length (z = −0.085; P = 0.932). The slowest walking with EMG control (0.25 m/second) was virtually indistinguishable from the slowest with automatic cycling (z = −0.239; P = 0.811). Conclusion: EMG control can increase the ability to modulate comfortable walking speed over pre-programmed cyclic stimulation. While control methods did not differ at the lowest speed, EMG-triggered stimulation allowed significantly faster walking than cyclic stimulation. The expanded range of available walking speeds could permit users to better avoid obstacles and naturally adapt to various environments. Further research is required to definitively determine the robustness, generalizability, and functional implications of these results.

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“…In our case, it was the first fully implanted FES system that aimed to restore shoulder, arm, and hand movement to people with high-level tetraplegia. It consisted of two implantable stimulator-telemeters [16], each with 12 stimulating channels and 2 EMG recording channels, for a total of 24 stimulation channels. The 10 channels used for hand-grasp control were not chosen by a model-based method, but rather were based on extensive previous experience [3].…”

Section: Neuroprosthesismentioning

confidence: 99%

Selection of muscle and nerve-cuff electrodes for neuroprostheses using customizable musculoskeletal model

Blana¹,

Hincapie²,

Chadwick³

et al. 2013

JRRD

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Abstract-Neuroprosthetic systems based on functional electrical stimulation aim to restore motor function to individuals with paralysis following spinal cord injury. Identifying the optimal electrode set for the neuroprosthesis is complicated because it depends on the characteristics of the individual (such as injury level), the force capacities of the muscles, the movements the system aims to restore, and the hardware limitations (number and type of electrodes available). An electrode-selection method has been developed that uses a customized musculoskeletal model. Candidate electrode sets are created based on desired functional outcomes and the hardware limitations of the proposed system. Inverse-dynamic simulations are performed to determine the proportion of target movements that can be accomplished with each set; the set that allows the most movements to be performed is chosen as the optimal set. The technique is demonstrated here for a system recently developed by our research group to restore whole-arm movement to individuals with high-level tetraplegia. The optimal set included selective nerve-cuff electrodes for the radial and musculocutaneous nerves; single-channel cuffs for the axillary, suprascapular, upper subscapular, and long-thoracic nerves; and muscle-based electrodes for the remaining channels. The importance of functional goals, hardware limitations, muscle and nerve anatomy, and surgical feasibility are highlighted.

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Design and Testing of an Advanced Implantable Neuroprosthesis With Myoelectric Control

Cited by 62 publications

References 42 publications

Implanted Neuroprosthesis for Restoring Arm and Hand Function in People With High Level Tetraplegia

Implanted Neuroprosthesis for Restoring Arm and Hand Function in People With High Level Tetraplegia

A preliminary comparison of myoelectric and cyclic control of an implanted neuroprosthesis to modulate gait speed in incomplete SCI

Selection of muscle and nerve-cuff electrodes for neuroprostheses using customizable musculoskeletal model

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