Hybrid paraplegic locomotion with the ParaWalker using intramuscular stimulation: a single subject study

Nene, A.V.; Jennings, Sophie

doi:10.1038/sc.1989.19

Cited by 26 publications

(9 citation statements)

References 6 publications

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“…A 4-month training protocol including preparatory ambulation, LE FES, and combined FES-RGO utilization significantly reduced energy expenditure for walking, but appeared impractical for community mobility [90]. Nene and Jennings added intramuscular glutei FES to the hip guidance orthosis (HGO) or parawalker and produced modest benefits in increased speed of ambulating with crutches, but found many of the same limitations that were experienced with the FES-RGO system, i.e., slow walking, difficult donning, difficult transfers, and less than desirable aesthetics [93]. Comparison of the commercially available advanced reciprocal gait orthosis (AR-GO) with and without FES and Parastep have demon-strated the latter to be more user-friendly (see Fig.…”

Section: Lower Extremitymentioning

confidence: 99%

Functional electrical stimulation therapies after spinal cord injury

Gater

Dolbow

Tsui

et al. 2011

NRE

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Section: Lower Extremitymentioning

confidence: 99%

Functional electrical stimulation therapies after spinal cord injury

Gater

Dolbow

Tsui

et al. 2011

NRE

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“…Several studies have shown improved gait speeds and lower energy consumption when FES and the RGO are combined (Solomonow et al, 1989, 1997; Hirokawa et al, 1990; Petrofsky and Smith, 1991; Isakov et al, 1992). Others have combined stimulation with the HGO (McClelland et al, 1987; Nene and Jennings, 1989); the Hybrid Assistive System (Popovic et al, 1989, 1990; Popovic, 1990), the Case Western Hybrid System (Ferguson et al, 1999; Marsolais et al, 2000), the Strathclyde Hybrid System) (Yang et al, 1997; Greene and Granat, 2003), and the Controlled-Brake Orthosis (Goldfarb and Durfee, 1996; Goldfarb et al, 2003). …”

Section: Orthoticsmentioning

confidence: 99%

Rehabilitation Robotics

Krebs

Volpe

2013

Neurological Rehabilitation

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This chapter focuses on rehabilitation robotics which can be used to augment the clinician’s toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual’s functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We will provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we will then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We will present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost.

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“…It is then free to swing with the momentum of the previous step. Crutches are used to advance the trunk over the stance leg (48). This device has also been used clinically as a purely mechanical orthosis, with success especially among children (19).…”

Section: Fns/orthotic Hybrid Systems For Paraplegic Walkingmentioning

confidence: 99%

Orthoses and Electrical Stimulation for Walking in Complete Paraplegia

Marsolais

Kobetic²,

Chizeck³

et al. 1991

Neurorehabilitation and Neural Repair

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Orthotic systems, orthoses combined with functional neuromuscular stimulation (FNS), and FNS systems alone, are compared for their safety, function, and ease of use as walking systems for people with complete paraplegia. Despite the safety and joint protection offered by orthoses, the majority of paraplegics with lesions above the T-1 2 level discard braces at the termination of the rehabilitation period. Reasons include the limited function provided, poor cosmetic appearance, and high energy cost of use. Conventional bracing has been combined with FNS to facilitate the swing phase of gait, but the disadvantages of braces are still present; the advantage of slightly reduced energy cost with FNS is offset by the drawback of increased complexity. Trials of both surface and percutaneous FNS systems have demonstrated that FNS walking for paraplegics is feasible in the research environment. While pure FNS systems eliminate the disadvantages of bracing, they have the requirements of complex electrode application in the case of surface systems, or care of electrode skin sites and connections in the case of percutaneous systems. Additional problems of FNS systems are a high energy cost and lack of trunk and hip stability, requiring the use of a walker. The authors are addressing these problems through the development of closed-loop control of stimulation to utilize muscles in more normal on/off cycles and in the development of totally implanted systems to increase reliability and convenience.

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Hybrid paraplegic locomotion with the ParaWalker using intramuscular stimulation: a single subject study

Cited by 26 publications

References 6 publications

Functional electrical stimulation therapies after spinal cord injury

Functional electrical stimulation therapies after spinal cord injury

Rehabilitation Robotics

Orthoses and Electrical Stimulation for Walking in Complete Paraplegia

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