Stair Ascending and Descending with the Cooperative Neuroprosthesis WALK!

Fuhr, T.; Quintern, J.; Schmidt, G.

doi:10.1046/j.1525-1403.2003.03007.x

Cited by 2 publications

(4 citation statements)

References 8 publications

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“…In agreement with previously published studies [5–8], we observed that forward stair descent with FNS-only was erratic. It was also uncomfortable for the participant because of the difficulty experienced attempting to control body lowering by deactivating trailing limb hip and knee extensors, leading to heavy reliance on arm support.…”

Section: Methodssupporting

confidence: 93%

“…While the VIKM orthosis showed an ability to regulate body lowering during trailing limb single support in place of stimulation, some limitations of FNS-driven swing motion during stair descent persisted, consistent with previously reported studies [5–8]. Namely, hip flexion during leg off and leg pull through were not strong enough to reliably achieve limb trajectory observed in nondisabled individuals during stair descent.…”

Section: Discussionsupporting

confidence: 88%

“…Previous studies report that control of stair descent via deactivation of hip and knee extensors requires 70 percent body weight support by the upper limbs [6] and that FNS users feel insecure during descent [8]. It has been postulated that insecurity during descent is a result of obstructed vision of the step below, but we hypothesize that lack of knee flexion control during the lowering phase is the primary contributor to discomfort.…”

Section: Discussionmentioning

confidence: 86%

“…Functional neuromuscular stimulation (FNS) is well suited for generation of concentric muscle contractions and has been employed in stair climbing systems previously with some success [5–8]. Although FNS-assisted stair ascent is possible, all reported systems exhibit insufficient stimulated lower-limb forces to independently overcome gravity, bring the body forward, and provide stability.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Forward stair descent with hybrid neuroprosthesis after paralysis: Single case study demonstrating feasibility

et al. 2014

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The ability to negotiate stairs is important for community access and independent mobility but requires more effort and strength than level walking. For this reason, previous attempts to utilize functional neuromuscular stimulation (FNS) to restore stair navigation after spinal cord injury (SCI) have had limited success and are not readily generalizable. Stair descent is particularly challenging because it requires energy absorption via eccentric muscle contractions, a task not easily accomplished with FNS. This article presents the design and initial testing of a hybrid neuroprosthesis with a variable impedance knee mechanism (VIKM-HNP) for stair descent. Using a 16-channel percutaneous FNS system, a muscle activation pattern was synthesized to descend stairs with the VIKM-HNP in a step-by-step fashion. A finite state control system was implemented to deactivate knee extensor stimulation and utilize the VIKM-HNP to absorb energy and regulate descent speed. Feasibility testing was performed on one individual with complete thoracic-level SCI. Stair descent was achieved with maximum upper-limb forces of less than 45% body weight compared with previously reported value of 70% with FNS only. The experiments also provided insight into design requirements for future hybrid systems for stair navigation, the implications of which are discussed.

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Section: Methodssupporting

confidence: 93%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Forward stair descent with hybrid neuroprosthesis after paralysis: Single case study demonstrating feasibility

et al. 2014

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Walking with WALK!

Fuhr¹,

Quintern

Riener

et al. 2008

IEEE Eng. Med. Biol. Mag.

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The goal of this paper is to design WALK! a cooperative, patient-driven neuroprosthetic (NP) system. In implementing sensor-supervised events to switch to subsequent medical prosthetics, NP users were able to actively control the timing of their movements. Performance and usability of WALK! was appreciated by the NP users because they were able to perceive the activities of the NP to actually support their movements. The future of NP will be based on fully implanted systems. To justify the high efforts, risks, and costs of an implantation to both NP users and health care providers, NPs have to offer true functionality that can only be achieved by a sophisticated and yet practicable control system. We believe that the WALK! control approach presented in this article can be considered a valuable contribution to the development of future neuroprosthetic systems for locomotion.

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Stair Ascending and Descending with the Cooperative Neuroprosthesis WALK!

Cited by 2 publications

References 8 publications

Forward stair descent with hybrid neuroprosthesis after paralysis: Single case study demonstrating feasibility

Forward stair descent with hybrid neuroprosthesis after paralysis: Single case study demonstrating feasibility

Walking with WALK!

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