A neuroprosthesis for control of seated balance after spinal cord injury
Open accessAbstract
BACKGROUND: A major desire of individuals with spinal cord injury (SCI) is the ability to maintain a stable trunk while in a seated position. Such stability is invaluable during many activities of daily living (ADL) such as regular work in the home and office environments, wheelchair propulsion and driving a vehicle. Functional neuromuscular stimulation (FNS) has the ability to restore function to paralyzed muscles by application of measured low-level currents to the nerves serving those muscles. METHODS: A feedback control system for maintaining seated balance under external perturbations was designed and tested in individuals with thoracic and cervical level spinal cord injuries. The control system relied on a signal related to the tilt of the trunk from the vertical position (which varied between 1.0 ≡ erect posture and 0.0 ≡ most forward flexed posture) derived from a sensor fixed to the sternum to activate the user's own hip and trunk extensor muscles via an implanted neuroprosthesis. A proportional-derivative controller modulated stimulation between trunk tilt values indicating deviation from the erect posture and maximum desired forward flexion. Tests were carried out with external perturbation forces set at 35%, 40% and 45% body-weight (BW) and maximal forward trunk tilt flexion thresholds set at 0.85, 0.75 and 0.70. RESULTS: Preliminary tests in a case series of five subjects show that the controller could maintain trunk stability in the sagittal plane for perturbations up to 45% of body weight and for flexion thresholds as low as 0.7. The mean settling time varied across subjects from 0.5(±0.4) and 2.0 (±1.1) seconds. Mean response time of the feedback control system varied from 393(±38) ms and 536(±84) ms across the cohort. CONCLUSIONS: The results show the high potential for robust control of seated balance against nominal perturbations in individuals with spinal cord injury and indicates that trunk control with FNS is a promising intervention for individuals with SCI.
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Implanted muscle electrodes can re-establish trunk stability in patients with spinal cord injury when implanted in the back and hip extensor muscles.
“Aside from the use in prosthetic control, implanted muscle electrodes can also be used to re-establish trunk stability in patients with spinal cord injury, when implanted in the back and hip extensor muscles [32].”
From Interfaces with the peripheral nervous system for the control of a neuroprosthetic limb: a review (2020) · cites this paper as [32]
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References 18 · Cited by 38
Research works printed but not linked: 1
- [4]Triolo RJ Kobetic R Betz R Harris G Standing and walking with FNS: technical and clinical challenges Human motion analysis 1996 New York NY IEEE Press 318 350
- Authors
- Audu, M. L., Lombardo, L. M., Schnellenberger, J. R., Foglyano, K. M., Miller, M. E., & Triolo, R. J.
- Affiliations
- Case Western Reserve University (US)
- Louis Stokes Cleveland VA Medical Center (US)
- Corresponding author
- Audu, Musa L
- Lombardo, Lisa M
- Schnellenberger, John R
- Foglyano, Kevin M
- Miller, Michael E
- Triolo, Ronald J
- Venue
- Journal of NeuroEngineering and Rehabilitation
- Published
- 2015
- Volume
- 12
- Issue
- 1
- Pages
- 8
- ISSN
- 1743-0003 (ISSN-L)
- PMC
- PMC4326199
- OpenAlex
- W2113578357
- Cited by
- 38
- References
- 18
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 5 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 1 · 2018: 5 · 2017: 3 · 2016: 4 · 2015: 2
- FWCI
- 3.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of NeuroEngineering and Rehabilitation (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- U.S. Department of Defense (B6406R, W81XWH)
- U.S. Department of Veterans Affairs (B6406R, A9259-L, Award No. A9259-L)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Physical Sciences › Engineering › Biomedical Engineering › Muscle activation and electromyography studies
- Keywords
- spinal cord injury, seated balance, neural prostheses, functional electrical stimulation, trunk tilt, feedback control, trunk extensor muscles, external disturbances, activities of daily living, wheelchair propulsion
- MeSH terms
- Activities of Daily Living, Adult, Algorithms, Biomechanical Phenomena, Cervical Vertebrae, Electric Stimulation, Postural Balance, Female, Humans, Male, Middle Aged, Paralysis, Reaction Time, Spinal Cord Injuries, Thoracic Vertebrae, Muscle, Skeletal, Feedback, Physiological, Neural Prostheses, Torso
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