scholarly journals The Effectiveness of Functional Electrical Stimulation (FES) in On-Off Mode for Enhancing the Cycling Performance of Team Phoenix at 2016 Cybathlon

2017 ◽  
Vol 27 (4) ◽  
Author(s):  
Kenry W.C. Leung ◽  
Raymond K.Y. Tong ◽  
Xiaojun Wang ◽  
Ginny T.Y. Lee ◽  
Peter M.K. Pang ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Lower Limb ◽  
Cycling Performance ◽  
Lower Limbs ◽  
Female Participant ◽  
Training Procedure ◽  
Mechanical Structure ◽  
Cord Injury ◽  
The Subject

In this study we designed a Functional Electrical Stimulation (FES) trike for a female subject with spinal cord injury to exercise her lower limbs and improve her lower limb muscle condition for attending the 2016 Cybathlon FES bike competition. Our FES pilot was the only female participant, in the FES cycling competition and she rode for Team Phoenix from the Chinese University of Hong Kong. Due to the weakness of muscles in the lower limb of the subject, and due to scoliosis over her thoracolumbar aéra, the mechanical structure of the trike had to be tailor-made to ensure she sat on the bike in a safe and secure position. A six-phase angle-driven stimulation pattern was developed to stimulate quadriceps and hamstrings without gluteus muscles for contraction through four surface electrodes, thereby creating a cycling movement. To improve the cycling endurance and reduce the muscle fatigue, an on-off mode was developed for controlling the stimulation time that allowed the subject to cycle for 20s, then pause while the trike advanced without stimulation for 5s, followed by a subsequent 20 sec stimulation, to continue cycling. The pilot participated in the training procedure including training exercise at home, trike fitting in the trike by modifying the mechanical structure, and conducting the cycling exercise for six months. We observed significant improvements in the pilot’s lower limb condition. The on-off mode enabled our pilot to extend her cycling endurance effectively, from 1 min to 2.5 mins and the distance from 62m to 100m. Over the eight minutes time limit, our team successfully finished 100 m in the Cybathlon FES.

scholarly journals Audio-visual stimulation in conjunction with functional electrical stimulation to address upper limb and lower limb movement disorder

2016 ◽  
Vol 26 (2) ◽  
Author(s):  
Deepesh Kumar ◽  
Sunny Verma ◽  
Sutapa Bhattacharya ◽  
Uttama Lahiri
Keyword(s):  
Electrical Stimulation ◽  
Movement Disorder ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Lower Limb ◽  
Neurological Disorders ◽  
Visual Stimulation ◽  
Lower Limbs ◽  
Lower Limb Movement ◽  
Rehabilitation Exercises

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.

scholarly journals Strategies and performances of Functional Electrical Stimulation Cycling using the BerkelBike with Spinal Cord Injury in a competition context (CYBATHLON)

2017 ◽  
Vol 27 (4) ◽  
Author(s):  
Rik Berkelmans ◽  
Billy Woods
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Lower Limb ◽  
Imperial College ◽  
Surface Electrode ◽  
Arm Cranking ◽  
Lower Limb Muscles ◽  
Cord Injury

The functional electrical stimulation (FES) bicycle race was an event at the Cybathlon, held in Zurich October 2016. BerkelBike BV (The Netherlands) in collaboration with Imperial College London entered a spinal cord injury pilot who had tetraplegia to compete in this event. The BerkelBike Pro is a commercially available FES capable recumbent which is normally driven by the arm- and leg power. The arm cranking part was disabled. Now the tricycle must be driven using the pilots own lower limb muscles through stimulation in accordance with race rules. The bike used during the race was also adapted with a fixed gear for improved efficiency. The pilot who represented this team come second place overall in the event and attained the fastest race time of all pilots who utilised surface electrode FES. Steps can be taken to increase the race efficiency of the BerkelBikes and its FES capabilities even further.

scholarly journals Development of practical functional electrical stimulation cycling systems based on an electromyography study of the Cybathlon 2016

2017 ◽  
Vol 27 (4) ◽  
Author(s):  
Jetsada Arnin ◽  
Traisak Yamsa-ard ◽  
Preechapawan Triponyuwasin ◽  
Yodchanan Wongsawat
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Muscle Activation ◽  
Cycling Performance ◽  
Activation Pattern ◽  
Muscle Activation Pattern ◽  
System A ◽  
Cord Injury ◽  
Cycling System ◽  
Processor Unit

The purpose of this study was to develop a functional electrical stimulation (FES) system based on the motor driving concept for use by spinal cord injury patients participating in the FES Cycling competition at the Cybathlon 2016. The proposed FES system consists of a low-power control system, a precise processor unit, and a 4-channel stimulation unit. Self-adhesive carbon conductive electrodes were utilized for stimulation. A 26-year-old SCI patient was qualified to participate in the competition. The pilot patient underwent training for 16 months, which included experience with FES stimulation, performing FES cycling, and reducing spasticity, to practice using the FES system. In addition, using surface electromyography (EMG) during cycling, the muscle activation pattern for generating the stimulation profile was applied and resulted in good performance. The best FES cycling performance the pilot achieved was 1000 meters translation with the cycling system during twelve minutes of using the FES system. The pilot achieved an 1000 meters translation mobility within an average of 16 minutes of cycling. Nevertheless, the system must be further investigated regarding muscle fatigue and other factors that may affect the stimulation conditions.

scholarly journals The Effect and Dose-Response of Functional Electrical Stimulation Cycling Training on Spasticity in Individuals With Spinal Cord Injury: A Systematic Review With Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Chia-Ying Fang ◽  
Angela Shin-Yu Lien ◽  
Jia-Ling Tsai ◽  
Hsiao-Chu Yang ◽  
Hsiao-Lung Chan ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Lower Limbs ◽  
Walking Ability ◽  
Cord Injury ◽  
Meta Regression ◽  
Meta Regression Analysis ◽  
Ashworth Scale ◽  
Cycling Training

Background: To investigate the effect and dose-response of functional electrical stimulation cycling (FES-cycling) training on spasticity in the individuals with spinal cord injury (SCI).Method: Five electronic databases [PubMed, Scopus, Medline (Proquest), Embase, and Cochrane Central Register of Controlled Trials (CENTRAL)] were searched before September 2021. The human trials and studies of English language were only included. Two authors independently reviewed and extracted the searched studies. The primary outcome measure was spasticity assessed by Modified Ashworth Scale or Ashworth Scale for lower limbs. The secondary outcome measures were walking abilities, such as 6 Min Walk Test (6MWT), Timed Up and Go (TUG), and lower limbs muscle strength (LEMS). A subgroup analysis was performed to investigate the efficacious threshold number of training sessions. A meta-regression analysis was used to examine the linear relationship between the training sessions and the effect on spasticity.Results: A total of 764 studies were identified. After screening, 12 selected studies were used for the qualitative synthesis, in which eight of them were quantitatively analyzed. Eight studies included ninety-nine subjects in total with SCI (male: female = 83:16). The time since injury was from less than 4 weeks to 17 years. The age ranged from 20 to 67 years. American Spinal Injury Association (ASIA) impairment level of the number of participants was 59 for ASIA A, 11 for ASIA B, 18 for ASIA C, and 11 for ASIA D. There were 43 subjects with tetraplegia and 56 subjects with paraplegia. Spasticity decreased significantly (95% CI = − 1.538 to − 0.182, p = 0.013) in favor of FES-cycling training. The walking ability and LEMS also improved significantly in favor of FES-cycling training. The subgroup analysis showed that spasticity decreased significantly only in more than 20 training sessions (95% CI = − 1.749 to − 0.149, p = 0.020). The meta-regression analysis showed training sessions and spasticity were not significantly associated (coefficient = − 0.0025, SE = 0.0129, p = 0.849, R2 analog = 0.37).Conclusion: Functional electrical stimulation-cycling training can improve spasticity, walking ability, and the strength of the lower limbs in the individuals with SCI. The number of training sessions is not linearly related to the decrease of spasticity. Twenty sessions of FES-cycling training are required to obtain the efficacy to decrease spasticity.

scholarly journals Effects of Functional Electrical Stimulation Cycling of Different Duration on Viscoelastic and Electromyographic Properties of the Knee in Patients with Spinal Cord Injury

2020 ◽  
Vol 11 (1) ◽  
pp. 7
Author(s):  
Antonino Casabona ◽  
Maria Stella Valle ◽  
Claudio Dominante ◽  
Luca Laudani ◽  
Maria Pia Onesta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Muscle Activity ◽  
Response Times ◽  
Electromyographic Activity ◽  
Functional Changes ◽  
Pendulum Test ◽  
Cord Injury

The benefits of functional electrical stimulation during cycling (FES-cycling) have been ascertained following spinal cord injury. The instrumented pendulum test was applied to chronic paraplegic patients to investigate the effects of FES-cycling of different duration (20-min vs. 40-min) on biomechanical and electromyographic characterization of knee mobility. Seven adults with post-traumatic paraplegia attended two FES-cycling sessions, a 20-min and a 40-min one, in a random order. Knee angular excursion, stiffness and viscosity were measured using the pendulum test before and after each session. Surface electromyographic activity was recorded from the rectus femoris (RF) and biceps femoris (BF) muscles. FES-cycling led to reduced excursion (p < 0.001) and increased stiffness (p = 0.005) of the knee, which was more evident after the 20-min than 40-min session. Noteworthy, biomechanical changes were associated with an increase of muscle activity and changes in latency of muscle activity only for 20-min, with anticipated response times for RF (p < 0.001) and delayed responses for BF (p = 0.033). These results indicate that significant functional changes in knee mobility can be achieved by FES-cycling for 20 min, as evaluated by the pendulum test in patients with chronic paraplegia. The observed muscle behaviour suggests modulatory effects of exercise on spinal network aimed to partially restore automatic neuronal processes.

scholarly journals Investigation of different stimulation patterns with doublet pulses to reduce muscle fatigue

2019 ◽  
Vol 6 ◽  
pp. 205566831982580 ◽  
Author(s):  
Ruslinda Ruslee ◽  
Jennifer Miller ◽  
Henrik Gollee
Keyword(s):  
Electrical Stimulation ◽  
Muscle Fatigue ◽  
Functional Electrical Stimulation ◽  
Muscle Activation ◽  
Motor Units ◽  
Pulse Interval ◽  
Time Interval ◽  
Fatigue Index ◽  
Significant Difference ◽  
Cord Injury

Introduction: Functional electrical stimulation is a common technique used in the rehabilitation of individuals with a spinal cord injury to produce functional movement of paralysed muscles. However, it is often associated with rapid muscle fatigue which limits its applications. Methods: The objective of this study is to investigate the effects on the onset of fatigue of different multi-electrode patterns of stimulation via multiple pairs of electrodes using doublet pulses: Synchronous stimulation is compared to asynchronous stimulation patterns which are activated sequentially (AsynS) or randomly (AsynR), mimicking voluntary muscle activation by targeting different motor units. We investigated these three different approaches by applying stimulation to the gastrocnemius muscle repeatedly for 10 min (300 ms stimulation followed by 700 ms of no-stimulation) with 40 Hz effective frequency for all protocols and doublet pulses with an inter-pulse-interval of 6 ms. Eleven able-bodied volunteers (28 ± 3 years old) participated in this study. Ultrasound videos were recorded during stimulation to allow evaluation of changes in muscle morphology. The main fatigue indicators we focused on were the normalised fatigue index, fatigue time interval and pre-post twitch–tetanus ratio. Results: The results demonstrate that asynchronous stimulation with doublet pulses gives a higher normalised fatigue index (0.80 ± 0.08 and 0.87 ± 0.08) for AsynS and AsynR, respectively, than synchronous stimulation (0.62 ± 0.06). Furthermore, a longer fatigue time interval for AsynS (302.2 ± 230.9 s) and AsynR (384.4 ± 279.0 s) compared to synchronous stimulation (68.0 ± 30.5 s) indicates that fatigue occurs later during asynchronous stimulation; however, this was only found to be statistically significant for one of two methods used to calculate the group mean. Although no significant difference was found in pre-post twitch–tetanus ratio, there was a trend towards these effects. Conclusion: In this study, we proposed an asynchronous stimulation pattern for the application of functional electrical stimulation and investigated its suitability for reducing muscle fatigue compared to previous methods. The results show that asynchronous multi-electrode stimulation patterns with doublet pulses may improve fatigue resistance in functional electrical stimulation applications in some conditions.

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