Investigation of Different Stimulation Patterns to Reduce Muscle Fatigue during Functional Electrical Stimulation

Functional electrical stimulation (FES) is a commonly used technique in rehabilitation and often associated with rapid muscle fatigue which becomes the limiting factor in its applications. The objective of this study is to investigate the effects on the onset of fatigue of conventional synchronous stimulation, as well as asynchronous stimulation that mimic voluntary muscle activation targeting different motor units which are activated sequentially or randomly via multiple pairs of stimulation electrodes. We investigate three different approaches with various electrode configurations, as well as different patterns of stimulation applied to the gastrocnemius muscle: Conventional Synchronous Stimulation (CSS), Asynchronous Sequential Stimulation (ASS) and Asynchronous Random Stimulation (ARS). Stimulation was applied repeatedly for 300 ms followed by 700 ms of no-stimulation with 40 Hz effective frequency for all protocols. Ten able-bodied volunteers (28±3 years old) participated in this study. As fatigue indicators, we focused on the analysis of Normalized Fatigue Index (NFI), Fatigue Time Interval (FTI) and pre-post Twitch-Tetanus Ratio (ΔTTR). The results demonstrated that ASS and ARS give higher NFI and longer FTI confirming less fatigue for asynchronous stimulation. In addition, ASS and ARS resulted in higher ΔTTR than conventional CSS. In this study, we proposed a randomly distributed stimulation method for the application of FES and investigated its suitability for reducing muscle fatigue compared to previously applied methods. The results validated that asynchronous stimulation reduces fatigue, and indicates that random stimulation may improve fatigue resistance in some conditions.

Electro-Thermal Imaging of Breast Phantom: An Experimental Study

To increase the temperature contrast in thermal images, the characteristics of the electrical conductivity and thermal imaging modalities can be combined. In this experimental study, it is objected to observe whether the temperature contrast created by the tumor tissue can be improved just due to the current application within medical safety limits. Various thermal breast phantoms are developed to simulate the female breast tissue. In vitro experiments are implemented using a thermal infrared camera in a controlled manner. Since experiments are implemented in vitro, there is no metabolic heat generation and blood perfusion. Only the effects and results of the electrical stimulation are investigated. Experimental study is implemented with two-dimensional models. Temperature contrasts due to the tumor tissues are obtained. Cancerous tissue is determined using the difference and ratio of healthy and tumor images. 1 cm diameter single tumor tissue causes almost 40 °mC temperature contrast on the thermal-breast phantom. Electrode artifacts are reduced by taking the difference and ratio of background (healthy) and tumor images. Ratio of healthy and tumor images show that temperature contrast is increased by the current application.

A Robotic Rehabilitation Arm Driven by Somatosensory Brain-Computer Interface

It was expected to benefit patient with hemiparesis after stroke by extensive arm rehabilitation, to partially regain forearm and hand function. This paper propose a robotic rehabilitation arm in assisting the hemiparetic patient to learn new ways of using and moving their weak arms. In this study, the robotic arm was driven by a somatosensory stimulated brain computer interface (BCI), which is a new modality BCI. The use of somatosensory stimulation is not only an input for BCI, but also a electrical stimulation for treatment of hemiparesis to strengthen the arm and improve its range of motion. A trial of this robotic rehabilitation arm was performed in a stroke patient with pure motor hemiparesis. The initial trial showed a promising result from the patient with great motivation and function improvement. It suggests that robotic rehabilitation arm driven by somatosensory BCI can enhance the rehabilitation performance and progress for hemiparetic patients after stroke.

A Virtual Electrode through Summation of Time Offset Pulses

Retinal prostheses have been successful in eliciting visual responses in implanted subjects. As these prostheses progress, one of their major limitations is the need for increased resolution. As an alternative to increasing the number of electrodes, virtual electrodes may be used to increase the effective resolution of current electrode arrays. This paper presents a virtual electrode technique based upon time-offsets between stimuli. Two adjacent electrodes are stimulated with identical pulses with too short of pulse widths to activate a neuron, but one has a time offset of one pulse width. A virtual electrode of twice the pulse width was then shown to appear in the center, with a total width capable of activating a neuron. This can be used in retinal implants by stimulating electrodes with pulse widths short enough to not elicit responses in neurons, but with their combined pulse width adequate to activate a neuron in between them.

Wireless Neural Stimulator with Adjustable Electrical Quantity

The neural stimulation has been gaining much interest in neuromodulation research and clinical trials. For efficiency, there is a need for variable electrical stimulation such as current and voltage stimuli as well as wireless framework. In this regard, we develop the wireless neural stimulator capable of voltage and current stimuli. The system consists of ZigBee which is a wireless communication module and stimulus generator. The stimulus generator with 8-bits resolution enable both mono-polar and bi-polar waveform in voltage (-3.3~3.3V) and current(-330~330µA) stimulus mode which is controllable. The experimental results suggest that the proposed neural stimulator can play a role as an effective approach for neuromodulation.

The Effect of Electrical Stimulation Intensity on VEGF Expression and Biomechanical Properties during Wound

We evaluated the effect of sensory (direct current (DC), 600μA) and motor (monophasic current, pulse duration 300μs, 100 Hz, 2.5-3mA) intensities of cathodal electrical stimulation (ES) current to release VEGF and biomechanical properties of wound. 54 male Sprague-dawley rats were randomly assigned into one control and two experimental groups. A full thickness skin incision was made on animals- dorsal region. The experimental groups received ES for 1h/day and every other day. VEGF expression was measured in skin on the 7th day after surgical incision and tensile strength was measured on 21st day. On the 7th day, the values of skin VEGF in the sensory group were significantly greater than those of the other groups (p < 0.05). Sensory and Motor intensity stimulation, can not improve the biomechanical properties of the repaired wounds. It seems the mechanical environment induced by sensory and motor intensity of electrical stimulation, could not simulate the role of normal daily stress and strain to maturation of collagen fibers and their cross links. Further work is needed to determine the relationship between VEGF expression after ES and its effect on tensile strength of healed wound.

Effect of FES Cycling Training on Spasticity in Spinal Cord Injured Subjects

Training with Functional Electrical Stimulation (FES) has both physiological and psychological benefits for spinal cord injured subjects. Commonly used methods for quantification of spasticity have shown controversial reliability. In this study we propose a method for quick determination of spasticity in spinal cord injured subjects on a cycling and measurement system. 23 patients did training sessions on an instrumented mobile FES cycle three times a week over two months as part of their clinical rehabilitation program. Spasticity (MAS) and the legs resistance to the pedaling motion were assessed before and after the FES training and measurements were done on the subjects ability to pedal with our without motor assistance. Measurements with test persons with incomplete spastic paraplegia have shown that spasticity is decreased after a 30 min cycling training with functional electrical stimulation (FES).

A Novel EMG Feedback Control Method in Functional Electrical Stimulation Cycling System for Stroke Patients

With getting older in the whole population, the prevalence of stroke and its residual disability is getting higher and higher recently in Taiwan. The functional electrical stimulation cycling system (FESCS) is useful for hemiplegic patients. Because that the muscle of stroke patients is under hybrid activation. The raw electromyography (EMG) represents the residual muscle force of stroke subject whereas the peak-to-peak of stimulus EMG indicates the force enhancement benefiting from ES. It seems that EMG signals could be used for a parameter of feedback control mechanism. So, we design the feedback control protocol of FESCS, it includes physiological signal recorder, FPGA biomedical module, DAC and electrical stimulation circuit. Using the intensity of real-time EMG signal obtained from patients, as a feedback control method for the output voltage of FES-cycling system.