Hybrid and adaptive control of functional electrical stimulation to correct hemiplegic gait for patients after stroke

Frontiers in Bioengineering and Biotechnology

Bioengineering and Biotechnology

Kangling Wang¹  Xiaohong Wang¹  Guozhi Huang¹  Ruxin He²  Kai Zheng²  Yiqun Dong²  Rong Song³ 

[1] Department of Rehabilitation Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China;School of Rehabilitation Medicine, Southern Medical University, Guangzhou, China;School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China;The Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China;School of Biomedical Engineering, Shenzhen Campus of Sun Yat-sen University, Shenzhen, China;The Key Laboratory of Sensing Technology and Biomedical Instrument of Guangdong Province, School of Biomedical Engineering, Sun Yat-sen University, Guangzhou, China;Shenzhen Research Institute of Sun Yat-sen University, Shenzhen, China;

关键词: functional electrical stimulation;    hemiplegic gait;    stroke;    iterative learning control;    hybrid;   

DOI  :  10.3389/fbioe.2023.1246014

 received in 2023-06-24, accepted in 2023-07-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

Introduction: Gait, as a fundamental human movement, necessitates the coordination of muscles across swing and stance phases. Functional electrical stimulation (FES) of the tibialis anterior (TA) has been widely applied to foot drop correction for patients with post-stroke during the swing phase. Although the gastrocnemius (GAS) during the stance phase is also affected, the Functional electrical stimulation of the gastrocnemius received less attention.Methods: To address this limitation, a timing- and intensity-adaptive Functional electrical stimulation control strategy was developed for both the TA and GAS. Each channel incorporates a speed-adaptive (SA) module to control stimulation timing and an iterative learning control (ILC) module to regulate the stimulation intensity. These modules rely on real-time kinematic or kinetic data during the swing or stance phase, respectively. The orthotic effects of the system were evaluated on eight patients with post-stroke foot drop. Gait kinematics and kinetics were assessed under three conditions: no stimulation (NS), Functional electrical stimulation to the ankle dorsiflexor tibialis anterior (SA-ILC DS) and FES to the tibialis anterior and the ankle plantarflexor gastrocnemius (SA-ILC DPS).Results: The ankle plantarflexion angle, the knee flexion angle, and the anterior ground reaction force (AGRF) in the SA-ILC DPS condition were significantly larger than those in the NS and SA-ILC DS conditions (p < 0.05). The maximum dorsiflexion angle during the swing phase in the SA-ILC DPS condition was similar to that in the SA-ILC DS condition, with both being significantly larger than the angle observed in the NS condition (p < 0.05). Furthermore, the angle error and force error relative to the set targets were minimized in the SA-ILC DPS condition.Discussion: The observed improvements can be ascribed to the appropriate stimulation timing and intensity provided by the SA-ILC DPS strategy. This study demonstrates that the hybrid and adaptive control strategy of functional electrical stimulation system offers a significant orthotic effect, and has considerable potential for future clinical application.

【 授权许可】

Unknown   
Copyright © 2023 Dong, Wang, He, Zheng, Wang, Huang and Song.