A portable assist-as-need upper-extremity hybrid exoskeleton for FES-induced muscle fatigue reduction in stroke rehabilitation

BMC Biomedical Engineering - Tập 1 - Trang 1-17 - 2019
Ashley Stewart1, Christopher Pretty1, Xiaoqi Chen1
1Mechanical Engineering, University of Canterbury, Christchurch, New Zealand

Tóm tắt

Hybrid exoskeletons are a recent development which combine Functional Electrical Stimulation with actuators to improve both the mental and physical rehabilitation of stroke patients. Hybrid exoskeletons have been shown capable of reducing the weight of the actuator and improving movement precision compared to Functional Electrical Stimulation alone. However little attention has been given towards the ability of hybrid exoskeletons to reduce and manage Functional Electrical Stimulation induced fatigue or towards adapting to user ability. This work details the construction and testing of a novel assist-as-need upper-extremity hybrid exoskeleton which uses model-based Functional Electrical Stimulation control to delay Functional Electrical Stimulation induced muscle fatigue. The hybrid control is compared with Functional Electrical Stimulation only control on a healthy subject. The hybrid system produced 24° less average angle error and 13.2° less Root Mean Square Error, than Functional Electrical Stimulation on its own and showed a reduction in Functional Electrical Stimulation induced fatigue. As far as the authors are aware, this is the study which provides evidence of the advantages of hybrid exoskeletons compared to use of Functional Electrical Stimulation on its own with regards to the delay of Functional Electrical Stimulation induced muscle fatigue.

Tài liệu tham khảo

World Heart Federation. Stroke 2015 July 2016]; Available from: http://www.world-heart-federation.org/cardiovascular-health/stroke/. Accessed 31 July 2016. Senelick RC. Technological advances in stroke rehabilitation—high tech marries high touch. US Neurology. 2010;6(2):102–4. Doucet BM, Lam A, Griffin L. Neuromuscular electrical stimulation for skeletal muscle function. Yale J Biol Med. 2012;85(2):201. Schill O, et al. OrthoJacket: an active FES-hybrid Orthosis for the paralysed upper extremity. Biomedizinische Technik/Biomedical Engineering. 2011;56(1):35–44. Pylatiuk C, et al. Design of a Flexible Fluidic Actuation System for a Hybrid Elbow Orthosis. In: ICORR 2009. IEEE International Conference on Rehabilitation Robotics: IEEE; 2009. https://ieeexplore.ieee.org/document/5209540. Stewart AM, et al. Review of Upper Limb Hybrid Exoskeletons. IFAC-PapersOnLine. 2017;50(1):15169–78. Lu EC, et al. The development of an upper limb stroke rehabilitation robot: identification of clinical practices and design requirements through a survey of therapists. Disabil Rehabil Assist Technol. 2011;6(5):420–31. Jarrassé N, et al. Robotic Exoskeletons: A Perspective for the Rehabilitation of Arm Coordination in Stroke Patients. Front Human Neurosci. 2014;8:947. Maciejasz P, et al. A survey on robotic devices for upper limb rehabilitation. J Neuroeng Rehabil. 2014;11(3):10.1186. Patton J, Small SL, Zev Rymer W. Functional restoration for the stroke survivor: informing the efforts of engineers. Top Stroke Rehabil. 2008;15(6):521–41. Loureiro RC, et al. Advances in upper limb stroke rehabilitation: a technology push. Med Biol Eng Computing. 2011;49(10):1103–18. Stewart AM, Pretty CG, Chen X. An investigation into the effect of electrode type and stimulation parameters on FES-induced dynamic movement in the presence of muscle fatigue for a voltage-controlled stimulator. IFAC J Syst Control. 2019;8:100043. Fougner A, et al. Control of upper limb prostheses: terminology and proportional myoelectric control—a review. IEEE Trans Neural Syst Rehabil Eng. 2012;20(5):663–77. Rong W, et al. Combined Electromyography (EMG)-driven Robotic System with Functional Electrical Stimulation (FES) for Rehabilitation. In: 2012 38th Annual Northeast Bioengineering Conference (NEBEC): IEEE; 2012. https://ieeexplore.ieee.org/document/6207090. Rong W, et al. Effects of electromyography-driven robot-aided hand training with neuromuscular electrical stimulation on hand control performance after chronic stroke. Disabil Rehabil Assist Technol. 2013;10(2):149–59. Tu X, et al. Design of a Wearable Rehabilitation Robot Integrated with Functional Electrical Stimulation. In: 2012 4th IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics (BioRob): IEEE; 2012. https://ieeexplore.ieee.org/abstract/document/6290720. Stewart AM, Pretty CG, Chen X. Design and Testing of a Novel, Low-cost, Low-voltage, Functional Electrical Stimulator. In: 2016 12th IEEE/ASME International Conference on Mechatronic and Embedded Systems and Applications (MESA): IEEE; 2016. https://ieeexplore.ieee.org/document/7587155. Stewart AM, Pretty CG, Chen X. An evaluation of the effect of stimulation parameters and electrode type on bicep muscle response for a voltage-controlled functional electrical stimulator. IFAC-PapersOnLine. 2017;50(1):15109–14. Perry JC, Rosen J, Burns S. Upper-limb powered exoskeleton design. IEEE/ASME Trans Mechatronics. 2007;12(4):408–17. Sparkfun. Actobotics. 2018 August 2018]; Available from: https://www.sparkfun.com/pages/Actobotics. Accessed 31 Aug 2018.