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Cycle-to-cycle control of swing phase of paraplegic gait induced by surface electrical stimulation

机译:表面电刺激诱发截瘫步态摆动阶段的逐周期控制

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摘要

Parameterised swing phase of gait in paraplegics was obtained using surface electrical stimulation of the hip flexors, hamstrings and quadriceps; the hip flexors were stimulated to obtain a desired hip angle range, the hamstrings to provide foot clearance in the forward swing, and the quadriceps to acquire knee extension at the end of the swing phase. We report on two main aspects; optimisation of the initial stimulation parameters, and parameter adaption (control). The initial stimulation patterns were experimentally optimised in two paraplegic subjects using a controlled stand device, resulting in an initial satisfactory swinging motion in both subjects. Intersubject differences appeared in the mechanical output (torque joint) per muscle group. During a prolonged open-loop controlled trial with the optimised but unregulated stimulation onsets and burst duration for the three muscle groups, the hip angle range per cycle initially increased above the desired value and subsequently decreased below it. The mechanical performance of the hamstrings and quadriceps remained relatively unaffected. A cycle-to-cycle controller was then designed, operating on the basis of the hip angle ranges obtained in previous swings. This controller successfully adapted the burst duration of the hip flexors to maintain the desired hip angle range.
机译:通过对髋屈肌,绳肌和股四头肌进行表面电刺激,获得截瘫患者步态的参数化摆动相位;刺激髋屈肌以获得所需的髋部角度范围,,绳肌在向前挥杆时提供足部间隙,而四头肌在挥杆阶段结束时获得膝盖伸展。我们报告两个主要方面;优化初始刺激参数,以及参数自适应(控制)。最初的刺激模式通过使用受控站立装置在两个截瘫患者中进行了实验优化,从而在两个患者中产生了令人满意的初始摆动运动。受试者之间的差异出现在每个肌肉组的机械输出(扭矩关节)中。在延长的开环对照试验中,对三个肌肉组进行了优化但不受控制的刺激发作和猝发持续时间,每个周期的髋关节角度范围最初增加到所需值之上,然后减小到其之下。绳肌和股四头肌的机械性能相对不受影响。然后设计了一个周期到周期的控制器,该控制器基于先前挥杆中获得的髋部角度范围进行操作。该控制器成功调整了髋屈肌的爆发持续时间,以维持所需的髋关节角度范围。

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