Journal article Open Access

A patient-controlled functional electrical stimulation system for arm weight relief

Klauer, Christian; Ferrante, Simona; Ambrosini, Emilia; Shiri, U; Dähne, F; Schmehl, I; Pedrocchi, Alessandra; Schauer, Thomas


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    <subfield code="a">&lt;p&gt;A patient-driven control strategy for Functional Electrical Stimulation (FES), which amplifies volitionally-initiated shoulder abductions, is proposed to improve stroke patients&amp;#39; rehabilitation. Based on the measured abduction angle, a FES-induced muscle recruitment is generated that yields a pre-specified percentage of this angle - yielding arm weight relief. To guarantee the correct recruitment also under fatigue and uncertain muscle activation we employ feedback control of the recruitment level determined by filtering the FES-evoked electromyogram. Filter parameters are user-optimized to obtain a linear relation between filter output and angle with a good signal-to-noise ratio. The auto-tuned recruitment controller (RC) was tested on five healthy subjects and compared to direct stimulation (DS) while muscle fatigue progressively occurred. Results showed a more linear relation between recruitment level and angle than between non-controlled stimulation intensity and angle (R&lt;sup&gt;2&lt;/sup&gt;=0.93 vs. R&lt;sup&gt;2&lt;/sup&gt;=0.79, angular range of 54&amp;deg;). After 6&amp;nbsp;min of stimulation, abduction decreased by 42% &amp;plusmn; 14 for DS and by 0% &amp;plusmn; 12 for RC, showing an effective compensation of fatigue. RC yielded significant smaller errors than DS in generating desired angles (0.23% &amp;plusmn; 5.9 vs. 14.6% &amp;plusmn; 9.7). When FES-induced arm weight support was provided, a mean reduction of the volitional effort (determined by Electromyography) of 78% was achieved compared to angular tracking without FES. First experiments with one acute stroke patient are also reported.&lt;/p&gt;</subfield>
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    <subfield code="u">Politecnico di Milano</subfield>
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    <subfield code="a">10.1016/j.medengphy.2016.06.006</subfield>
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