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Upper limb stroke rehabilitation using functional electrical stimulation mediated by iterative learning control

Upper limb stroke rehabilitation using functional electrical stimulation mediated by iterative learning control
Upper limb stroke rehabilitation using functional electrical stimulation mediated by iterative learning control
Introduction

Following stroke, over 50% of patients have an impairment of one arm, affecting their ability to perform everyday reach and grasp tasks. Functional electrical stimulation (FES) has been shown to restore movement, with effectiveness increased when combined with voluntary intention. Recent clinical trials that incorporated an advanced control framework to adjust FES applied to two muscle groups in a virtual reality scenario showed reductions in impairment.

Aim

The current study examines the feasibility of providing precisely controlled FES to three muscle groups in the upper limb, assisting performance of real-world, functional reach and grasp tasks.

Method

Data were recorded from 5 hemiparetic, chronic stroke participants who undertook 18, 1 hour training sessions comprising functional tasks, such as button pressing and closing a drawer. Assistive FES, controlled by advanced iterative learning (ILC) algorithms, was applied to the anterior deltoid, triceps and wrist extensors of the impaired limb. ILC uses data from previous task attempts to update the FES applied to each muscle group on the next trial, increasing performance and encouraging voluntary effort. For assessment, participants completed unassisted and assisted functional tasks, and the error between participants’ movement and idealised trajectories were recorded. The Fugl-Meyer and Action Research Arm Test were also completed pre and post-training.

Results

Preliminary results show that performance error reduced over a range of functional tasks. Overall improvements ranged from 22-32%, though individual joint improvement reached 63%. Data collection is on-going.

Discussion

The feasibility of applying precisely controlled FES to three muscle groups in the upper limb was demonstrated. The application of this technology is expected to significantly reduce upper limb impairment following chronic stroke. Work is underway to include an electrode array to precisely stimulate individual finger and hand extensors, and to adapt the system for home use.
Meadmore, Katie
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Exell, Timothy
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Hallewell, E.
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Freeman, Christopher
ccdd1272-cdc7-43fb-a1bb-b1ef0bdf5815
Hughes, Ann-Marie
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Kutlu, Mustafa
4e99ab81-ef5e-4c66-b042-8aeee432f468
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Rogers, E.
611b1de0-c505-472e-a03f-c5294c63bb72
Meadmore, Katie
4b63707b-4c44-486c-958e-e84645e7ed33
Exell, Timothy
eab3e272-643a-4a55-82a6-2949d0dc0e01
Hallewell, E.
6c2fdbaf-e8f8-4693-9150-889d9b021b92
Freeman, Christopher
ccdd1272-cdc7-43fb-a1bb-b1ef0bdf5815
Hughes, Ann-Marie
11239f51-de47-4445-9a0d-5b82ddc11dea
Kutlu, Mustafa
4e99ab81-ef5e-4c66-b042-8aeee432f468
Burridge, J.H.
0110e9ea-0884-4982-a003-cb6307f38f64
Rogers, E.
611b1de0-c505-472e-a03f-c5294c63bb72

Meadmore, Katie, Exell, Timothy, Hallewell, E., Freeman, Christopher, Hughes, Ann-Marie, Kutlu, Mustafa, Burridge, J.H. and Rogers, E. (2013) Upper limb stroke rehabilitation using functional electrical stimulation mediated by iterative learning control. 4th Annual Conference of the International Functional Electrical Stimulation Society (UK and Ireland Chapter).

Record type: Conference or Workshop Item (Paper)

Abstract

Introduction

Following stroke, over 50% of patients have an impairment of one arm, affecting their ability to perform everyday reach and grasp tasks. Functional electrical stimulation (FES) has been shown to restore movement, with effectiveness increased when combined with voluntary intention. Recent clinical trials that incorporated an advanced control framework to adjust FES applied to two muscle groups in a virtual reality scenario showed reductions in impairment.

Aim

The current study examines the feasibility of providing precisely controlled FES to three muscle groups in the upper limb, assisting performance of real-world, functional reach and grasp tasks.

Method

Data were recorded from 5 hemiparetic, chronic stroke participants who undertook 18, 1 hour training sessions comprising functional tasks, such as button pressing and closing a drawer. Assistive FES, controlled by advanced iterative learning (ILC) algorithms, was applied to the anterior deltoid, triceps and wrist extensors of the impaired limb. ILC uses data from previous task attempts to update the FES applied to each muscle group on the next trial, increasing performance and encouraging voluntary effort. For assessment, participants completed unassisted and assisted functional tasks, and the error between participants’ movement and idealised trajectories were recorded. The Fugl-Meyer and Action Research Arm Test were also completed pre and post-training.

Results

Preliminary results show that performance error reduced over a range of functional tasks. Overall improvements ranged from 22-32%, though individual joint improvement reached 63%. Data collection is on-going.

Discussion

The feasibility of applying precisely controlled FES to three muscle groups in the upper limb was demonstrated. The application of this technology is expected to significantly reduce upper limb impairment following chronic stroke. Work is underway to include an electrode array to precisely stimulate individual finger and hand extensors, and to adapt the system for home use.

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More information

Published date: 13 April 2013
Venue - Dates: 4th Annual Conference of the International Functional Electrical Stimulation Society (UK and Ireland Chapter), 2013-04-12
Organisations: Physical & Rehabilitation Health, EEE, Southampton Wireless Group

Identifiers

Local EPrints ID: 350933
URI: http://eprints.soton.ac.uk/id/eprint/350933
PURE UUID: 442a363c-5ee9-419a-a5cb-ec8794fb7096
ORCID for Katie Meadmore: ORCID iD orcid.org/0000-0001-5378-8370
ORCID for Ann-Marie Hughes: ORCID iD orcid.org/0000-0002-3958-8206
ORCID for J.H. Burridge: ORCID iD orcid.org/0000-0003-3497-6725
ORCID for E. Rogers: ORCID iD orcid.org/0000-0003-0179-9398

Catalogue record

Date deposited: 10 Apr 2013 15:52
Last modified: 11 Dec 2021 04:09

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Contributors

Author: Katie Meadmore ORCID iD
Author: Timothy Exell
Author: E. Hallewell
Author: Christopher Freeman
Author: Mustafa Kutlu
Author: J.H. Burridge ORCID iD
Author: E. Rogers ORCID iD

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