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EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients
Hock Guan TAN, Cheng Yap SHEE, Keng He KONG, Cuntai GUAN, Wei Tech ANG
EEG controlled neuromuscular electrical stimulation of the upper limb for stroke patients
This paper describes the Brain Computer Interface (BCI) system and the experiments to allow post-acute (<3 months) stroke patients to use electroencephalogram (EEG) to trigger neuromuscular electrical stimulation (NMES)-assisted extension of the wrist/fingers, which are essential pre-requisites for useful hand function. EEG was recorded while subjects performed motor imagery of their paretic limb, and then analyzed to determine the optimal frequency range within the mu-rhythm, with the greatest attenuation. Aided by visual feedback, subjects then trained to regulate their mu-rhythm EEG to operate the BCI to trigger NMES of the wrist/finger. 6 post-acute stroke patients successfully completed the training, with 4 able to learn to control and use the BCI to initiate NMES. This result is consistent with the reported BCI literacy rate of healthy subjects. Thereafter, without the loss of generality, the controller of the NMES is developed and is based on a model of the upper limb muscle (biceps/triceps) groups to determine the intensity of NMES required to flex or extend the forearm by a specific angle. The muscle model is based on a phenomenological approach, with parameters that are easily measured and conveniently implemented.
brain computer interface / neuromuscular electrical stimulation / stroke / musculoskeletal modeling
[1] |
Wade D T, Langton-Hewer R, Wood V A, Skilbeck C E, Ismail H M. The hemiplegic arm after stroke: measurement and recovery. Journal of Neurology, Neurosurgery, and Psychiatry, 1983, 46(6): 521–524
CrossRef
Pubmed
Google scholar
|
[2] |
Sunderland A, Tinson D J, Bradley L, Hewer R L. Arm function after stroke. An evaluation of grip strength as a measure of recovery and a prognostic indicator. Journal of Neurology, Neurosurgery, and Psychiatry, 1989, 52(11): 1267–1272
CrossRef
Pubmed
Google scholar
|
[3] |
Pfurtscheller G, Neuper C, Guger C, Harkam W, Ramoser H, Schlögl A, Obermaier B, Pregenzer M. Current trends in Graz Brain-Computer Interface (BCI) research. IEEE Transactions on Rehabilitation Engineering, 2000, 8(2): 216–219
CrossRef
Pubmed
Google scholar
|
[4] |
Buch E, Weber C, Cohen L G, Braun C, Dimyan M A, Ard T, Mellinger J, Caria A, Soekadar S, Fourkas A, Birbaumer N. Think to move: a neuromagnetic brain-computer interface (BCI) system for chronic stroke. Stroke, 2008, 39(3): 910–917
CrossRef
Pubmed
Google scholar
|
[5] |
Daly J J, Cheng R, Hrovat K, Litinas K, McCabe J P, Rogers J M, Dohring M E.Feasibility and accuracy of EEG-BCI system control during imposed upper limb motor tasks and relax conditions by stroke survivors. Society for Neuroscience, Abstract 712.9
|
[6] |
Sheffler L R, Chae J. Neuromuscular electrical stimulation in neurorehabilitation. Muscle & Nerve, 2007, 35(5): 562–590
CrossRef
Pubmed
Google scholar
|
[7] |
Jasper H H. The ten-twenty electrode system of the international federation. Electroencephalography and Clinical Neurophysiology, 1958, 10: 371–375
|
[8] |
Pfurtscheller G, Neuper C, Andrew C, Edlinger G. Foot and hand area mu rhythms. International Journal of Psychophysiology, 1997, 26(1–3): 121–135
CrossRef
Pubmed
Google scholar
|
[9] |
Veluvolu K C, Tan U X, Ang W T, Latt W T, Shee C Y. Bandlimited multiple fourier linear combiner for real-time tremor compensation. Proceedings of the 29th IEEE Engineering in Medicine and Biology Conference, Lyon, France, 2007, 2847–2850
|
[10] |
Tan H G, Zhang H H, Wang C C, Shee C Y, Ang W T, Guan C T. Arm flexion and extension exercises using a brain-computer interface and functional electrical stimulation. Proceedings of the 6th IASTED International Conference on Biomedical Engineering, Innsbruck, Austria, 2008
|
[11] |
Tan H G, Zhang H H, Wang C C, Shee C Y, Ang W T, Guan C T. A step towards discretized motion control of the upper limb using brain-computer interface and electrical stimulation. Proceedings of the 13th Annual International FES Society Conference, Freiburg, Germany, 2008
|
[12] |
Pfurtscheller G, Neuper C. Motor imagery activates primary sensorimotor area in humans. Neuroscience Letters, 1997, 239(2–3): 65–68
CrossRef
Pubmed
Google scholar
|
[13] |
Keller T, Popovic M R, Pappas I P I, Müller P Y. Transcutaneous functional electrical stimulator “Compex Motion”. Artificial Organs, 2002, 26(3): 219–223
CrossRef
Pubmed
Google scholar
|
[14] |
Thrasher T A, Zivanovic V, McIlroy W, Popovic M R. Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy. Neurorehabilitation and Neural Repair, 2008, 22(6): 706–714
CrossRef
Pubmed
Google scholar
|
[15] |
Shin H K, Cho S H, Jeon H S, Lee Y H, Song J C, Jang S H, Lee C H, Kwon Y H. Cortical effect and functional recovery by the electromyography-triggered neuromuscular stimulation in chronic stroke patients. Neuroscience Letters, 2008, 442(3): 174–179
CrossRef
Pubmed
Google scholar
|
[16] |
Chae J, Sheffler L, Knutson J. Neuromuscular electrical stimulation for motor restoration in hemiplegia. Topics in Stroke Rehabilitation, 2008, 15(5): 412–426
CrossRef
Pubmed
Google scholar
|
[17] |
Nijholt A, Tan D, Pfurtscheller G, Brunner C, Mill J, Allison B, Graimann B, Popescu F, Blankertz B, M K R. Trends & controversies: brain-computer interfacing for intelligent systems. IEEE Intelligent Systems, 2008, 23(3): 72–79
CrossRef
Google scholar
|
[18] |
Sharma N, Pomeroy V M, Baron J C. Motor imagery: a backdoor to the motor system after stroke? Stroke, 2006, 37(7): 1941–1952
CrossRef
Pubmed
Google scholar
|
[19] |
Müller K, Bütefisch C M, Seitz R J, Hömberg V. Mental practice improves hand function after hemiparetic stroke. Restorative Neurology and Neuroscience, 2007, 25(5–6): 501–511
Pubmed
|
[20] |
Hill A V. The heat of shortening and the dynamic constants of muscle. Proceedings of the Royal Society of London. Series B. Biological Sciences, 1938, 126(843): 136–195
CrossRef
Google scholar
|
[21] |
Huxley A F. Muscle structure and theories of contraction. Progress in Biophysics and Biophysical Chemistry, 1957, 7: 255–318
Pubmed
|
[22] |
Winters J M, Stark L. Muscle models: what is gained and what is lost by varying model complexity. Biological Cybernetics, 1987, 55(6): 403–420
CrossRef
Pubmed
Google scholar
|
[23] |
Ferrarin M, Palazzo F, Riener R, Quintern J. Model-based control of FES-induced single joint movements. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 2001, 9(3): 245–257
CrossRef
Pubmed
Google scholar
|
[24] |
Zatsiorsky V M, Seluyanov V. The mass and inertia characteristics of the main segments of human body. In Biomechanics VIII-B, Matsui H & Kobayashi K, (Eds.). Champaign, IL: Human Kinetics, 1983, 1152–1159
|
[25] |
Hatze H. Myocybernetic control models of skeletal muscle: Characteristics and applications [dissertation]. University of South Africa, Pretoria, 1981
|
[26] |
Zajac F E. Muscle and tendon: properties, models, scaling, and application to biomechanics and motor control. Critical Reviews in Biomedical Engineering, 1989, 17(4): 359–411
Pubmed
|
[27] |
Riener R, Ferrarin M, Pavan E E, Frigo C A. Patient-driven control of FES-supported standing up and sitting down: experimental results. IEEE Transactions on Rehabilitation Engineering, 2000, 8(4): 523–529
CrossRef
Pubmed
Google scholar
|
[28] |
Ferrarin M, Iacuone P, Mingrino A, Frigo C, Pedotti A. A dynamic model of electrically activated knee muscles in healthy and paraplegics. In Neuroprosthetics from Basic Research to Clinical Applications. Pedotti A, Ferrarin M, Riener R, Quintern J (Eds.), Berlin, Germany: Springer-Verlag, 1996, 81–90
|
[29] |
Garner B A, Pandy M G. Estimation of musculotendon properties in the human upper limb. Annals of Biomedical Engineering, 2003, 31(2): 207–220
CrossRef
Pubmed
Google scholar
|
[30] |
Stein R B, Zehr E P, Lebiedowska M K, Popović D B, Scheiner A, Chizeck H J. Estimating mechanical parameters of leg segments in individuals with and without physical disabilities. IEEE Transactions on Rehabilitation Engineering, 1996, 4(3): 201–211
CrossRef
Pubmed
Google scholar
|
[31] |
Riener R, Edrich T. Identification of passive elastic joint moments in the lower extremities. Journal of Biomechanics, 1999, 32(5): 539–544
CrossRef
Pubmed
Google scholar
|
[32] |
Edrich T, Riener R, Quintern J. Analysis of passive elastic joint moments in paraplegics. IEEE Transactions on Bio-Medical Engineering, 2000, 47(8): 1058–1065
CrossRef
Pubmed
Google scholar
|
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|
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