title: Patient-driven loop control for ambulation function restoration in a non-invasive functional electrical stimulation system.
abstract: OBJECTIVE
  In this study, a patient-driven loop control in a non-invasive functional electrical stimulation (FES) system was designed to restore ambulation function of patients with stroke with their residual capabilities.
  
  
  METHODS
  With this patient-driven loop control, patients use the electromyographic (EMG) signals from their voluntary controlled muscles in affected extremity to adjust stimulus parameters of the system. A special designed FES system generated electrical stimuli to excite the paralysed muscles through surface electrodes on the basis of the control command from the residual myoelectric signals. The EMG signals were also served as the trigger and the adjustment of stimulus parameters and thereby adding versatility of the FES system. One patient with hemiplegia was recruited to conduct clinical evaluation and treated by using the new closed-loop FES system.
  
  
  RESULTS
  The experimental results showed that hemiplegic could successfully control the system to restore their lost ambulation functions with the strategy of patient-driven loop control. It is revealed that the mean velocity, cadence, stride length, active ankle motion range and functional ambulation category have improved significantly from 0.22 + or - 0.17 m/s, 37.3 + or - 15.5 steps/min, 0.32 + or - 0.11 m, 10 degrees , level 2 to 0.46 + or - 0.23 m/s, 58.2 + or - 19.1 steps/min, 0.73 + or - 0.22 m, 35 degrees , level 4 respectively for the patient. A paired t-test indicated that differences in the EMG of the tibialis anterior and the gastrocnemius muscles between patient's disabled (affected-side) foot and normal (unaffected-side) foot are not significant (p > 0.05) after 12 weeks of training.
  
  
  CONCLUSIONS
  According to the experiment results, this patient-driven loop control can be beneficial for patient with hemiplegia to restore their ambulation functions such as dorsi-flexion and plantar-flexion. The control strategy of this study has the potential to be employed not only in the FES system but also in other assistive devices.
authors.affiliation: Department of Electrical Engineering, Chang Gung University, Tao-Yuan, Taiwan. allen@tea.ntue.edu.tw
authors.forename: W L
authors.initials: WL
authors.lastname: Chen
authors.forename: S C
authors.initials: SC
authors.lastname: Chen
authors.forename: C C
authors.initials: CC
authors.lastname: Chen
authors.forename: C H
authors.initials: CH
authors.lastname: Chou
authors.forename: Y Y
authors.initials: YY
authors.lastname: Shih
authors.forename: Y L
authors.initials: YL
authors.lastname: Chen
authors.forename: T S
authors.initials: TS
authors.lastname: Kuo
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000295:instrumentation* / Q000379:methods; D004576:Electromyography; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006429:Hemiplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D020521:Stroke / Q000150:complications