Alteration of Volumetric Bone Mineral Density Parameters in Men with Spinal Cord Injury.

Spinal cord injury (SCI) induces severe losses of trabecular and cortical volumetric bone mineral density (vBMD), which cannot be discriminated with conventional dual-energy X-ray absorptiometry (DXA) analysis. The objectives were to: (i) determine the effects of SCI on areal BMD (aBMD) and vBMD determined by advanced 3D-DXA-based methods at various femoral regions and (ii) model the profiles of 3D-DXA-derived parameters with the time since injury. Eighty adult males with SCI and 25 age-matched able-bodied (AB) controls were enrolled in this study.

Activating effective functional hand movements in individuals with complete tetraplegia through neural stimulation.

Individuals with complete cervical spinal cord injury suffer from a permanent paralysis of upper limbs which prevents them from achieving most of the activities of daily living. We developed a neuroprosthetic solution to restore hand motor function. Electrical stimulation of the radial and median nerves by means of two epineural electrodes enabled functional movements of paralyzed hands.

Influence of the H-reflex on the selectivity of recruitment using multi-contact epineural stimulation of the median nerve in a participant with complete tetraplegia.

Multi-contact epineural electrical stimulation is a technique that can be used to restore grip movements in people with complete tetraplegia. However, neural stimulation can induce undesired H-reflex. This reflex is known to induce a global lower recruitment threshold together with a steepest recruitment curve leading to a degraded selective response.

OIDA: An optimal interval detection algorithm for automatized determination of stimulation patterns for FES-Cycling in individuals with SCI.

Background: FES-Cycling is an exciting recreational activity, which allows certain individuals after spinal cord injury or stroke to exercise their paralyzed muscles. The key for a successful application is to activate the right muscles at the right time.

Methods: While a stimulation pattern is usually determined empirically, we propose an approach using the torque feedback provided by a commercially available crank power-meter installed on a standard trike modified for FES-Cycling.

Frequency-Domain sEMG Classification Using a Single Sensor.

Working towards the development of robust motion recognition systems for assistive technology control, the widespread approach has been to use a plethora of, often times, multi-modal sensors. In this paper, we develop single-sensor motion recognition systems. Utilising the peripheral nature of surface electromyography (sEMG) data acquisition, we optimise the information extracted from sEMG sensors.

A Residual Movement Classification Based User Interface for Control of Assistive Devices by Persons With Complete Tetraplegia.

Objective: Complete tetraplegia can deprive a person of hand function. Assistive technologies may improve autonomy but needs for ergonomic interfaces for the user to pilot these devices still persist. Despite the paralysis of their arms, people with tetraplegia may retain residual shoulder movements.

Restoring Hand Functions in People with Tetraplegia through Multi-Contact, Fascicular, and Auto-Pilot Stimulation: A Proof-of-Concept Demonstration.

Two multi-contact epineural electrodes were placed around radial and median nerves of two subjects with high tetraplegia C4, American Spinal Injury Association Impairment Scale (AIS) A, group 0 of the International Classification for Surgery of the Hand in Tetraplegia. The purpose was to study the safety and capability of these electrodes to generate synergistic motor activation and functional movements and to test control interfaces that allow subjects to trigger pre-programmed stimulation sequences. The device consists of a pair of neural cuff electrodes and percutaneous cables with two extracorporeal connection cables inserted during a surgical procedure and maintained for 28 days.

Weight-bearing shoulder and rotator cuff tear.

Two percent of the general population are wheelchair-dependent. The shoulder takes on the weight-bearing locomotor function, and tends with age to develop degenerative pathologies, notably in the rotator cuff. The association between weight-bearing shoulder and rotator cuff tear raises several questions: what are the mechanisms by which wheelchair propulsion and transfer overload the shoulder, and what specificities do the lesions display? They occur in younger patients than in the rest of the population, after about 15 years' fairly constant wheelchair use.

Benefits of 1-Yr Home Training With Functional Electrical Stimulation Cycling in Paraplegia During COVID-19 Crisis.

The purpose of this observational study was to report the experience of a 1-yr home training with functional electrical stimulation cycling of a person with T4 American Impairment Scale A paraplegia for 9 yrs, homebound due to the COVID-19 health crisis. The 40-yr-old participant had a three-phase training: V1, isometric stimulation; V2, functional electrical stimulation cycling for 3 sessions/wk; and V3, functional electrical stimulation cycling for 2-4 sessions/wk. Data on general and physical tolerance, health impact, and performance were collected.

Sacral Anterior Root Stimulation and Visceral Function Outcomes in Spinal Cord Injury-A Systematic Review of the Literature Over Four Decades.

Objective: Sacral anterior root stimulation (SARS) was developed 40 years ago to restore urinary and bowel functions to individuals with spinal cord injury. Mostly used to restore lower urinary tract function, SARS implantation is coupled with sacral deafferentation to counteract the problems of chronic detrusor sphincter dyssynergia and detrusor overactivity. In this article, we systematically review 40 years of SARS implantation and assess the medical added value of this approach in accordance with the PRISMA guidelines.

A Novel Framework for Quantifying Accuracy and Precision of Event Detection Algorithms in FES-Cycling.

Functional electrical stimulation (FES) is a technique used in rehabilitation, allowing the recreation or facilitation of a movement or function, by electrically inducing the activation of targeted muscles. FES during cycling often uses activation patterns which are based on the crank angle of the pedals. Dynamic changes in their underlying predefined geometrical models (e.

A Sensor-Based Multichannel FES System to Control Knee Joint and Reduce Stance Phase Asymmetry in Post-Stroke Gait.

Most of the studies using functional electrical stimulation (FES) in gait rehabilitation have been focused on correcting the drop foot syndrome. Using FES to control the knee joint in individuals with central nervous system (CNS) disorders could also play a key role in gait recovery: spasticity decrease, higher range of motion, positive effect on balance, limiting hyperextension and flexion in stance phase, reducing joint overload, etc. In stance phase, an accurate timing and a fine tuning of stimulation parameters are however required to provide a proper control of the knee stimulation while ensuring a safe and efficient support.

Standardizing fatigue-resistance testing during electrical stimulation of paralysed human quadriceps muscles, a practical approach.

Background: Rapid onset of muscular fatigue is still one of the main issues of functional electrical stimulation (FES). A promising technique, known as distributed stimulation, aims to activate sub-units of a muscle at a lower stimulation frequency to increase fatigue-resistance. Besides a general agreement on the beneficial effects, the great heterogeneity of evaluation techniques, raises the demand for a standardized method to better reflect the requirements of a practical application.

Perspectives on usability and accessibility of an autonomous humanoid robot living with elderly people.

Purpose: The aim of this study was to assess how cohabitation with a social robot for seven days night and day is perceived by elderly potential users and to suggest technological improvements for future home integration.

Methods: Fifteen participants were invited to interact with Pepper, 24 h a day and 7 days a week. Perceived utility assessment was achieved using a dedicated questionnaire.

Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia.

Background: We hypothesized that a selective neural electrical stimulation of radial and median nerves enables the activation of functional movements in the paralyzed hand of individuals with tetraplegia. Compared to previous approaches for which up to 12 muscles were targeted through individual muscular stimulations, we focused on minimizing the number of implanted electrodes however providing almost all the needed and useful hand movements for subjects with complete tetraplegia.

Methods: We performed acute experiments during scheduled surgeries of the upper limb with eligible subjects.

Responsiveness of the Motor Capacities Scale to upper limb reconstructive surgery in persons with tetraplegia due to cervical spinal cord injury.

Study Design: Psychometric Study.

Objectives: To assess responsiveness of the Motor Capacities Scale (MCS) in people with tetraplegia who have undergone upper limb reconstructive surgery.

Settings: Rehabilitation clinics in France.

Wireless Electrical Stimulators and Sensors Network for Closed Loop Control in Rehabilitation.

This paper presents a wireless distributed Functional Electrical Stimulation (FES) architecture. It is based on a set of, potentially heterogeneous, distributed stimulation and measurement units managed by a wearable controller. Through a proof-of-concept application, the characterization of the wireless network performances was assessed to check the adequacy of this solution with open-loop and closed-loop control requirements.

FES-Induced Cycling in Complete SCI: A Simpler Control Method Based on Inertial Sensors.

This article introduces a novel approach for a functional electrical stimulation (FES) controller intended for FES-induced cycling based on inertial measurement units (IMUs). This study aims at simplifying the design of electrical stimulation timing patterns while providing a method that can be adapted to different users and devices. In most of studies and commercial devices, the crank angle is used as an input to trigger stimulation onset.

Periostin and sclerostin levels in individuals with spinal cord injury and their relationship with bone mass, bone turnover, fracture and osteoporosis status.

Background: Spinal cord injury (SCI) induces an acute alteration in bone metabolism. Although the aetiology of the bone disturbances is not precisely known, immobilisation reduces mechanical loading and the morphology of osteocytes, which are the primary mechanosensors. Periostin and sclerostin are secreted mostly by osteocytes and are involved in bone's mechanical response.

[Neuroprostheses to compensate for motor impairments].

Neuroprostheses are medical devices which, interfaced with the nervous system, are able to provoke the artificial generation of nerve signals. These signals, correctly coded, can then be interpreted by target organs such as the muscles.

Overview of FES-Assisted Cycling Approaches and Their Benefits on Functional Rehabilitation and Muscle Atrophy.

Central nervous system diseases include brain or spinal cord impairments and may result in movement disorders almost always manifested by paralyzed muscles with preserved innervations and therefore susceptible to be activated by electrical stimulation. Functional electrical stimulation (FES)-assisted cycling is an approach mainly used for rehabilitation purposes contributing, among other effects, to restore muscle trophism. FES-assisted cycling has also been adapted for mobile devices adding a leisure and recreational benefit to the physical training.

Training with FES-assisted cycling in a subject with spinal cord injury: Psychological, physical and physiological considerations.

Context: People with spinal cord injury (SCI) experience the effects of a sedentary lifestyle very early on. Literature data suggest that programs using FES-assisted cycling would contribute to reduce the consequences of physical inactivity. The objective was to assess the feasibility of 12-month training on a FES-assisted bike of a subject with paraplegia for 21 years, T3, Asia Impairment Scale (AIS) A.

Validity and internal consistency of the French version of the revised Skin Management Needs Assessment Checklist in people with spinal cord injury.

Study Design: Cross-sectional psychometrics study.

Objectives: To determine the construct validity and internal consistency of the revised Skin Management Needs Assessment Checklist (revised SMnac).

Setting: Six spinal cord rehabilitation centers.