Journal of Rehabilitation Research & Development (JRRD)

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Volume 53 Number 6, 2016
   Pages 919 — 932

Abstract — Accelerometer-based step initiation control for gait-assist neuroprostheses

Kevin M. Foglyano, BS;1* John R. Schnellenberger, MS;1 Rudi Kobetic, MS;1 Lisa Lombardo, PT;1 Gilles Pinault, MD;1 Stephen Selkirk, MD, PhD;1–2 Nathaniel S. Makowski, PhD;1 Ronald J. Triolo, PhD1,3

1Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; Departments of 2Neurology and 3Biomedical Engineering and Orthopaedics, Case Western Reserve University, Cleveland, OH

Abstract — Electrical activation of paralyzed musculature can generate or augment joint movements required for walking after central nervous system trauma. Proper timing of stimulation relative to residual volitional control is critical to usefully affecting ambulation. This study evaluates three-dimensional accelerometers and customized algorithms to detect the intent to step from voluntary movements and trigger stimulation during walking in individuals with significantly different etiologies, mobility limitations, manual dexterities, and walking aids. Three individuals with poststroke hemiplegia or partial spinal cord injury exhibiting varying gait deficits were implanted with multichannel pulse generators to provide joint motions at the hip, knee, and ankle. An accelerometer integrated into the external control unit was used to detect heel strike or walker movement, and wireless accelerometers were used to detect crutch strike. Algorithms were developed for each sensor location to detect intent to step to progress through individualized stimulation patterns. Testing these algorithms produced detection accuracies of at least 90% on both level ground and uneven terrain. All participants use their accelerometer-triggered implanted gait systems at home and in the community; the validation/system testing was completed in the hospital. The results demonstrated that safe, reliable, and convenient accelerometer-based step initiation can be achieved regardless of specific gait deficits, manual dexterities, and walking aids.

Clinical Trial Registration: ClinicalTrials.gov; "Improving ambulatory community access after paralysis": NCT01570816; https://clinicaltrials.gov/ct2/show/NCT01570816?term=NCT01570816&rank=1

Key words: accelerometer, gait, neuroprosthesis, rehabilitation, spinal cord injury, step, step initiation, stimulation, stroke, trigger.


View HTML ?? View PDF ?? Contents Vol. 53, No. 6
This article and any supplementary material should be cited as follows:
Foglyano KM, Schnellenberger JR, Kobetic R, Lombardo L, Pinault G, Selkirk S, Makowski NS, Triolo RJ. Accelerometer-based step initiation control for gait-assist neuroprostheses. J Rehabil Res Dev. 2016;53(6):919–32.
http://dx.doi.org/10.1682/JRRD.2015.09.0188
ORCID: Kevin M. Foglyano, BS: 0000-0002-4781-1404; Rudi Kobetic, MS: 0000-0003-2689-026X
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