Bipedal gait model for precise gait recognition and optimal triggering in foot drop stimulator: a proof of concept

AbstractElectrical stimulators are often prescribed to correct foot drop walking. However, commercial foot drop stimulators trigger inappropriately under certain non-gait scenarios. Past researches addressed this limitation by defining stimulation control based on automaton of a gait cycle executed by foot drop of affected limb/foot only. Since gait is a collaborative activity of both feet, this research highlights the role of normal foot for robust gait detection and stimulation triggering. A novel bipedal gait model is proposed where gait cycle is realized as an automaton based on concurrent gait sub-phases (states) from each foot. The input for state transition is fused information from feet-worn pressure and inertial sensors. Thereafter, a bipedal gait model-based stimulation control algorithm is developed. As a feasibility study, bipedal gait model and stimulation control are evaluated in real-time simulation manner on normal and simulated foot drop gait measurements from 16 able-bodied participants with three speed variations, under inappropriate triggering scenarios and with foot drop rehabilitation exercises. Also, the stimulation control employed in commercial foot drop stimulators and single foot gait-based foot drop stimulators are compared alongside. Gait detection accuracy (98.9%) and precise triggering under all investigations prove bipedal gait model reliability. This infers that gait detection leveraging bipedal periodicity is a promising strategy to rectify prevalent stimulation triggering deficiencies in commercial foot drop stimulators. Graphical abstractBipedal information-based gait recognition and stimulation triggering

[1]  R. Stein,et al.  Surface Electrical Stimulation for Foot Drop: Control Aspects and Walking Performance , 2008 .

[2]  I.P.I. Pappas,et al.  A reliable, gyroscope based gait phase detection sensor embedded in a shoe insole , 2002, Proceedings of IEEE Sensors.

[3]  A. Geurts,et al.  Definition dependent properties of the cortical silent period in upper-extremity muscles, a methodological study , 2014, Journal of NeuroEngineering and Rehabilitation.

[4]  Zoran A. Salcic,et al.  Analysis and selection of the Force Sensitive Resistors for gait characterisation , 2015, 2015 6th International Conference on Automation, Robotics and Applications (ICARA).

[5]  Nitish V. Thakor,et al.  Implantable neurotechnologies: electrical stimulation and applications , 2015, Medical & Biological Engineering & Computing.

[6]  T. Sinkjaer,et al.  A review of portable FES-based neural orthoses for the correction of drop foot , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[7]  Roger Pissard-Gibollet,et al.  Continuous gait cycle index estimation for electrical stimulation assisted foot drop correction , 2014, Journal of NeuroEngineering and Rehabilitation.

[8]  M. Hanlon,et al.  Real-time gait event detection using wearable sensors. , 2006, Gait & posture.

[9]  R. Stein,et al.  Long-Term Therapeutic and Orthotic Effects of a Foot Drop Stimulator on Walking Performance in Progressive and Nonprogressive Neurological Disorders , 2010, Neurorehabilitation and neural repair.

[10]  Guido Pasquini,et al.  Online Phase Detection Using Wearable Sensors for Walking with a Robotic Prosthesis , 2014, Sensors.

[11]  Thomas Seel,et al.  The adaptive drop foot stimulator - Multivariable learning control of foot pitch and roll motion in paretic gait. , 2016, Medical engineering & physics.

[12]  Tzyy-Yuang Shiang,et al.  Assessment of walking, running, and jumping movement features by using the inertial measurement unit. , 2015, Gait & posture.

[13]  B.T. Smith,et al.  Evaluation of force-sensing resistors for gait event detection to trigger electrical stimulation to improve walking in the child with cerebral palsy , 2002, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[14]  Gearóid ÓLaighin,et al.  Electronic stimulators for surface neural prosthesis , 2008 .

[15]  Katja D. Mombaur,et al.  Nonlinear model predictive control of joint ankle by electrical stimulation for drop foot correction , 2013, 2013 IEEE/RSJ International Conference on Intelligent Robots and Systems.

[16]  Jörg Raisch,et al.  Iterative learning control of a drop foot neuroprosthesis — Generating physiological foot motion in paretic gait by automatic feedback control , 2016 .

[17]  Hermano Igo Krebs,et al.  Robot-Aided Neurorehabilitation: A Novel Robot for Ankle Rehabilitation , 2009, IEEE Transactions on Robotics.

[18]  J. Harris,et al.  Review of therapeutic electrical stimulation for dorsiflexion assist and orthotic substitution from the American Congress of Rehabilitation Medicine stroke movement interventions subcommittee. , 2014, Archives of physical medicine and rehabilitation.

[19]  P.L. Melo,et al.  Technical developments of functional electrical stimulation to correct drop foot: sensing, actuation and control strategies. , 2014, Clinical biomechanics.

[20]  Danny Rafferty,et al.  A comparison of the orthotic effect of the Odstock Dropped Foot Stimulator and the Walkaide functional electrical stimulation systems on energy cost and speed of walking in Multiple Sclerosis , 2015, Disability and rehabilitation. Assistive technology.

[21]  Kari Dunning,et al.  Peroneal Stimulation for Foot Drop After Stroke: A Systematic Review , 2015, American journal of physical medicine & rehabilitation.

[22]  D Kotiadis,et al.  Inertial Gait Phase Detection for control of a drop foot stimulator Inertial sensing for gait phase detection. , 2010, Medical engineering & physics.

[23]  G. Lyons,et al.  The use of accelerometry to detect heel contact events for use as a sensor in FES assisted walking. , 2003, Medical engineering & physics.

[24]  Choukri Mecheraoui,et al.  A distributed three-channel wireless Functional Electrical Stimulation system for automated triggering of stimulation to enable coordinated task execution by patients with neurological disease , 2013, Biomed. Signal Process. Control..

[25]  Edward P. Washabaugh,et al.  A Novel Application of Eddy Current Braking for Functional Strength Training During Gait , 2016, Annals of Biomedical Engineering.

[26]  Thomas Seel,et al.  Online Monitoring of Muscle Activity During Walking for Bio-feedback and for Observing the Effects of Transcutaneous Electrical Stimulation , 2017 .

[27]  M.R. Popovic,et al.  A reliable gait phase detection system , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[28]  G. M. Lyons,et al.  Finite state control of functional electrical stimulation for the rehabilitation of gait , 2000, Medical and Biological Engineering and Computing.

[29]  Alfred D. Grant Gait Analysis: Normal and Pathological Function , 2010 .

[30]  M.M. Skelly,et al.  Real-time gait event detection for paraplegic FES walking , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[31]  Thomas Seel,et al.  Online Gait Phase Detection with Automatic Adaption to Gait Velocity Changes Using Accelerometers and Gyroscopes , 2014 .

[32]  G M Lyons,et al.  A system for the delivery of programmable, adaptive stimulation intensity envelopes for drop foot correction applications. , 2006, Medical engineering & physics.

[33]  M. Kafri,et al.  Therapeutic Effects of Functional Electrical Stimulation on Gait in Individuals Post-Stroke , 2014, Annals of Biomedical Engineering.