Metrological characterization of a cycle-ergometer to optimize the cycling induced by functional electrical stimulation on patients with stroke.

Functional electrical stimulation (FES) is a well established method in the rehabilitation of stroke patients. Indeed, a bilateral movement such as cycling induced by FES would be crucial for these patients who had an unilateral motor impairment and had to recover an equivalent use of limbs. The aim of this study was to develop a low-cost meteorologically qualified cycle-ergometer, optimized for patients with stroke. A commercial ergometer was instrumented with resistive strain gauges and was able to provide the torque produced at the right and left crank, independently. The developed system was integrated with a stimulator, obtaining a novel FES cycling device able to control in real-time the movement unbalance. A dynamic calibration of the sensors was performed and a total torque uncertainty was computed. The system was tested on a healthy subject and on a stroke patient. Results demonstrated that the proposed sensors could be successfully used during FES cycling sessions where the maximum torque produced is about 9Nm, an order of magnitude less than the torque produced during voluntary cycling. This FES cycling system will assist in future investigations on stroke rehabilitation by means of FES and in new exercise regimes designed specifically for patients with unilateral impairments.

[1]  L. Sheffler,et al.  Neuromuscular electrical stimulation in neurorehabilitation , 2007, Muscle & nerve.

[2]  Hemiplegia , 1901, The Hospital.

[3]  S A Kautz,et al.  Increased workload enhances force output during pedaling exercise in persons with poststroke hemiplegia. , 1998, Stroke.

[4]  D. Brown,et al.  Limb-loaded cycling program for locomotor intervention following stroke. , 2005, Physical therapy.

[5]  J. Chen,et al.  Kinesiological and kinematical analysis for stroke subjects with asymmetrical cycling movement patterns. , 2005, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[6]  Zeevi Dvir,et al.  The influence of early cycling training on balance in stroke patients at the subacute stage. Results of a preliminary trial , 2006, Clinical rehabilitation.

[7]  Sergio Mariotti,et al.  The impact of stroke in Italy: First step for a National Burden of Disease Study , 2005, Disability and rehabilitation.

[8]  N.-O. Negard,et al.  Control strategies for integration of electric motor assist and functional electrical stimulation in paraplegic cycling: utility for exercise testing and mobile cycling , 2004, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[9]  Giancarlo Ferrigno,et al.  Simulation and Experimental Design of a Symmetry Controller for FES Cycling Optimised on Stroke Patients , 2009, BIODEVICES.

[10]  R. Trumbower,et al.  Kinematic analyses of semireclined leg cycling in able-bodied and spinal cord injured individuals , 2005, Spinal Cord.

[11]  T. Angeli,et al.  Test bed with force-measuring crank for static and dynamic investigations on cycling by means of functional electrical stimulation , 2001, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[12]  Thomas Schauer,et al.  Feedback control of cycling in spinal cord injury using functional electrical stimulation , 2006 .

[13]  Paolo Pennacchi,et al.  Biomechanical Analysis of Pedalling for Rehabilitation Purposes: Experimental Results on Two Pathological Subjects and Comparison with Non-pathological Findings , 2004, Computer methods in biomechanics and biomedical engineering.

[14]  S. Locke Clinical Neurology , 1953, Progress in neurology and psychiatry.

[15]  Thomas Brandt,et al.  Functional output improvement in FES cycling by means of forced smooth pedaling. , 2007, Medicine and science in sports and exercise.

[16]  S. Standard GUIDE TO THE EXPRESSION OF UNCERTAINTY IN MEASUREMENT , 2006 .

[17]  E. G. Jones,et al.  Cortical and subcortical contributions to activity-dependent plasticity in primate somatosensory cortex. , 2000, Annual review of neuroscience.

[18]  G Ferrigno,et al.  Cycling induced by functional electrical stimulation improves the muscular strength and the motor control of individuals with post-acute stroke. Europa Medicophysica-SIMFER 2007 Award Winner. , 2008, European journal of physical and rehabilitation medicine.