Article
Medicine, General & Internal
Md Akhlasur Rahman, Niraj Singh Tharu, Sylvia M. Gustin, Yong-Ping Zheng, Monzurul Alam
Summary: Spinal cord injury (SCI) is a debilitating injury with severe complications, but recent development of noninvasive electrical neuromodulation treatments offers hope for rehabilitation. Trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS) have shown promising results in improving sensorimotor and autonomic functions.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Biochemistry & Molecular Biology
Amandine Robac, Pauline Neveu, Alizee Hugede, Elisabeth Garrido, Lionel Nicol, Quentin Delarue, Nicolas Guerout
Summary: The study demonstrates that repetitive trans-spinal magnetic stimulation (rTSMS) can modulate lesion scar and induce functional locomotor recovery after spinal cord injury (SCI) in rats. rTSMS decreases formation of cystic cavities and improves axonal survival in both SCI models, showing promising effects for potential use in human treatment.
Article
Biochemistry & Molecular Biology
Hatice Kumru, Loreto Garcia-Alen, Aina Ros-Alsina, Sergiu Albu, Margarita Valles, Joan Vidal
Summary: This study aimed to investigate whether transcutaneous spinal cord stimulation (tSCS) could improve respiratory function in individuals with cervical spinal cord injury (cSCI). The results showed that subjects who received tSCS combined with inspiratory muscle training (IMT) experienced significant improvements in breathlessness/dyspnea, hypophonia, maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), and forced vital capacity. Therefore, tSCS may serve as an effective adjunctive therapy for respiratory impairments following SCI.
Article
Clinical Neurology
Ashraf S. Gorgey, Refka E. Khalil, William Carter, Boyd Ballance, Ranjodh Gill, Rehan Khan, Lance Goetz, Timothy Lavis, Adam P. Sima, Robert A. Adler
Summary: The study compared the combined effects of NMES-RT and FES-LEC with PMT and FES-LEC on various physiological indicators in adults with SCI. NMES-RT showed benefits in increasing peak leg VO2 and decreasing total VAT, while FES-LEC had a modest impact on increasing leg VO2 peak.
FRONTIERS IN NEUROLOGY
(2023)
Review
Engineering, Biomedical
Emi A. Kiyotake, Michael D. Martin, Michael S. Detamore
Summary: This review discusses the potential of regenerative medicine and rehabilitation approaches for SCI, as well as the role of conductive biomaterials in synergizing these two fields. Current limitations and translational challenges for conductive biomaterials in becoming therapeutics for SCI are identified.
ACTA BIOMATERIALIA
(2022)
Article
Engineering, Biomedical
Aidan R. W. Friederich, Xuefeng Bao, Ronald J. Triolo, Musa L. Audu
Summary: Feedback control of neural stimulation can maintain upright seated posture and facilitate trunk movements necessary for completing reaching tasks in individuals with spinal cord injury (SCI). Replication of these findings on a larger number of subjects is necessary for generalization to the SCI population.
JOURNAL OF NEUROENGINEERING AND REHABILITATION
(2022)
Review
Clinical Neurology
Alice Lin, Elias Shaaya, Jonathan S. Calvert, Samuel R. Parker, David A. Borton, Jared S. Fridley
Summary: This review assesses the efficacy of spinal cord stimulation for individuals with chronic spinal cord injury. The results show that spinal cord stimulation can improve sensorimotor and autonomic function. However, further research and optimization are needed before clinical translation.
Article
Engineering, Biomedical
David J. Houston, Janelle Unger, Jae W. Lee, Kei Masani, Kristin E. Musselman
Summary: The study found that participants in the FES + VFBT program perceived benefits that led to meaningful improvements in activities of daily living and felt they still had the capacity to improve. They felt they had increased their balance confidence, while a few participants also reported a decrease in their risk of falling. The inclusion of qualitative inquiry allows for the evaluation of the meaningfulness of an intervention and its perceived impact on the lives of the participants.
JOURNAL OF NEUROENGINEERING AND REHABILITATION
(2021)
Article
Neurosciences
Wei-wei Deng, Guang-yan Wu, Ling-xia Min, Zhou Feng, Hui Chen, Ming-liang Tan, Jian-feng Sui, Hong-liang Liu, Jing-ming Hou
Summary: Activation of glutamate neurons in the primary motor cortex can significantly improve motor function scores in rats, shorten the incubation period of motor evoked potentials, and increase motor potentials' amplitude. Accurate activation of the primary motor cortex can effectively promote tissue recovery and neurofilament growth, while also increasing the content of some growth-related proteins at the injured site. These findings suggest that selective activation of glutamate neurons in the primary motor cortex may play a significant role in promoting functional recovery after SCI and understanding the neural cell mechanism involved in recovery induced by motor cortex stimulation.
FRONTIERS IN NEUROSCIENCE
(2021)
Review
Medicine, General & Internal
David R. Dolbow, Ashraf S. Gorgey, Therese E. Johnston, Ines Bersch
Summary: Electrical stimulation exercise is an important modality for individuals with SCI to improve mobility and health. It can stimulate peripheral nerves in extremities, strengthen muscles, and assist with functional activities. It can also predict hand deformities and rehabilitate grasping activities.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Computer Science, Information Systems
Luis G. Hernandez-Rojas, Jessica Cantillo-Negrete, Omar Mendoza-Montoya, Ruben Carino-Escobar, Ismael Leyva-Martinez, Ana Aguirre-Guemez, Aida Barrera-Ortiz, Paul Carrillo-Mora, Javier M. Antelis
Summary: This study presents the design and implementation of a Motor Imagery (MI)-based Brain-Computer Interface (BCI) system for assisting upper limb motor recovery in patients with spinal cord injury (SCI). The system was evaluated with healthy subjects and SCI patients in experimental sessions, showing promising results in terms of MI task recognition accuracy and triggering the Functional Electrical Stimulation (FES) device. The study provides evidence of the feasibility and functionality of the proposed BCI system in a motor rehabilitation context.
Review
Rehabilitation
Amira Hassan Bekhet, Alhadi M. Jahan, Vanesa Bochkezanian, Kristin E. Musselman, Amr A. Elsareih, Ashraf S. Gorgey
Summary: The objective of this study was to determine the effects of neuromuscular electrical stimulation (NMES) or functional electrical stimulation (FES), or both, training on different body composition parameters in individuals with spinal cord injury. The findings suggest that NMES/FES is an effective rehabilitation strategy for muscle hypertrophy and increasing lean mass (LM). Weekly training volumes are associated with muscle hypertrophy after NMES loading exercise. However, there is a lack of rationale for the selection of stimulation parameters.
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION
(2022)
Review
Clinical Neurology
Alessandro de Sire, Lucrezia Moggio, Nicola Marotta, Claudio Curci, Lorenzo Lippi, Marco Invernizzi, Kamal Mezian, Antonio Ammendolia
Summary: Spinal cord injury (SCI) leads to functional impairments due to damage to spinal nerve fiber tracts. Volumetric muscle loss (VML), characterized by abnormal reduction in skeletal muscle volume below the injury level, can occur as a result. This systematic review examined the effects of different rehabilitation approaches on VML reduction in individuals with SCI (humans and animals). The findings showed that electrical stimulation and treadmill training were effective in reducing VML in this population. Further clinical observations are needed to determine optimal timing and modalities for intervention.
NEUROREHABILITATION
(2023)
Review
Clinical Neurology
Matteo Lorusso, Nevio Luigi Tagliamonte, Marco Tramontano, Anna Fresch, Giulia Granelli, Nicola Smania, Federica Tamburella
Summary: This systematic review explored the technology-assisted strategies to assess and rehabilitate balance function in persons with Spinal Cord Injury (SCI). The findings suggest that while technology-assisted rehabilitation has positive effects on balance, the improvements are not greater than those achieved through other rehabilitation therapies. The heterogeneity, low methodological quality, and limited number of studies included in the review prevent reaching general conclusions about the usefulness of technology-assisted balance assessment and training in individuals with SCI, despite some studies reporting significant improvements.
NEUROREHABILITATION
(2022)
Article
Neurosciences
Marcel Simis, Deniz Doruk Camsari, Marta Imamura, Thais Raquel Martins Filippo, Daniel Rubio De Souza, Linamara Rizzo Battistella, Felipe Fregni
Summary: Functional changes after SCI are linked to cortical plasticity, which can be measured by EEG and used as a clinical biomarker. In a study with participants undergoing RAGT, high beta EEG activity negatively correlated with gait and balance at baseline, while improvement in gait and balance correlated with changes in alpha/theta ratio. These findings suggest that EEG may serve as a potential surrogate marker for functional improvement during SCI rehabilitation.
FRONTIERS IN HUMAN NEUROSCIENCE
(2021)
Article
Clinical Neurology
Kevin M. Foglyano, Lisa M. Lombardo, John R. Schnellenberger, Ronald J. Triolo
Summary: This study aims to develop an automatic system that can detect destabilizing events during wheelchair propulsion in real-world conditions and trigger neural stimulation to maintain the seated postures of users with paralysis.
JOURNAL OF SPINAL CORD MEDICINE
(2022)
Article
Rehabilitation
Stephanie Nogan Bailey, Kevin M. Foglyano, Nicholas F. Bean, Ronald J. Triolo
Summary: This study aims to reliably determine the two main phases of manual wheelchair propulsion using a simple wearable sensor. Modulated trunk and hip stimulation was found to significantly increase speed during challenging tasks. The use of wrist-mounted accelerometers for phase transition detection proved to be an effective and cost-efficient alternative to elaborate instrumented systems.
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION
(2021)
Article
Chemistry, Analytical
Mingxiao Liu, Samuel Wilder, Sean Sanford, Soha Saleh, Noam Y. Harel, Raviraj Nataraj
Summary: Sensory feedback from wearables, such as an instrumented glove, can enhance movement learning and accelerate gains in motor function during rehabilitation. The study demonstrated that providing visual and auditory feedback with shorter time delays can increase users' sense of control during functional tasks. Future work will involve model-based algorithms for predicting secure grasps, virtual reality immersion, and testing with clinical populations.
Article
Neurosciences
Courtney E. Shell, Breanne P. Christie, Paul D. Marasco, Hamid Charkhkar, Ronald J. Triolo
Summary: Research shows that electrical stimulation or vibration on the foot can lead to postural adjustments in lower-limb amputees, demonstrating their importance in maintaining stability during standing.
FRONTIERS IN NEUROSCIENCE
(2021)
Article
Engineering, Biomedical
Kevin A. Walsh, Sean P. Sanford, Brian D. Collins, Noam Y. Harel, Raviraj Nataraj
Summary: This study utilized machine learning algorithms to map EMG signals from multiple muscles in the upper body to directional commands, with adaptive boosting and bootstrap aggregating showing significantly higher classification accuracy. Maze task performance depended on the combination of classifier and muscle set utilized.
BIOMEDICAL SIGNAL PROCESSING AND CONTROL
(2021)
Article
Rehabilitation
Sean Sanford, Mingxiao Liu, Raviraj Nataraj
Summary: This study compared the effects of continuous and bandwidth feedback in different display modes on the two-legged squat training and short-term memory. Continuous feedback showed higher accuracy and consistency during training, while bandwidth feedback demonstrated greater learning potential.
JOURNAL OF SPORT REHABILITATION
(2021)
Article
Biophysics
Xuefeng Bao, Musa L. Audu, Aidan R. Friederich, Ronald J. Triolo
Summary: This study presents a control method that uses functional neuromuscular stimulation to restore trunk movements in individuals with spinal cord injury. The method combines robust control and an artificial neural network-based mapping mechanism to achieve stable control and convergence of muscle-generated torques.
JOURNAL OF BIOMECHANICAL ENGINEERING-TRANSACTIONS OF THE ASME
(2022)
Article
Psychology, Experimental
Raviraj Nataraj, Sean Sanford, Mingxiao Liu, Noam Y. Harel
Summary: This study investigated the effects of limb dominance on virtual reality rehabilitation, finding that different control modes and limb dominance have different effects on performance and perception. Developers should consider limb dominance to optimize settings for better performance and engagement.
Correction
Multidisciplinary Sciences
Breanne P. Christie, Hamid Charkhkar, Courtney E. Shell, Christopher J. Burant, Dustin J. Tyler, Ronald J. Triolo
SCIENTIFIC REPORTS
(2022)
Article
Chemistry, Analytical
Aidan R. W. Friederich, Musa L. Audu, Ronald J. Triolo
Summary: Feedback control using accelerometers in functional neuromuscular stimulation can enhance daily function and seated stability for individuals with spinal cord injuries (SCIs). This study presents a method for calibrating multiple randomly oriented accelerometers and fusing their signals to measure trunk orientation. The calibration results demonstrate high accuracy and feasibility of the proposed method.
Article
Engineering, Biomedical
Sandra Hnat, Raviraj Nataraj
Summary: Powered orthoses using virtual muscle models can generate more natural torque and motion outputs. In this study, we designed and implemented a muscle controller based on the Hill model to control the torque signals of the orthosis. Real-time simulation of muscle dynamics was conducted in a MATLAB/Simulink environment. The results showed a good match between the commanded and measured torque outputs for the knee joint of the orthosis.
PROCEEDINGS OF THE INSTITUTION OF MECHANICAL ENGINEERS PART H-JOURNAL OF ENGINEERING IN MEDICINE
(2023)
Review
Computer Science, Artificial Intelligence
Sophie Dewil, Shterna Kuptchik, Mingxiao Liu, Sean Sanford, Troy Bradbury, Elena Davis, Amanda Clemente, Raviraj Nataraj
Summary: This paper presents previous works on augmented sensory guidance and psychophysiological factors in motor learning, and discusses how these approaches can optimize motor rehabilitation after neurotraumas with virtual reality. The authors conducted a comprehensive literature review using various electronic databases and search engines, focusing on upper extremity rehabilitation, virtual reality, cognition, and sensory feedback. They propose that strategic activation of sensory modalities in virtual reality can improve motor training and skill retention in individuals with impulsive neurological damage. Additionally, monitoring psychophysiological factors can help evaluate novel designs in computerized rehabilitation. The authors emphasize the need for virtual reality approaches to incorporate augmented sensory feedback and leverage psychophysiological factors in order to advance motor rehabilitation after neurotraumas.
JOURNAL ON MULTIMODAL USER INTERFACES
(2023)
Article
Computer Science, Software Engineering
Sean Sanford, Brian Collins, Mingxiao Liu, Sophie Dewil, Raviraj Nataraj
Summary: This study investigates how variations in the complexity and intermittency of augmented visual guidance affect the performance of a muscle control task. The results demonstrate that simpler and more intermittent feedback leads to better performance, reduced cognitive loading, and increased physical arousal.
FRONTIERS IN VIRTUAL REALITY
(2022)
Article
Biotechnology & Applied Microbiology
Nathaniel S. Makowski, Marshaun N. Fitzpatrick, Ronald J. Triolo, Ryan-David Reyes, Roger D. Quinn, Musa Audu
Summary: An iterative learning control strategy is developed for a muscle first motor-assisted hybrid neuroprosthesis. The strategy enables swing-leg motions in a biologically inspired fashion, maximizing muscular recruitment and activating motorized exoskeletal bracing as necessary.
BIOENGINEERING-BASEL
(2022)
Article
Engineering, Biomedical
Na Zhang, Ke Li, Guanglin Li, Raviraj Nataraj, Na Wei
Summary: Production of functional forces by human motor systems requires coordination across multiple muscles. This study investigated intermuscular coordination for grip and pinch at different force levels using a novel method called multiplex recurrence networks (MRN). The results showed differences in network parameters between grasp types and force levels, with extrinsic muscles exhibiting higher muscle coupling than intrinsic muscles.
IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING
(2021)
