Abstract

Loss of mobility due to lower limb paralysis is a common result of thoracic level spinal cord injury. Functional electrical stimulation (FES) can restore primitive gait in the vicinity of a wheelchair by using electrical stimulation to generate muscle contractions. A new concept for FES-assisted gait is presented that combines electrical stimulation with an orthosis that contains a fluid power system to store and transfer energy during the gait cycle. The energy storage orthosis (ESO) can be driven through a complete gait cycle using only stimulation of the quadriceps muscles. The conceptual design of the ESO was completed and implemented in a dynamic simulation model and in a benchtop prototype for engineering measurements. No studies were conducted with human subjects. The results demonstrate the potential of the ESO concept for a feasible gait-assist system and the validity of the simulation model as a means for designing the system.

1.
Marsolais
,
E. B.
, and
Kobetic
,
R.
, 1987, “
Functional Electrical Stimulation for Walking in Paraplegia
,”
J. Bone Jt. Surg., Am. Vol.
0021-9355,
69A
, pp.
728
733
.
2.
Kobetic
,
R.
,
Triolo
,
R. J.
, and
Marsolais
,
E. B.
, 1997, “
Muscle Selection and Walking Performance of Multichannel FES Systems for Ambulation in Paraplegia
,”
IEEE Trans. Rehabil. Eng.
1063-6528,
5
(
1
), pp.
23
29
.
3.
Cybulski
,
G.
,
Penn
,
R.
, and
Jaeger
,
R.
, 1984, “
Lower Extremity Functional Neuromuscular Stimulation in Cases of Spinal Cord Injury
,”
Neurosurgery
0148-396X,
15
(
1
), pp.
132
146
.
4.
Graupe
,
D.
, and
Kohn
,
K.
, 1994,
Functional Electrical Stimulation for Ambulation by Paraplegics
,
Krieger
, Melbourne, FL.
5.
Kralj
,
A.
, and
Bajd
,
T.
, 1989,
Functional Electrical Stimulation: Standing and Walking After Spinal Cord Injury
,
CRC Press
, Boca Raton.
6.
Marsolais
,
E. B.
, and
Kobetic
,
R.
, 1983, “
Functional Walking in Paralyzed Patients by Means of Electrical Stimulation
,”
Clin. Orthop. Relat. Res.
0009-921X,
175
, pp.
30
36
.
7.
Creasey
,
G. H.
,
Ho
,
C. H.
,
Triolo
,
R. J.
,
Gater
,
D. R.
,
DiMarco
,
A. F.
,
Bogie
,
K. M.
, and
Keith
,
M. W.
, 2004, “
Clinical Applications of Electrical Stimulation After Spinal Cord Injury
,”
J. Spinal Cord Med.
1079-0268,
27
(
4
), pp.
365
375
.
8.
Kobetic
,
R.
,
Triolo
,
R. J.
,
Uhlir
,
J. P.
,
Bieri
,
C.
,
Wibowo
,
M.
,
Polando
,
G.
,
Marsolais
,
E. B.
,
Davis
,
J. A.
, Jr.
, and
Ferguson
,
K. A.
, 1999, “
Implanted Functional Electrical Stimulation System for Mobility in Paraplegia: A Follow-Up Case Report
,”
IEEE Trans. Rehabil. Eng.
1063-6528,
7
(
4
), pp.
390
398
.
9.
Kralj
,
A.
,
Bajd
,
T.
, and
Turk
,
R.
, 1988, “
Enhancement of Gait Restoration in Spinal Injured Patients by Functional Electrical Stimulation
,”
Clin. Orthop. Relat. Res.
0009-921X,
233
, pp.
34
43
.
10.
Hausdorff
,
J. M.
, and
Durfee
,
W. K.
, 1991, “
Open-Lop Position Control of the Knee Joint Using Electrical Stimulation of the Quadriceps and Hamstrings
,”
Med. Biol. Eng. Comput.
0140-0118,
29
, pp.
269
280
.
11.
Hirokawa
,
S.
,
Grimm
,
M.
,
Le
,
T.
,
Solomonow
,
M.
,
Baratta
,
R.
,
Shoji
,
H.
, and
D'Ambrosia
,
R.
, 1990, “
Energy Consumption in Paraplegic Ambulation Using the Reciprocating Gait Orthosis and Electric Stimulation of the Thigh Muscles
,”
Arch. Phys. Med. Rehabil.
0003-9993,
71
(
9
), pp.
687
694
.
12.
Petrofsky
,
J.
, and
Smith
,
J.
, 1991, “
Physiologic Costs of Computer-Controlled Walking in Persons With Paraplegia Using a Reciprocating-Gait Orthosis
,”
Arch. Phys. Med. Rehabil.
0003-9993,
72
(
11
), pp.
890
896
.
13.
Solomonow
,
M.
,
Aguilar
,
E
,
Reisin
,
E.
,
Baratta
,
R.
,
Best
,
R.
,
Coetzee
,
T.
, and
D'Ambrosia
,
R.
, 1997, “
Reciprocating Gait Orthosis Powered With Electrical Muscle Stimulation (RGO II). Part I: Performance Evaluation of 70 Paraplegic Patients
,”
Orthopedics
0147-7447,
20
(
4
), pp.
315
324
.
14.
Solomonow
,
M.
,
Baratta
,
R.
,
Hirokawa
,
S.
,
Rightor
,
N.
,
Walker
,
W.
,
Beaudelte
,
P.
,
Shoji
,
H.
, and
D'Ambrosia
,
R.
, 1989, “
The RGO Generation II: Muscle Stimulation Powered Orthosis as a Practical Walking System for Thoracic Paraplegics
,”
Orthopedics
0147-7447,
12
(
10
), pp.
1309
1315
.
15.
Isakov
,
E.
,
Douglas
,
R.
, and
Berns
,
P.
, 1992, “
Ambulation Using the Reciprocating Gait Orthosis and Functional Electrical Stimulation
,”
Paraplegia
0031-1758,
30
, pp.
239
245
.
16.
McClelland
,
M.
,
Andrews
,
B.
,
Patrick
,
J.
,
Freeman
,
P.
, and
el Masri
,
W.
, 1987, “
Augmentation of the Oswestry Parawalker Orthosis by Means of Surface Electrical Stimulation: Gait Analysis of Three Patients
,”
Paraplegia
0031-1758,
25
, pp.
32
38
.
17.
Nene
,
A.
, and
Jennings
,
S.
, 1989, “
Hybrid Paraplegic Locomotion With the Parawalker Using Intramuscular Stimulation: A Single Subject Study
,”
Paraplegia
0031-1758,
27
, pp.
125
132
.
18.
Andrews
,
B.
,
Baxendale
,
R.
,
Barnett
,
R.
,
Phillips
,
G.
,
Yamazaki
,
T.
,
Paul
,
J.
, and
Freeman
,
P.
, 1988, “
Hybrid FES Orthosis Incorporating Closed Loop Control and Sensory Feedback
,”
J. Biomed. Eng.
0141-5425,
10
, pp.
189
195
.
19.
Popovic
,
D.
,
Tomovic
,
R.
, and
Schwirtlich
,
L.
, 1989, “
Hybrid Assistive System: The Motor Neuroprosthesis
,”
IEEE Trans. Biomed. Eng.
0018-9294,
36
(
7
), pp.
729
737
.
20.
Popovic
,
D.
,
Schwirtlich
,
L.
, and
Radosavljevic
,
S.
, 1990, “
Powered Hybrid Assistive System
,”
Advances in External Control of Human Extremities
,
D.
Popovic
, ed., Nauka, Belgrade, pp.
177
186
.
21.
Popovic
,
D.
,
Schwirtlich
,
L.
, and
Radosavljevic
,
S.
, 1990, “
Powered Hybrid Assistive System
,”
Advance External Contr. Human Extremities
,
D.
Popovic
, ed.,
Nauka
, Belgrade, pp.
177
186
.
22.
Marsolais
,
E. B.
,
Kobetic
,
R.
,
Polando
,
G.
,
Ferguson
,
K.
,
Tashman
,
S.
,
Gaudio
,
R.
,
Nandurkar
,
S.
, and
Lehneis
,
H. R.
, 2000, “
The Case Western Reserve University Hybrid Gait Orthosis
,”
J. Spinal Cord Med.
1079-0268,
23
(
2
), pp.
100
108
.
23.
Ferguson
,
K. A.
,
Polando
,
G.
,
Kobetic
,
R.
,
Triolo
,
R. J.
, and
Marsolais
,
E. B.
, 1999, “
Walking With a Hybrid Orthosis System
,”
Spinal Cord
1362-4393,
37
(
11
), pp.
800
804
.
24.
Greene
,
P. J.
, and
Granat
,
M. H.
, 2003, “
A Knee and Ankle Flexing Hybrid Orthosis for Paraplegic Ambulation
,”
Med. Eng. Phys.
1350-4533,
25
(
7
), pp.
539
545
.
25.
Yang
,
L.
,
Granat
,
M. H.
,
Paul
,
J. P.
,
Condie
,
D. N.
, and
Rowley
,
D. I.
, 1997, “
Further Development of Hybrid Functional Electrical Stimulation Orthoses
,”
Artif. Organs
0160-564X,
21
(
3
), pp.
183
187
.
26.
Kobetic
,
R.
,
Marsolais
,
E. B.
,
Triolo
,
R. J.
,
Davy
,
D. T.
,
Gaudio
,
R.
, and
Tashman
,
S.
, 2003, “
Development of a Hybrid Gait Orthosis: A Case Report
,”
J. Spinal Cord Med.
1079-0268,
26
(
3
), pp.
254
258
.
27.
Goldfarb
,
M.
, and
Durfee
,
W. K.
, 1996, “
Design of a Controlled-Brake Orthosis for FES-Aided Gait
,”
IEEE Trans. Rehabil. Eng.
1063-6528,
4
(
1
), pp.
13
24
.
28.
Goldfarb
,
M.
,
Korkowski
,
K.
,
Harrold
,
B.
, and
Durfee
,
W.
, 2003, “
Preliminary Evaluation of a Controlled-Brake Orthosis for FES-Aided Gait
,”
IEEE Trans. Neural Syst. Rehabil. Eng.
,
11
(
3
), pp.
241
248
.
29.
van den Bogert
,
A. J.
, 2003, “
Exotendons for Assistance of Human Locomotion
,”
BioMedical Engineering OnLine
,
2
(
17
).
30.
Jefferson
,
R.
, and
Whittle
,
M.
, 1990, “
Performance of Three Walking Orthoses for the Paralysed: A Case Study Using Gait Analysis
,”
Prosthet. Orthot Int.
0309-3646,
14
, pp.
103
110
.
31.
Gharooni
,
S.
,
Heller
,
B.
, and
Tokhi
,
M. O.
, 2001, “
A New Hybrid Spring Brake Orthosis for Controlling Hip and Knee Flexion in the Swing Phase
,”
IEEE Trans. Neural Syst. Rehabil. Eng.
,
9
(
1
), pp.
106
107
.
32.
Durfee
,
W. K.
, and
Palmer
,
K. I.
, 1994, “
Estimation of Force-Activation, Force-Length, and Force-Velocity Properties in Isolated, Electrically Stimulated Muscle
,”
IEEE Trans. Biomed. Eng.
0018-9294,
41
(
3
), pp.
205
216
.
33.
Winter
,
D.
, 1979,
Biomechanics of Human Movement
,
Wiley
, New York.
You do not currently have access to this content.