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Closed-loop wrist stabilization in C4 and C5 tetraplegia

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2 Author(s)
Lemay, M.A. ; Rehab. Eng. Center, MetroHealth Med. Center, Cleveland, OH, USA ; Crago, P.E.

The authors investigated the feasibility of using functional neuromuscular stimulation (PNS) to stabilize wrist flexion/extension angle in individuals with tetraplegia at C4 and C5. Three wrist position controllers were evaluated experimentally and in simulation. Closed-loop feedback regulation increased wrist stability in the presence of wrist moment disturbances, using less wrist muscle activation than an open-loop cocontraction system. However, if the disturbances were large compared to the available wrist muscle moment, controller saturation made the open-loop system more economical, even though the feedback controllers still performed better. The simulations also showed that stimulating the finger flexors can induce a negative stiffness: load at the wrist, which destabilizes wrist position. The destabilizing effects of the negative stiffness were reduced if the passive wrist moment model included nonlinear damping instead of linear damping

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Rehabilitation Engineering, IEEE Transactions on  (Volume:5 ,  Issue: 3 )