Neuromodulation : journal of the International Neuromodulation Society
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The objective of this study was to evaluate the effect of automatic event-driven electrical stimulation on the dorsal penile/clitoral nerve for management of neurogenic detrusor overactivity in spinal cord injured subjects. In order to reach the objectives it was necessary to design and realize a portable device for ambulatory urodynamic studies which was able to activate an electrical stimulator when the detrusor pressure exceeded a certain threshold. ⋯ In testing the automatic event-driven system in the spinal cord injured subject, detrusor contractions were successfully inhibited until a certain bladder volume was reached and no incontinence episodes were observed prior to disabling the system. The preliminary results indicate that automatic event-driven electrical stimulation on the dorsal penile/clitoral nerve can inhibit involuntary detrusor contractions in spinal cord injured subjects and hereby restore continence and increase bladder capacity.
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The aim of this article is to introduce the robotic orthosis Lokomat, developed to automate treadmill training rehabilitation of locomotion for spinal cord injured and stroke patients, to the Functional Electrical Stimulation (FES) and Neuromodulation research communities, and to report on our newly conducted research. We first illustrate the primary use of Lokomat in rehabilitation and focus on control aspects and algorithms associated with robotic rehabilitation of locomotion. ⋯ The first application is closed-loop control of the FES-induced shank movement and the second is the development of a neural network model of the spinal locomotor centers. This model was used to derive a neural locomotion controller for the Lokomat.
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This paper presents the use of multiple sensors for walking assessment and provision of cognitive feedback during early re-education of incomplete spinal cord injured (SCI) humans. The paper is focused on the swing phase estimation as an important part of the Functional Electrical Stimulation (FES) gait re-education system for incomplete spinal cord injured persons. The proposed sensory system comprises four accelerometers, one gyro placed at the shank of the paretic leg, and two goniometers placed at the knee and ankle joints, respectively. ⋯ The results showed that the timing of FES triggering played an important role in sensory-supported FES-assisted walking, that is, the auditory feedback was also a cue to the therapist controlling the FES. The swing quality estimation enabled patients to voluntarily improve their walking, consequently the intensity of FES assistance was decreased. This suggests that the use of an FES multisensor system for cognitive feedback is efficient rehabilitative method in early stage of rehabilitation of walking.
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This study was aimed to test whether the administration of transcutaneous electrical neural stimulation (TENS), heat or cold alone, or the coadministration of TENS in combination with heat or with cold may alter the thresholds of the sensory (algosity) and the affective (unpleasantness) dimensions of experimental pain. Mechanical pain induced by a pressure algometer was applied to the tibial shaft of 180 healthy volunteers before and after random application of one of the six following modalities: sham-stimulation, cold, heat, TENS, combination of TENS + cold, or combination of TENS + heat. ⋯ Only the combination of TENS + heat significantly elevated the thresholds of algosity (from 221 mmHg to 262 mmHg, p < 0.01) and of unpleasantness (from 134 ± 9 to 197 ± 9 mmHg; p < 0.001). These findings suggest that the coadministration of several physical modalities can be more efficacious in the treatment of pain than each modality alone.