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Research project: Iterative learning Control for re-education of upper limb function mediated by electrical stimulation (ES) and Restoration of Reach and Grasp in Stroke Patients using ES and Haptic Feedback

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When you practice playing tennis you become better at it, because new nerve connections have been made within your brain. Not only do you need to practice, but you also need feedback of your performance so that you can improve. When people re-learn skills after a stroke they go through the same process as you do when you learn to play tennis. But they have a problem. Because some of the nerves connecting their brain and their muscles have been damaged they can hardly move at al. Consequently they cannot practice which means they don’t get feedback. In this research we are developing a way of electrically stimulating the nerves to make the muscles move so that the person with a stroke can practice movements. They will do this either with their arm resting in a robot, playing computer games, or reaching and grasping everyday objects. The clever bit is that the level and timing of stimulation is adjusted on each movement in response to the performance on the previous one. This is the way your brain learns skills like playing tennis - by correcting errors. It is called Iterative Learning Control (ILC). ILC has been used in industrial processes - think about robots making cars - but this is the first time it has been used to help stroke patients recover their movement. In this research project engineers, therapists and psychologists will work together to design the system and test it with patients.

Our initial work over the last 5 years has developed ILC algorithms to control FES applied to one muscle (triceps brachii) and then two muscles (triceps brachii and anterior deltoid) during reaching tasks; first a planar robot and then the Armeo 3D robot. Algorithms have been tested clinically with two small samples of stroke patients and a reduction of upper limb impairment has been demonstrated following a period of training.

Our latest project will develop an FES system to assist real-world goal-oriented movements, using stimulation applied to multiple muscles in the upper limb to produce movement in the shoulder, arm, wrist and hand. Clinical trials will be performed using both: 1) Armeo + glove, and 2) low-cost sling + glove (in patient’s own homes). There will be a strong emphasis on tying task selection and assistance specification to motor learning theory.

The project employs clinical and engineering research fellows and PhD students who work closely together to achieve the core project deliverables, involving system integration, movement analysis, FES controller implementation and testing, and clinical trials. A PhD student will focus on analysis of task progression and task/stimulation protocols for neurorehabilitation. A simple 2-webcam system which uses image-processing to provide the real-time arm position (shoulder, elbow, wrist positions) will be used with the Hocoma Boom or ErgoRest to replace the Armeo during some of the clinical tests.

Project team

Professor Jane Burridge, Dr Ann Marie Hughes (Senior Research fellow), Dr Katie Meadmore (Research fellow)

Professor Eric Rogers, School of Electronics and Computer Science
Information: Signals, Images, Systems Research Group

Dr Christopher Freeman (Lecturer) , School of Electronics and Computer Science
Information: Signals, Images, Systems Research Group

Dr Timothy Excel (Research fellow) School of Electronics and Computer Science
Information: Signals, Images, Systems Research Group

Project funder

EPSRC

Associated research themes

Functional Electrical Stimulation
Iterative Learning Control
Stroke
Recovery of arm and hand function
Rehabilitation robotics

Related research groups

Active Living and Rehabilitation

Conferences and events associated with this project:

1. Freeman, C. T., Hughes, A. M., Burridge, J. H., Chappell, P. H., Lewin, P. L. and Rogers, E. (2006) Iterative Learning Control as an Intervention Aid to Stroke Rehabilitation. In: UKACC Control 2006 Mini Symposium: InstMC Control Concepts in Healthcare and Rehabilitation, 31 August 2006, Glasgow, Scotland, UK. pp. 225-233.

2. Hughes, A. M., Burridge, J., Freeman, C., Chappell, P., Lewin, P. and Rogers, E. (2006) What is the current role of rehabilitation robots in upper limb post stroke therapy? In: 1st UK Stroke Forum Conference, 07 December 2006, Harrogate, UK.

3. Hughes, A. M., Freeman, C., Burridge, J., Chappell, P., Lewin, P. and Rogers, E. (2007) Can Iterative Learning Control (ILC) mediated by Functional Electrical Stimulation (FES) be used in the re-education of upper limb function post stroke? In: International Functional Electrical Stimulation Society Conference, 10-14th November 2007, Philadelphia, USA .

4. Hughes, A. M., Freeman, C. T., Burridge, J. H., Chappell, P. H., Lewin, P. L. and Rogers, E. (2007) Can Iterative Learning Control be used in the Re-education of Upper Limb Function, Mediated by Functional Electrical Stimulation (FES)? In: Progress in Motor Control VI, 9-12 August 2007, Santos, Brazil S217-S218..

5. Hughes, A. M., Burridge, J. H., Freeman, C., Chappell, P., Lewin, P. and Rogers, E. (2007) Can Iterative Learning Control Be Used In The Re-Education of Upper Limb Function, Mediated by Functional Electrical Stimulation (FES)? In: The Future of Restorative Neuroscience in Stroke Rehabilitation, 24 - 26 September 2007, Windsor, UK.

6. Hughes, A. M., Burridge, J., Freeman, C., Chappell, P., Lewin, P. and Rogers, E. (2007) Can Iterative Learning Control be used in the Re-education of upper limb function? In: LSI Forum Conference, 15 March 2007, Southampton.

7. Freeman, C. T., Hughes, A. M., Burridge, J., Chappell, P. H., Lewin, P. L. and Rogers, E. (2007) An Experimental Facility using Functional Electrical Stimulation for Stroke Rehabilitation of the Upper Limb. In: 10th IEEE International Conference on Rehabilitation Robotics, 12 - 15 June 2007, Noordwijk, The Netherlands.

8. Hughes, A. M., Burridge, J., Freeman, C., Chappell, P., Lewin, P. and Rogers, E. (2008) Changes in upper limb isometric strength and error tracking following training using iterative learning control (ILC) mediated by functional electrical stimulation (FES). In: Annual Meeting of European Society For Movement Analysis For Adults and Children, 08-13 September 2008, Antalya, Turkey.

9. Freeman, C., Hughes, A. M., Burridge, J., Chappell, P., Lewin, P. and Rogers, E. (2008) Modelling of the Upper Limb Using Electrical Stimulation for Stroke Rehabilitation. In: 23rd IAR Workshop on Advanced Control and Diagnosis, 27-28 November 2008, Coventry University, UK. pp. 66-71

10. Hughes, A. M., Burridge, J., Freeman, C., Chappell, P., Lewin, P. and Rogers, E. (2008) Re-education of upper limb function post stroke, using Iterative Learning Control (ILC) mediated by Functional Electrical Stimulation (FES). In: 6th World Stroke Congress, Sept 24-27, Vienna, Austria. p. 343.

11. Freeman, C., Hughes, A. M., Burridge, J., Chappell, P., Lewin, P. and Rogers, E. (2009) Design and Control of an Upper Arm FES Workstation for Rehabilitation. In: 11th International Conference on Rehabilitation Robotics, 23-26 June, Kyoto, Japan pp. 66-72

12. Freeman, C., Hughes, A. M., Burridge, J., Chappell, P., Lewin, P. and Rogers, E. (2009) An Upper Limb Model Using FES for Stroke Rehabilitation. In: European Control Conference 2009 - ECC’09, 23-26 August, 2009, Budapest, Hungary. pp. 3208-3213

13. Hughes, A. M., Freeman, C. T., Burridge, J. H., Chappell, P. H., Lewin, P. L. and Rogers, E. (2009) Upper Limb Rehabilitation of Stroke Participants using Electrical Stimulation: Changes in Tracking and EMG Timing (best paper prize). In: 11th International Conference on Rehabilitation Robotics, 23-26 June, Kyoto, Japan. pp. 59-65.

14. Hughes, A. M., Freeman, C., Burridge, J., Chappell, P., Lewin, P. and Rogers, E. (2009) Clinical effectiveness and patient perceptions of an ILC mediated by ES system using a robotic workstation. In: XVIII European Stroke Conference, 26-29 May 2009, Stockholm, Sweden.

15. Burridge, J.H., Freeman, C.T., Hughes, A.M., Rogers, E., Lewin, P.L. and Chappell, P.H. (2010) Relationship between changes in tracking performance and timing and amplitude of biceps and triceps EMG following training in a planar arm robot in a sample of people with post-stroke hemiplegia. At XVIII Congress of the International Society of Electrophysiology and Kinesiology, Aalborg, Denmark 16 - 19 Jun 2010

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