Patient-driven control of FES-supported standing up and sitting down: experimental results.

A patient-driven control strategy for standing-up and sitting-down was experimentally tested on two paraplegic patients by applying functional electrical stimulation (FES) to the quadriceps muscle. The strategy--also known as "patient-driven motion reinforcement" (PDMR)--was developed by computer simulations reported in a former study. It is based on an inverse dynamic model (IDM) that predicts the stimulation pattern required to maintain the movement as it is initiated by the patient's voluntary effort. For reasons of safety and weight relief, the movement was supported by a seesaw construction. After some practice the patients were able to influence the stimulator output and to control the movement by their voluntary effort. Consequently, no pre-programmed reference trajectory was required. As a positive side effect, upper body effort could be minimized compared to trials without FES. To achieve a satisfactory performance of the PDMR controller a careful parameter identification of the inverse dynamic model was fundamental.