MAE 250 Biorobotics

Functional Electrical Stimulation (FES)

and Muscle Mechanics

Outline:
Overview of FES
Muscle Mechanics:

Motivation: Need to understand the response properties of the

actuator if you want to control muscle externally or infer from
movement what the brain is doing
Parastep video: http://www.youtube.com/watch?v=1AoH7fr9iMI&featur
e=related

FES: History

Stimulating muscles with a therapeutic or assistive goal

The possibility of evoking involuntary contractions of paralyzed muscles was investigated by Benjamin
Franklin in 1757

Development of FES for skeletal muscle inspired by the development of the artificial cardiac pacemaker
(1957, first wearable pacemaker, Earl Bakken, Medtronic founder)

1960 First demonstration of standing with FES (Kantrowitz)

1961 First portable neuroprostheses (Liberson et al.)

Implantable systems developed in the 1970s

Devices exist for controlling standing, walking, and grasping

stimulation of quadriceps and glutei muscles via surface electrodes)

Goal: prevent foot drop in hemiplegic patients

Stimulated peroneal nerve with surface electrode
Used footswitch to time stimulation

FES: Stimulation Basics

Activates motor neurons, because the threshold of stimulation of motor axons is far below the
threshold for muscle fibers (sometimes called functional neural stimulation)
Uses pulsed currents to elicit action potentials; steady currents cause the neurons to adapt
and stop firing
Pulses are typically biphasic (charge-balanced) because repeated use of monophasic
pulses can cause tissue damage due to Galvanic processes
Amplitude and duration of pulses (charge delivered) determines if a neuron is recruited
(typical parameters: 0.3 msec pulse, 30 Hz)
More charge recruits more fibers producing more force
Higher stimulation frequency produces more force because of summation of muscle twitches

FES: Differences from Natural Activation

Recruitment order

Natural activation follows the size principle:

Small, slow, non-fatigable, motor units are recruited first (posture)

Large, fast, fatigable, motor units are recruited next (locomotion, jumping)

FES reverses recruitment order because large motor units have a smaller threshold for
activation by external stimulation

Recruitment selection

Natural activation rotates between different motor units to reduce fatigue

FES stimulates the same motor units repeatedly

Activation pattern

Natural activation uses asynchronous action potentials in different motor units,

producing smooth contractions
FES stimulates different motor units at the same time

All of these factors lead to more fatigue for a given level of force output

FES: Commercialization

FES has produced viable commercial products

FES for skeletal muscle not widely accepted

Reasons:

Hearing (cochlear implants > 50,000 implanted)

Breathing (phrenic nerve pacing)
Bladder and pain control

Example: foot-drop stimulators

< 14,000 manufactured
Peroneal nerve stimulation
target population: 1,000,000

Difficulty donning surface electrodes

Skin irritation
Poor tolerance of the sensation of stimulation
Poor selectivity (single channel)
Unreliable sensing (e.g. footswitch)
Lack of adaptability of control (e.g. stair climbing)
Wheelchairs work well

The future?

http://www.bioness.com/NESS_L300_fo
r_Foot_Drop/How_NESS_L300_Works.php

implanted electrodes that make use of recordings from natural sensors

Commercialization: Freehand System Example

The case study examines the history of the device and
the founding of NeuroControl Corp. in 1993. Despite
raising several million dollars in venture capital funds,
the company was unable to make the device a
commercial success, withdrawing it from the market in
2002. The commercialization of the Freehand system
and its subsequent withdrawal from the market suggest
that implantable upper extremity neuroprostheses may
be unmarketable in the current regulatory and
reimbursement environment, Hall concludes.
According to Hall, delays in obtaining FDA approval and
Medicare reimbursement were key factors in the
commercial failure of the Freehand device.
NeuroControl spent about $10 million to get through
the FDA approval process, and ended up covering much
of the unreimbursed device cost. Medicare
reimbursement was in the range of $18,000 to
$30,000, while the cost of the device and implantation
procedure ranged from $55,000 to $70,000.
From: Analyst Probes Commercialization of Neuroprostheses
Neurotech Business Report, by James Cavuoto, editor

Quiz

Does FES first activate neurons or muscles?

What does an FES signal look like and why?

How can you recruit more muscle fibers by changing an FES signal?

How can you get a smooth contraction by changing an FES signal?

What are three differences in the way FES activates a muscle, compared to normal
activation?

What are limitations of FES systems?

Name specific problems that the Freehand system encountered.

Muscle Mechanics
There are over 600
muscles in the human
body.
How does muscle
respond mechanical
when it is stimulated,
given its length and
velocity?

How is muscle constructed

as an actuator?
Muscle is modular, in
increasingly smaller units

fascicles
fibers
fibrils
filaments
sarcomeres

 Alpha motor neuron

Actuator Wiring

final common pathway to activate skeletal

muscle
alpha refers to size (large diameter MNs)
humans also have gamma motor neurons,
which, when activated, change the
sensitivity of the stretch sensors (Muscle
spindles) in muscle
frogs (but not humans) have beta MNs,
which branch to both skeletal muscle and
stretch sensors so that they are like alpha
and gamma motor neurons combined.

Motor unit: an alpha motor neuron and the

muscle fibers it innervates
eye muscle: 10 fibers to 1 neuron
gluteous muscle: 1000s fibers to 1 neuron

Muscle Twitch

Isometric force
response of a motor unit
to a single action
potential
= the impulse response
of muscle
twitches summate

Tetanus

How can central nervous system (CNS)

increase the force of a contraction?
Two methods:
1.
rate coding:
stimulate motor unit at higher

frequency
2.

recruitment:
activate more motor units

size principle: small motor units are

recruited first

The figure shows how individual motor

units are recruited, then increase their
firing rate, as a human subject abducts his
index finger. Notice that recruitment
mainly happens at lower forces. MVC =
maximum voluntary contraction

Note: Electromyogram (EMG) measures

both rate coding and recruitment

From: Moritz, Chet T., Benjamin K. Barry, Michael A.

Pascoe, and Roger M. Enoka. Discharge rate variability
influences the variation in force fluctuations across the
working range of a hand muscle. J Neurophysiol 93: 2449
2459, 2005.

How does muscle respond to forces and motion?:

Background: Mechanical Circuit Elements

force generator F(t)

dashpot: F = - BV
Fo
spring: F=- KX
Ks
B
Kp

Background: Springs
Springs in series

force equal
compliances add

1/Keq = 1/K1 + 1/K2

Springs in parallel
forces add
stiffnesses add

Keq = K1 + K2

How does Muscle respond to Forces and Movement?

Classic Muscle Tests
Test
1. Isometric Twitch
2. Isometric Tetanus
3. Max Isovelocity
4. Max Isotonic
5. Quick Release

Neural Input
impulse
maximum step
maximum
maximum
maximum

Velocity
0
0
constant
measured
measured

From: Winters J. Terminology and foundations of movement science

Force
measured
measured
measured
constant
high-to-low step

Isometric Twitch

Isometric Tetanus

Force Length Curve

Filament overlap
explains the shape
of the Active
Increment

Max Isovelocity or Max isotonic experiment

Hill Equation: (F + a)(V + b) = c

Quick Release

Quick release
experiment implies a
series elastic element

Series Elastic Element

K = dF/dx = cF

Hill Model
Fo
Ks
B
Kp

Hill Model
Phenomenological, lumped-element model
Useful for predicting mechanics, but not as useful for
understanding mechanisms
Widely used in biomechanical simulations
e.g. https://www.youtube.com/user/OpenSimVideos
Can also model mechanics and mechanisms by
starting with biochemical reactions involved with
crossbridges (Huxley Model)

Important special case of muscle mechanics

(and thus simplification of Hill Model)

For rapid perturbations,

muscle acts like spring

Stiffness increases with

activation because of
crossbridge mechanism

In terms of Hill Model,

think of damper resisting
rapid change; muscle
impedance therefore looks
just like series elastic
element

Variation of muscle stiffness with force

Most important mechanical characteristic of muscle
Hunter and Lafontaine, 1992, A comparison of muscle with
artificial actuators

muscles can only pull, so they operate in pairs

forces of opposing muscles subtract
stiffnesses of opposing muscles add
Thus, combined force and stiffness of two opposing
muscles can be controlled independently
Impedance Control

Mechanical Impedance and Muscle

For small perturbation amplitudes, human joints exhibit a linear
impedance

I (l ) B (l ) K (l )
where I (inertia), B (damping), K (stiffness) depend on operating
point (background force and joint angle)
example: human ankle stiffness (Kearney and Kirsch)

decreases with displacement amplitude

increases with background torque
increases near joint limits
does not change during fatigue

Ankle stiffness
increases with
background torque
(but not B or I)

from Mirbagheri et al. 2000

Exp. Br. Res 135:423-436

I (l ) B (l ) K (l )

Perturbation

Model Fit (~90% VAR)

Next Homework

Implement a Muscle Model

based on:
An identified model for
human wrist movements
S.L. Lehman and B.M.
Calhoun
Experimental Brain
Research 81:199-208
Fourth-order
Antagonist/Agonist Hill
Model of wrist movement

Simulation Results: Model sophistication determines

simulation fidelity
Left
Solid line: actual wrist movement
Long dashes 2nd order mass alone
Short dashes: 4th order linear

Right:
Long dashes Hill model
Short dashes full model

Muscle Quiz
1.If you measure the isometric force production of a sarcomere
versus its length, you will find that it has the shape of an inverted u.
Briefly explain why, using simple diagrams.
2.Why does the stiffness of a muscle increase as it becomes more
activated?
3.You are building a biomechanical model of the arm. You plan to
simplify the anatomy, but to include a shoulder flexor muscle, shoulder
extensor muscle, elbow flexor muscle, elbow extensor muscle, and an
agonist/antagonist pair of two-joint muscles that span both the
shoulder and elbow.
a)
The equations of motion are Nth nonlinear differential
equations. What is N, assuming you model each muscle with a Hill
model?
b)
Identify all sources of nonlinearity in your model.