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1. Risk factors of pelvic pressure ulcer recurrence after primary skin flap surgery in people with spinal cord injury

Author

C. Mauri, Nicolas Frasson, A. Gelis, C. Herlin, Arnaud Dupeyron, B. Amara, C. Verollet, H. Rouays, Jacques Morel, J.-P. Daures, C. Jourdan, Isabelle Almeras, Service de Médecine Physique et Réadaptation [CHU de Grenoble] (MPR), Centre Hospitalier Universitaire [Grenoble] (CHU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Hôpital Lapeyronie [Montpellier] (CHU), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Euromov (EuroMov), Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), and Institut Universitaire de Recherche Clinique

Subjects
Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Multivariate analysis, medicine.medical_treatment, Spinal cord injury, Surgical Flaps, Pelvis, Young Adult, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Recurrence, Risk Factors, medicine, Humans, Orthopedics and Sports Medicine, Risk factor, Spinal Cord Injuries, Aged, Proportional Hazards Models, Retrospective Studies, Aged, 80 and over, Pressure Ulcer, business.industry, Flap surgery, Rehabilitation, Hazard ratio, Colostomy, Retrospective cohort study, Skin Transplantation, Middle Aged, medicine.disease, Confidence interval, 3. Good health, Surgery, Treatment Outcome, Regression Analysis, Female, Observational study, 0305 other medical science, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, 030217 neurology & neurosurgery
Abstract

Background Flap surgery for deep pelvic pressure ulcers (PPUs) has been found effective, but the recurrence rate remains high and few risk factors have been identified. Objective We evaluated risk factors for PU recurrence after primary flap surgery in people with spinal cord injury (SCI). Patients and methods This observational retrospective study based on medical charts included all individuals with SCI who underwent primary flap surgery for a PPU in the Herault department in France between 2006 and 2014. Overall, 100 biomedical, psychological, socioeconomic and care management factors were studied. The primary outcome was PPU recurrence (surgical site and/or other pelvic site). The secondary outcome was recurrence at the surgical site. Cox proportional hazards regression was used to determine associated factors, estimating hazard ratios (HRs) and 95% confidence intervals (CIs). Results We included 85 patients. Half had a PPU recurrence, and in one-third, the recurrence was at the surgical site. On multivariate analysis, global PPU recurrence was associated with colostomy (HR = 2.79) and living with a partner (HR = 2.29). Non-traumatic SCI and sacral wound were associated with PPU recurrence (HR = 3.39, HR = 0.48) and recurrence at the surgical site (HR = 3.3, HR = 0.3). Conclusion Risk factors of PPU recurrence are based on both biomedical and social models. After primary flap surgery, the risk of recurrence justifies regular follow-up and strict monitoring.

Published
2019

2. Rehabilitation of the upper arm early after stroke: Video games versus conventional rehabilitation. A randomized controlled trial

Author

Arnaud Dupeyron, Jérôme Froger, Huei Yune Bonnin, Isabelle Laffont, Denis Mottet, Liesjet van Dokkum, Philippe Armingaud, Abdelkader Gouaich, Emmanuelle Le Bars, Anthony Gelis, Marie Christine Picot, Audrey Jaussent, Caroline Arquizan, C. Jourdan, K. Bakhti, Euromov (EuroMov), Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Système Multi-agent, Interaction, Langage, Evolution (SMILE), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Institut d’Imagerie Fonctionnelle Humaine [CHU Montpellier] (I2FH), Laboratoire Charles Coulomb (L2C), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Département de Médecine Physique et de Réadaptation [Montpellier], Hôpital Lapeyronie [Montpellier] (CHU), Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université de Montpellier (UM)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université Montpellier 1 (UM1), and Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM)

Subjects
Occupational therapy, Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Randomization, medicine.medical_treatment, law.invention, [SHS]Humanities and Social Sciences, Video games, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Quality of life, Randomized controlled trial, Occupational Therapy, law, medicine, Humans, Orthopedics and Sports Medicine, Single-Blind Method, [INFO.INFO-HC]Computer Science [cs]/Human-Computer Interaction [cs.HC], Upper limb, Stroke, Aged, Aged, 80 and over, Rehabilitation, Hand Strength, business.industry, Stroke Rehabilitation, Recovery of Function, Middle Aged, University hospital, medicine.disease, 3. Good health, medicine.anatomical_structure, Treatment Outcome, Physical therapy, Arm, Female, 0305 other medical science, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Background Few rehabilitation methods have proven their efficacy in increasing sensori-motor recovery and/or function of the upper limb (UL) after stroke. Video games (VGs) are promising tools in this indication. Objective To compare UL rehabilitation by using VGs and conventional rehabilitation (CR) in patients with sub-acute stroke. Design Single-blind, multicentric trial, with central randomization and stratification by center. Setting Physical and rehabilitation medicine departments of 2 university hospitals. Participants Adults within 3 months after a first vascular cerebral accident, with UL Fugl Meyer Score (UL-FMS) Intervention A 45-min additional session of conventional occupational therapy (OT) or a VG-based OT session as add-on therapy to usual rehabilitation programs, 5 days/week for 6 weeks. Main Outcome Measures Primary outcome: UL-FMS. Secondary outcome: Box and Block Test (BBT), Wolf Motor Function test (WMFT), Motor Activity Log (MAL), Barthel Index and quality of life (SF-36). Results We included 51 patients (20 women) at a mean (SD) of 27.2 (19.4) days post-stroke (mean age 58 years [range 24–83]), 26 in the CR group and 25 in the VG group (23 in each group at 6-month follow-up). The mean duration of the additional rehabilitation session was similar in both groups: 29.3 (4.3) vs 28.0 (4.4) min in CR and VG groups. Shoulder pain occurred in 4 patients in the VG group versus 7 in the CR group. At day 45, gain in UL-FMS did not significantly differ between the groups (CR mean 17.8 [14.6] vs VG 24.1 [14.8]; P = 0.10), whereas gain in BBT was doubled in the VG group (CR 7.4 [12.2] vs VG 15.7 [16.3]; P = 0.02). At 6-month follow-up, the study was inconclusive about between-group differences in UL-FMS, BBT and other criteria. Post-hoc analysis showed that gains in UL-FMS or BBT were significantly higher in the VG than CR group for patients included within 30 days post-stroke. Conclusion In general, we cannot conclude that video gaming and conventional OT led to different long-term sensorimotor recovery of the UL after sub-acute stroke. However, when applied within the first month after stroke, video gaming was more efficient than conventional rehabilitation on both sensorimotor recovery and gross grasping function. Trial registration ClinicalTrials.gov ( NCT01554449 ).

Published
2020

3. Validity and internal consistency of the French version of the revised Skin Management Needs Assessment Checklist in people with spinal cord injury

Author

Gélis, Anthony, Dupeyron, Arnaud, Daures, Jean Pierre, Goossens, David, Gault, Dominique, Pedelucq, Jean Paul, Enjalbert, Michel, Maupas, Eric, Kennedy, Paul, Fattal, Charles, Group, French SMNAC, Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Euromov (EuroMov), Laboratoire de génétique des maladies rares. Pathologie moleculaire, etudes fonctionnelles et banque de données génétiques (LGMR), IFR3, Université Montpellier 1 (UM1)-Université Montpellier 1 (UM1)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre de Rééducation Fonctionnelle Divio [Dijon] (CRF COS Divio)

Subjects
Adult, Male, Health Knowledge, Attitudes, Practice, 030506 rehabilitation, medicine.medical_specialty, Psychometrics, Cross-sectional study, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Hospital Anxiety and Depression Scale, Skin Diseases, Young Adult, 03 medical and health sciences, 0302 clinical medicine, 80 and over, medicine, Humans, Spinal cord injury, Spinal Cord Injuries, Aged, Rank correlation, Aged, 80 and over, Practice, Rehabilitation, business.industry, Health Knowledge, Self-Management, Reproducibility of Results, Construct validity, General Medicine, Middle Aged, medicine.disease, Checklist, 3. Good health, Cross-Sectional Studies, Neurology, Attitudes, Physical therapy, Female, Neurology (clinical), 0305 other medical science, business, Needs Assessment, 030217 neurology & neurosurgery
Abstract

International audience; STUDY DESIGN: Cross-sectional psychometrics study. OBJECTIVES: To determine the construct validity and internal consistency of the revised Skin Management Needs Assessment Checklist (revised SMnac). SETTING: Six spinal cord rehabilitation centers. METHODS: One-hundred and thirty-two community-dwelling individuals with spinal cord injury (SCI) were included. Construct validity was assessed by a Spearman's rank correlation coefficient between the revised SMnac and several questionnaires: Rosenberg Self-Esteem Scale, Ways of Coping Questionnaire, Hospital Anxiety and Depression Scale (HADS), Braden scale; or clinical variables: educational level, presence of a pressure ulcer (PU), history of multiple PUs, time since injury, and pain. RESULTS: The study evidenced construct validity with a fair to moderate correlation coefficient between the revised SMnac and Rosenberg scale (rs = 0.25; p = 0.03), active coping (rs = 0.29; p = 0.001), HADS (rs = -0.43; p \textless 0.0001), and time since injury (rs = 0.49; p \textless 0.0001). The presence of PU and history of multiple PUs were strongly correlated with the revised SMnac score (respectively, p = 0.01 and 0.001). Internal consistency was excellent (α = 0.907). CONCLUSION: These results show that the revised SMnac is a valid tool to assess PU self-management in individuals with SCI. Further studies are needed to assess the revised SMnac's responsiveness to change.

Published
2018

4. Taux de complications et de récidives après chirurgie des prolapsus des organes pelviens : résultats à moyen terme d’une étude prospective chez 2341 patientes (Registre VIGI-MESH)

Author

S. Campagne-Loiseau, C. Carlier, R. Ramanah, Michel Cosson, R. de Tayrac, Laurent Wagner, A.C. Pizzoferrato, Christian Saussine, P.O. Bosset, L. Panel, J.-P. Lucot, T. Charles, Thibault Thubert, Arnaud Fauconnier, L. Bressler, X. Deffieux, P. De Bodinance, Xavier Fritel, E. Nkounkou, P. Ferry, Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Hopital saint louis (LA ROCHELLE - Hôpital Saint Louis), CH La Rochelle, Service de réanimation chirurgicale [Béclère], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-AP-HP - Hôpital Antoine Béclère [Clamart], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Groupe Hospitalier de l'Institut Catholique de Lille (GHICL), CHI Poissy-Saint-Germain, CH de Dunkerque, CHU Strasbourg, Service d'Urologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), CH de Châtellerault, Centre hospitalier universitaire de Nantes (CHU Nantes), Institut Languedoc mutualité, Hôpital Foch [Suresnes], Centre hospitalier de Béthune, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Centre hospitalier universitaire de Poitiers (CHU Poitiers), Centre Hospitalier Universitaire de Nancy (CHU Nancy), and CHU Lille

Subjects
Gynecology, medicine.medical_specialty, Prolapsus d'organe pelvien, business.industry, Urology, 030232 urology & nephrology, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Promontofixation, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, business
Abstract

International audience; Objectifs : le prolapsus des organes pelviens (POP) de la femme est une situation fréquente qui mène dans 19 % des cas à un traitement chirurgical. Le registre VIGI-MESH a permis de collecter les interventions chirurgicales de POP dans 19 centres et à surveiller les complications et les révisions chirurgicales. Nous présentons ici les premiers résultats à moyen terme de notre registre.Méthodes : l’analyse comprend 2 341 patientes dont la chirurgie prévue était une promontofixation par laparoscopie avec prothèse (n = 1 143), une chirurgie transvaginale avec prothèse (n = 694) ou sans prothèse (n = 504). La promontofixation a été converti dix fois (0,9 %) : 5 par laparotomie, 2 fixations latérales par laparoscopie, 3 voies transvaginale dont 2 avec prothèse. Les patientes étaient plus jeunes, avec moins de comorbidités dans le groupe promontofixation, et avec plus d’antécédents chirurgicaux chez les patients opérés par voie vaginale. Il y a une majorité de chirurgie avec prothèse en cas de prolapsus antérieur ou apical.Résultats : avec 15 mois de suivi médian, nous avons observé des complications Clavien–Dindo grade III ou plus chez 48 patientes (2,05 %). L’incidence de complications graves à 12 mois est significativement supérieure pour la réparation vaginale prothétique soit 3,71 % [2,28–5,13] versus 1,27 pour la réparation vaginale non prothétique [0,25–2,29] et 1,44 pour la promontofixation [0,71–2,167] avec p = 0,005 (Fig. 1). Il y a 29 réinterventions (1,24 %) en raison d’échec ou de récidive du prolapsus : 11 après promontofixation (0,96 %), 6 après prothèse vaginale (0,86 %) et 12 après réparation vaginale autologue (2,38 %). La réparation vaginale native comporte un risque de reprise chirurgicale pour prolapsus récidivé trois fois plus élevé qu’en cas de promontofixation (RR 0,34 [0,15–0,77]) ou de prothèse vaginale (RR = 0,29 [0,11–0,76]) .Conclusion : dans notre registre, la promontofixation présente le meilleur ratio bénéfice/risque par rapport à la réparation vaginale. Cette dernière expose à un faible risque de complications en cas de réparation autologue mais avec un risque de récidive 3 fois plus élevé et à l’inverse à un faible risque de récidive en cas de chirurgie prothétique mais avec un risque de complication grave 3 fois plus élevé.

Published
2020

5. 'What pressure ulcers mean to me?' Representations of pressure ulcer in persons with spinal cord injury: A qualitative study

Author

David Goossens, Bernard Foulon, Arnaud Dupeyron, Anthony Gelis, Sarah Mathieu, Mathieu Gourlan, Isabelle Laffont, Dominique Gault, Sandrine Robineau, Marc Lefort, Alessandra Pellechia, Grégory Ninot, Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Paul-Valéry - Montpellier 3 (UPVM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Unité Transversale D'éducation Du Patient (UTEP (Montpellier)), Médecine Physique et de Réadaptation [Rennes] (Pôle Saint-Hélier), Association des Paralysés de France (APF (Montpellier)), Centre de Rééducation Clémenceau, Hôpital Saint-Jacques [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Rééducation de La Tour de Gassies (CMPR), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] (CMRRF), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, Département Médecine Physique et Réadaptation [Montpellier], Hôpital Lapeyronie [Montpellier] (CHU), Euromov (EuroMov), Université de Montpellier (UM), Département de Rééducation et Réadaptation Neuro Orthopédique [Nîmes] (Pôle NACRRE), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), and Languedoc Mutualité

Subjects
Male, MESH: Chi-Square Distribution, Psychological intervention, Surgical Flaps, Cohort Studies, 030207 dermatology & venereal diseases, 0302 clinical medicine, Risk Factors, MESH: Spinal Cord Injuries / complications, Surveys and Questionnaires, MESH: Qualitative Research, Spinal cord injury, MESH: Cohort Studies, Qualitative Research, Pressure Ulcer, education.field_of_study, Self-management, MESH: Middle Aged, 030504 nursing, Middle Aged, 3. Good health, MESH: Pressure Ulcer / etiology, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Female, 0305 other medical science, Paraplegia, Psychosocial, MESH: Surgical Flaps / blood supply, Adult, medicine.medical_specialty, Referral, Population, Dermatology, Pathology and Forensic Medicine, 03 medical and health sciences, medicine, Humans, MESH: Surgical Flaps / surgery, education, Spinal Cord Injuries, MESH: Humans, Chi-Square Distribution, Inpatient care, business.industry, Prevention, medicine.disease, Physical therapy, Qualitative study, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

Objectives Explore the perceptions and beliefs related to pressure ulcers (PU), their prevention and treatment strategies, in order to discuss potential learning objectives for PU-related therapeutic education in persons with spinal cord injury (SCI). Design Qualitative study, using grounded theory for the analysis of data collected via a questionnaire. Setting Nine SCI referral centers, inpatient care. Participants 131 persons with SCI were included. 76% were male, and 65% presented with paraplegia. The median age was 48 years (33.5; 58) and median time since injury was 11 years (3; 24.5). 70% had experience with PU. Interventions None. Main outcome measures Data collection via an open-ended questionnaire on the representation of PU, its prevention and life experience of having a PU. Results Six categories were identified: (1) identifying what might become problematic, (2) daily preventive actions, (3) detecting the early signs, (4) managing the early signs, (5) need for care, (6) experience with PU and being bedridden. Pressure ulcers have dramatic consequences on psychosocial health. Prevention and treatment require self-management skills, such as self-risk assessment abilities, self-detection skills and problem-solving strategies, to optimise daily PU prevention in persons with SCI. Conclusion PU prevention tackled by persons with SCI bears some specificities that the physician must take into account in the construction of a self-management program in this high-risk population.

Published
2019

6. Periostin and sclerostin levels in individuals with spinal cord injury and their relationship with bone mass, bone turnover, fracture and osteoporosis status

Author

Patrick Garnero, Laurent Maïmoun, Anthony Gelis, Denis Mariano-Goulart, Safa Aouinti, Jean-Claude Souberbielle, Marie Piketty, Charles Fattal, Fayçal Ben Bouallègue, Pascal Philibert, Thibault Mura, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Physiopathologie, diagnostic et traitements des maladies osseuses / Pathophysiology, Diagnosis & Treatments of Bone Diseases (LYOS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre de Rééducation et Réadaptation Fonctionnelle

Subjects
musculoskeletal diseases, Adult, Male, medicine.medical_specialty, Histology, Physiology, Sclerostin, Endocrinology, Diabetes and Metabolism, Osteoporosis, 030209 endocrinology & metabolism, Spinal cord injury, Periostin, Bone and Bones, Bone remodeling, 03 medical and health sciences, chemistry.chemical_compound, Fractures, Bone, 0302 clinical medicine, Bone Density, Internal medicine, Bone mineral density, Medicine, Humans, Tetraplegia, Spinal Cord Injuries, 030304 developmental biology, Adaptor Proteins, Signal Transducing, Aged, Bone mineral, Paraplegia, 0303 health sciences, business.industry, Organ Size, medicine.disease, Endocrinology, chemistry, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Female, Bone Remodeling, business, Bone turnover markers, Cell Adhesion Molecules, Biomarkers
Abstract

International audience; Background: Spinal cord injury (SCI) induces an acute alteration in bone metabolism. Although the aetiology of the bone disturbances is not precisely known, immobilisation reduces mechanical loading and the morphology of osteocytes, which are the primary mechanosensors. Periostin and sclerostin are secreted mostly by osteocytes and are involved in bone's mechanical response.Objective: The present study was conducted to determine whether individuals with SCI present alterations in serum periostin and sclerostin and to assess their relationships with bone mineral density, bone turnover markers, fracture status, time since injury, densitometric osteoporosis and paraplegic vs. tetraplegic status.Subjects and methods: One hundred and thirty-one individuals with SCI (96 males and 35 females; 42.8 ± 13.7 yr old) with a mean 14.2 ± 12.1 years since the time of injury were evaluated and compared with 40 able-bodied controls in a cross-sectional study. Periostin and sclerostin were assayed by ELISA from Biomedica® (Vienna, Austria), and bone turnover markers and areal bone mineral density (aBMD) were concomitantly analysed.Results: Compared with controls, individuals with SCI presented higher periostin (p

Published
2019

7. Analgesic gas for rehabilitation of frozen shoulder: Protocol for a randomized controlled trial

Author

Dominique Richard, I. Tavares, Sylvie Petiot, Anthony Gelis, Arnaud Dupeyron, Emmanuel Coudeyre, Christel Castelli, Lech Dobija, Marie Dénarié, Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Montpellier (UM), Euromov (EuroMov), Service de Médecine Physique et de Réadaptation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-Hôpital Corentin Celton [Issy-les-Moulineaux], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Département de Biostatistique, Epidémiologie, Santé Publique et Informatique Médicale (BESPIM), Département Médecine Physique et Réadaptation, Centre Hospitalier Universitaire Lapeyronie (CHU Lapeyronie), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, and Institut National de la Recherche Agronomique (INRA)

Subjects
Adult, Male, 030506 rehabilitation, medicine.medical_specialty, Shoulder, Nitrogen, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Analgesic, Adhesive capsulitis, Placebo, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, Quality of life, Double-Blind Method, law, Bursitis, Medicine, Humans, Orthopedics and Sports Medicine, Range of Motion, Articular, Physical Therapy Modalities, Pain Measurement, Randomized Controlled Trials as Topic, Analgesics, Rehabilitation, business.industry, Frozen shoulder, medicine.disease, 3. Good health, Oxygen, Regimen, Capsulitis, Treatment Outcome, Physical therapy, Quality of Life, Female, Analgesia, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract

Background There is little evidence regarding the best way to treat adhesive capsulitis. Physical therapy can reduce pain and improve function and range of motion. However, we lack clear indications on the regimen, techniques or intensity of physical therapy to achieve better results. Intensive physical therapy seems to be confined to the later stages of adhesive capsulitis (chronic stage) given that rehabilitation-induced pain could worsen the outcomes. Here we describe a protocol for a study comparing the efficacy of a standardized program of intensive mobilization under analgesic gas to a similar program under placebo gas and questioning the impact of pain. Method/Design A randomized, double-blind, multicenter study — the MEOPA Trial — was designed to include adults with strictly defined clinical adhesive capsulitis for a 14-day intensive physical rehabilitation program under an equimolar mixture of oxygen and nitrous oxide or sham gas administration. Efficacy will be assessed by the Constant-Murley score. Data for secondary criteria including pain, disability, quality of life and perceived efficacy by the patient or physiotherapist will be collected over 6 months. Discussion This randomized controlled trial has been designed to test the effectiveness of intensive physical therapy under a simple and safe analgesic method. This study will also address the effect of pain during rehabilitation in adhesive capsulitis. Furthermore, results from the 6-month multidimensional follow-up of painful mobilization for this condition could be extrapolated to other musculoskeletal conditions. Trial registration ClinicalTrials.gov No. NCT01087229 .

Published
2019

8. Investigating Upper Limb Movement Classification on Users with Tetraplegia as a Possible Neuroprosthesis Interface

Author

Benjamin Navarro, Lucas Oliveira da Fonseca, Christine Azevedo-Coste, Antonio Padilha Lanari Bo, David Guiraud, Anthony Gelis, Laboratório de Automação e Robótica (LARA), Universidade de Brasilia [Brasília] (UnB), Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Interactive Digital Humans (IDH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)

Subjects
Tetraplegia, Nervous system, 030506 rehabilitation, medicine.medical_specialty, Neuroprosthetics, Computer science, [SDV]Life Sciences [q-bio], Movement, Quadriplegia, [SPI.AUTO]Engineering Sciences [physics]/Automatic, Upper Extremity, [SPI]Engineering Sciences [physics], 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Humans, Spinal Cord Injuries, Neurorehabilitation, business.industry, Supervised learning, Robotics, Prostheses and Implants, Hand, medicine.disease, Statistical classification, medicine.anatomical_structure, SCI, Robot, Unsupervised learning, [SDV.IB]Life Sciences [q-bio]/Bioengineering, Supervised Machine Learning, Adaptive learning, Artificial intelligence, 0305 other medical science, business, Algorithms, 030217 neurology & neurosurgery
Abstract

Lucas Fonseca was among the 15th finalists selected for the 2018 EMBS Student Paper Competition; International audience; Spinal cord injury (SCI), stroke and other nervous system conditions can result in partial or total paralysis of individual's limbs. Numerous technologies have been proposed to assist neurorehabilitation or movement restoration, e.g. robotics or neuroprosthesis. However, individuals with tetraplegia often find difficult to pilot these devices. We developed a system based on a single inertial measurement unit located on the upper limb that is able to classify performed movements using principal component analysis. We analyzed three calibration algorithms: unsupervised learning, supervised learning and adaptive learning. Eight participants with tetraplegia (C4-C7) piloted three different postures in a robotic hand. We achieved 89% accuracy using the supervised learning algorithm. Through offline simulation, we found accuracies of 76% on the unsupervised learning, and 88% on the adaptive one.

Published
2018

9. Arthrodesis Versus Carpometacarpal Preservation in Key-Grip Procedures in Tetraplegic Patients: A Comparative Study of 40 Cases

Author

Thomas Waitzenegger, Bertrand Coulet, Charles Fattal, Adeline Cambon-Binder, Michel Chammas, Cyril Lazerges, Jacques Teissier, Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Centre Mutualiste de Réeducation Neurologique Propara ( PROPARA ), Languedoc Mutualité, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Euromov (EuroMov), Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
Adult, Male, Abductor Pollicis Longus, musculoskeletal diseases, medicine.medical_specialty, Arthrodesis, medicine.medical_treatment, Tenodesis, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, tetraplegia, 030230 surgery, Wrist, Thumb, Quadriplegia, [ SDV.MHEP.RSOA ] Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Tendon transfer, Carpometacarpal joint, medicine, Humans, Orthopedics and Sports Medicine, Carpometacarpal arthrodesis, [ SDV.MHEP.CHI ] Life Sciences [q-bio]/Human health and pathology/Surgery, 030222 orthopedics, Hand Strength, business.industry, Carpometacarpal Joints, Index finger, thumb positioning, musculoskeletal system, key grip, Surgery, Upper limb surgery, body regions, medicine.anatomical_structure, [SDV.MHEP.RSOA]Life Sciences [q-bio]/Human health and pathology/Rhumatology and musculoskeletal system, Female, business, carpometacarpal fusion, Follow-Up Studies
Abstract

PURPOSE: Constructing a lateral key pinch (KP) is a universal aim of any functional upper limb surgery program for tetraplegia. Three stages are required: (1) activating the pinch mechanism by flexor pollicis longus tenodesis to the radius or by tendon transfer to the flexor pollicis longus, (2) simplifying the polyarticular chain, and (3) positioning the thumb column. We compared 2 techniques for accomplishing the latter stage, 1 utilizing arthrodesis of the carpometacarpal joint (CMC) and 1 that did not require arthrodesis of the CMC. MATERIALS AND METHODS: We reviewed 40 cases of KP reconstruction at a mean follow-up of 7.4 years: 17 who had undergone CMC arthrodesis and 23 without CMC arthrodesis. In this group, an abductor pollicis longus tenodesis was necessary to properly position the thumb column in 17 patients. RESULTS: Active KP cases with CMC arthrodesis were significantly stronger than those without an arthrodesis. For passive KP cases, the difference between those cases with CMC arthrodesis and those without was not significant. Regarding opening, for active KP cases with CMC preservation alone, the mean distance between the thumb pulp and the index finger was 4.0 cm at rest and 5.8 cm when passively grasping large objects; for active KP cases without arthrodesis, these values were 3.4 and 6.8 cm, respectively, with the wrist in flexion. For passive KP cases, these values were 2.2 and 3.5 cm with CMC arthrodesis compared with 2.4 and 6.9 cm without arthrodesis. Overall, 23.5% of patients with CMC arthrodesis could not maintain contact between the thumb and the index finger compared with 30.4% without arthrodesis. CONCLUSIONS: Active KP is stronger with than without CMC arthrodesis; however, the KP reconstruction does not open as far when grasping large objects. For passive KP, CMC arthrodesis significantly limits passive opening, with no gain in strength. Neither technique is superior in terms of KP stability. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.

Published
2018

10. Added value of 18 F-florbetaben amyloid PET in the diagnostic workup of most complex patients with dementia in France: A naturalistic study

Author

Ceccaldi, Mathieu, Jonveaux, Thérèse, Verger, Antoine, Krolak-Salmon, Pierre, Houzard, Claire, Godefroy, Olivier, Shields, Trevor, Perrotin, Audrey, Gismondi, Rossella, Bullich, Santiago, Jovalekic, Aleksandar, Raffa, Nicola, Pasquier, Florence, Semah, Franck, Dubois, Bruno, Habert, Marie-Odile, Wallon, David, Chastan, Mathieu, Payoux, Pierre, Felician, Olivier, Didic, Mira, Gueriot, Claude, Koric, Lejla, Kletchkova-Gantchev, Radka, Andriuta, Daniela, Devendeville, Agnès, Dupuis, Diane, Binot, Ingrid, Barbay, Mélanie, Meyer, Marc-Etienne, Moullard, Véronique, Magnin, Eloi, Chamard, Ludivine, Haffen, Sophie, Drouet, Clément, Boulahdour, Hatem, Goas, Philippe, Querellou-Lefranc, Solène, de La Sayette, Vincent, Cogez, Julien, Branger, Pierre, Agostini, Denis, Manrique, Alain, Bejot, Yannick, Jacquin-Piques, Agnès, Dygai-Cochet, Inna, Berriolo-Riedinger, Alina, Moreaud, Olivier, Sauvee, Mathilde, Crépin, Céline, Bombois, Stéphanie, Lebouvier, Thibaud, Mackowiak-Cordoliani, Marie-Anne, Deramecourt, Vincent, Rollin-Sillaire, Adeline, Cassagnaud-Thuillet, Pascaline, Chen, Yaohua, Petyt, Grégory, Federico, Denis, Danaila, Keren, Guilhermet, Yves, Magnier, Christophe, Makaroff, Zaza, Rouch, Isabelle, Xie, Jing, Roubaud, Caroline, Coste, Marie-Hélène, David, Kenny, Sarciron, Alain, Waissi, Aziza, Scheiber, Christian, Gabelle-Deloustal, Audrey, Bennys, Karim, Marelli, Cecilia, Touati, Lynda, de Verbizier-Lonjon, Delphine, Benetos, Athanase, Kearney-Schwartz, Anna, Perret-Guillaume, Christine, Vercelletto, Martine, Boutoleau-Bretonniere, Claire, Pouclet-Courtemanche, Hélène, Wagemann, Nathalie, Pallardy, Amandine, Hugon, Jacques, Paquet, Claire, Dumurgier, Julien, Millet, Pascal, Queneau, Mathieu, Epelbaum, Stéphane, Levy, Marcel, Novella, Jean-Luc, Jaidi, Yacine, Morland, David, Belliard, Serge, Salmon, Anne, Lejeune, Florence, Hannequin, Didier, Martinaud, Olivier, Zarea, Aline, Pariente, Jérémie, Thalamas, Claire, Galitzky-Gerber, Monique, Tricoire Ricard, Anne-Marie, Calvas, Fabienne, Rigal, Emilie, Hitzel, Anne, Delrieu, Julien, Ousset, Pierre-Jean, Lala, Françoise, Sastre-Hengan, Nathalie, Morel, Olivier, Rouaud, Olivier, Mariano-Goulart, Denis, Papathanassiou, Dimitri, Le Jeune, Florence, Stephens, Andrew, Guedj, Eric, Hôpital de la Timone [CHU - APHM] (TIMONE), Institut de Neurosciences des Systèmes (INS), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Gériatrie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Service de neurologie [Amiens], CHU Amiens-Picardie, Service de Médecine Nucléaire [Amiens], Piramal Imaging, Troubles cognitifs dégénératifs et vasculaires - U 1171 (TCDV), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Institut National de la Santé et de la Recherche Médicale (INSERM), Troubles cognitifs vasculaires et dégénératifs, Université de Lille, Sciences et Technologies, Institut de la Mémoire et de la Maladie d'Alzheimer [Paris] (IM2A), Sorbonne Université (SU), Laboratoire d'Imagerie Biomédicale (LIB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de neurologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service de médecine nucléaire [Rouen], CRLCC Haute Normandie-CRLCC Henri Becquerel, Toulouse Neuro Imaging Center (ToNIC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Institut de Neurosciences de la Timone (INT), Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Neurobiologie intégrative et adaptative (NIA), Université de Provence - Aix-Marseille 1-Centre National de la Recherche Scientifique (CNRS), Service de neurologie et de neuropsychologie, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM)- Hôpital de la Timone [CHU - APHM] (TIMONE), Université de Picardie Jules Verne (UPJV), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Université de Bourgogne (UB), Université de Lorraine (UL), Nanomédecine, imagerie, thérapeutique - UFC (EA 4662) (NIT / NANOMEDECINE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service de neurologie, Centre Hospitalier Universitaire [Grenoble] (CHU), Service de Neurologie [Brest], Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Neuropsychologie cognitive et neuroanatomie fonctionnelles de la mémoire humaine, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupe coeur et ischémie, CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Université de Caen Normandie (UNICAEN), Normandie Université (NU), Service de médecine nucléaire [CHU Caen], Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Optimisation - Système - Energie (GEPEA-OSE), Laboratoire de génie des procédés - environnement - agroalimentaire (GEPEA), Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes (UN)-Centre National de la Recherche Scientifique (CNRS)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes (UN)-Centre National de la Recherche Scientifique (CNRS), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Médecine Nucléaire, Centre Régional de Lutte contre le cancer Georges-François Leclerc [Dijon] (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Service de Médecine Nucléaire, Centre Georges-François Leclerc [Dijon] (CGFL), Pôle Psychiatrie et Neurologie [Grenoble], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Neuroendocrinologie et physiopathologie neuronale, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, Département de neurologie[Lille], Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Hôpital des Charpennes [CHU - HCL], CEA Le Ripault (CEA Le Ripault), Direction des Applications Militaires (DAM), Commissariat à l'énergie atomique et aux énergies alternatives (CEA)-Commissariat à l'énergie atomique et aux énergies alternatives (CEA), Unité de Gériatrie, Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)-Centre Mémoire de Ressources et de Recherche (CMRR Lyon), Système Nerveux Autonome - Epidémiologie, Physiologie, Ingénierie, Santé (SNA-EPIS), Université Jean Monnet [Saint-Étienne] (UJM)-Centre Hospitalier Universitaire de Saint-Etienne, Institut Jacques Monod (IJM (UMR_7592)), Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière (CRICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de Gérontologie [CHRU Nancy], Clinique neurologique, Hôpital Laennec, Service de neurologie [Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Hôpital Guillaume-et-René-Laennec [Saint-Herblain], Service de Médecine Nucléaire [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Neurologie Cognitive [Paris], Université Paris Diderot - Paris 7 (UPD7)-Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Parasitologie-Immunologie (EA 3677), Université Bordeaux Segalen - Bordeaux 2, Institut du Cerveau et de la Moëlle Epinière = Brain and Spine Institute (ICM), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Centre National de la Recherche Scientifique (CNRS), Hôpital de Reims - Service de neuro-gériatrie, Hôpital de Reims, Service de neurologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service de médecine nucléaire [Rennes], CRLCC Eugène Marquis (CRLCC), Génétique médicale et fonctionnelle du cancer et des maladies neuropsychiatriques, Université de Rouen Normandie (UNIROUEN), Normandie Université (NU)-Normandie Université (NU)-Institut National de la Santé et de la Recherche Médicale (INSERM), UNIROUEN - UFR Santé (UNIROUEN UFR Santé), Institut National de la Santé et de la Recherche Médicale (INSERM), CIC - Biotherapie - Toulouse, CHU Clermont-Ferrand, Epidémiologie et analyses en santé publique : risques, maladies chroniques et handicaps (LEASP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Gérontopôle, Department of Geriatrics, Centre Hospitalier Universitaire de Toulouse, Troubles cognitifs dégénératifs et vasculaires (U1171), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-INSERM, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Hôpital Purpan [Toulouse], CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre National de la Recherche Scientifique (CNRS)-Aix Marseille Université (AMU), Bureau de Recherches Géologiques et Minières (BRGM) (BRGM), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université de Franche-Comté (UFC), École pratique des hautes études (EPHE)-Université de Caen Normandie (UNICAEN), Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Centre National de la Recherche Scientifique (CNRS)-Université Bretagne Loire (UBL)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Centre Régional de Lutte contre le cancer - Centre Georges-François Leclerc (CRLCC - CGFL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Université Paris Diderot - Paris 7 (UPD7)-Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [APHP]-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Neurosciences Fonctionnelles et Pathologies - UR UPJV 4559 (LNFP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Laboratoire d'Imagerie Biomédicale [Paris] (LIB), CRLCC Haute Normandie-Centre de Lutte Contre le Cancer Henri Becquerel Normandie Rouen (CLCC Henri Becquerel), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Toulouse Mind & Brain Institut (TMBI), Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université Toulouse - Jean Jaurès (UT2J), Université de Toulouse (UT)-Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT), Service d'Obstétrique et de Gynécologie [CHRU Nancy], Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Sciences et Technologies de l'Information et de la Communication - EA 3804 (CRESTIC), Université de Reims Champagne-Ardenne (URCA), Comportement et noyaux gris centraux = Behavior and Basal Ganglia [Rennes], Université de Rennes (UR)-Université européenne de Bretagne - European University of Brittany (UEB)-CHU Pontchaillou [Rennes]-Institut des Neurosciences Cliniques de Rennes = Institute of Clinical Neurosciences of Rennes (INCR), H. Lundbeck A/S, Novartis, Roche, Pfizer, Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-Ecole Polytechnique de l'Université de Nantes (EPUN), Université de Nantes (UN)-Université de Nantes (UN)-Institut Universitaire de Technologie - Nantes (IUT Nantes), Université de Nantes (UN)-Institut Universitaire de Technologie Saint-Nazaire (IUT Saint-Nazaire), Université de Nantes (UN)-Institut Universitaire de Technologie - La Roche-sur-Yon (IUT La Roche-sur-Yon), Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL)-Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS)-Université Bretagne Loire (UBL), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Pontchaillou [Rennes]-Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université européenne de Bretagne - European University of Brittany (UEB)-Institut des Neurosciences Cliniques de Rennes (INCR)

Subjects
0301 basic medicine, NATIONAL INSTITUTE, Pathology, Epidemiology, IMPACT, Amyloid pet, Clinical practice, BETA PLAQUES, 0302 clinical medicine, MESH: Stilbenes, Diagnosis, MESH: Aged, UTILITY, medicine.diagnostic_test, Health Policy, Alzheimer's disease, MESH: Dementia, MESH: Positron-Emission Tomography, 3. Good health, ALZHEIMERS-DISEASE, Psychiatry and Mental health, Positron emission tomography, Radiology, MESH: Radiopharmaceuticals, medicine.medical_specialty, CSF BIOMARKERS, [SDV.IB.MN]Life Sciences [q-bio]/Bioengineering/Nuclear medicine, Amyloid imaging, 18F-florbetaben, MESH: Aniline Compounds, 03 medical and health sciences, Cellular and Molecular Neuroscience, MESH: Brain, Naturalistic observation, SCANS, Developmental Neuroscience, MESH: Diagnosis, Differential, medicine, [INFO.INFO-IM]Computer Science [cs]/Medical Imaging, MANAGEMENT, Dementia, Florbetaben, MESH: Amyloid, MESH: Humans, business.industry, medicine.disease, MESH: Male, MESH: France, 030104 developmental biology, Multicenter study, Etiology, Patient management, Neurology (clinical), Geriatrics and Gerontology, business, MESH: Female, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Introduction: Although some studies have previously addressed the clinical impact of amyloid positron emission tomography (PET), none has specifically addressed its selective and hierarchical implementation in relation to cerebrospinal fluid analysis in a naturalistic setting.Methods: This multicenter study was performed at French tertiary memory clinics in patients presenting with most complex clinical situations (i.e., early-onset, atypical clinical profiles, suspected mixed etiological conditions, unexpected rate of progression), for whom cerebrospinal fluid analysis was indicated but either not feasible or considered as noncontributory (ClinicalTrials.gov: NCT02681172).Results: Two hundred five patients were enrolled with evaluable florbetaben PET scans; 64.4% of scans were amyloid positive. PET results led to changed diagnosis and improved confidence in 66.8% and 81.5% of patients, respectively, and altered management in 80.0% of cases.Discussion: High-level improvement of diagnostic certainty and management is provided by selective and hierarchical implementation of florbetaben PET into current standard practices for the most complex dementia cases. (C) 2017 The Authors. Published by Elsevier Inc. on behalf of the Alzheimer's Association.

Published
2018

11. A novel EMG interface for individuals with tetraplegia to pilot robot hand grasping

Author

Christine Azevedo Coste, Andrea Cherubini, Benjamin Navarro, Charles Fattal, X. Gorron, Anthony Gelis, David Guiraud, Wafa Tigra, Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), MXM-AXONIC, Interactive Digital Humans (IDH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire Pluridisciplinaire de Recherche en Ingénierie des Systèmes, Mécanique et Energétique (PRISME), Université d'Orléans (UO)-Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Euromov (EuroMov), Université de Montpellier (UM), Centre de Rééducation Fonctionnelle Divio [Dijon] (CRF COS Divio), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and Ecole Nationale Supérieure d'Ingénieurs de Bourges (ENSI Bourges)-Université d'Orléans (UO)

Subjects
Adult, Male, Tetraplegia, 030506 rehabilitation, medicine.medical_specialty, Computer science, Interface (computing), Biomedical Engineering, Electromyography, Wrist, Quadriplegia, [SPI.AUTO]Engineering Sciences [physics]/Automatic, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, EMG, Robot hand, Control, Internal Medicine, medicine, Humans, [INFO.INFO-RB]Computer Science [cs]/Robotics [cs.RO], Patient Comfort, Assistive device, [INFO.INFO-BT]Computer Science [cs]/Biotechnology, [PHYS.MECA.BIOM]Physics [physics]/Mechanics [physics]/Biomechanics [physics.med-ph], Muscle, Skeletal, Set (psychology), Spinal Cord Injuries, Grip function, Modalities, Hand Strength, medicine.diagnostic_test, General Neuroscience, Rehabilitation, Robotics, Hand, Self-Help Devices, medicine.disease, body regions, medicine.anatomical_structure, Physical therapy, Feasibility Studies, 0305 other medical science, Algorithms, 030217 neurology & neurosurgery
Abstract

International audience; This article introduces a new human-machine interface for individuals with tetraplegia. We investigated the feasibility of piloting an assistive device by processing supra-lesional muscle responses online. The ability to voluntarily contract a set of selected muscles was assessed in five spinal cord-injured subjects through electromyographic (EMG) analysis. Two subjects were also asked to use the EMG interface to control palmar and lateral grasping of a robot hand. The use of different muscles and control modalities was also assessed. These preliminary results open the way to new interface solutions for high-level spinal cord-injured patients.

Published
2018

12. Muscle Fatigue Tracking with Evoked EMG via Recurrent Neural Network: Toward Personalized Neuroprosthetics

Author

David Guiraud, Charles Fattal, Zhan Li, Mitsuhiro Hayashibe, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
Récurrent neural networks, [SDV.BIO]Life Sciences [q-bio]/Biotechnology, Neuroprosthetics, Computer science, Torque measurement, Electromyography, Theoretical Computer Science, Predictive models, Patient rehabilitation, Artificial Intelligence, Control theory, medicine, Functional electrical stimulation, Torque sensor, Torque, [INFO.INFO-BT]Computer Science [cs]/Biotechnology, Motion control, Fatigue, Simulation, Computational intelligence, Prosthetics, Muscle fatigue, medicine.diagnostic_test, Muscles, Computational modeling, [SPI.MECA]Engineering Sciences [physics]/Mechanics [physics.med-ph], Recurrent neural network
Abstract

International audience; One of the challenging issues in computational rehabilitation is that there is a large variety of patient situations depending on the type of neurological disorder. Human characteristics are basically subject specific and time variant; for instance, neuromuscular dynamics may vary due to muscle fatigue. To tackle such patient specificity and time-varying characteristics, a robust bio-signal processing and a precise model-based control which can manage the nonlinearity and time variance of the system, would bring break-through and new modality toward computational intelligence (CI) based rehabilitation technology and personalized neuroprosthetics. Functional electrical stimulation (FES) is a useful technique to assist restoring motor capability of spinal cord injured (SCI) patients by delivering electrical pulses to paralyzed muscles. However, muscle fatigue constraints the application of FES as it results in the time-variant muscle response. To perform adaptive closedloop FES control with actual muscle response feedback taken into account, muscular torque is essential to be estimated accurately. However, inadequacy of the implantable torque sensor limits the direct measurement of the time-variant torque at the joint. This motivates the development of methods to estimate muscle torque from bio-signals that can be measured. Evoked electromyogram (eEMG) has been found to be highly correlated with FES-induced torque under various muscle conditions, indicating that it can be used for torque/force prediction. A nonlinear ARX (NARX) type model is preferred to track the relationship between eEMG and stimulated muscular torque. This paper presents a NARX recurrent neural network (NARX-RNN) model for identification/prediction of FES-induced muscular dynamics with eEMG. The NARX-RNN model may possess novelty of robust prediction performance. Due to the difficulty of choosing a proper forgetting factor of Kalman filter for predicting time-variant torque with eEMG, the- presented NARX-RNN could be considered as an alternative muscular torque predictor. Data collected from five SCI patients is used to evaluate the proposed NARX-RNN model, and the results show promising estimation performances. In addition, the general importance regarding CI-based motor function modeling is introduced along with its potential impact in the rehabilitation domain. The issue toward personalized neuroprosthetics is discussed in detail with the potential role of CI-based identification and the benefit for motor-impaired patient community.

Published
2014

13. Exploring selective neural electrical stimulation for upper limb function restoration

Author

B. Coulet, Chloé Picq, Jacques Teissier, Pawel Maciejasz, Anthony Gelis, David Guiraud, Wafa Tigra, Christine Azevedo Coste, Charles Fattal, Olivier Rossel, David Andreu, Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), MXM-AXONIC, Hôpital Lapeyronie [Montpellier] (CHU), Euromov (EuroMov), Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre de Rééducation Fonctionnelle Divio [Dijon] (CRF COS Divio), Clinique Médicale Beausoleil, and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
0301 basic medicine, medicine.medical_specialty, Grasping function restoration, lcsh:Medicine, Stimulation, Wrist, lcsh:QM1-695, 03 medical and health sciences, Neural selectivity, 0302 clinical medicine, Physical medicine and rehabilitation, medicine, Orthopedics and Sports Medicine, Molecular Biology, Tetraplegia, 2016 IFESS Conference, Video recording, business.industry, lcsh:R, Cuff electrode, Cell Biology, lcsh:Human anatomy, medicine.disease, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation, 030104 developmental biology, medicine.anatomical_structure, Electrical stimulation, Upper limb, Neurology (clinical), business, 030217 neurology & neurosurgery
Abstract

International audience; This article introduces a new approach of selective neural electrical stimulation of the upper limb nerves. Median and radial nerves of individuals with tetraplegia are stimulated via a multipolar cuff electrode to elicit movements of wrist and hand in acute conditions during a surgical intervention. Various configurations corresponding to various combinations of a 12-poles cuff electrode contacts are tested. Video recording and electromyographic (EMG) signals recorded via sterile surface electrodes are used to evaluate the selectivity of each stimulation configuration in terms of activated muscles. In this abstract we introduce the protocol and preliminary results will be presented during the conference.

Published
2016

14. A hybrid functional electrical stimulation for real-time estimation of joint torque and closed-loop control of muscle activation

Author

David Andreu, Zhan Li, Mitsuhiro Hayashibe, David Guiraud, Charles Fattal, Anthony Gelis, Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre de Rééducation Fonctionnelle Divio [Dijon] (CRF COS Divio), Euromov (EuroMov), Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
030506 rehabilitation, medicine.medical_specialty, Functional electrical stimulation (FES), Computer science, 0206 medical engineering, lcsh:Medicine, Stimulation, 02 engineering and technology, [SPI.AUTO]Engineering Sciences [physics]/Automatic, lcsh:QM1-695, Torque prediction, 03 medical and health sciences, Physical medicine and rehabilitation, Time estimation, Hybrid stimulation system, medicine, Torque, Functional electrical stimulation, Orthopedics and Sports Medicine, Molecular Biology, Muscle activation control, 2016 IFESS Conference, Work (physics), lcsh:R, Healthy subjects, Muscle activation, Cell Biology, lcsh:Human anatomy, 020601 biomedical engineering, Neurology (clinical), 0305 other medical science, Joint (audio engineering)
Abstract

International audience; As a neuroprosthetic technique, functional electrical stimulation (FES) can restore lost motor performance of impaired patients. Through delivering electrical pulses to target muscles, the joint movement can be eventually elicited. This work presents a real-time FES system which is able to deal with two neuroprosthetic missions: one is estimating FES-induced joint torque with evoked electromyograph (eEMG), and the other is artificially controlling muscle activation with such eEMG feedback. The clinical experiment results on spinal cord injured (SCI) patients and healthy subjects show promising performance of the proposed FES system.

Published
2016

15. Upper and lower body coordination in FES-assisted sit-to-stand transfers in paraplegic subjects - A case study

Author

Charles Fattal, Jovana Jovic, Philippe Fraisse, Christine Azevedo Coste, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
[SPI.OTHER]Engineering Sciences [physics]/Other, Technology, medicine.medical_specialty, Computer science, Cognitive Neuroscience, 0206 medical engineering, 02 engineering and technology, fes, Motion (physics), 03 medical and health sciences, Behavioral Neuroscience, Acceleration, paraplegia, 0302 clinical medicine, Lower body, Physical medicine and rehabilitation, Developmental Neuroscience, Artificial Intelligence, medicine, Functional electrical stimulation, Sit to stand, Work (physics), 020601 biomedical engineering, Trunk, sit-to-stand, Human-Computer Interaction, 030217 neurology & neurosurgery
Abstract

The objective of the work presented is to improve functional electrical stimulation (FES) assisted sit-to-stand motion in complete paraplegic individuals by restoring coordination between the upper part of the subject’s body, under voluntary control, and the lower part of the body, under FES control. The proposed approach is based on the observation of trunk movement during rising motion and a detection algorithm, which triggers a pre-programmed stimulation pattern. We present a pilot study carried out on one T6 paraplegic subject. We validated the ability of the subject to produce repeatable trunk acceleration during sit-to-stand transfers under FES and, the ability of the system to trigger the stimulator at the desired instant in time. We also analyzed the influence of the timing of leg stimulation, relative to the trunk acceleration profile, on upper limb efforts applied during sit-to-stand motion.

Published
2011

16. Real-Time Closed-Loop Functional Electrical Stimulation Control of Muscle Activation with Evoked Electromyography Feedback for Spinal Cord Injured Patients

Author

Mitsuhiro Hayashibe, Charles Fattal, David Guiraud, Zhan Li, David Andreu, Anthony Gelis, Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre de Rééducation Fonctionnelle Divio [Dijon] (CRF COS Divio), Tohoku University [Sendai], and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
Adult, Male, 0209 industrial biotechnology, medicine.medical_specialty, Time Factors, Computer Networks and Communications, Electric Stimulation Therapy, Stimulation, Spinal cord injury, 02 engineering and technology, Stimulus (physiology), Models, Biological, Feedback, [SPI.AUTO]Engineering Sciences [physics]/Automatic, Young Adult, 03 medical and health sciences, 020901 industrial engineering & automation, 0302 clinical medicine, Physical medicine and rehabilitation, Functional electrical stimulation, Humans, Medicine, Muscle, Skeletal, Muscle activation control, Spinal Cord Injuries, eEMG, Electromyography, business.industry, Work (physics), Neurological Rehabilitation, Muscle activation, General Medicine, Middle Aged, Spinal cord, medicine.disease, Neurophysiological Monitoring, Evoked electromyography, FES, medicine.anatomical_structure, SCI, Female, [SDV.IB]Life Sciences [q-bio]/Bioengineering, business, 030217 neurology & neurosurgery
Abstract

Functional electrical stimulation (FES) is a neuroprosthetic technique to help restore motor function of spinal cord-injured (SCI) patients. Through delivery of electrical pulses to muscles of motor-impaired subjects, FES is able to artificially induce their muscle contractions. Evoked electromyography (eEMG) is used to record such FES-induced electrical muscle activity and presents a form of [Formula: see text]-wave. In order to monitor electrical muscle activity under stimulation and ensure safe stimulation configurations, closed-loop FES control with eEMG feedback is needed to be developed for SCI patients who lose their voluntary muscle contraction ability. This work proposes a closed-loop FES system for real-time control of muscle activation on the triceps surae and tibialis muscle groups through online modulating pulse width (PW) of electrical stimulus. Subject-specific time-variant muscle responses under FES are explicitly reflected by muscle excitation model, which is described by Hammerstein system with its input and output being, respectively, PW and eEMG. Model predictive control is adopted to compute the PW based on muscle excitation model which can online update its parameters. Four muscle activation patterns are provided as desired control references to validate the proposed closed-loop FES control paradigm. Real-time experimental results on three able-bodied subjects and five SCI patients in clinical environment show promising performances of tracking the aforementioned reference muscle activation patterns based on the proposed closed-loop FES control scheme.

Published
2018

17. Living Lab MACVIA Handicap

Author

R Morales, Jérôme Froger, Jacques Morel, Olivier Jonquet, Christian Hérisson, Bernard Combe, Arnaud Dupeyron, O Hantkié, F Nouvel, L. Landreau, Denis Mottet, Philippe Fraisse, Jean Bousquet, Isabelle Laffont, E. Galano, Karine Patte, V Cros, P Nicolas, A. Gelis, P Kouyoumdjian, E. Viollet, M Fouletier, Bertrand Coulet, P Coignard, David Guiraud, Gérard Dray, Jacques Mercier, Benoît G. Bardy, J. Pelissier, F. Coroian, M Enjalbert, Jérôme Cottalorda, C Leblond, C Fattal, Hubert Blain, Pierre Labauge, B Soua, Christine Azevedo, L Schifano, François Rivier, M. Porte, H.-Y. Bonnin, E Pastor, C. Jourdan, Rodolphe Bourret, K. Bakhti, I. Tavares, William Camu, V. Carre, Institut fédératif de recherche sur le handicap / Réseau fédératif de recherche sur le handicap ( IFRH / RFRH ), Université Panthéon-Sorbonne ( UP1 ) -Université Montpellier 1 ( UM1 ) -Institut national d'études démographiques ( INED ) -Université de Versailles Saint-Quentin-en-Yvelines ( UVSQ ) -Université Bordeaux Segalen - Bordeaux 2-Université de Lille, Sciences et Technologies-Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Université Claude Bernard Lyon 1 ( UCBL ), Université de Lyon-Université de Lyon-Université de Bourgogne ( UB ) -Université de Valenciennes et du Hainaut-Cambresis ( UVHC ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Université Paris Diderot - Paris 7 ( UPD7 ) -Conservatoire National des Arts et Métiers [CNAM] ( CNAM ) -INST GARCHES-CTNERHI-Université de Lille, Sciences Humaines et Sociales-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Lille, Droit et Santé-Université de Rennes 2 ( UR2 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Université de Lorraine ( UL ) -Centre National de la Recherche Scientifique ( CNRS ), Centre de Coopération Internationale en Recherche Agronomique pour le Développement, Euromov ( EuroMov ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Laboratoire de Spectrométrie de Masse et de Chimie Laser ( LSMCL ), Université Paul Verlaine - Metz ( UPVM ), Laboratoire composants et systèmes pour télécommunications ( LCST ), Institut National des Sciences Appliquées ( INSA ), Unité mixte de physique CNRS/Thalès ( UMP CNRS/THALES ), THALES-Centre National de la Recherche Scientifique ( CNRS ), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Department of Computer Sciences, Universidad de Málaga [Málaga], Hôpital Universitaire Carémeau [Nîmes], Centre de résonance magnétique biologique et médicale ( CRMBM ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ) -Centre National de la Recherche Scientifique ( CNRS ), Service de chirurgie pédiatrique [Hôpital Lapeyronie-Arnaud de Villeneuve], Hôpital Lapeyronie [Montpellier] ( CHU ), Institut de Médecine Tropicale du Service de Santé des Armées ( IMTSSA ), Service de Santé des Armées, Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] ( CMRRF ), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, Departamento de Química Física, Tenerife, Universidad de la Laguna, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon ( MACVIA-LR ), Université Montpellier 1 ( UM1 ) -World Health Organization ( WHO/OMS ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -European Innovation Partnership on Active and Healthy Ageing Reference Site, Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de Médecine Physique et de Réadaptation, Centre Hospitalier Universitaire de Nîmes ( CHU de Nîmes ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Euromov (EuroMov), Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre de Rééducation et de Réadaptation Fonctionnelles de La Chataigneraie [Menucourt] (CRRF), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Unité mixte de physique CNRS/Thales (UMPhy CNRS/THALES), Centre National de la Recherche Scientifique (CNRS)-THALES, Institut Marin St Pierre, IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Laboratoire de Biochimie [CHRU Nîmes], Hôpital Lapeyronie [Montpellier] (CHU), Laboratoire de Mécanique et Génie Civil (LMGC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Bourgès - Oc Santé [Castelnau], Oc Santé [Montpellier], Institut de Médecine Tropicale du Service de Santé des Armées (IMTSSA), Centre Bouffard-Vercelli, Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] (CMRRF), Association ADAGES - Les Fontaines d'Ô, Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre communale d'action sociale [Lattes] (CCAS de Lattes), Mairie de Lattes, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), THALES [France]-Centre National de la Recherche Scientifique (CNRS), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Institut des Neurosciences de Montpellier (INM), Biomécanique des Interactions et de l'Organisation des Tissus et des Cellules (BIOTIC), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
Gerontology, Patient care team, [ SDV ] Life Sciences [q-bio], business.industry, [SDV]Life Sciences [q-bio], Public-Private Sector Partnership, General Medicine, 03 medical and health sciences, Health personnel, 0302 clinical medicine, Chronic disease, Living lab, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Medicine, Frail elderly, 030212 general & internal medicine, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, ComputingMilieux_MISCELLANEOUS
Abstract

La Presse Medicale - In Press.Proof corrected by the author Available online since vendredi 16 octobre 2015

Published
2015

18. Le site de référence du Partenariat européen d’innovation pour un vieillissement actif et en bonne santé MACVIA-LR (contre les maladies chroniques pour un vieillissement en bonne santé en Languedoc-Roussillon)

Author

Miren David, Ariane Sultan, Guillaume Pandraud, Benoît G. Bardy, Jacques Morel, Giacomo Cavalli, Sylvain Jacquemin, Christine Rolland, Cyril Breuker, Philippe Boulet, Gregoire Mercier, Stéphane Bouly, Valérie Bruguière, Gwen Mathieu, Marc Meissonnier, Hervé Tassery, Vincent Marmelat, Michel Dauzat, Hubert Blain, Gérard Dray, Cyril Laurent, Christine Viarouge-Reunier, Marie Virginie Calmels, François Rivier, Gérard Dupeyron, Gérard Bourrel, Jacquie Berthe, Philippe Domy, Béatrice Lognos, Martine Aoustin, Davide Caimmi, Michel Kaczorek, Mélanie Badin, Pierre Nicolas, Alain Le Quellec, Sylvie Boichot, Vincent Le Moing, C. Boegner, Jérôme Fernandes, Michel Amouyal, Matthieu Desplan, Jean Paul Cristol, T. Camuzat, Karima Bakhti, Jean Michel Verdier, Paule Adnet, Christophe Jorgensen, Denis Sablot, Jean Ribstein, Henriette Dhivert-Donnadieu, Céline Vergne-Richard, Emilie Porte, Christine Azevedo, Isabelle Quéré, Dominique Jakovenko, Marion Gellerat-Rogier, Michel Tanfin, Karen Ritchie, Flavia Oana Coroian, Bernard Guillot, Fabrice Nouvel, J. Pelissier, Anna Bedbrook, Daniel Laune, Jean-Luc Bourrain, Yves Marie Pers, Jean Luc Savy, Chantal Marion, Cherif Heroum, Marianna Danko, Grégoire Vergotte, Françoise Radier-Pontal, Jean Luc Pasquié, Olivier Bénézet, Bernard Combe, Sylvain Richard, Liliane Landreau, Valérie Cros, Isabelle Rédini-Martinez, Emilie Viollet, David Guiraud, François Roubille, Jérôme Froger, Bertrand Coulet, Laurent Journot, Marie Suzanne Léglise, Sylvie Arnavieilhe, Isabel Tavares, Samir Jaber, Olivier Jonquet, David Morquin, Philippe Van de Perre, Roland Sicard, Raphaël Chiron, Vincent Tribout, Pierre Senesse, Xavier Quantin, Jacques Touchon, Kevin Mandrick, Alain Uziel, Vincent Bouix, Marie Christine Picot, Philippe Augé, Martine Lapierre, Antoine Avignon, Eric Pastor, Pascal Demoly, Kjerstin Torre, Jacques Mercier, Jean-Marie Robine, Dominique Larrey, D. J. Costa, Grégory Ninot, Laurent Schifano, Baya Soua, Anne Wojtusciszyn, Jean-Christophe Gris, Didier Delignières, Florence Gressard, Marie Pierre Pasdelou, Fabienne Portejoie, Michel Mondain, Philippe Nérin, Olivier Hantkié, Xavier Bobia, Delphine Paccard, Pierre Géraud Claret, Maxime Villiet, Jacques Burille, Christian Hérisson, Guillaume Tallon, V. Attalin, Jean Emmanuel de la Coussaye, William Camu, Didier Hoa, Chokri Boubakri, Jacques Reynes, Michel Enjalbert, Pascal Kouyoumdjian, Anthony Gellis, Jean Marc Lussert, Jean Philippe Pin, Christian Bourquin, Jean-Marc Lemaitre, Rodolphe Bourret, Isabelle Laffont, Claudine Berr, Marie Christine Courrouy-Michel, Nicolas Giraudeau, Trias Asteriou, Catherine Leblond, Cyril Meunier, Sylvain Lehmann, M. Nogues, Denise Strubel, Raul Punta-Morales, Alain Makinson, Jacques Bringer, Stéphane Perrey, Nathalie Pinto, Yannick Stephan, Charles Fattal, Jean Marc Davy, Arnaud Bourdin, Emilie Royère, Arnaud Dupeyron, Claire Daien, François Vialla, Frédéric Viart, Joël Bockaert, Arnaud Yves Goucham, Pierre Aubas, Huei Yune Bonnin, Fares Gouzi, Véronique Carre, Nicolas Best, Jean Pierre Riso, Jérome Cottalorda, Max Villain, Philippe Dauenhauer, Patrick Messner, Amélie Matheron, Claude Jeandel, Roxana Taddei-Ologeanu, Bernard Alomène, Sylvie Albert, Stéphane Cade, Gérard Canovas, Pauline Coignard, Karine Patte, Sofiane Ramdani, Frédéric Abecassis, Maurice Hayot, Marc Ychou, Anne Laure Coupet, Nathalie Raffort, D. Heve, Philippe Gabrion, Pierre Mares, Pierre Labauge, Marie Pierre Battesti, Denis Mottet, Philippe Fraisse, Jean Bousquet, Jean Louis Pujol, Emilie Galano, Pierre Fesler, Vincent Dufour, Gregory Baptista, Pierre Louis Bernard, Mireille Fouletier, Pierre Dujol, Xavier Vasquez, Jean Paul Ortiz, Pierre Martin-Gousset, Philippe Courtet, Oude Engberink, Valérie Handweiler, S. Granier, Laurence Vian, Françoise Leclercq, Frédéric Cuisinier, Pierre Costa, Guillaume Cayla, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon (MACVIA-LR), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO), Département d'anesthésie-réanimation[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Centre Hospitalier Régional Universitaire de Nîmes (CHRU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Department of Geriatrics - Efficiency and Deficiency Laboratory, Hadassah Hebrew University Medical Center [Jerusalem], IMT - MINES ALES (IMT - MINES ALES), Institut Mines-Télécom [Paris] (IMT), Département de Biostatistiques, Agence Régionale de Santé Languedoc Roussillon (ARS), Institut de Recherche en Infectiologie de Montpellier (IRIM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Roche Pharma Research and Early Development [Basel] (pRED), F. Hoffmann-La Roche [Basel], Service de gynécologie-obstétrique, Mécanismes adaptatifs : des organismes aux communautés (MAOAC), Centre National de la Recherche Scientifique (CNRS)-Collège de France (CdF)-Muséum national d'Histoire naturelle (MNHN), Laboratoire de Géochimie Isotopique Environnementale (GIS) / Université de Nîmes (GIS), Université de Nîmes (UNIMES)-Centre National de la Recherche Scientifique (CNRS), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Agence nationale de sécurité sanitaire de l'alimentation, de l'environnement et du travail (ANSES), Genre (LARHRA GENRE), LAboratoire de Recherche Historique Rhône-Alpes - UMR5190 (LARHRA), Centre National de la Recherche Scientifique (CNRS)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Grenoble Alpes (UGA)-Centre National de la Recherche Scientifique (CNRS)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Université Lumière - Lyon 2 (UL2)-École normale supérieure - Lyon (ENS Lyon)-Université Pierre Mendès France - Grenoble 2 (UPMF)-Université Grenoble Alpes (UGA), Département de Médecine générale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Control of Artificial Movement and Intuitive Neuroprosthesis (CAMIN), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Département de médecine générale, Université de Montpellier (UM), Euromov (EuroMov), Centre Européen de Réalité Virtuelle (CERV), École Nationale d'Ingénieurs de Brest (ENIB), Laboratoire de Mathématiques Blaise Pascal (LMBP), Université Blaise Pascal - Clermont-Ferrand 2 (UBP)-Centre National de la Recherche Scientifique (CNRS), Pathologies du système nerveux : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), CERFRANCE Nord Est - Ile de France, Réseau de Vigilance en Dermato-Allergologie - Groupe d'Etudes et de Recherches en DERmato-Allergologie (Revidal-Gerda), Réseau de Vigilance en Dermato-Allergologie (Revidal), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] (CMRRF), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de Kerpape, Laboratoire de Bioingénierie et NanoSciences (LBN), Institut de Génétique Moléculaire de Montpellier (IGMM), Dynamique des capacités humaines et des conduites de santé (EPSYLON), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UM3)-Université de Montpellier (UM), Laboratory of Cardio-Vascular Physiology (LCVP), Université Montpellier 1 (UM1), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Rééducation et Réadaptation Neuro Orthopédique [Nîmes] (Pôle NACRRE), Hôpital Universitaire Carémeau [Nîmes], Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Oc Santé Montpellier, Artificial movement and gait restoration (DEMAR), Unité de Rééducation Neurologique, Centre Hélio-Marin CHU Nîmes, Department de Dermatologie, Médecine physique et de réadaptation, Hôpital Lapeyronie [Montpellier] (CHU), Institut de Génomique Fonctionnelle - Montpellier GenomiX (IGF MGX), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Service de Chirurgie Orthopédique, Département de neurologie [Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier]-Université de Montpellier (UM), Centre Bouffard-Vercelli, Laboratoire de Mécanique et Technologie (LMT), École normale supérieure - Cachan (ENS Cachan)-Université Pierre et Marie Curie - Paris 6 (UPMC)-Centre National de la Recherche Scientifique (CNRS), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Plateforme de Protéomique Clinique, CHU Saint-Eloi, Recherches Translationnelles sur le VIH et les maladies infectieuses (TransVIHMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Recherche pour le Développement (IRD)-Université Montpellier 1 (UM1)-Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Universtié Yaoundé 1 [Cameroun]-Université de Montpellier (UM), Département Conception et conduite des véhicules Aéronautiques et Spatiaux (DCAS), Institut Supérieur de l'Aéronautique et de l'Espace (ISAE-SUPAERO), Lab-STICC_TB_CID_TOMS, Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance (Lab-STICC), École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS)-École Nationale d'Ingénieurs de Brest (ENIB)-Université de Bretagne Sud (UBS)-Université de Brest (UBO)-Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques (IBNM), Université de Brest (UBO)-Université européenne de Bretagne - European University of Brittany (UEB)-École Nationale Supérieure de Techniques Avancées Bretagne (ENSTA Bretagne)-Institut Mines-Télécom [Paris] (IMT)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de recherche souterrain de Meuse/Haute-Marne, Agence Nationale de gestion des Déchets Radioactifs, Aix-Marseille Université - Faculté des Sciences du Sport (AMU FSS), Aix Marseille Université (AMU), HORIBA Medical (HORIBA ABX SAS), HORIBA Scientific [France], Unité Mathématique, Informatique et Génome (MIG), Institut National de la Recherche Agronomique (INRA), Interactions, Corpus, Apprentissages, Représentations (ICAR), École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines-Centre National de la Recherche Scientifique (CNRS), Unité clinique d'Immuno-Rhumatologie & Thérapeutique des maladies ostéo-articulaires, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Chimie des Substances Naturelles (ICSN), Centre National de la Recherche Scientifique (CNRS), UNICANCER - Institut régional du Cancer [Montpellier] (ICM), CRLCC Val d'Aurelle - Paul Lamarque, Biocommunication en Cardio-Métabolique (BC2M), Neuropsychiatrie : recherche épidémiologique et clinique, Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Département d'oncologie médicale et digestive, Centre de cancérologie Val d'Aurelle, Complexité, Innovation, Activités Motrices et Sportives (CIAMS), Université d'Orléans (UO)-Université Paris-Sud - Paris 11 (UP11), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] (CAPS), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM), Physiopathologie et thérapie des déficits sensoriels et moteurs, Université Montpellier 2 - Sciences et Techniques (UM2)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche et de Diagnostic sur le Sida (CeDreS), CHU Treichville, Interaction entre Systèmes Protéiques et Différenciation dans la Cellule Tumorale (ISPDCT), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique (CNRS), Dynamiques du droit (DD), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Centre National de la Recherche Scientifique (CNRS), Centre de pharmacologie et innovation dans le diabète (CPID), Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre National de la Recherche Scientifique (CNRS), Recherche en épidémiologie et biostatistique, Université Paris-Sud - Paris 11 ( UP11 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Gui de Chauliac, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] ( PhyMedExp ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), IMT - Mines Alès Ecole Mines - Télécom ( IMT - MINES ALES ), Agence Régionale de Santé Languedoc Roussillon ( ARS ), Institut de Recherche en Infectiologie de Montpellier ( IRIM ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ), Roche Pharma Research and Early Development [Basel] ( pRED ), Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ), Mécanismes adaptatifs : des organismes aux communautés ( MAOAC ), Muséum National d'Histoire Naturelle ( MNHN ) -Collège de France ( CdF ) -Centre National de la Recherche Scientifique ( CNRS ), Laboratoire de Géochimie Isotopique Environnementale (GIS) / Université de Nîmes ( GIS ), Centre National de la Recherche Scientifique ( CNRS ) -Université de Nîmes ( UNIMES ), Institut de recherche en cancérologie de Montpellier ( IRCM ), Université Montpellier 1 ( UM1 ) -CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc-Roussillon ( MACVIA-LR ), Université Montpellier 1 ( UM1 ) -World Health Organization ( WHO/OMS ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre Hospitalier Régional Universitaire de Nîmes ( CHRU Nîmes ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -European Innovation Partnership on Active and Healthy Ageing Reference Site, Agence Nationale de Sécurité Sanitaire, de l'Alimentation, de l'environnement et du Travail ( ANSES ), ANSES, Genre ( LARHRA GENRE ), LAboratoire de Recherche Historique Rhône-Alpes - UMR5190 ( LARHRA ), Centre National de la Recherche Scientifique ( CNRS ) -Université Jean Moulin - Lyon III-Université Lumière - Lyon 2 ( UL2 ) -École normale supérieure - Lyon ( ENS Lyon ) -Université Pierre Mendès France - Grenoble 2 ( UPMF ) -Université Grenoble Alpes ( UGA ) -Centre National de la Recherche Scientifique ( CNRS ) -Université Jean Moulin - Lyon III-Université Lumière - Lyon 2 ( UL2 ) -École normale supérieure - Lyon ( ENS Lyon ) -Université Pierre Mendès France - Grenoble 2 ( UPMF ) -Université Grenoble Alpes ( UGA ), Université Montpellier 1 ( UM1 ), Artificial movement and gait restoration ( DEMAR ), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier ( LIRMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ) -Inria Sophia Antipolis - Méditerranée ( CRISAM ), Institut National de Recherche en Informatique et en Automatique ( Inria ) -Institut National de Recherche en Informatique et en Automatique ( Inria ), Université de Montpellier ( UM ), Euromov ( EuroMov ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Centre Européen de Réalité Virtuelle ( CERV ), École Nationale d'Ingénieurs de Brest ( ENIB ), Laboratoire de Mathématiques Blaise Pascal ( LMBP ), Université Blaise Pascal - Clermont-Ferrand 2 ( UBP ) -Centre National de la Recherche Scientifique ( CNRS ), Université Montpellier 1 ( UM1 ) -IFR76-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Génomique Fonctionnelle ( IGF ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 2 - Sciences et Techniques ( UM2 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Réseau de Vigilance en Dermato-Allergologie - Groupe d'Etudes et de Recherches en DERmato-Allergologie ( Revidal-Gerda ), Réseau de Vigilance en Dermato-Allergologie ( Revidal ), Centre Mutualiste de Rééducation et de Réadaptation Fonctionnelles de KERPAPE [Ploemeur] ( CMRRF ), Laboratoire de Bioingénierie et NanoScience-UM, Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Institut de Génétique Moléculaire de Montpellier ( IGMM ), Université de Montpellier ( UM ) -Centre National de la Recherche Scientifique ( CNRS ), Dynamique des capacités humaines et des conduites de santé ( EPSYLON ), Université Paul-Valéry - Montpellier 3 ( UM3 ) -Université Jean Monnet [Saint-Étienne] ( UJM ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Laboratory of Cardio-Vascular Physiology ( LCVP ), Institut Pierre Louis d'Epidémiologie et de Santé Publique ( iPLESP ), Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Département de Rééducation et Réadaptation Neuro Orthopédique [Nîmes] ( Pôle NACRRE ), Centre Mutualiste de Réeducation Neurologique Propara ( PROPARA ), Hôpital Lapeyronie [Montpellier] ( CHU ), Institut de Génomique Fonctionnelle - Montpellier GenomiX ( IGF MGX ), Laboratoire de Mécanique et Technologie ( LMT ), École normale supérieure - Cachan ( ENS Cachan ) -Université Pierre et Marie Curie - Paris 6 ( UPMC ) -Centre National de la Recherche Scientifique ( CNRS ), CHU Saint-Eloi-Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Montpellier ( UM ), Recherches Translationnelles sur le VIH et les maladies infectieuses ( TransVIHMI ), Université Montpellier 1 ( UM1 ) -Université Cheikh Anta Diop ( UCAD ) -Universtié Yaoundé 1 (Cameroun)-Université de Montpellier ( UM ), Département Conception et conduite des véhicules Aéronautiques et Spatiaux ( DCAS ), Institut Supérieur de l'Aéronautique et de l'Espace ( ISAE-SUPAERO ), Laboratoire des sciences et techniques de l'information, de la communication et de la connaissance ( Lab-STICC ), École Nationale d'Ingénieurs de Brest ( ENIB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université européenne de Bretagne ( UEB ) -ENSTA Bretagne-Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ) -École Nationale d'Ingénieurs de Brest ( ENIB ) -Université de Bretagne Sud ( UBS ) -Université de Brest ( UBO ) -Télécom Bretagne-Institut Brestois du Numérique et des Mathématiques ( IBNM ), Université de Brest ( UBO ) -Université européenne de Bretagne ( UEB ) -ENSTA Bretagne-Institut Mines-Télécom [Paris]-Centre National de la Recherche Scientifique ( CNRS ), Aix-Marseille Université - Faculté des Sciences du Sport ( AMU FSS ), Aix Marseille Université ( AMU ), HORIBA Medical ( HORIBA ABX SAS ), Unité Mathématique, Informatique et Génome ( MIG ), Institut National de la Recherche Agronomique ( INRA ), Interactions, Corpus, Apprentissages, Représentations ( ICAR ), École normale supérieure - Lyon ( ENS Lyon ) -Université Lumière - Lyon 2 ( UL2 ) -INRP-Ecole Normale Supérieure Lettres et Sciences Humaines-Centre National de la Recherche Scientifique ( CNRS ), Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Hôpital Lapeyronie, Institut de Chimie des Substances Naturelles ( ICSN ), Centre National de la Recherche Scientifique ( CNRS ), UNICANCER - Institut régional du Cancer [Montpellier] ( ICM ), Efficience Déficience Motrice [Montpellier] ( EDM ), Centre de pharmacologie et innovation dans le diabète ( CPID ), Université Montpellier 1 ( UM1 ) -Centre Hospitalier Régional Universitaire [Montpellier] ( CHRU Montpellier ) -Centre National de la Recherche Scientifique ( CNRS ), Complexité, Innovation, Activités Motrices et Sportives ( CIAMS ), Université Paris-Sud - Paris 11 ( UP11 ) -Université d'Orléans ( UO ), Cognition, Action, et Plasticité Sensorimotrice [Dijon - U1093] ( CAPS ), Université de Bourgogne ( UB ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université Montpellier 2 - Sciences et Techniques ( UM2 ) -IFR76-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre de recherche et de Diagnostic sur le Sida ( CeDreS ), Interaction entre Systèmes Protéiques et Différenciation dans la Cellule Tumorale ( ISPDCT ), Université de la Méditerranée - Aix-Marseille 2-Centre National de la Recherche Scientifique ( CNRS ), Dynamiques du droit ( DD ), Centre National de la Recherche Scientifique ( CNRS ) -Université Montpellier 1 ( UM1 ) -Université de Montpellier ( UM ), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-European Innovation Partnership on Active and Healthy Ageing Reference Site (EIP on AHA), Commission Européenne-Commission Européenne-Organisation Mondiale de la Santé / World Health Organization Office (OMS / WHO)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), CERMES3 - Centre de recherche Médecine, sciences, santé, santé mentale, société (CERMES3 - UMR 8211 / U988 / UM 7), École des hautes études en sciences sociales (EHESS)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de Génie Informatique et Ingénierie de Production (LGI2P), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Agence Régionale de la Santé (ARS), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université Pierre Mendès France - Grenoble 2 (UPMF)-École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Université Pierre Mendès France - Grenoble 2 (UPMF)-École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-Université Jean Moulin - Lyon 3 (UJML), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Neuropsychiatrie : recherche épidémiologique et clinique (PSNREC), Université Montpellier 1 (UM1)-Université Paul-Valéry - Montpellier 3 (UPVM)-Université de Montpellier (UM), Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes)-Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Oc Santé [Montpellier], Interactive Digital Humans (IDH), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Hôpital Gui de Chauliac [Montpellier]-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Recherches Translationnelles sur le VIH et les maladies infectieuses endémiques er émergentes (TransVIHMI), Université Cheikh Anta Diop [Dakar, Sénégal] (UCAD)-Institut de Recherche pour le Développement (IRD)-Université de Yaoundé I-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Université Montpellier 1 (UM1), Service de Rhumatologie [CHRU Montpellier], École normale supérieure - Lyon (ENS Lyon)-Université Lumière - Lyon 2 (UL2)-INRP-Ecole Normale Supérieure Lettres et Sciences Humaines (ENS LSH)-Centre National de la Recherche Scientifique (CNRS), Centre National de la Recherche Scientifique (CNRS)-Institut de Chimie du CNRS (INC), Institut du Cancer de Montpellier (ICM), Université Paris-Sud - Paris 11 (UP11)-Université d'Orléans (UO), Centre de recherche et de Diagnostic sur le Sida [Abidjan, Côte d'Ivoire] (CeDreS), Centre Hospitalier Universitaire de Treichville [Abidjan, Côte d'Ivoire] (CHU de Treichville), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université Montpellier 1 (UM1), Centre National de la Recherche Scientifique (CNRS)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1), Muséum national d'Histoire naturelle (MNHN)-Collège de France (CdF)-Centre National de la Recherche Scientifique (CNRS), and CRLCC Val d'Aurelle - Paul Lamarque-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Aging, [ SDV ] Life Sciences [q-bio], business.industry, [SDV]Life Sciences [q-bio], General Medicine, MESH: Accidental Falls, 3. Good health, 03 medical and health sciences, 0302 clinical medicine, [ SDV.MHEP ] Life Sciences [q-bio]/Human health and pathology, Medicine, 030211 gastroenterology & hepatology, Accidental Falls, MESH: Aging, 030212 general & internal medicine, business, Humanities, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Le site de référence du Partenariat européen d'innovation pour un vieillissement actif et en bonne santé MACVIA-LR (contre les maladies chroniques pour un vieillissement en bonne santé en Languedoc-Roussillon)

Published
2015

19. Ergonomics of the control by a quadriplegic of hand functions

Author

Charles Fattal, David Guiraud, Wafa Tigra, Christine Azevedo Coste, MXM-AXONIC, Artificial movement and gait restoration (DEMAR), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
030506 rehabilitation, medicine.medical_specialty, Grasping, Assistive devices, Deltoid curve, Orthotics, Electromyography, Contracts, Spinal cord injury, Biceps, 03 medical and health sciences, [SPI]Engineering Sciences [physics], 0302 clinical medicine, Physical medicine and rehabilitation, Forearm, medicine, Functional electrical stimulation, Injuries, medicine.diagnostic_test, business.industry, Muscles, body regions, medicine.anatomical_structure, Upper limb, 0305 other medical science, Trapezius muscle, business, 030217 neurology & neurosurgery
Abstract

International audience; In subjects with complete Spinal Cord Injury (SCI) above C7, the four limbs are paralyzed (quadriplegia). Recovery of grasping movements is then reported as a priority. Indeed, most activities of daily living are achieved through upper limbs. Thus, restoration of hand and forearm active mobility could significantly increase independence and quality of life of these people and decrease their need of human aid. Although most of the subjects plebiscite pharmacological or biological solutions, only orthotics and Functional Electrical Stimulation (FES) allow, so far, to restore hand movements but they are rarely used. Limited ergonomics and comfort of piloting modes could partly explain the low usage of these systems. In this context, our aim is to explore possible solutions for subjects to interact with such devices. In this article, we propose to evaluate the capacity of active upper limb muscles contraction to be used to intuitively control FES in tetraplegic subjects. In this study, we assessed the ability to gradually contract different muscles: trapezius, deltoid, platysma and biceps. Three subjects with C6 to C7 neurological levels of lesion were included. We show that over the active upper limb muscles tested, contraction of the trapezius muscle was considered by the subjects as the most comfortable and could be employed as an intuitive mode of control of functional assistive devices.

Published
2015

20. Coordinating Upper and Lower Body During FES-Assisted Transfers in Persons With Spinal Cord Injury in Order to Reduce Arm Support

Author

Philippe Fraisse, Sonia Henkous, Jovana Jovic, Charles Fattal, Christine Azevedo Coste, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
Adult, Male, Patient Transfer, 030506 rehabilitation, medicine.medical_specialty, Adolescent, Lower limb, 03 medical and health sciences, [SPI]Engineering Sciences [physics], Young Adult, 0302 clinical medicine, Physical medicine and rehabilitation, Lower body, Medicine, Functional electrical stimulation, Humans, Prospective Studies, Spinal Cord Injury, Muscle, Skeletal, Spinal cord injury, Tetraplegia, Spinal Cord Injuries, Aged, Functional Electrical Stimulation, Stimulation fonctionnelle électrique, business.industry, sit-to-stand transfer, Torso, General Medicine, Middle Aged, medicine.disease, Trunk, Electric Stimulation, FES, Anesthesiology and Pain Medicine, Neurology, Lower Extremity, Complete paraplegia, Physical therapy, Arm, Female, Neurology (clinical), Muscle Stimulation, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract

International audience; Objective:The goal of this study is to minimize arm forces applied during sit-to-stand (STS) transfers in persons with spinal cord injury (SCI) by using functional electrical stimulation (FES) applied to lower limbs muscles.Materials and Methods:A new FES system has been used to automatically trigger muscle stimulation of the lower limbs, at the desired moment in regards to trunk motion. The objective was to decrease arm participation during STS motion of a person with complete paraplegia and low-level tetraplegia. Six participants with chronic SCI participated in the study. Participants with SCI were recruited to complete STS movement using a new system for FES-assisted STS transfer. All participants attended one muscle mapping session to test their muscles condition, two training sessions to become familiarized with the experimental setup, and two measurement sessions using the proposed system for FES-assisted STS movement. The applied arm forces during STS movement were recorded and analyzed for different stimulation onset values with respect to the maximal trunk acceleration signal using one-way ANOVA statistical test. Post-hoc analysis was performed using Tukey's method.Results:The results of this study showed that the moment of the stimulation onset has an influence on the arm forces applied during the STS motion. The lowest values of arm forces were obtained for STS movements where the electrical stimulation was triggered before and around the time corresponding to the maximal value of the trunk acceleration signal.Conclusion:Lowest arm forces values were obtained for STS motions that were similar to those of healthy persons in terms of trunk movements and beginning of lower limb movements in regards to maximal trunk acceleration signal. The FES system was able to mimic the rising motion of a healthy individual by triggering the FES at the appropriate moment. This method could prove useful for pivot transfer, therapeutic or functional verticalization.

Published
2014

21. Implanted functional electrical stimulation: case report of a paraplegic patient with complete SCI after 9 years

Author

Mourad Benoussaad, David Guiraud, Charles Fattal, Christine Azevedo Coste, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Male, medicine.medical_specialty, Neurology, Time Factors, Neuroprosthetics, [SDV]Life Sciences [q-bio], Stimulation, Health Informatics, Electric Stimulation Therapy, [SPI.AUTO]Engineering Sciences [physics]/Automatic, Physical medicine and rehabilitation, medicine, Functional electrical stimulation, Humans, Muscle Strength, Muscle, Skeletal, Spinal Cord Injury, Spinal cord injury, Gait, Spinal Cord Injuries, Paraplegia, Muscle fatigue, Functional Electrical Stimulation, business.industry, Research, Rehabilitation, Prostheses and Implants, medicine.disease, Biomechanical Phenomena, Physical therapy, Implant, business, Follow-Up Studies
Abstract

International audience; (provisional)--Backgrounds-- Experience of an implanted functional electrical stimulation neuroprosthesis (FES) associating 8-channel epimysial and 4-channel neural stimulations. The primary objective consisted in presenting clinical and technological experiences based on a 9-year follow-up of one patient implanted with this FES device. The secondary objective consisted in assessing resulting functional benefits. --Methods-- One patient recruited in 1996 within the European Stand Up and Walk Project benefited from a 9-year follow-up with clinical and technological evaluations. --Results-- The patient was still using the system nine years later making this a unique case, even when compared to other similar studies. The analysis of muscular response to FES underlined the great variability of stimulation thresholds evolution (−26% to +360%, mean +110%) and quality of the induced contraction. Three muscles out of five scored at least 4/5 on the Medical Research Council scale, all stimulated via neural pathways. The patient used the system once a week for 6 years, up to 2006, due to lack of use, the FES-induced muscular response worsened even though the implant was properly functioning, leading to significant decline in gait performances (best 3.45 m/s on 2.9 m), due to muscle fatigue and loss of muscle mass. --Conclusion-- Two major issues arise: first the importance of muscle fatigue, underlining the relevance of muscle strength training, and second technological hurdles raising up the question of neural vs. epimysial FES. This advanced technology proves the concept of restoring lower limb motor functions in patients with spinal cord injury. The main features of the stimulation device remain stable even after long periods of inactivity, yet there is a real need for close clinical and technological monitoring.

Published
2014

22. Neural and muscular mechanisms of electrically induced fatigue in patients with spinal cord injury

Author

Charles Fattal, Alain Varray, David Guiraud, Maria Papaiordanidou, Euromov (EuroMov), Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)

Subjects
Adult, Male, musculoskeletal diseases, [SPI.OTHER]Engineering Sciences [physics]/Other, medicine.medical_specialty, muscle excitability, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, paraplegia, medicine, Humans, In patient, Muscle, Skeletal, Spinal cord injury, Spinal Cord Injuries, Electric stimulation, spinal excitability, 030304 developmental biology, 0303 health sciences, business.industry, General Medicine, Middle Aged, medicine.disease, Electric Stimulation, Neurology, contractile properties, Muscle Fatigue, Female, Neurology (clinical), Paraplegia, business, 030217 neurology & neurosurgery, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Muscle Contraction
Abstract

International audience; Study design: Intervention study. Objectives: The present study aimed at examining whether spinal and/or peripheral alterations are in the origin of neuromuscular fatigue development induced by intermittent neuromuscular electrical stimulation (NMES) in subjects with complete spinal cord injury (SCI). Setting: Neurological Rehabilitation Center CMN Propara, Montpellier, France. Methods: Thirteen volunteers with complete SCI participated in the study. The right triceps surae muscle was fatigued using a 30-Hz NMES protocol (2 s ON-2 s OFF) composed of three series of five trains. Spinal excitability (assessed by the H-reflex), muscle excitability (assessed by the M-wave), muscle contractile properties (assessed by mechanical response parameters) and torque evoked by NMES were tested before and after each five-train series. Results: NMES-evoked torque significantly decreased throughout the protocol (P

Published
2014

23. Experimental parameter identification of a multi-scale musculoskeletal model controlled by electrical stimulation: application to patients with spinal cord injury

Author

Mitsuhiro Hayashibe, Charles Fattal, Mourad Benoussaad, David Guiraud, Philippe Poignet, Christine Azevedo-Coste, Artificial movement and gait restoration (DEMAR), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Conception et commande de robots pour la manipulation (DEXTER), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Robotique médicale et mécanismes parallèles (DEXTER), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
Adult, Male, medicine.medical_specialty, Scale (ratio), Knee Joint, Parameter identification, Computer science, 0206 medical engineering, Biomedical Engineering, Stimulation, Electric Stimulation Therapy, 02 engineering and technology, Models, Biological, Cross-validation, Nonlinear programming, Quadriceps Muscle, [SPI.AUTO]Engineering Sciences [physics]/Automatic, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Physical medicine and rehabilitation, Biomechanical model, medicine, Humans, Spinal cord injury, Spinal Cord Injuries, Protocol (science), Paraplegia, Middle Aged, medicine.disease, 020601 biomedical engineering, Computer Science Applications, Identification (information), [SDV.IB]Life Sciences [q-bio]/Bioengineering, Muscle model, 030217 neurology & neurosurgery, Simulation, Biomedical engineering, Muscle Contraction
Abstract

International audience; We investigated the parameter identification of a multi-scale physiological model of skeletal muscle, based on Huxley's formulation. We focused particularly on the knee joint controlled by quadriceps muscles under electrical stimulation (ES) in subjects with a complete spinal cord injury. A noninvasive and in vivo identification protocol was thus applied through surface stimulation in nine subjects and through neural stimulation in one ES-implanted subject. The identification protocol included initial identification steps, which are adaptations of existing identification techniques to estimate most of the parameters of our model. Then we applied an original and safer identification protocol in dynamic conditions, which required resolution of a nonlinear programming (NLP) problem to identify the serial element stiffness of quadriceps. Each identification step and cross validation of the estimated model in dynamic condition were evaluated through a quadratic error criterion. The results highlighted good accuracy, the efficiency of the identification protocol and the ability of the estimated model to predict the subject-specific behavior of the musculoskeletal system. From the comparison of parameter values between subjects, we discussed and explored the inter-subject variability of parameters in order to select parameters that have to be identified in each patient.

Published
2013

24. Optimization of FES-assisted rising motion in individuals with paraplegia

Author

Christine Azevedo Coste, Jovana Jovic, Charles Fattal, Vincent Bonnet, Philippe Fraisse, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Interactive Digital Humans (IDH), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Jovic, Jovana, Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Inria Sophia Antipolis - Méditerranée (CRISAM), and Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM)

Subjects
[SPI.OTHER]Engineering Sciences [physics]/Other, medicine.medical_specialty, Environmental Engineering, 0206 medical engineering, lcsh:QR1-502, 02 engineering and technology, 030204 cardiovascular system & hematology, lcsh:Microbiology, lcsh:Physiology, Industrial and Manufacturing Engineering, Motion (physics), 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Control theory, lcsh:Zoology, medicine, Functional electrical stimulation, lcsh:QL1-991, Spinal cord injury, lcsh:QP1-981, [SPI.OTHER] Engineering Sciences [physics]/Other, 16. Peace & justice, medicine.disease, 020601 biomedical engineering, Trunk, medicine.anatomical_structure, Physical therapy, Upper limb, Ankle, Paraplegia
Abstract

International audience; The objective of this paper is to investigate what would be the optimal strategy for voluntary trunk movement, which would minimize hip, knee and ankle torques demanding as well minimal upper limb participation during Functional Electrical Stimulation (FES)-assisted sit to stand motion in person suffering from Spinal cord injury. Our results suggest that paraplegic patients should bend their body forward in order to use linear momentum of the trunk in sit off phase, i.e. they should generate the motion similar to the one of healthy subjects. Those results have been experimentally tested using a closed-loop controller for FES-assisted standing-up. The controller should automatically trigger leg stimulation in optimal moment with respect to the trunk motion in order to decrease arm participation during rising phase of the motion.

Published
2011

25. On the Use of FES to Attenuate Tremor by Modulating Joint Impedance

Author

Antonio Padilha Lanari Bo, Charles Fattal, Christian Geny, Christine Azevedo-Coste, Philippe Poignet, Conception et commande de robots pour la manipulation (DEXTER), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Artificial movement and gait restoration (DEMAR), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Robotique médicale et mécanismes parallèles (DEXTER), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), and Azevedo Coste, Christine

Subjects
0209 industrial biotechnology, medicine.medical_specialty, business.industry, 0206 medical engineering, Healthy subjects, 02 engineering and technology, Motion control, 020601 biomedical engineering, nervous system diseases, [SPI.AUTO]Engineering Sciences [physics]/Automatic, 020901 industrial engineering & automation, Physical medicine and rehabilitation, Neuromuscular stimulation, [SPI.AUTO] Engineering Sciences [physics]/Automatic, Control theory, medicine, Functional electrical stimulation, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], business, Joint (audio engineering), Electrical impedance
Abstract

International audience; In this paper, we describe a closed-loop pathological tremor attenuation system using Func- tional Electrical Stimulation (FES). The proposed strategy, which is based on the modulation of joint impedance using FES, was developed after experi- mental evidence was obtained on open-loop trials with tremor patients. The method relies rstly on an online tremor estimation algorithm, which also lters the voluntary motion performed by the patient. Based on this information, the impedance of the trembling joint may be increased accordingly by applying the appropriate stimulation parameters on a pair of antag- onist muscles that act on the joint, thus attenuating the e ects of tremor. An experimental evaluation of the system, which involved 4 healthy subjects and 1 tremor patient, is also presented.

Published
2011

26. Evoked EMG-based torque prediction under muscle fatigue in implanted neural stimulation

Author

Mitsuhiro Hayashibe, Charles Fattal, David Guiraud, Qin Zhang, Artificial movement and gait restoration (DEMAR), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, 0206 medical engineering, Biomedical Engineering, Electric Stimulation Therapy, Stimulation, 02 engineering and technology, Stimulus (physiology), 03 medical and health sciences, Cellular and Molecular Neuroscience, 0302 clinical medicine, Physical medicine and rehabilitation, [INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing, Predictive Value of Tests, Median frequency, medicine, Humans, Torque, Spinal cord injury, Spinal Cord Injuries, Neurons, Muscle fatigue, Proprioception, Electromyography, business.industry, Evoked Potentials, Motor, medicine.disease, 020601 biomedical engineering, Electrodes, Implanted, Muscle Fatigue, Neural stimulation, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], business, [SPI.SIGNAL]Engineering Sciences [physics]/Signal and Image processing, 030217 neurology & neurosurgery, Follow-Up Studies
Abstract

International audience; In patients with complete spinal cord injury, fatigue occurs rapidly and there is no proprioceptive feedback regarding the current muscle condition. Therefore, it is essential to monitor the muscle state and assess the expected muscle response to improve the current FES system toward adaptive force/torque control in the presence of muscle fatigue. Our team implanted neural and epimysial electrodes in a complete paraplegic patient in 1999. We carried out a case study, in the specific case of implanted stimulation, in order to verify the corresponding torque prediction based on stimulus evoked EMG (eEMG) when muscle fatigue is occurring during electrical stimulation. Indeed, in implanted stimulation, the relationship between stimulation parameters and output torques is more stable than external stimulation in which the electrode location strongly affects the quality of the recruitment. Thus, the assumption that changes in the stimulation-torque relationship would be mainly due to muscle fatigue can be made reasonably. The eEMG was proved to be correlated to the generated torque during the continuous stimulation while the frequency of eEMG also decreased during fatigue. The median frequency showed a similar variation trend to the mean absolute value of eEMG. Torque prediction during fatigue-inducing tests was performed based on eEMG in model cross-validation where the model was identified using recruitment test data. The torque prediction, apart from the potentiation period, showed acceptable tracking performances that would enable us to perform adaptive closed-loop control through implanted neural stimulation in the future.

Published
2011

27. Laparoscopic implantation of neural electrodes on pelvic nerves: an experimental study on the obturator nerve in a chronic minipig model

Author

Demetrio Larraín, Revaz Botchorishvili, Jean Michel Chardigny, Paul Avan, Pierre Rabischong, Stephane Gerard Gallego, Philippe Gaydier, Benoit Rabischong, Georges Fraisse, Unité de Nutrition Humaine (UNH), Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université-Institut National de la Recherche Agronomique (INRA), CHU Clermont-Ferrand, Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, ingénierie - études techniques, and Université d'Auvergne - Clermont-Ferrand I (UdA)

Subjects
medicine.medical_specialty, Swine, Pelvic nerves, [SDV]Life Sciences [q-bio], Electric Stimulation Therapy, Dissection (medical), Palpation, Pelvis, surgery, 03 medical and health sciences, 0302 clinical medicine, Medicine, Animals, Laparoscopy, ComputingMilieux_MISCELLANEOUS, 030219 obstetrics & reproductive medicine, Paravesical fossa, medicine.diagnostic_test, business.industry, medicine.disease, Neuromodulation (medicine), Surgery, Electrodes, Implanted, Chronic electrical stimulation, medicine.anatomical_structure, Nerve cuff electrodes, Cuff, Swine, Miniature, Obturator nerve, Female, business, Obturator Nerve, 030217 neurology & neurosurgery
Abstract

Laparoscopic exposure of pelvic nerves has opened a new area in the field of neuromodulation. However, electrode design and material deterioration remain issues that limit clinical application. The objective of this study was to evaluate experimentally the laparoscopic implantation of different types of neural electrodes in order to achieve functional and selective electrical stimulation of pelvic nerves. This was a prospective comparative study of the laparoscopic implantation and tolerance and efficacy of three monopolar cuff electrodes implanted on the obturator nerve in ten Gottingen minipigs (18–20 months old; 14.5–24 kg body weight). Animals were allocated to two groups. A 3-mm-diameter laparoscopic instrument was used during dissection of paravesical fossa and obturator nerve on both sides in order to minimize nerve damage. In all animals, a “split-cylinder” cuff electrode was implanted around the left obturator nerve. On the right side, a “lasso” cuff electrode was implanted in the first group and a “closed-cylinder” cuff was implanted in the second group. Electrical stimulation (0–5 V, 20 Hz) was performed for implanted electrodes on days 0, 7, 15, 30, 45, 60, and 90. Current intensity thresholds were identified by palpation of muscle contraction. Strength developed according to stimulation level and was measured using weight transducers. All procedures were performed by laparoscopy. Mean operative times differed significantly among groups, the shortest being for split-cylinder electrodes (P = 0.0002). No electrical spread phenomena were observed. Initial thresholds were below 1.5 V (range = 0.5–1.3); however, a significant rise was observed, with time to a maximum of 2.7 V (P

Published
2011

28. Improving Valid and Deficient Body Segment Coordination to Improve FES-ASSISTED SIT-TO-STAND in Paraplegic Subjects

Author

Vincent Bonnet, Jovana Jovic, Christine Azevedo Coste, Charles Fattal, Philippe Fraisse, Azevedo Coste, Christine, Artificial movement and gait restoration (DEMAR), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Interactive Digital Humans (IDH), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
medicine.medical_specialty, Engineering, Movement, Physics::Medical Physics, 0206 medical engineering, Posture, 02 engineering and technology, Motion capture, Motion (physics), [SPI.AUTO]Engineering Sciences [physics]/Automatic, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Control theory, medicine, Torque, Functional electrical stimulation, Humans, ComputingMilieux_MISCELLANEOUS, Paraplegia, business.industry, 020601 biomedical engineering, Trunk, Electric Stimulation, medicine.anatomical_structure, [SPI.AUTO] Engineering Sciences [physics]/Automatic, Lower Extremity, Trajectory, Ankle, business, 030217 neurology & neurosurgery, Algorithms
Abstract

We investigated dynamic optimization as a tool to improve functional electrical stimulation (FES) assisted sit to stand transfers of paraplegic subjects. The objective would be to find optimal strategy for voluntary trunk movement, which would minimize hip, knee and ankle torques and demand minimal upper limb participation during the motion. Motion of the knee and the ankle were constrained by electrical stimulation. Motion capture (MOCAP) data, and signals from handle force sensors were acquired during FES-assisted rising motion of one paraplegic subject. Based on a 3 DOF dynamic model, we used an optimization algorithm in order to determine optimal trajectories in terms of minimizing joint torques for various conditions of force level applied to handles. Motion computed using the optimization process is compared with the one recorded during the experiment. Our results suggest that in order to minimize the sum of joint torques and arm effort participation, paraplegic patients should bend their body forward in order to use linear momentum of the trunk in sit off phase. This information can be used to design controller for closed-loop FES-assisted standing-up. The controller could use trunk motion to trigger legs stimulation in order to optimize body segment coordination.

Published
2011

29. Evaluating self-reported pressure ulcer prevention measures in persons with spinal cord injury using the revised Skin Management Needs Assessment Checklist: reliability study

Author

Charles Fattal, Charles Benaim, Jean-Pierre Daures, Paul Kennedy, Denis Colin, P.A. Joseph, Thierry Albert, Anthony Gelis, Jacques Pélissier, Collier, Jean-Yves, Euromov (EuroMov), Université de Montpellier (UM), Département de Médecine Physique et de Réadaptation [Montpellier], Hôpital Lapeyronie [Montpellier] (CHU), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Aide à la Décision pour une Médecine Personnalisé - Laboratoire de Biostatistique, Epidémiologie et Recherche Clinique - EA 2415 (AIDMP), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Pôle Rééducation - Réadaptation (Médecine Physique et Réadaptation) (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Department of Clinical Psychology, National Spinal Injuries Centre-Stoke Mandeville Hospital, Centre de rééducation fonctionnelle de coubert, Centre de rééducation fonctionnelle de l'Arche, Service de Médecine Physique et Réadaptation, CHU Bordeaux [Bordeaux], and We would like to thank the Fondation Paul Bennetot for its financial support

Subjects
Adult, Cross-Cultural Comparison, Male, 030506 rehabilitation, medicine.medical_specialty, knowledge, weight pressure relief, behaviors, 03 medical and health sciences, Young Adult, 0302 clinical medicine, prevention, Reliability study, Surveys and Questionnaires, medicine, Humans, Spinal cord injury, Reliability (statistics), Spinal Cord Injuries, Aged, Pain Measurement, Aged, 80 and over, Pressure Ulcer, education, business.industry, Spinal Cord Trauma, [SCCO.NEUR]Cognitive science/Neuroscience, [SCCO.NEUR] Cognitive science/Neuroscience, General Medicine, Middle Aged, medicine.disease, Checklist, spinal cord injury, 3. Good health, Self Care, Vertebral canal, Neurology, Needs assessment, Physical therapy, Pressure Ulcer Prevention, Female, Neurology (clinical), Self Report, 0305 other medical science, business, 030217 neurology & neurosurgery, Needs Assessment
Abstract

International audience; STUDY DESIGN: Cross-cultural adaptation and reliability study. OBJECTIVE: To translate, evaluate the reliability and cross-culturally adapt the Skin Management Needs Assessment Checklist (SMnac), a questionnaire evaluating the knowledge on pressure ulcer (PU) prevention measures in persons with spinal cord injury (SCI). SUBJECTS: 138 persons with SCI, mean age 45.9 years, mean time since injury 94 months. MATERIAL AND METHOD: The study was carried out in two stages. First, the questionnaire went through a forward-backward translation process and was cross-culturally adapted, according to a validated methodology for self-reported measures. Then, the test-retest reliability was evaluated on a population of persons with SCI. RESULTS: The standardized back-translation and cross-cultural adaptation led to the revised Smack grid, with the addition of seven items representing an update of PU prevention measures. The reliability was excellent (intraclass correlation coefficient: 0.899). CONCLUSION: The revised SMnac is an adaptation of the SMnac, including therapeutic education frameworks and the latest PU prevention practices. It appears to be a reliable tool for assessing the knowledge and benefits of PU prevention in persons with SCI. Further studies are needed to explore its validity and responsiveness to change.

Published
2011

30. Torque Prediction Using Stimulus Evoked EMG and its Identification for Different Muscle Fatigue States in SCI Subjects

Author

Philippe Fraisse, Qin Zhang, Mitsuhiro Hayashibe, Charles Fattal, Maria Papaiordanidou, David Guiraud, Artificial movement and gait restoration (DEMAR), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Efficience Déficience Motrice [Montpellier] (EDM), Université Montpellier 1 (UM1), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), and Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM)

Subjects
Adult, Male, medicine.medical_specialty, Computer science, 0206 medical engineering, 02 engineering and technology, Electromyography, Stimulus (physiology), Models, Biological, [SPI.AUTO]Engineering Sciences [physics]/Automatic, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Triceps surae muscle, spinal cord injury (SCI), medicine, Humans, Torque, Computer Simulation, Muscle, Skeletal, Spinal Cord Injuries, Muscle force, Stimulus evoked EMG, medicine.diagnostic_test, Muscle fatigue, Biomechanics, 030229 sport sciences, Middle Aged, 020601 biomedical engineering, Electric Stimulation, medicine.anatomical_structure, Electrical stimulation, Female, muscle fatigue, [SDV.IB]Life Sciences [q-bio]/Bioengineering, medicine.symptom, Ankle, Algorithms, Muscle Contraction, Muscle contraction
Abstract

International audience; Muscle fatigue is an unavoidable problem when electrical stimulation is applied to paralyzed muscles. The detection and compensation of muscle fatigue is essential to avoid movement failure and achieve desired trajectory. This work aims to predict ankle plantar-flexion torque using stimulus evoked EMG (eEMG) during different muscle fatigue states. Five spinal cord injured patients were recruited for this study. An intermittent fatigue protocol was delivered to triceps surae muscle to induce muscle fatigue. A hammerstein model was used to capture the muscle contraction dynamics to represent eEMG-torque relationship. The prediction of ankle torque was based on measured eEMG and past measured or past predicted torque. The latter approach makes it possible to use eEMG as a synthetic force sensor when force measurement is not available in daily use. Some previous researches suggested to use eEMG information directly to detect and predict muscle force during fatigue assuming a fixed relationship between eEMG and generated force. However, we found that the prediction became less precise with the increase of muscle fatigue when fixed parameter model was used. Therefore, we carried out the torque prediction with an adaptive parameters using the latest measurement. The prediction of adapted model was improved with 16.7\%-50.8\% comparing to the fixed model.

Published
2010

31. Adult human spinal cord harbors neural precursor cells that generate neurons and glial cells in vitro

Author

Keith Langley, Florence Vachiery-Lahaye, Cecile Dromard, Valérie Rigau, Manuel Gaviria, H. Guillon, Chantal Ripoll, Jean-Charles Sabourin, Luc Bauchet, P. Sabatier, C. Tran Van Ba, Alain Privat, S. Bozza, Nicolas Lonjon, Florence E. Perrin, Loic P. Deleyrolle, Frédérique Scamps, Jean-Philippe Hugnot, Monica Prieto, Hugues Duffau, A. Boularan, Physiopathologie et thérapie des déficits sensoriels et moteurs, Université Montpellier 2 - Sciences et Techniques (UM2)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anatomopathologie, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département de neurochirurgie, Coordination hospitalière de prélèvement et Etablissement Français des Greffes, NEUREVA, Département Anesthésie Réanimation C, Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Hamel, Christian, Institut de génétique humaine (IGH), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Service de Biopathologie [CHRU Montpellier], Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), SYNAPSE, Laboratoire Images, Signaux et Systèmes Intelligents (LISSI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Chercheur indépendant, Service de Neurochirurgie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Gui de Chauliac [Montpellier], Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU Clermont-Ferrand, University of Oslo (UiO), Service Geologique de la Nouvelle-Calédonie, Direction de l'Industrie, des Mines et de l'Energie, and Institut des Neurosciences de Montpellier (INM)

Subjects
Pathology, MESH: Tissue Donors, Cell Culture Techniques, MESH: Neurons, MESH: Spinal Cord, Mice, 0302 clinical medicine, MESH: Animals, MESH: Nerve Tissue Proteins, ComputingMilieux_MISCELLANEOUS, Neurons, 0303 health sciences, Stem Cells, Endogenous regeneration, Cell Differentiation, Neural stem cell, Tissue Donors, Neuroepithelial cell, Spinal Cord, Amniotic epithelial cells, GDF7, MESH: Neuroglia, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Stem cell, Neuroglia, Adult stem cell, Adult, MESH: Cell Differentiation, medicine.medical_specialty, Brain Death, MESH: Brain Death, Nerve Tissue Proteins, MESH: Stem Cells, Biology, 03 medical and health sciences, Cellular and Molecular Neuroscience, Neurosphere, medicine, Animals, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], MESH: Mice, 030304 developmental biology, MESH: Cell Culture Techniques, MESH: Humans, [SCCO.NEUR]Cognitive science/Neuroscience, MESH: Biological Markers, MESH: Adult, nervous system, 030217 neurology & neurosurgery, Biomarkers
Abstract

International audience; Adult human and rodent brains contain neural stem and progenitor cells, and the presence of neural stem cells in the adult rodent spinal cord has also been described. Here, using electron microscopy, expression of neural precursor cell markers, and cell culture, we investigated whether neural precursor cells are also present in adult human spinal cord. In well-preserved nonpathological post-mortem human adult spinal cord, nestin, Sox2, GFAP, CD15, Nkx6.1, and PSA-NCAM were found to be expressed heterogeneously by cells located around the central canal. Ultrastructural analysis revealed the existence of immature cells close to the ependymal cells, which display characteristics of type B and C cells found in the adult rodent brain subventricular region, which are considered to be stem and progenitor cells, respectively. Completely dissociated spinal cord cells reproducibly formed Sox2(+) nestin(+) neurospheres containing proliferative precursor cells. On differentiation, these generate glial cells and gamma-aminobutyric acid (GABA)-ergic neurons. These results provide the first evidence for the existence in the adult human spinal cord of neural precursors with the potential to differentiate into neurons and glia. They represent a major interest for endogenous regeneration of spinal cord after trauma and in degenerative diseases.

Published
2008

32. Metastatic paraplegia: care management characteristics within a rehabilitation center

Author

L Bauchet, Charles Fattal, C. Leblond, F. Schindler, D Gossens, H. Rouays-Mabit, D. Gault, M Fabro, Hamel, Christian, Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Centre de Réadaptation Fonctionnelle Clémenceau, Centre Bouffard-Vercelli, Centre La Tour de Gassies, CRLC Oncologie Val d'Aurelle, Neurochirurgie [Hôpital Gui de Chauliac], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Physiopathologie et thérapie des déficits sensoriels et moteurs, and Université Montpellier 2 - Sciences et Techniques (UM2)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Visual analogue scale, medicine.medical_treatment, Neurological disorder, Rehabilitation Centers, Young Adult, Spinal cord compression, medicine, Humans, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Spinal Cord Injuries, Aged, Pain Measurement, Retrospective Studies, Aged, 80 and over, Neurologic Examination, Paraplegia, Rehabilitation, Spinal Neoplasms, business.industry, Managed Care Programs, Chronic pain, Retrospective cohort study, General Medicine, Middle Aged, medicine.disease, Functional Independence Measure, Neurology, Physical therapy, Female, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Neurology (clinical), business, Follow-Up Studies
Abstract

International audience; Study design:Retrospective study.Objectives:To determine the potential impact of rehabilitation care on associated symptoms and functional improvements of paraplegic patients with metastatic spinal cord compression.Setting:CMN Propara, Montpellier (France).Measures:Demographics, Functional Independence Measure (FIM), Frankel Modified Score and Visual Analog Scale (VAS) for pain, intercurrent adverse medical events and neurological outcome, duration of stay, survival time, rehospitalization in a non-Spinal Cord Injury unit, number of contracts defining the patients rehabilitation goals, number of contracts defining the patients duration of stay within the rehabilitation center.Results:We reviewed the charts of 26 patients. The initial neurological profile was paraplegia or paraparesis for 24 patients and quadriparesis for 2 patients. Regarding functional improvements: four patients demonstrated a poor functional evolution, five patients showed no functional improvements or very slight improvements and all the other patients showed an increase in their overall functional aptitudes. At the end of the stay, 14 patients were urinary independent. Our study reports 52 rehospitalizations in an another unit and 101 outpatient visits during their rehabilitation stay in a physical medicine and rehabilitation (PM&R) center. For the 14 patients who were deceased at the time of data collection, the median survival rate post-paraplegia was 12.7 months. A total of 12 of the 14 patients spent more than a third of their remaining survival time in a rehabilitation center.Discussion:Compared to the patients' life expectancy, their stay in a rehabilitation center is too long and prevents them from spending time with family and loved ones. The occurrence rate of the associated symptoms is high because of both cancer-related disorders and neurological disorders caused by the spinal cord lesion. PM&R professionals are faced with patients affected by chronic pain and fatigue as well as frequent rehospitalizations, short stays and outpatient stays, in the primary oncology unit. This study focuses on the need to privilege the patients' comfort over their functional rehabilitation.Spinal Cord advance online publication, 10 June 2008; doi:10.1038/sc.2008.75.

Published
2008

33. T-16 Modeling and Experimental Identification for Muscular Force Estimation Based on Evoked EMG in FES

Author

Mitsuhiro Hayashibe, Charles Fattal, Philippe Fraisse, Qin Zhang, David Guiraud, Artificial movement and gait restoration (DEMAR), Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Laboratoire d'Informatique de Robotique et de Microélectronique de Montpellier (LIRMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)-Inria Sophia Antipolis - Méditerranée (CRISAM), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), and Hayashibe, Mitsuhiro

Subjects
medicine.medical_specialty, Computer science, Biomedical Engineering, Biophysics, 02 engineering and technology, 01 natural sciences, Physical medicine and rehabilitation, Triceps surae muscle, 0202 electrical engineering, electronic engineering, information engineering, medicine, Functional electrical stimulation, Torque, Muscular force, Orthopedics and Sports Medicine, Muscle force, [SDV.IB] Life Sciences [q-bio]/Bioengineering, Muscle fatigue, 010401 analytical chemistry, Rehabilitation, 020206 networking & telecommunications, [INFO.INFO-MO]Computer Science [cs]/Modeling and Simulation, 0104 chemical sciences, medicine.anatomical_structure, [SDV.IB]Life Sciences [q-bio]/Bioengineering, [INFO.INFO-MO] Computer Science [cs]/Modeling and Simulation, Ankle, medicine.symptom, Muscle contraction
Abstract

International audience; Functional Electrical Stimulation (FES) has been used to restore motor function or produce movements in Spinal Cord Injured (SCI) patients. However, muscle fatigue is an unavoidable problem when electrical stimulation is applied to paralyzed muscles. The detection and compensation of muscular force decreased by muscle fatigue is essential to avoid movement failure and achieve the desired trajectory. In addition, there is no sensory feedback for SCI patients to monitor their muscular force and fatigue condition. An adequate implantable force sensor is not yet available to be used for FES control. Therefore, it's essential to monitor muscle state and assess the generated force to compensate the fatigue and achieve more precise FES control considering the muscle state. It's also important to cease the stimulation depending on muscle fatigue to prevent serious muscle damage. In the previous researches, one reported solution is to use stimulus evoked EMG (eEMG) signal for prediction of the varied muscle force. It is important to predict generated force when FES is applied along with muscle fatigue. In this work, we aim to predict ankle plantar-flexion torque using eEMG during different muscle fatigue level. Five spinal cord injured patients were recruited for this study. An intermittent fatigue protocol was delivered to triceps surae muscle to induce muscle fatigue. A hammerstein model was used to capture the muscle contraction dynamics to represent eEMG-torque relationship. The prediction of ankle torque was based on measured eEMG and past measured or past predicted torque. The latter approach makes it possible to use only eEMG for muscle force prediction when force measurement is not available in daily use. Some previous researches suggested the usage of eEMG information to detect and predict muscle force during fatigue assuming a fixed relationship between eEMG and generated force. However, we found that the prediction became less precise with the increase of muscle fatigue when fixed parameter model was used. Therefore, we carried out the torque prediction with adaptive parameters using the latest measurement. The prediction of adapted model was improved with 16.7%-50.8% comparing to the fixed model. This presentation especially focuses on the modelling methodology and experimental identification algorithms to track the relationship variation between evoked EMG and torque induced by electrical stimulation according to the muscle fatigue. For the future, we aim at on-line estimation of varying torque due to muscle property change based on evoked EMG signals to be applied for new FES control strategy.

Published
2010

34. Strategies for spinal cord repair after injury: A review of the literature and information

Author

C. Gilbert, Nicolas Lonjon, Florence E. Perrin, Alain Privat, Charles Fattal, Luc Bauchet, Centre Mutualiste de Réeducation Neurologique Propara (PROPARA), Languedoc Mutualité, Neurochirurgie [Hôpital Gui de Chauliac], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Gui de Chauliac [Montpellier], Physiopathologie et thérapie des déficits sensoriels et moteurs, Université Montpellier 2 - Sciences et Techniques (UM2)-IFR76-Institut National de la Santé et de la Recherche Médicale (INSERM), and Hamel, Christian

Subjects
medicine.medical_specialty, medicine.medical_treatment, MEDLINE, Spinal cord repair, Central nervous system disease, 03 medical and health sciences, 0302 clinical medicine, Réhabilitation, medicine, Humans, Regeneration, Régénération, Orthopedic Procedures, Orthopedics and Sports Medicine, [SDV.NEU] Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], Intensive care medicine, Spinal Cord Injuries, 030304 developmental biology, 0303 health sciences, Spinal cord, Transplantation, Rehabilitation, business.industry, Information médicale, Moelle épinière, medicine.disease, Nerve Regeneration, 3. Good health, Clinical trial, medicine.anatomical_structure, Medical information resources, Physical therapy, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC], business, 030217 neurology & neurosurgery
Abstract

International audience; INTRODUCTION: Thanks to the Internet, we can now have access to more information about spinal cord repair. Spinal cord injured (SCI) patients request more information and hospitals offer specific spinal cord repair medical consultations. OBJECTIVE: Provide practical and relevant elements to physicians and other healthcare professionals involved in the care of SCI patients in order to provide adequate answers to their questions. METHOD: Our literature review was based on English and French publications indexed in PubMed and the main Internet websites dedicated to spinal cord repair. RESULTS: A wide array of research possibilities including notions of anatomy, physiology, biology, anatomopathology and spinal cord imaging is available for the global care of the SCI patient. Prevention and repair strategies (regeneration, transplant, stem cells, gene therapy, biomaterials, using sublesional uninjured spinal tissue, electrical stimulation, brain/computer interface, etc.) for the injured spinal cord are under development. It is necessary to detail the studies conducted and define the limits of these new strategies and benchmark them to the realistic medical and rehabilitation care available to these patients. CONCLUSION: Research is quickly progressing and clinical trials will be developed in the near future. They will have to answer to strict methodological and ethical guidelines. They will first be designed for a small number of patients. The results will probably be fragmented and progress will be made through different successive steps.

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