Control mechanisms for restoring posture and movements in paraplegics. 1989

J Quintern, and P Minwegen, and K H Mauritz

The control mechanisms underlying undisturbed movements were analysed in two series of experiments: (1) normal physiological responses were investigated in neurologically intact subjects; (2) an artificial motor control system for paraplegic patients using functional neuromuscular stimulation (FNS) of the paralysed leg muscles was developed and tested. In both series of experiments standing-up from a chair and sitting-down were studied. A three-link model of the human body was used for recording and processing biomechanical data. In 5 normal subjects ground reaction forces and the surface electromyogram of different leg muscles were also recorded. Basic physiological aspects of FNS such as muscle force regulation and fatigue could be documented. For the standing-up and sitting-down experiments in 2 paraplegic patients the gluteal and quadriceps muscles were stimulated. The best results were achieved with a combination of open-loop and closed-loop stimulation with position and velocity feedback. The importance of feedforward and feedback control during undisturbed movements is discussed for natural and artificial motor control systems. It is concluded that the control of knee joint angle during standing-up and sitting-down represents an unstable system which cannot be controlled open-loop only. Different aspects of sensory feedback including the regulated variables, gain and stability of the system are discussed on the basis of the experimental data and the literature.

UI MeSH Term Description Entries
D009068 Movement The act, process, or result of passing from one place or position to another. It differs from LOCOMOTION in that locomotion is restricted to the passing of the whole body from one place to another, while movement encompasses both locomotion but also a change of the position of the whole body or any of its parts. Movement may be used with reference to humans, vertebrate and invertebrate animals, and microorganisms. Differentiate also from MOTOR ACTIVITY, movement associated with behavior. Movements
D010264 Paraplegia Severe or complete loss of motor function in the lower extremities and lower portions of the trunk. This condition is most often associated with SPINAL CORD DISEASES, although BRAIN DISEASES; PERIPHERAL NERVOUS SYSTEM DISEASES; NEUROMUSCULAR DISEASES; and MUSCULAR DISEASES may also cause bilateral leg weakness. Paralysis, Lower Extremities,Paraplegia, Spastic,Spastic Paraplegia,Paralysis, Legs,Paralysis, Lower Limbs,Paraplegia, Ataxic,Paraplegia, Cerebral,Paraplegia, Flaccid,Paraplegia, Spinal,Ataxic Paraplegia,Ataxic Paraplegias,Cerebral Paraplegia,Cerebral Paraplegias,Flaccid Paraplegia,Flaccid Paraplegias,Paraplegias,Paraplegias, Ataxic,Paraplegias, Cerebral,Paraplegias, Flaccid,Paraplegias, Spastic,Paraplegias, Spinal,Spastic Paraplegias,Spinal Paraplegia,Spinal Paraplegias
D011187 Posture The position or physical attitude of the body. Postures
D004599 Electric Stimulation Therapy Application of electric current in treatment without the generation of perceptible heat. It includes electric stimulation of nerves or muscles, passage of current into the body, or use of interrupted current of low intensity to raise the detection threshold of the skin to pain. Electrotherapy,Electrical Stimulation Therapy,Interferential Current Electrotherapy,Therapeutic Electric Stimulation,Therapeutic Electrical Stimulation,Therapy, Electric Stimulation,Electric Stimulation, Therapeutic,Electrical Stimulation, Therapeutic,Electrotherapy, Interferential Current,Stimulation Therapy, Electric,Stimulation Therapy, Electrical,Stimulation, Therapeutic Electric,Stimulation, Therapeutic Electrical,Therapy, Electrical Stimulation
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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