Section: Overall Objectives
Introduction
Functional Electrical Stimulation (FES) has been used for about 30 years in order to restore deficient physiological functions. At the beginning, only surface stimulation was possible and thus only used in a clinical context due to the low reliability of electrode placements. In the early eighties, implanted FES appeared through well-known applications: pacemaker, Brindley bladder control, cochlear implant, and more recently deep brain stimulation (DBS).
Currently, FES is the only way to restore motor function even though biological solutions are studied, but not yet successfully tested on humans. Few teams carry out researches on implanted FES and the functional results remain poor. Nevertheless, the technique has proved to be useable and needs enhancements that we address in DEMAR. Regarding technology, complex electrode geometries associated with complex stimulus waveforms provide a way to perform fibre type selectivity and spatial localisation of the stimuli in the nerves. These features are not yet implemented and demand new hardware and software architectures. Several teams in Denmark (SMI U. Aalborg), Germany (IBMT Franhaufer Institute), England (U. College of London), Belgium (U. Catholique de Louvain), United States (Cleveland FES centre), and Canada (Ecole Polytechnique de Montréal), work on multi-polar neural stimulation but mainly on electrode aspect, except Polystim Lab of Montréal.
Such a complex system needs advanced control theory tools coupled with a deep understanding of the underlying neurophysiological processes. This major area of research will be also an important part of the DEMAR objectives.
Besides, experiments are necessary to: improve neurophysiology knowledge, identify and validate models, evaluate control strategies or test neuroprostheses. Our experiments are carried on valid and non-valid individuals in clinical environment, but also on animals. Nevertheless, it really worth the effort in order to bring theory to useable systems.
Finally, industrial transfer is mandatory since we aim at proposing effective solutions to patients. Thus we try to prototype all our findings in order to validate and transfer efficiently our concepts. To be useable in clinical or private environments by the patients themselves, systems need to be certified as an industrial Medical Device.
DEMAR research is organized as follows:
Modelling and identification of the human sensory-motor system.
Interfacing artificial and natural parts through neuroprosthetic devices: both stimulation and recording.
The main applied research fields are then:
Quantitative characterization of the human sensory-motor system firstly for motor disorders diagnosis and objective quantification, and secondly in order to help the design and the control of neuroprosthetic devices.
Restoring motor and sensitive functions through implanted FES and neural signal sensing such as lower limb movement synthesis and control for spinal cord injured patients, synergetic control of the deficient limb for hemiplegic patients, bladder control, pain relief...
Improving surface stimulation for therapy such as active verticalization of paraplegic patients, reduction of tremor, reeducation of hemiplegic post-stroke patients...