Musculoskeletal Model-Guided, Customizable Selection of Shoulder and Elbow Muscles for a C5 SCI Neuroprosthesis

IEEE Trans Neural Syst Rehabil Eng., 2008 · DOI: 10.1109/TNSRE.2008.922681 · Published: June 1, 2008

Spinal Cord Injury Neurology Biomechanics

Simple Explanation

This paper introduces a method using computer models to determine the best muscles to stimulate for restoring arm and elbow function in people with C5 spinal cord injuries. The model uses data from able-bodied individuals to simulate the movements and muscle forces needed, then adjusts the model to mimic the muscle weakness caused by the spinal cord injury. By testing different combinations of stimulated muscles in the model, researchers can identify which muscle sets provide the most significant improvement in arm function.

Study Duration

Not specified

Participants

Four able-bodied subjects

Evidence Level

Not specified

Key Findings

1
A muscle set consisting of the serratus anterior, infraspinatus and triceps would enable the greatest range of relevant movements.
2
Serratus anterior is critical for these movements.
3
The infraspinatus was also chosen as an essential muscle because 1) removing it resulted in a 64.5% failure rate in the “added endpoint mass” trials

Research Summary

This study used a musculoskeletal model to simulate the effects of FES on shoulder and elbow function in individuals with C5 SCI. The model helped identify a set of three 'essential' muscles (serratus anterior, triceps, and infraspinatus) whose stimulation significantly improved functional movement. The proposed approach can be customized for specific individuals with cervical SCI if specific maximum muscle forces can be estimated.

Practical Implications

Targeted FES Therapy

Focusing on stimulating serratus anterior, infraspinatus, and triceps can maximize functional gains in C5 SCI patients.

Customizable Neuroprosthesis Design

The model allows for tailoring neuroprosthesis configurations to individual patient needs and specific functional goals.

Pre-surgical Planning

The simulation results can aid in surgical planning by identifying the most crucial muscles to target for FES implantation.

Study Limitations

1
The model assumes a generic C5 SCI and specific movements, affecting muscle selection.
2
Maximum relative forces for each muscle are approximations, although muscle selection is unlikely to change drastically with minor adjustments.
3
Individuals with SCI may develop compensatory movement strategies that differ from able-bodied movements, potentially influencing optimal muscle selection.

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