calf muscles improve bilateral insufficiency of the ankle push-off during gait in patients with Multiple Sclerosis

Can bilateral functional electrical stimulation (FES) of the calf muscles improve bilateral insufficiency of the ankle push-off during gait in patients with Multiple Sclerosis?

Background and problem statement

Insufficiency of the ankle push-off is a large contributor to the decline of walking ability in patients with Multiple Sclerosis (MS). Bilateral reduction of the push-off is seen in almost all patients who are classified as moderately impaired walkers. Functional Electrical Stimulation (FES) of the calf muscles (gastrocnemius and soleus) may improve push-off if an optimal stimulation algorithm is used. However, to control stimulation timing, foot switches as a trigger are not effective, for they cannot react to changes in walking speed. It is hypothesized that FES timing-control based on angular shank velocities (using a gyroscope) and a two-leg algorithm will result in effectively promoting ankle push-off during gait in patients with MS.

Assignment

The project will be carried out at the department of Rehabilitation Medicine at the VU University Medical Center (VUmc) in Amsterdam.

In this project, the first objective is to determine the optimal FES stimulation parameters (electrode localization; stimulation amplitude; timing of the stimulation; stimulation duration; frequency of pulses; pulse width; rising edge ramp time) and to develop an algorithm for bilateral FES of the calf muscles. The second objective is to determine the preliminary effects of bilateral FES on net ankle power generation, walking speed, and energy cost of walking in MS patients with bilateral insufficiency of the ankle push-off.

Components

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Literature study about FES and MS

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Experiments in 5 healthy subjects and 5 MS patients (at the VUmc)

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Data analysis

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Thesis writing

Educational program

MSc

BMT/TG

Research theme

From Neural Circuit Behaviour to Human Sensory-Motor Function

Principal Investigator track

Peter Veltink

Sensing and control of human movement

Supervision and info

Josien van den Noort (UT/VUmc)

Peter Veltink (UT)

Heleen Beckerman (VUmc)

Jaap Harlaar (VUmc)