Evidence map›Paper›PMID 29530053›Full record

Trial reportJournal of neuroengineering and rehabilitation2018

Automatic application of neural stimulation during wheelchair propulsion after SCI enhances recovery of upright sitting from destabilizing events.

Kiley L Armstrong, Lisa M Lombardo, Kevin M Foglyano, Musa L Audu, Ronald J Triolo

Registry-linked trialAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neuroengineering and rehabilitation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01474148 (A Neuroprosthesis for Seated Posture and Balance), which is not on this map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01474148 narecruitingnot on this map

A Neuroprosthesis for Seated Posture and Balance

TypeinterventionalSponsorVA Office of Research and DevelopmentRan2011 to 2027Enrolled10ConditionsSpinal Cord Injury, Paralysis, Tetraplegia, ParaplegiaArmsIRS-8 (8-Channel implanted stimulator-telemeter)
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Review
  5. Review
  6. Article
  7. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Kiley L ArmstrongDepartment of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. kla34@case.edu.
Lisa M LombardoAdvanced Platform Technology Center, Cleveland Louis Stokes Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
Kevin M FoglyanoAdvanced Platform Technology Center, Cleveland Louis Stokes Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland, OH, 44106, USA.
Musa L AuduDepartment of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.
Ronald J TrioloDepartment of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA.

Funding

Enhancing Seated Stability and Reaching After Spinal Cord InjuryR01NS101043 · NINDS · CASE WESTERN RESERVE UNIVERSITY · PI AUDU, MUSA L, TRIOLO, RONALD J · 2018 to 2021
$1.7M
Rehabilitation Research and Development Service B6406R
6 · The paper itself

Abstract

backgroundThe leading cause of injury for manual wheelchair users are tips and falls caused by unexpected destabilizing events encountered during everyday activities. The purpose of this study was to determine the feasibility of automatically restoring seated stability to manual wheelchair users with spinal cord injury (SCI) via a threshold-based system to activate the hip and trunk muscles with electrical stimulation during potentially destabilizing events.

methodsWe detected and classified potentially destabilizing sudden stops and turns with a wheelchair-mounted wireless inertial measurement unit (IMU), and then applied neural stimulation to activate the appropriate muscles to resist trunk movement and restore seated stability. After modeling and preliminary testing to determine the appropriate inertial signatures to discriminate between events and reliably trigger stimulation, the system was implemented and evaluated in real-time on manual wheelchair users with SCI. Three participants completed simulated collision events and four participants completed simulated rapid turns. Data were analyzed as a series of individual case studies with subjects acting as their own controls with and without the system active.

resultsThe controller achieved 93% accuracy in detecting collisions and right turns, and 100% accuracy in left turn detection. Two of the three subjects who participated in collision testing with stimulation experienced significantly decreased maximum anterior-posterior trunk angles (p < 0.05). Similar results were obtained with implanted and surface stimulation systems.

conclusionsThis study demonstrates the feasibility of a neural stimulation control system based on simple inertial measurements to improve trunk stability and overall safety of people with spinal cord injuries during manual wheelchair propulsion. Further studies are required to determine clinical utility in real world situations and generalizability to the broader SCI or other population of manual or powered wheelchair users.

trial registrationClinicalTrials.gov Identifier NCT01474148 . Registered 11/08/2011 retrospectively registered.

Indexed as

Sitting PositionSpinal Cord InjuriesWheelchairsAccidental FallsAdultBiomechanical PhenomenaElectric Stimulation TherapyEquipment DesignFemaleHumansMaleMiddle AgedPersons with DisabilitiesPostural BalanceRetrospective StudiesEvent detectionFunctional neuromuscular stimulationSpinal cord injury

Identifiers

PMID29530053
PMCPMC5848592

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.