CPPE

The goal of this study was to test the feasibility and efficacy of using microstimulators (BIONs) to correct foot drop, the first human application of BIONs in functional electrical stimulation (FES). A prototype BIONic foot drop stimulator was developed by modifying a WalkAide2 stimulator to control BION stimulation of the ankle dorsiflexor muscles. BION stimulation was compared with surface stimulation of the common peroneal nerve provided by a normal WalkAide2 foot drop stimulator. Compared to surface stimulation, we found that BION stimulation of the deep peroneal nerve produces a more balanced ankle flexion movement without everting the foot. A three-dimensional motion analysis was performed to measure the ankle and foot kinematics with and without stimulation. Without stimulation, the toe on the affected leg drags across the ground. The BIONic WalkAide elevates the foot such that the toe clears the ground by 3 cm, which is equivalent to the toe clearance in the unaffected leg. The physiological cost index (PCI) was used to measure effort during walking. The PCI is high without stimulation (2.29 +/- 0.37; mean +/- S.D.) and greatly reduced with surface (1.29 +/- 0.10) and BION stimulation (1.46 +/- 0.24). Also, walking speed is increased from 9.4 +/- 0.4 m/min without stimulation to 19.6 +/- 2.0 m/min with surface and 17.8 +/- 0.7 m/min with BION stimulation. We conclude that functional electrical stimulation with BIONs is a practical alternative to surface stimulation and provides more selective control of muscle activation.

SYNOPSIS. Mammalian skeletal muscles are all composed of similar structural el- ements. However, they gain a large degree of functional specialization by confi- guring those elements in different ways. The traditional anatomical descriptors of muscle—length, ...

The feline anterior sartorius is a long strap‐like muscle composed of short muscle fibers. Nerve branches that enter this muscle contain the axons of motor units whose constituent muscle fibers are distributed asymmetrically within the muscle. In the present study, twitch and tetanic isometric contractions were evoked by stimulating individual nerve branches while muscle force was recorded and intramuscular length changes were monitored optically by the movement of reflective markers on the muscle. Contractions elicited by stimulating the parent nerve produced little change in the positions of the surface markers. Contractions elicited by stimulating the proximally or distally directed nerve branches caused the muscle to shorten at the end closest to the nerve branch and lengthen at the opposite end. Some muscles were supplied by a centrally directed nerve branch whose stimulation produced variable effects: in some cases a portion of the muscle shortened whereas the rest lengthened,...

This paper presents a case study that tested the feasibility and efficacy of using injectable microstimulators (BIONs®) in a functional electrical stimulation (FES) device to correct foot drop. Compared with surface stimulation of the common peroneal nerve, stimulation with BIONs provides more selective activation of specific muscles. For example, stimulation of the tibialis anterior (TA) and extensor digitorum longus (EDL) muscles with BIONs produces ankle flexion without excessive inversion or eversion of the foot (i.e., balanced flexion). Efficacy was assessed using a 3-dimensional motion analysis of the ankle and foot trajectories during walking with and without stimulation. Without stimulation, the toe on the affected leg drags across the ground. BION stimulation of the TA muscle and deep peroneal nerve (which innervates TA and EDL) elevates the foot such that the toe clears the ground by 3 cm, which is equivalent to the toe clearance in the less affected leg. The physiological...

PurposeWe investigated the feasibility of using real‐time sonography to measure muscle thickness. Clinically, this technique would be used to measure the thickness of human muscles in which intramuscular microstimulators have been implanted to treat or prevent disuse atrophy.MethodsPorcine muscles were implanted with microstimulators and imaged with sonography, MRI, and CT to assess image artifacts created by the microstimulators and to design protocols for image alignment between methods. Sonography and MRI were then used to image the deltoid and supraspinatus muscles of 6 healthy human subjects.ResultsMicrostimulators could be imaged with all 3 methods, producing only small imaging artifacts. Muscle‐thickness measurements agreed well between methods, particularly when external markers were used to precisely align the imaging planes. The correlation coefficients for sonographic and MRI measurements were 0.96 for the supraspinatus and 0.97 for the deltoid muscle. Repeated sonographi...

Sartorius (SART) and tensor fasciae latae (TFL) in the cat hindlimb are functionally heterogeneous muscles with regions that differ in their skeletal actions and electromyographic recruitment during normal activity. The topographical organization of motoneurons supplying different regions of SART or TFL has been investigated by exposing cut nerve branches supplying different peripheral territories to a combination of retrograde tracers, including Fast Blue (FB), Fluorogold (FG), and horseradish peroxidase (HRP). Motoneurons supplying medial, central, and anterior regions of SART were intermixed extensively throughout a single columnar nucleus located in the ventrolateral part of segments L4 and L5. Within this column, motoneurons supplying medial SART tended to lie more rostrally than those supplying anterior regions, but the gradient was modest and showed some cat‐to‐cat variation. Two major branches entered anterior SART at different proximodistal levels. When these two branches w...

The cat hindlimb contains several long, biarticular strap muscles composed of parallel muscle fascicles that attach to short tendons. Three of these muscles ‐sartorius, tenuissimus, and semitendinosus ‐were studied by dissecting individual gold‐stained fibers and determining the surface distribution of acetylcholinesterase‐stained end‐plate zones. In each muscle, fascicles were composed of muscle fibers that ran only part of the fascicle length and tapered to end as fine strands that interdigitated with other tapering fibers within the muscle mass. Most muscle fibers measured 2–3 cm in length. Fascicles of muscle fibers were crossed by short transverse bands of endplates (1 mm wide by 1–5 mm long) that were spaced at fairly regular intervals from the origin to the insertion of the muscle. The endplate pattern suggested that the fiber fascicles were organized into multiple longitudinal strips. In the sartorius, the temporospatial distribution of electromyographic (EMG) activity evoke...