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Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurorobot. | doi: 10.3389/fnbot.2019.00097

Neuromusculoskeletal Modelling-based Prostheses for Recovery after Spinal Cord Injury

  • 1School of Allied Health Sciences, Griffith Health, Griffith University, Australia
  • 2Gold Coast Orthopaedic Research and Education Alliance, Menzies Health Institute, Griffith University, Australia
  • 3Hopkins Centre. Menzies Health Institute, Griffith University, Australia
  • 4Gold Coast University Hospital, Australia
  • 5School of Medical Sciences, Griffith Health, Griffith University, Australia
  • 6Department of Physical Medicine and Rehabilitation, Harvard Medical School, United States
  • 7Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, United States
  • 8VA Boston Healthcare System, United States

Concurrent stimulation and reinforcement of motor and sensory pathways has been proposed as an effective approach to restoring function after developmental or acquired neurotrauma. This can be achieved by applying multimodal rehabilitation regimens, such as thought-controlled exoskeletons or epidural electrical stimulation to recover motor pattern generation in individuals with spinal cord injury (SCI). However, the human neuromusculoskeletal (NMS) system has often been oversimplified in designing rehabilitative and assistive devices. As a result, the neuromechanics of the muscles is seldom considered when modelling the relationship between electrical stimulation, mechanical assistance from exoskeletons, and final joint movement. A powerful way to enhance current neurorehabilitation is to develop the next generation prostheses incorporating personalised NMS models of patients. This strategy will enable an individual voluntary interfacing with multiple electromechanical rehabilitation devices targeting key afferent and efferent systems for functional improvement. This narrative review discusses how real-time NMS models can be integrated with finite element of musculoskeletal tissues and interface multiple assistive and robotic devices with individuals with SCI to promote unmatched levels of neural restoration. In particular, the utility of NMS models for optimising muscle stimulation patterns, tracking functional improvement, monitoring safety and providing augmented feedback during exercise-based rehabilitation are discussed.

Keywords: spinal cord injury, Neuromusculoskeletal modelling, Functional Electrical Stimulation (FES), Assistive device, Brain-computer interface, Digital Twin, Real-time

Received: 15 May 2019; Accepted: 05 Nov 2019.

Copyright: © 2019 Pizzolato, Saxby, Palipana, Diamond, Barrett, Teng and Lloyd. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Claudio Pizzolato, School of Allied Health Sciences, Griffith Health, Griffith University, Gold Coast, 4222, Australia,