A third-year undergraduate student, Kramay Patel, recently shared the Sunnybrook Research Prize for his work on improving dynamic trunk stability in spinal cord injury patients by developing neural prostheses.
Patel understood the efficiency of functional electric stimulation (FES) from his own experience. He suffered from a herniated disc and undergoing FES therapy made him both empathetic towards and interested in helping individuals suffering from spinal cord injury.
“FES uses small currents to artificially and extrinsically contract muscles,” Patel says. Individuals with higher thoracic or cervical spinal cord injuries often lose control over their trunk muscles, including the abdomen and back, which results in a condition known as trunk instability in addition to a poor sitting posture. In these individuals, a small disturbance to their sitting position may lead to an increased risk of falling which can result in worsening their current injury as well as potentially causing secondary ones.
Working in collaboration with his supervisors, PhD student Matija Milosevic, and U of T professor Dr. Milos R. Popovic, Patel is looking to use FES technology to increase trunk stability of individuals with spinal cord injuries while driving a powered wheelchair.
“This means that I have to develop an effective controller that can intelligently contract the right muscles on the individual’s trunk at the right time and in response to the right accelerations in order to increase trunk stability,” says Patel.
By increasing the trunk stability of these patients and eliminating the restrictive belt straps and chest harnesses presently used, this system will allow patients to have more functional workspace and hence increased quality of life. Patel says that FES has been shown to improve muscle tone, reduce loss of muscle mass, and to have rehabilitative effects. These are some of the things Patel and his supervisors expect to see in a test of their system.
Patel’s project is different from the research that has been conducted thus far in that it applies to a different subset of patients. “Some groups have looked at improving trunk posture using FES in static and voluntary conditions but not under external dynamic perturbations,” he says.
Patel’s project is a novel wheelchair-based neural prosthetic device. “Our system, which we affectionately call FES-Wheels, is the first of its kind…” he adds.
The promise of significant clinical results has driven the development of this device.
“It can most certainly be used by a large population of individuals with spinal cord [injuries] to not only increase immediate wheelchair safety, but also help improve their quality of life while helping them potentially rehabilitate and fight the secondary complications of spinal cord injuries such as loss of muscle tone and muscle mass,” Patel explains.
The next step in his research will be to perform a full-scale study of the system with a large, able-bodied test group.
“Once we can demonstrate improved trunk stability on able-bodied individuals, we can move on to individuals with spinal cord injury,” concludes Patel.
Correction (January 26, 2015, 4:52 pm): A previous version of this article incorrectly referred to the “Sunnybrook Research Award.” In fact, the award is called the “Sunnybrook Research Prize.”