Electrostimulation for Treating Motor Function Disturbances
Development of Methods, Tools, Pilot Models of an Electrostimulation System with Complex Biotechnical Feedback for Treating Motor Function Disturbances of Skeletal Muscles, Colon and Anal Sphincters
Tech Area / Field
- MED-DID/Diagnostics & Devices/Medicine
- INF-SIG/Sensors and Signal Processing/Information and Communications
3 Approved without Funding
Belarussian State University of Informatics and Radioelectronics, Belarus, Minsk
- First City Hospital of Minsk, Belarus, Minsk\nResearch Institution of Neurology, Neurosurgery and Physiotherapy, Belarus, Minsk
- Aalborg University / Center for Sensory-Motor Interaction, Denmark, Aalborg\nUniversity of Chicago, USA, IL, Chicago\nSonoAce GmbH, Germany, Marl\nBrunel University / Department of Health & Social Care, UK, Middlesex, Uxbridge\nVienna University of Technology, Austria, Vienna\nUniversity of Twente / Faculty of Electrical Engineering, Mathematics and Computer Science, The Netherlands, Enschede\nDon Carlo Gnocchi Foundation ONLUS, Italy, Milan
Project summaryThe brief description of the project. The objective of the project is to develop new methods and tools of electrostimulation based on a complex biotechnical feedback (CBTFB) for treating motor function disturbances of skeletal muscles, rectum and anal sphincters, and to make pilot models of a multichannel electrostimulation system for muscular groups of the upper and lower limbs and a multichannel electrostimulation system for the rectum and anal sphincters.
State of the art in the field of researches. Diseases of the central and peripheral nervous systems result in a wide spectrum of impairment of the neuromuscular structures. Now special attention of the specialists is paid to the following two disturbances depending on the kind of the muscular tissue involved in a pathological process: 1) disturbances of motor functions of skeletal muscles; 2) disturbances of motor function of the large intestine and dysfunction of a rectal sphincter apparatus.
Many diseases (first of all, neurologic, neurosurgical and orthopedic ones) are accompanied by disturbances of motor functions and are the cause of disability of patients. For example, in Russia more than 400,000 persons and in the USA about 500,000 persons annually suffer from disturbances of cerebral circulation (insult) that is one of the causes of disability and mortality. Besides, 25-30% of persons who have survived insult remain invalid. The leading role among post-insult defects belongs to motor disturbances.
Treatment of chronic constipations and fecal incontinence provoked by disturbances of the motor functions of skeletal muscles, sphincter apparatus and rectal muscles is a complex problem. Only in the USA 2.5 million cases in one year of doctor’s visits concerning constipations are annually registered. The purpose of treatment is to normalize intestinal transit, establish defecation reflex and restore normal peristalsis.
Development of effective methods and technical tools for treating patients with disturbances of motor functions of skeletal muscles, sphincter apparatus and rectal muscles represents a difficult task. An integral part of medical rehabilitation in cases of the above-mentioned diseases is electrostimulation therapy [7th Annual Conference of the International Functional Electrical Stimulation Society, Ljubljana, 2002]. The traditional methods of electrostimulation insufficiently effectively solve the rehabilitation problem of patients with disturbances of motor functions of skeletal muscles, rectum and anal sphincter. Nowadays the further development of methods and tools of electrostimulation is associated with application of computer and information technologies and new methods of biosignal processing (wavelet transforms, adaptive filtering, independent component analysis, nonlinear dynamics methods, etc). One of the promising approaches is use of two feedbacks: biological feedback (BFB) [6th Annual Meeting of the Biofeedback Foundation of Europe, Amsterdam, Holland, 2002] and biotechnical feedback (BTFB). In this connection development of methods and tools of electrostimulation for rehabilitation of patients with the pathology is one of the principal medical and social problems of public health.
Influence of the proposed project on progress in the field is connected to development and usage of the new approach that does not have the analogs in the world and bases on integration and coordinated interaction of BFB and BTFB by means of up-to date computer and information technologies. Project fulfilment will allow to develop the theory and practice of medical systems with feedback, improve digital processing methods of biomedical signals and the methods of functional electrostimulation and functional diagnostics. Using the project results in medical practice will reduce treatment period, increase rehabilitation efficiency and quality of patients with nervomuscular apparatus diseases.
Participants of the project. Teams of three Participant Institutions will take part in the project: Belarusian State University of Informatics and Radioelectronics (BSUIR), Research Institution of Neurology, Neurosurgery and Physiotherapy of Ministry of Health of Republic of Belarus (RINNP), First City Hospital of Minsk (FCH). Participants from BSUIR are specialists in weapons and work on automatic guidance, rocket materials and technologies. The work carried out at RINNP is non-medicinal treatment of insult consequences. FCH is the head medical institution in Republic of Belarus in treating patients with fecal incontinence and constipations. The works on the project will be carried out by 15 Doctors of technical sciences and Doctors of medical sciences (the total of 29, weapon participants total of 12), leading specialists of Ministry of Health. The methods and electrostimulation system to be developed within the framework of the project are first proposed and in part approved by project participants.
Expected results. The following results are to be obtained:
1. Methods of fast diagnostics of a state of skeletal muscles, rectal and anal sphincter muscles for effective realization of feedbacks in electrostimulation system.
2. Electrostimulation signals with optimal frequency-time parameters on the basis of power criterion.
3. Functional and structural models of dynamics of the state of skeletal muscles, rectal and anal sphincter muscles for synthesizing correction functions of electrostimulation signal parameters.
4. Methods of multichannel electrostimulation with СBTFB for treating diseases of the neuromuscular apparatus.
5. Electrostimulation systems with CBTFB.
6. A pilot model of electrostimulation system for rectal and anal sphincters.
7. A pilot model of electrostimulation system for the locomotorium.
Scientific value of the project is to develop new effective methods and tools of electrodiagnostics and electrostimulation with CBTFB. It is supposed to apply for the following patents: a method of electrodiagnostics of a functional state of locomotorium muscles, a method of the neuromuscular apparatus electrostimulation, construction and technology of a rectal electrode. Practical value: application of the obtained results in medical practice will allow to decrease the treatment period, to increase efficiency and quality of rehabilitation. Application field: the project results can be used in neurology, orthopedy, traumatology, proctology, and children's surgery. Commercial value: the pilot models of the systems that do not have analogs are to become the basis for industrial production. They will be implemented in rehabilitation departments of hospitals, out-patient-clinic, and sanatorium-resort institutions. It is supposed to protect intellectual property obtained in fulfilling the project.
Conformity with the objectives and tasks of the ISTC:
- the participants working with weapons will redirect their skills to the development of medical equipment;
- integration of project participants with the international scientific community, in particular, participation in the International Functional Electrical Stimulation Society, Biofeedback Foundation of Europe, etc.;
- support of applied researches and technology development in the field of public health;
- contributing to the solution of one of the basic medical and social problems of public health, namely rehabilitation of patients with disturbances of motor functions of skeletal muscles and large intestine pathology.
Scope of Activities. The project duration is 30 months. Total project effort is equal to 8346 person-days. The project will solve 7 tasks. The project participants from BSUIR will decide the problems associated with biomedical signal processing, modelling and synthesis of electostimulation systems, and development of soft-hardware tools (5394 person-days). The project participants from RINNP will fulfil medical research and testing of methods and tools of skeletal muscles electrostimulation (1430 person-days). The project participants from FCH will fulfil medical research and testing of methods and tools of electrostimulation of a rectum and anal sphincters (1522 person-days).
The design documentation will be developed, the pilots of 2 electrostimulation systems will be produced and clinical testing will be carried out (2721 person-days).
Role of Foreign Collaborators. The approaches proposed in the project have been discussed and supported by the leading specialists namely Raphael C. Lee, Chicago University (USA) professor (scientific and medical research parts of the project) and Klaus Holle, general manager of SonoAse (Germany) (technical part of the project). The role of foreign collaborators is to exchange information in the course of project implementation, to provide comments to the results obtained by project participants, to take part and conduct joint seminars on functional electrostimulation, biotechnical and biological feedbacks.
Technical Approach and Methodology. The methods and electrostimulation systems developed within the framework of the project are first proposed and in part tested by project participants. Experience and results obtained by project participants in the field of digital biomedical information processing, biotechnical system modelling, physiological parameter research of neuromuscular tissue, and neuroreflex activity regulation of gastrointestinal tract are the basis of success in achievement of project objectives. Effectiveness of developed systems will be estimated by experimental methods (electromyography and electrodiagnostics) and results of clinic testing. To achieve the project objectives an approach based on realization of CBTFB is proposed. The essence of the approach is in the coordinated interaction in the system of two methods: BFB and BTFB. The loop of BTFB in real time controls the parameters of electrostimulation signals according to a functional state of the neuromuscular apparatus. The loop of BFB provides a training of natural self-regulation using a computer monitor display in visual and/or audio-form of the physiological parameters of the neuromuscular apparatus of a patient. The project task decision will be based on using methods and tools of digital signal processing, functional and structural identification of physiological systems, automatic monitoring, electrical and impedance diagnostics, combined electrostimulation and psychophysiological self-regulation. Experiments with animals will be carried out in accordance with «Rules of treatment with laboratory animals in the ISTC projects». The pilot models of electrostimulation systems will be realized according to requirements of IEC 601-1, 601-2-10, 601-1-4.