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Riener
07-21-1999, 04:46 PM
Dear Colleague:

The first joint conference of the Biomedical Engineering Society
(BMES) and the IEEE Engineering in Medicine and Biology
Society (EMBS) in Atlanta in October 12-16 is coming closer.

We want to draw your attention to the preconference workshop
"NEUROPROSTHETICS FOR FUNCTIONAL MOVEMENT
RESTORATION" and remind you to register soon, if you are
interested!

More information and description how to register is available
on the internet: http://bmes-embs99.gatech.edu

Yours sincerely,
R. Riener, M. Ferrarin, A. Pedotti, J. Quintern

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Program of the Preconference Workshop:

NEUROPROSTHETICS FOR FUNCTIONAL MOVEMENT RESTORATION
Atlanta, October 12th, 1999

Organizers: Robert Riener(1,2), Maurizio Ferrarin(1),
Antonio Pedotti(1), Jochen Quintern(3)

(1) Centro di Bioingegneria, Fondazione Don C. Gnocchi, Politechnico
di Milano, Italy
(2) Inst. of Automatic Control Engineering, Technical University
of Munich, Germany
(3) Neurological Clinic, Klinikum Grosshadern, LMU, Munich, Germany


MOTIVATION

Neuroprostheses on the basis of FES are used to restore motor
function in patients with upper motor neuron lesions. Multi-joint
movements with high coordinative requirements such as climbing stairs
(paraplegics) or using tools for eating and drinking (tetraplegics)
are very difficult to control with a neuroprosthesis. However, in
the last 15 years the rapid progress in microprocessor technology,
modeling and simulation, controller development, miniaturization of
biosensors, electrode implantation, etc. provided the means for more
complex computer-controlled FES systems. It is expected that
functionally useful FES systems will be available in the near future.


BRIEF OVERVIEW

After presenting a medical and technical overview, the workshop
gives an impression about the state of the art and the problems that
exist in the field of neuroprosthetics. Different model and control
strategies, sensor approaches, and clinical applications will be
discussed. Eventually, ethical aspects and problems in technology
transfer will be presented. The workshop closes with an overview
about future directions in the field of FES.


PRELIMINARY PROGRAM

A. Pedotti, Italy: INTRODUCTION TO THE WORKSHOP

J. Quintern, Germany: NEUROPHYSIOLOGICAL BASICS
- Upper and lower motor neuron
- Patient selection criteria for Functional Electrical Stimulation (FES)

- Nonlinear activation of nerve and muscles by means of FES
- Spasticity
- Interaction between spinal reflexes and FES
- General applications of electrical stimulation in medicine

P. Veltink, The Netherlands: ARTIFICIAL SUPPORT OF
IMPAIRED HUMAN MOTOR CONTROL
- The human motor system as a feedback controlled dynamic system
(controller, plant, sensors)
- Impaired human motor control
- Artificial support systems with controller, mechanics and sensors
- Interactions between impaired human motor system and artificial
support system
- Design of artificial support systems
- User interaction

R. Riener, Germany/Italy: MODELING IN NEUROPROSTHETICS
- Modeling overview: general purpose of modeling, model types, parameter

identification
- Model applications: model-based neurophysiological investigations,
model-based biomechanical motion analysis, model-based design of
control strategies, on-line model application in control
- Examples: model applications for the development of lower-limb
prosthesis

D. Popovic, Yugoslavia: CONTROL OF MOVEMENTS
- Biological control of movements: Comparison of goal directed and
cyclic movements
- Analytic models for control of movements: Modeling multi-joint
structures and using Hill muscle models can be applied to analyze
control of movement
- Nonanalytic modeling of movements: Design of different control
strategies by black box models (e.g., multilayer perception,
adaptive fuzzy control, inductive learning, ANN)
- Hybrid modeling of controllers: "Feedback error learning"

T. Sinkjśr, Denmark: NATURAL VERSUS ARTIFICIAL
SENSORS FOR FES CONTROL
- Skin sensors in functional hand restoration
- Muscle sensors in leg restoration
- Bladder sensors in treating detrusor hyperrerflexia
- Cognitive feedback from foot sensors for restoration of standing

M. Ferrarin, Italy: ORTHOTIC AND HYBRID SYSTEMS FOR
PARAPLEGIC WALKING
- Mechanical orthoses for walking restoration: principles, clinical
results and problems
- Traditional and innovative orthoses
- Biomechanical analysis and orthoses' optimization
- Hybrid systems : mechanical orthoses and FES

D. Graupe, USA: REVIEW OF 16 YEARS OF AMBULATION
BY PARAPLEGICS USING TRANSCUTANEOUS FNS:
APPARATUS, TRAINING, AMBULATION-PERFORMANCE,
AND MEDICAL EVALUATION
Discussion of a transcutaneous unbraced FNS system (PARASTEP) which
allows T1-T12 traumatic paraplegics to stand and ambulate short
distances independently:
- PARASTEP development and technical features (size, stimulation
output, control)
- Patient admissibility, training, and ambulation performance
- Medical benefits concerning muscle-mass, spasticity, peak-work
capacity, heart-rate, blood-flow, depression scores, ambulation
distance
- Discussion of a specific training program

U. Stanic, Slovenia: ELECTRICAL STIMULATION IN
RECOVERY OF BREATHING
- Modelling of the respiratory system
- Mechanical and neuromuscular components
- Analysis of respiration in spinal cord injured people
- Artificial support systems: mechanical, phrenic nerve
stimulation, abdominal muscle stimulation
- Example of clinical applications and future developments

R. Jaeger, USA: ETHICAL ASPECTS
- Epidemiology of SCI (who gets injured and why)
- Psychological adjustment after SCI (will I walk again)
- Expectations and motivation (researcher, clinician, user)
- Research versus treatment (informed consent and reimbursement)
- Alternatives to FES
- Safety (screening, stimulators, instructions for use)
- Risk assessment and liability considerations

G. Loeb, Canada: TECHNOLOGY TRANSFER
Technology transfer for FES is somewhat more difficult than for
many other engineering and biomedical applications:
- Medical device manufacturers are generally smaller than pharma-
ceutical companies, with narrower in-house R&D capabilities.
- Permanently implanted devices with complex electronic functions
present lengthy and difficult regulatory hurdles.
- Clinical trials are expensive and involve complex outcome measures.
- Markets are relatively small and difficult to penetrate as a result
of reluctant insurers and conservative clinicians.
Nevertheless, technology transfer is possible, rewarding and ultimately
necessary. Applied research that does not result in a marketed product
cannot attain its goal of making people well.

P. Rabischong, France: FUTURE DIRECTIONS FOR THE NEXT DECADE
- Problems and requirements
- Future research
- Future clinical applications


--
------------------------------------------------------
Dr.-Ing. Robert Riener
------------------------------------------------------
Neuroprosthetics Group
Institute of Automatic Control Engineering (LSR)
Technische Universitaet Muenchen (TUM)
Arcisstr. 21, 80333 Muenchen, Germany

Phone: +49-89-289-23421
Fax: +49-89-289-28340
E-mail: mailto:robert.riener@ei.tum.de
WWW: http://www.lsr.ei.tum.de/~riener
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