The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study

The use of assistive technologies, such as a non-invasive interface for neuroelectrical signal and functional electrical stimulation (NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mro...

Full description

Bibliographic Details
Main Authors: Felipe Augusto Fiorin, Larissa Gomes Sartori, María Verónica González Méndez, Christiane Henriques Ferreira, Maria Bernadete de Morais França, Eddy Krueger
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Eng
Subjects:
Online Access:https://www.mdpi.com/2673-4117/4/2/97
_version_ 1797594978539536384
author Felipe Augusto Fiorin
Larissa Gomes Sartori
María Verónica González Méndez
Christiane Henriques Ferreira
Maria Bernadete de Morais França
Eddy Krueger
author_facet Felipe Augusto Fiorin
Larissa Gomes Sartori
María Verónica González Méndez
Christiane Henriques Ferreira
Maria Bernadete de Morais França
Eddy Krueger
author_sort Felipe Augusto Fiorin
collection DOAJ
description The use of assistive technologies, such as a non-invasive interface for neuroelectrical signal and functional electrical stimulation (NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>), can mitigate the effects of spinal cord injury (SCI), including impairment of motor, sensory, and autonomic functions. However, it requires an adaptation process to enhance the user’s performance by tuning the learning curve to a point of extreme relevance. Therefore, in this pilot study, the learning curves of two people with complete SCI (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>A</mi></msub></semantics></math></inline-formula>: paraplegic-T<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mn>6</mn></msub></semantics></math></inline-formula>, and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>B</mi></msub></semantics></math></inline-formula>: quadriplegic-C<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mn>4</mn></msub></semantics></math></inline-formula>) were analyzed, with results obtained on the accuracy of the classifier (Ac<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mrow><mi>C</mi><mi>S</mi><mi>P</mi><mo>−</mo><mi>L</mi><mi>D</mi><mi>A</mi></mrow></msub></semantics></math></inline-formula>), repetitions of intra-day training, and number of hits and misses in the activation of FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> for sixteen interventions using the NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> interface. We assumed that the data were non-parametric and performed the Spearman’s <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>ρ</mi></semantics></math></inline-formula> test (and <i>p</i>-value) for correlations between the data. There was variation between the learning curves resulting from the training of the NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> interface for the two participants, and the variation was influenced by factors both related and unrelated to the individual users. Regardless of these factors, <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>A</mi></msub></semantics></math></inline-formula> improved significantly in its learning curve, as it presented lower values in all variables in the first interventions compared to the <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>B</mi></msub></semantics></math></inline-formula>, although only <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>A</mi></msub></semantics></math></inline-formula> showed statistical correlation (on Ac<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mrow><mi>C</mi><mi>S</mi><mi>P</mi><mo>−</mo><mi>L</mi><mi>D</mi><mi>A</mi></mrow></msub></semantics></math></inline-formula> values in RLL). It was concluded that despite the variations according to factors intrinsic to the user and the functioning of the equipment used, sixteen interventions were sufficient to achieve a good learning effect to control the NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> interface.
first_indexed 2024-03-11T02:30:22Z
format Article
id doaj.art-01bbc847ad834de486f8544e24b69a75
institution Directory Open Access Journal
issn 2673-4117
language English
last_indexed 2024-03-11T02:30:22Z
publishDate 2023-06-01
publisher MDPI AG
record_format Article
series Eng
spelling doaj.art-01bbc847ad834de486f8544e24b69a752023-11-18T10:15:17ZengMDPI AGEng2673-41172023-06-01421711172210.3390/eng4020097The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot StudyFelipe Augusto Fiorin0Larissa Gomes Sartori1María Verónica González Méndez2Christiane Henriques Ferreira3Maria Bernadete de Morais França4Eddy Krueger5Laboratório de Engenharia Neural e de Reabilitação, Departamento de Anatomia, Universidade Estadual de Londrina, Londrina 86057-970, BrazilLaboratório de Engenharia Neural e de Reabilitação, Departamento de Anatomia, Universidade Estadual de Londrina, Londrina 86057-970, BrazilEngenharia Elétrica e Informática Industrial, Universidade Tecnológica Federal do Paraná, Curitiba 80230-901, BrazilLaboratório de Engenharia Neural e de Reabilitação, Departamento de Anatomia, Universidade Estadual de Londrina, Londrina 86057-970, BrazilLaboratório de Automação e Instrumentação Inteligente, Departamento de Engenharia Elétrica, Universidade Estadual de Londrina, Londrina 86057-970, BrazilLaboratório de Engenharia Neural e de Reabilitação, Departamento de Anatomia, Universidade Estadual de Londrina, Londrina 86057-970, BrazilThe use of assistive technologies, such as a non-invasive interface for neuroelectrical signal and functional electrical stimulation (NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>), can mitigate the effects of spinal cord injury (SCI), including impairment of motor, sensory, and autonomic functions. However, it requires an adaptation process to enhance the user’s performance by tuning the learning curve to a point of extreme relevance. Therefore, in this pilot study, the learning curves of two people with complete SCI (<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>A</mi></msub></semantics></math></inline-formula>: paraplegic-T<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mn>6</mn></msub></semantics></math></inline-formula>, and <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>B</mi></msub></semantics></math></inline-formula>: quadriplegic-C<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mn>4</mn></msub></semantics></math></inline-formula>) were analyzed, with results obtained on the accuracy of the classifier (Ac<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mrow><mi>C</mi><mi>S</mi><mi>P</mi><mo>−</mo><mi>L</mi><mi>D</mi><mi>A</mi></mrow></msub></semantics></math></inline-formula>), repetitions of intra-day training, and number of hits and misses in the activation of FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> for sixteen interventions using the NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> interface. We assumed that the data were non-parametric and performed the Spearman’s <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mi>ρ</mi></semantics></math></inline-formula> test (and <i>p</i>-value) for correlations between the data. There was variation between the learning curves resulting from the training of the NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> interface for the two participants, and the variation was influenced by factors both related and unrelated to the individual users. Regardless of these factors, <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>A</mi></msub></semantics></math></inline-formula> improved significantly in its learning curve, as it presented lower values in all variables in the first interventions compared to the <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>B</mi></msub></semantics></math></inline-formula>, although only <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mi>P</mi><mi>A</mi></msub></semantics></math></inline-formula> showed statistical correlation (on Ac<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mrow><mi>C</mi><mi>S</mi><mi>P</mi><mo>−</mo><mi>L</mi><mi>D</mi><mi>A</mi></mrow></msub></semantics></math></inline-formula> values in RLL). It was concluded that despite the variations according to factors intrinsic to the user and the functioning of the equipment used, sixteen interventions were sufficient to achieve a good learning effect to control the NES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula>-FES<inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><msub><mrow></mrow><mi>s</mi></msub></semantics></math></inline-formula> interface.https://www.mdpi.com/2673-4117/4/2/97paraplegiaelectrical stimulationbrain–computer interface
spellingShingle Felipe Augusto Fiorin
Larissa Gomes Sartori
María Verónica González Méndez
Christiane Henriques Ferreira
Maria Bernadete de Morais França
Eddy Krueger
The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study
Eng
paraplegia
electrical stimulation
brain–computer interface
title The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study
title_full The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study
title_fullStr The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study
title_full_unstemmed The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study
title_short The Learning Curve of People with Complete Spinal Cord Injury Using a NES<sub>s</sub>-FES<sub>s</sub> Interface in the Sitting Position: Pilot Study
title_sort learning curve of people with complete spinal cord injury using a nes sub s sub fes sub s sub interface in the sitting position pilot study
topic paraplegia
electrical stimulation
brain–computer interface
url https://www.mdpi.com/2673-4117/4/2/97
work_keys_str_mv AT felipeaugustofiorin thelearningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT larissagomessartori thelearningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT mariaveronicagonzalezmendez thelearningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT christianehenriquesferreira thelearningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT mariabernadetedemoraisfranca thelearningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT eddykrueger thelearningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT felipeaugustofiorin learningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT larissagomessartori learningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT mariaveronicagonzalezmendez learningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT christianehenriquesferreira learningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT mariabernadetedemoraisfranca learningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy
AT eddykrueger learningcurveofpeoplewithcompletespinalcordinjuryusinganessubssubfessubssubinterfaceinthesittingpositionpilotstudy