Restoring Function and Enabling Exercise in Spinal Cord Injury: the key role of feedback control in rehabilitation engineering

We describe the development of systems which enable people with spinal cord injury to perform intensive cyclical exercise interventions, and we illustrate the effect this can have on physiological status. The work forms part of the research programme of the Centre for Rehabilitation Engineering at the University of Glasgow, in collaboration with the Queen Elizabeth National Spinal Injuries Unit in Glasgow. These developments are based upon controlled electrical stimulation of paralysed muscle to allow upper- and lower-limb cycling exercise, weight-supported treadmill gait, and automatic control of balance during quiet standing. The presentation will highlight the key role played by feedback control in enabling these forms of exercise and function, and in allowing determination of important physiological variables. Our programme includes estimation of the key markers of cardiopulmonary status using real-time breath-by-breath measurements during exercise testing, evaluation of lower-limb bone integrity using quantitative computed tomography (pQCT), and the evaluation of muscle and skin integrity using MRI scanning and dynamometry. These physiological factors are related to some of the secondary complications arising from a spinal cord injury, and we illustrate the positive effect that our physical interventions can have on these parameters. Full details of this work can be found in (K. J. Hunt, 2005)