Neuromuscular Stimulation

{
  "publication_number": "US2008288020A1",
  "country": "US",
  "kind": "A1",
  "title": "Neuromuscular Stimulation",
  "abstract": "Apparatus for muscle activation, comprising: at least one electrode (138, 140, 142, 144) adapted to deliver a neuromuscular stimulation (NMES) signal to a body portion (146); at least one controller (124) adapted to provide a NMES signal comprising a sequence of stimulation signals to said at least one electrode; and a mechanical motion element (300) coupled to at least one of said body portion and a mirror body portion, wherein said mechanical motion element is operatively coupled to said at least one controller and wherein said at least one controller controls said NMES signal in conjunction with said mechanical motion element.",
  "claims": [
    "1. Apparatus for muscle activation, comprising: at least one electrode adapted to deliver a neuromuscular stimulation (NMES) signal to a body portion; at least one controller adapted to provide a NMES signal comprising a sequence of stimulation signals to said at least one electrode; and a mechanical motion element coupled to at least one of said body portion and a mirror body portion, wherein said mechanical motion element is operatively coupled to said at least one controller and wherein said at least one controller controls said NMES signal in conjunction with said mechanical motion element. 2. Apparatus according to claim 1, wherein said mechanical motion element moves said body portion. 3. Apparatus according to claim 1 or claim 2, wherein said mechanical motion element measures motion of said body portion, which motion is in response to said NMES sequence. 4. Apparatus according to any of the preceding claims, wherein said mechanical motion element guides motion of said body portion, which motion is in response to said NMES sequence. 5. Apparatus according to any of the preceding claims, wherein said mechanical motion element guides motion of said mirror body portion, which NMES is generated in response to said motion. 6. Apparatus according to any of the preceding claims, comprising a programmer adapted to program NMES sequences for said electrodes. 7. Apparatus according to claim 6, wherein said programmer includes a sequence optimizer which modifies NMES sequences in response to at least one optimization criterion. 8. Apparatus according to claim 7, wherein said optimization criterion comprises the ability of a patient. 9. Apparatus according to claim 7, wherein said optimization criterion comprises electrode limitations. 10. Apparatus according to claim 7, wherein said optimization criterion comprises a quality of result, as measured by said mechanical motion element. 11. Apparatus according to any of claims 1 - 10, comprising an EMG sensor, wherein said controller is adapted to generate an NMES sequence based on sensed EMG signals from said sensor. 12. Apparatus according to claim 11, wherein said EMG signals are measured from a mirror body portion. 13. Apparatus according to claim 11, wherein said EMG signals are measured from a different person. 14. Apparatus according to claim 11, wherein said EMG signals are measured from the same body portion. 15. Apparatus according to claim 14, wherein said controller generates a NMES signal responsive to at least one of an amplitude and existence of EMG signal at a location to which NMES is to be applied. 16. Apparatus according to any of the preceding claims, wherein said controller is adapted to generate an indication of which electrodes of said at least one electrode to use. 17. Apparatus according to any of the preceding claims, comprising a memory storing therein a plurality of NMES sequences, for at least one daily activity. 18. Apparatus according to any of the preceding claims, comprising a user input for generating a NMES sequence. 19. Apparatus according to any of the preceding claims, wherein said controller is adapted to generate a NMES sequence for use for said electrodes based on a desired motion of said body part. 20. Apparatus according to any of the preceding claims, wherein said controller is adapted to modify a stored NMES sequence for use for said electrodes based on a desired motion of said body part. 21. Apparatus according to any of the preceding claims, wherein said controller is adapted to compare an actual effect of a NMES sequence and a desired effect of said sequence and detect at least one deviation. 22. Apparatus according to any of the preceding claims, wherein said mechanical motion element is adapted to measure force applied by said body portion in response to said NMES. 23. Apparatus according to any of the preceding claims, comprising a calibrator adapted to calibrate at least one sensor associated with motion of said portion. 24. Apparatus according to any of the preceding claims, comprising an interactive user guide for electrode NMES programming. 25. Apparatus according to any of the preceding claims, wherein said electrodes are implantable. 26. Apparatus according to any of the preceding claims, wherein said electrodes form part of a prosthesis. 27. Apparatus according to any of the preceding claims, wherein said electrodes are adapted to be worn for the long term. 28. Apparatus according to any of the preceding claims, wherein said electrodes and at least one of said at least one controller are adapted to act independently of and removed from said motion element. 29. Apparatus according to any of the preceding claims, wherein said NMES sequence comprises a sequence for application to at least two muscles. 30. Apparatus according to any of the preceding claims, wherein said NMES sequence is at least 20 seconds long. 31. Apparatus according to any of claims wherein said mechanical motion element comprises an actuator. 32. Apparatus according to claim 31, wherein said actuator comprises a robotic actuator with at least 3 degrees of motion. 33. A method of electrode setting for NMES, comprising: applying a NMES sequence to a limb; measuring motion of the limb; modifying said NMES sequence responsive to said measured motion; and repeating said applying, said measuring and said modifying, using a mechanical motion element to at least one of move said limb, resist motion of said limb and measure motion of said limb."
  ],
  "description_excerpt": "The field of the invention is devices for rehabilitation of patients with motor control problems.\n\nVoluntary muscle movement is caused by electrical impulses which originate in the somato-motor cortex of the brain. A neuron in the somato-motor cortex sends electrical signals to a motor neuron in the spinal cord, which in turn sends electrical signals which stimulate the contraction of muscle fibers, producing movement. All of the muscle fibers which are stimulated by a given motor neuron are called a “motor unit.” Each muscle fiber exhibits an electrical potential across its cell membrane, which changes when the muscle contracts.\n\nIn electromyography (EMG), the difference in potential on the surface of the skin is measured between the center and the ends of a muscle, which gives a measure of the number of contracting muscle fibers. EMG is regularly used to diagnose a variety of medical conditions in patients, as well as in healthy subjects for research on muscle function.\n\nIn stroke patients with damage to their somato-motor cortex, electrical signals are not generated for one or more muscles or parts of muscles, or do not reach those muscles, and normal contraction of those muscles is impossible. Often, residual EMG signals, too weak or too spread out to cause the muscles to contract, are still detectable.\n\nNeuromuscular electrical stimulation (NMES) is used to produce contraction of a muscle which cannot contract normally in a stroke patient. NMES may stop spasticity in a muscle, and may prevent the muscle from atrophying.",
  "cpc": [
    "A61N 1/36003",
    "A61B 5/389",
    "A61B 5/395"
  ],
  "ipc": [
    "A61N 1/36",
    "A61N 1/04"
  ],
  "assignees": [
    "Motorika Inc"
  ],
  "inventors": [
    "Omer Einav",
    "Ernesto Korenman"
  ],
  "filing_date": "2005-04-28",
  "publication_date": "2008-11-20",
  "priority_date": "2004-02-05",
  "application_number": "US-56846305-A",
  "family_id": "56290685",
  "cited_by_count": 131,
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}