Closed-loop Neuroprosthetic Control through Spared Neural Activity Enables Proportional Foot Movements after Spinal Cord Injury

[2506.16468] Closed-loop Neuroprosthetic Control through Spared Neural Activity Enables Proportional Foot Movements after Spinal Cord Injury Skip to main content Search Submit Donate Log in Search arXiv Press Enter to search · Advanced search Computer Science > Human-Computer Interaction arXiv:2506.16468 (cs) [Submitted on 19 Jun 2025 ( v1 ), last revised 8 Apr 2026 (this version, v2)] Title: Closed-loop Neuroprosthetic Control through Spared Neural Activity Enables Proportional Foot Movements after Spinal Cord Injury Authors: Vlad Cnejevici , Matthias Ponfick , Dietmar Fey , Raul C. Sîmpetru , Alessandro Del Vecchio View a PDF of the paper titled Closed-loop Neuroprosthetic Control through Spared Neural Activity Enables Proportional Foot Movements after Spinal Cord Injury, by Vlad Cnejevici and 3 other authors View PDF HTML (experimental) Abstract: Loss of voluntary foot movement after spinal cord injury (SCI) can significantly limit independent mobility and quality of life. To improve motor output after injury, functional electrical stimulation (FES) is used to deliver stimulation pulses through the skin to affected muscles. While commercial FES systems typically use motion-based triggers, prior research shows that spared movement intent can be decoded after SCI using surface electromyography (EMG). Our aim is to assess how well spared neural signals of the lower limb after SCI can be decoded and used to control electrical stimulation for restoring foot movement. We developed a wearable machine learning-powered neuroprosthetic that records EMG from the affected lower limb using a 32-channel electrode bracelet and enables closed-loop control of a FES device for foot movement restoration. Five participants with SCI used the predicted control signal to follow trajectories on a screen with their foot and achieve distinct motor activation patterns for foot flexion, extension, and inversion or eversion. Three of these participants also achieved 2 proportional activation levels during foot flexion/extension with more than 70% accuracy. To validate how these neural signals can be used for closed-loop neuroprosthetic control, two participants used their decoded activity to control a FES device and stimulate their affected foot. This resulted in an increased foot flexion range for both participants of 33.6% and 40% of a functional healthy range, respectively (p smaller than 0.001). One of the participants also achieved voluntary proportional control of up to 6 stimulation levels during foot flexion/extension. These results suggest that wearable EMG decoding coupled with FES systems provides a scalable strategy for closed-loop neuroprosthetic control supporting voluntary foot movement. Comments: 17 pages, 6 figures, 2 tables, 2 supplementary figures, 1 supplementary table Subjects: Human-Computer Interaction (cs.HC) ; Systems and Control (eess.SY) Cite as: arXiv:2506.16468 [cs.HC] (or arXiv:2506.16468v2 [cs.HC] for this version) https://doi.org/10.48550/arXiv.2506.16468 Focus to learn more arXiv-issued DOI via DataCite Submission history From: Vlad Cnejevici [ view email ] [v1] Thu, 19 Jun 2025 17:08:16 UTC (2,441 KB) [v2] Wed, 8 Apr 2026 17:43:22 UTC (5,691 KB) Full-text links: Access Paper: View a PDF of the paper titled Closed-loop Neuroprosthetic Control through Spared Neural Activity Enables Proportional Foot Movements after Spinal Cord Injury, by Vlad Cnejevici and 3 other authors View PDF HTML (experimental) TeX Source view license Current browse context: cs.HC < prev | next > new | recent | 2025-06 Change to browse by: cs cs.SY eess eess.SY References & Citations NASA ADS Google Scholar Semantic Scholar export BibTeX citation Loading... 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