Assist-as-needed Control for FES in Foot Drop Management

Foot drop is commonly managed using Functional Electrical Stimulation (FES), typically delivered via open-loop controllers with fixed stimulation intensities. While users may manually adjust the intensity through external controls, this approach risks overstimulation, leading to muscle fatigue and discomfort, or understimulation, which compromises dorsiflexion and increases fall risk. In this study, we propose a novel closed-loop FES controller that dynamically adjusts the stimulation intensity based on real-time toe clearance, providing "assistance as needed". We evaluate this system by inducing foot drop in healthy participants and comparing the effects of the closed-loop controller with a traditional open-loop controller across various walking conditions, including different speeds and surface inclinations. Kinematic data reveal that our closed-loop controller maintains adequate toe clearance without significantly affecting the joint angles of the hips, the knees, and the ankles, and while using significantly lower stimulation intensities compared to the open-loop controller. These findings suggest that the proposed method not only matches the effectiveness of existing systems but also offers the potential for reduced muscle fatigue and improved long-term user comfort and adherence.