System including controller and electrical stimulation system

Abstract

This disclosure provides a controller and method for providing signaling to an ES system to operate an electrode array in detection mode, causing the ES system to provide a plurality of electrical parameter detection bursts, each electrical parameter detection burst configured not to provide muscle stimulation, and causing the system to detect one or more detection parameters indicating the degree of muscle movement associated with each electrical parameter detection burst, each electrical parameter detection burst being provided by applying a potential difference between different pairs of electrodes, and the controller is configured to calculate the electrical parameters between each detection electrode pair based on one or more detection parameters. This disclosure also relates to related electrical stimulation systems and computer-readable media.

Description

Technical Field

[0001] The present disclosure relates to a controller for an electrical stimulation (ES) system and a corresponding ES system.

Background Art

[0002] Inactivity is emerging as one of the greatest health challenges of modern times. This problem is particularly acute for medical patients in a state of immobilization. Immobilization and muscle inactivity lead to major medical disorders such as muscle wasting, diabetes, pain, overweight, edema, deep vein thrombosis and pulmonary embolism, all of which can result in pain and death. These medical disorders impose a huge cost on healthcare but are potentially preventable.

[0003] Treatment of immobilization requires mobilization, i.e., physical activity, which may not be carried out in the correct amounts and is not always possible for some people. In summary, the low efficiency of the intervention is caused by low compliance with the treatment. One treatment for activating immobilized muscles is neuromuscular electrical stimulation (NMES), an example of electrical stimulation (ES) technology, which is used by physiotherapists and, albeit less so, by end-users to stimulate inactive skeletal muscles.

[0004] To effectively apply NMES, electrodes must be precisely positioned at the so-called motor points to achieve the most comfortable and energy-efficient muscle stimulation. While motor points tend to be in similar locations across individuals, there is still considerable variability in their exact location. Furthermore, even the individual motor points of a single user can change position over time. The electrode matrix can be used to stimulate nerves or muscles at body locations. Measuring such stimulation requires the addition of sensors, such as flex sensors or other sensors, to detect movement at body locations. Adding appropriate sensors can occupy space that could otherwise be used for electrodes within the electrode matrix, making it challenging to balance sensitivity with precision and flexibility in stimulation application. [Overview of the Initiative]

[0005] According to a first aspect of the present disclosure, a controller is provided for providing signaling to at least one electrical stimulation (ES) system and for receiving signaling from the ES system, wherein the ES system comprises an electrode array including a plurality of electrodes for applying electrical stimulation to the muscles of a user, the electrodes being further configured to measure an electrical parameter between any one electrode of the electrode array and any one other electrode of the electrode array, and the controller provides signaling to the ES system to cause the electrode array to operate in detection mode during a detection period, the signaling causing the ES system to provide a plurality of electrical parameter detection bursts, each electrical parameter detection burst comprising one or more detection pulses, and each electrical parameter detection burst being configured not to provide muscle stimulation. The controller is configured to provide and detect one or more detection parameters indicating the degree of muscle movement associated with each electrical parameter detection burst, each electrical parameter detection burst being provided by applying a potential difference between different pairs of electrodes, the pair of electrodes referring to a combination of a first detection electrode and a second detection electrode selected from any electrodes in the electrode array, such that when the controller provides a subsequent electrical parameter detection burst, the electrode pair corresponding to the subsequent electrical parameter detection burst includes any two electrodes in the electrode array, except for any electrode pair corresponding to any electrical parameter detection burst previously provided in the detection period, and the controller is configured to calculate the electrical parameters between each pair of detection electrodes based on one or more detection parameters.

[0006] It will be understood that not providing muscle stimulation refers to applying an electrical parameter detection burst with sufficient intensity to cause muscle activation. The degree of muscle movement will be understood as the amount of muscle movement, which can include zero movement. That is, the detection parameter can indicate whether or not the muscle moved, and to what extent. In some embodiments, the degree of muscle or body movement is the response to muscle stimulation caused by the stimulation pulse.

[0007] In one or more embodiments, the controller may be configured to provide signaling to the ES system to operate the electrode array in a stimulation mode, the signaling causing the ES system to provide a plurality of stimulation pulses separated by rest periods, each stimulation pulse comprising applying a stimulation potential difference between a first stimulation electrode and a second stimulation electrode of the electrode array such that the stimulation potential difference provides muscle stimulation, and each rest period includes a period in which no stimulation pulse is present.

[0008] In one or more embodiments, the detection period may occur during a pause period such that one or more detection parameters are measured during the application of a stimulation pulse.

[0009] In one or more embodiments, the controller may be configured to provide signaling to the ES system so that the ES system provides electrical parameter detection bursts during at least 50% of the detection electrode pairs that can be defined in the electrode array, and in correspondingly so that it detects one or more detection parameters indicating the degree of body movement associated with each electrical parameter detection burst.

[0010] In yet another alternative embodiment, the controller may be configured to provide signaling to the ES system, causing the ES system to provide electrical parameter detection bursts among at least 30%, at least 40%, at least 60%, at least 70%, at least 80%, at least 90%, or at least 100% of the detection electrode pairs that can be defined within the electrode array, and correspondingly to detect one or more detection parameters indicating the degree of body movement associated with each electrical parameter detection burst. By performing a large number of measurements among different pairs of electrodes that can be defined within the array, a corresponding number of sensors can be effectively created, which can provide improved accuracy, reliability, and location specificity compared to, for example, using a small number of flex sensors instead.

[0011] In one or more embodiments, the controller may be further configured to determine, based on electrical parameters calculated between each pair of sensing electrodes, whether to signal the ES system to operate the electrode array in sensing mode or to signal the ES system to operate in alternative mode.

[0012] In one or more embodiments, the detection parameter may be the current between a pair of electrodes during each electrical parameter detection burst.

[0013] In one or more embodiments, the calculated electrical parameter may be at least one of electrical resistivity, electrical resistance, electrical conductivity, electrical conductance, electrical impedance, and electrical admittance.

[0014] In one or more embodiments, the controller may be further configured to generate an electrical parameter map representing the spatial distribution of electrodes in an electrode array, the electrical parameter map comprising a plurality of elements arranged in a grid, each element comprising an element value based on one or more electrical parameters calculated by the controller.

[0015] In one or more embodiments, each element of the electrical parameter map may correspond to an electrode in an electrode array, and the element value of the element of the electrical parameter map is based on the sum of each calculated electrical parameter using the corresponding electrode.

[0016] In one or more embodiments, each element of the electrical parameter map may correspond to an electrode in an electrode array, and the element value of the element of the electrical parameter map is based on the average of each calculated electrical parameter using the corresponding electrode.

[0017] In one or more embodiments, the controller may be configured to acquire an electrical parameter map of the electrodes of the electrode array acquired during the current detection period, the element values ​​of the electrical parameter map being based on the difference between the element values ​​calculated during the current detection period and the element values ​​calculated during a preceding detection period taken at a time prior to the current detection period, and one of the predefined element values.

[0018] In one or more embodiments, each element of the electrical parameter map may correspond to a pair of electrodes in an electrode array, and the element value of the electrical parameter element is based on the difference between the electrical parameter calculated between the pair during an electrical parameter detection burst and the electrical parameter calculated between the pair during a previous electrical parameter detection burst.

[0019] In one or more embodiments, the controller may be further configured to determine, based on an electrical parameter map, whether to signal the ES system to operate the electrode array in detection mode or to signal the ES system to operate in alternative mode.

[0020] In one or more embodiments, the electrical parameter detection burst may include a plurality of detection pulses, each having a pulse frequency of 10 Hz to 100 MHz.

[0021] In one or more embodiments, the current supplied between each pair of detection electrodes for detecting the detection parameter may be 0.1 mA or less.

[0022] In one or more embodiments, the controller may be configured to cause the ES system to apply a plurality of skin resistance reduction pulses during the stimulation period, the skin resistance reduction pulses having a higher frequency and lower intensity compared to the plurality of stimulation pulses.

[0023] In one or more embodiments, multiple skin resistance reduction pulses may be superimposed on multiple stimulation pulses.

[0024] In one or more embodiments, the skin resistance reduction pulse may carry a current of 0.1 mA or less per pulse and have a frequency of 1 to 100,000 Hz.

[0025] In one or more embodiments, the controller may be configured to cause the ES system to apply a plurality of sensory blocking pulses while operating in the stimulation mode, and the sensory blocking pulses have an intensity lower than the intensity of the stimulation pulses.

[0026] In one or more embodiments, the sensory blocking pulses may have a frequency of 0.1 to 150 Hz.

[0027] According to a second aspect of the present disclosure, an electrical stimulation (ES) system is provided that receives signaling from the controller of the first aspect and provides signaling to the controller of the first aspect.

[0028] In one or more embodiments, the ES system of the second aspect may further include clothing, and the clothing provides a support for the relative arrangement of the electrodes in the electrode array and is configured to distribute at least the electrodes over at least a body part of the user.

[0029] According to a third aspect of the present disclosure, a computer-readable medium is provided that includes computer program code configured to operate a controller according to the first aspect or the second aspect.

[0030] ​According to a fourth aspect of the present disclosure, a method is provided for providing electrical stimulation (ES) to a user's muscles using at least one ES system, the ES system comprising a controller and an electrode array including a plurality of electrodes for applying electrical stimulation to the muscles, the electrodes being further configured to measure electrical parameters between any one electrode of the electrode array and any other one electrode of the electrode array, the method comprising the step of the controller providing signaling to the ES system to operate the electrode array in a detection mode during a detection period, the signaling causing the ES system to provide a plurality of electrical parameter detection bursts during at least one detection period, each electrical parameter detection burst including one or more detection pulses and each electrical parameter detection burst being configured not to provide muscle stimulation; the step of the controller detecting one or more detection parameters indicative of the degree of movement of the muscles associated with each electrical parameter detection burst, each electrical parameter detection burst being provided by applying a potential difference between different pairs of the plurality of electrodes, a pair of electrodes being selected from any electrode of the electrode array such that when the controller provides a subsequent electrical parameter detection burst, the electrode pair corresponding to the subsequent electrical parameter detection burst includes any two electrodes of the electrode array other than any electrode pair corresponding to an electrical parameter detection burst provided prior to the detection period, the pair of electrodes referring to a combination of a first detection electrode and a second detection electrode; and the step of the controller calculating the electrical parameters between each pair of detection electrodes based on the one or more detection parameters.

[0031] In one or more embodiments, the method of the fourth aspect may further comprise the step of the controller providing signaling to the ES system to operate the electrode array in a stimulation mode, the signaling causing the ES system to provide a plurality of stimulation pulses separated by a rest period, each stimulation pulse including applying a stimulation potential difference between a first stimulation electrode and a second stimulation electrode of the electrode array such that the stimulation potential difference is configured to provide muscle stimulation, each rest period including a period in which no stimulation pulse is present.

[0032] According to a fifth aspect of the present disclosure, a controller is provided for providing signaling to at least one system and for receiving signaling from the system, the system comprising an electrode array comprising a plurality of electrodes, the electrodes further configured to measure an electrical parameter between any one electrode of the electrode array and any one other electrode of the electrode array, the controller providing signaling to the system for operating the electrode array in detection mode during a detection period, the signaling causing the system to provide a plurality of electrical parameter detection bursts, each electrical parameter detection burst comprising one or more detection pulses, each electrical parameter detection burst configured not to provide muscle stimulation, and each electrical parameter detection burst The controller is configured to detect one or more detection parameters indicating the degree of muscle movement associated with a burst, and each electrical parameter detection burst is provided by applying a potential difference between different pairs of electrodes, the pair of electrodes refers to a combination of a first detection electrode and a second detection electrode selected from any electrodes in the electrode array, such that when the controller provides a subsequent electrical parameter detection burst, the electrode pair corresponding to the subsequent electrical parameter detection burst includes any two electrodes in the electrode array, except for any electrode pair corresponding to any electrical parameter detection burst previously provided in the detection period, and the controller is configured to calculate the electrical parameters between each pair of detection electrodes based on one or more detection parameters. In one or more examples, the controller of the fifth embodiment may be a controller for a sensing system, which is configured to sense muscle movement (i.e., muscle stimulation) whether the muscle movement is induced by intentional user movement, involuntary user movement, or caused by an external stimulation device. The following description provides the disclosure in the context of a stimulation system, but it will be understood that any part of the disclosure that is not essentially related to causing a stimulus can be equally implemented in a sensing system, such as a fifth-dimensional sensing system, to sense muscle movement.

[0033] While this disclosure can be described in relation to NMES therapy, as discussed in the background technology, other applications are also envisioned. Many industries have a need for accurate and low-cost motion detection.

[0034] One example is the gaming and simulation industry, particularly virtual reality (VR) and assisted reality (AR) games. Embodiments of the Disclosure can be used to capture the motion of one or more areas of a user's body. The motion capture data is then processed and used as input to a control feedback loop in the game interface. This provides the user with a more immersive gaming experience. Embodiments of the Disclosure can be integrated into clothing or other wearable devices worn by the user while playing the game. Some embodiments of the Disclosure can be configured to provide the user with a mild electrical stimulus as part of the control feedback loop in the game interface. For example, if an area of ​​the user's avatar in the game is injured, a mild electrical stimulus may be applied to the corresponding area of ​​the user's body to warn the user of the injury.

[0035] In another example, embodiments of the present disclosure may be used in conjunction with motion enhancement systems such as powered exoskeletons. Exoskeletons are increasingly used in military, industrial, and medical applications to provide structural support to a user's body. They can enhance a user's physical strength and endurance, or assist the motion of injured or disabled users. Embodiments of the present disclosure can be used to capture the motion of one or more areas of a user's body. The motion capture data is then processed and used as input to a control feedback loop of the powered exoskeleton, enabling the user to control the exoskeleton using their own body. In some embodiments, the system is configured to provide a mild electrical stimulus to the user's body to provide feedback from the powered exoskeleton. For example, the user may be alerted to contact forces applied to the outside of the exoskeleton by applying a mild electrical stimulus to a corresponding area of ​​the user's body. Electrode arrays can be incorporated into flexible materials and clothing, as used by the latest generation of “soft” exoskeletons (also known as powered clothing).

[0036] Next, one or more embodiments will be described as examples only, with reference to the attached drawings. [Brief explanation of the drawing]

[0037] [Figure 1] Exemplary embodiments of the system of this disclosure, including a controller and an ES system, are shown. [Figure 2] This shows an illustrative representation of a point of motion on the user's calf. [Figure 3] An exemplary embodiment of an electrode array on the user's calf is shown. [Figure 4] An exemplary embodiment of the electrode array is shown, with individual electrical parameter detection bursts metaphorically represented as dotted lines. [Figure 5] This is a voltage-versus-time trace plot showing exemplary multiple stimulation pulses and multiple detection bursts between a pair of electrodes. [Figure 6]An exemplary embodiment of an electrode array including a group electrode is shown. [Figure 7(a)] This is a trace plot of electrostatic voltage against time, depicting the skin resistance reduction pulse between a pair of electrodes, independently and in conjunction with the stimulation pulse. [Figure 7(b)] This is a trace plot of electrostatic voltage against time, depicting the skin resistance reduction pulse between a pair of electrodes, independently and in conjunction with the stimulation pulse. [Figure 7(c)] This is a trace plot of electrostatic voltage against time, depicting the skin resistance reduction pulse between a pair of electrodes, independently and in conjunction with the stimulation pulse. [Figure 8] An exemplary voltage-versus-time trace plot is shown, depicting both the stimulation pulse and the deprivation pulse. [Figure 9] This disclosure illustrates an exemplary method for providing electrical stimulation to a user's muscles using at least one electrical stimulation (ES) system. [Figure 10] This flowchart shows an exemplary method for performing detection. [Figure 11] An exemplary embodiment of a computer-readable storage medium is shown. [Modes for carrying out the invention]

[0038] As shown in Figure 1, the present disclosure describes a system 100 comprising a controller 101 and an electrical stimulation (ES) system 102. The ES system 102 comprises an electrode array 104 and one or more sensors 105. In one or more embodiments, the ES system 102 may further comprise a garment 103. In one or more embodiments, the ES system 102 may comprise a plurality of garments 103, each garment comprising a corresponding electrode array 104 and one or more sensors 105, or a single garment may comprise a plurality of electrode arrays 104 and one or more associated sensors 105. Within a single garment, each electrode array 104 may form an independent ES system 102 having its own controller.

[0039] The controller 101 may be any suitable electronic controller 101 configured to provide signaling to and receive signaling from the ES system 102 or any component of the ES system 102. The controller 101 may comprise at least one processor and at least one memory containing computer program code. The at least one memory and computer program code, together with the at least one processor, may be configured to cause the controller 101 to provide signaling to the ES system 102. The controller 101 may also be configured to receive signaling from the ES system 102 and process the received signaling so that the controller 101 can act based on the information contained in the signaling. Actions that the controller 101 may take based on the received signaling will be described in more detail below. It will be understood that any preferred means may be used by the controller 101 to provide and receive signaling. For example, the controller 101 may be electrically coupled to the ES system 102 so that signals are transmitted directly via physical conductive means such as wires, conductive tracks, conductive fibers, or conductive fabrics. Alternatively, the controller 101 may provide signaling for a wireless transceiver to transmit and receive signaling to and from the ES system 102, and the ES system 102 may include a corresponding transceiver configured to both transmit and receive signaling. In such an example, the ES system 102 may include an ES controller (not shown) configured to interpret the signaling received from the controller 101.

[0040] In some examples, the controller 101 may be integrated into one or more garments 103, or it may be a remote device such as a buttock-mounted control box that can provide communication with one or more garments 103 of the ES system 102, or a computing device such as a mobile phone, tablet computer, laptop computer, or personal computer (PC).

[0041] In one or more embodiments, the controller 101 may comprise a coordinating controller and one or more ES system controllers. In such embodiments, each ES system controller transmits and receives signals to control a single ES system 102, and transmits and receives signals via the coordinating controller. The coordinating controller transmits high-level control signals to the ES system controllers, which then generate low-level control signals for the ES system 102. For example, the coordinating controller may instruct all ES system controllers to switch to detection mode, causing the ES system controllers to start generating signals to measure detection parameters between electrode pairs in the electrode array 104.

[0042] In one example, the user wears clothing that covers their legs, and this clothing includes multiple separate ES systems, each containing an ES system controller. One ES system includes an electrode array 104 positioned on the right leg, and another ES system includes an electrode array 104 positioned on the left leg. The coordinating controller may be a mobile phone, tablet, or any other mobile device that communicates wirelessly with each of the ES system controllers. The coordinating controller performs calculations and determines the operating mode of the ES system 102.

[0043] Electrical stimulation (ES) encompasses a range of techniques involving the application of one or more electrical signals or pulses to stimulate one or more muscles or nerves at a target body location. One such example of ES is neuromuscular electrical stimulation (NMES), but it will be understood that any suitable ES technique may be used. Other examples of suitable electrical stimulation techniques include, but are not limited to, electrical muscle stimulation (EMS), Russian electrical stimulation, functional electrical stimulation (FES), and transcutaneous electrical nerve stimulation (TENS).

[0044] In one or more examples, several electrodes of the electrode array 104 may be configured to connect directly to the user by any preferred means. The electrode array may comprise both stimulating electrodes configured to provide stimulation of either muscles or nerves or both, and sensing electrodes configured to detect electrical parameters indicating muscle or nerve stimulation. For example, several individual electrode pads may be attached to the user, and together these electrodes constitute the array of electrodes 104. In such embodiments, the controller 101 may be connected to the electrodes of the electrode array 104 in any preferred manner. In yet another example, one or more of the electrodes of the electrode array 104 may provide both stimulating and sensing electrode functions. In yet another example, clothing 103 may provide support for the relative arrangement of the electrodes of the electrode array 104. Clothing 103 may be, for example, clothing, patches, wrappings, or adhesive-attached pads configured to be worn by the user.

[0045] In this specification, the user is defined as the person or animal to which electrical stimulation is applied. This does not exclude one or more other people assisting the user, such as a healthcare professional. There may also be cases where the user is unaware and not interacting with System 100 at all, but another person, such as a healthcare professional, is providing any necessary input to the system.

[0046] In an example where the ES system 102 comprises a single garment 103, the system 100 as a whole may be fully integrated into the garment 103 itself, such that the controller 101 comprises a microprocessor embedded in the garment 103 along with the electrode array 104 and one or more sensors 105 of the ES system 102. In other examples, the overall system 100 may comprise multiple garments 103, with each of the electrode array 104 and one or more sensors 105 of each garment signaling to the controller 101. In embodiments where the ES system 102 comprises multiple garments 103, the controller 101 may be integrated into one of the garments 103, or it may be integrated into a device separate from any of the garments 103 of the ES system 102.

[0047] As already discussed, ES technology can be used to prevent multiple undesirable medical pains or to improve physical function. When properly applied, ES helps reduce the effects and potential of these pains by stimulating muscles, thereby making them work and stronger or maintaining their current strength, by forcing blood to move through veins, by activating the nervous system, by releasing growth factors, and by releasing anticoagulant factors, through multiple mechanisms including stimulating muscles and thereby making them work and stronger or maintaining their current strength. The additional assistance in moving blood may be particularly beneficial and useful for some users whose blood circulation is below a desirable level.

[0048] In this specification, clothing 103 refers to an article that can be worn on the body of a human or animal, and a human or animal wearing clothing 103 is defined as a user of the ES system 102. Clothing 103 may be understood to include clothing such as socks, gloves, tights, boxer shorts, boots, vests, or other garments. Alternatively, clothing 103 may be a bandage, patch, cast, or another medical wrapping or support garment that can be applied to the body of a human or animal for an extended period and during the user's normal activities. Clothing 103 as referred to herein is configured to provide support for the relative placement of electrodes of electrode array 104 and one or more sensors 105 in order to distribute at least electrodes over at least a portion of the user's body. Clothing 103 may be configured to distribute the electrodes of electrode array 104 such that each electrode is in contact with the user's skin, so that the application of two different voltages to two different electrodes of electrode array 104 causes stimulation of muscles or their innervation beneath the skin, if present. A muscle can be made to contract in response to electrical stimulation if the muscle or its nerve supply is located beneath the skin to which electrodes are electrically connected. Stimulation of a muscle can be done by its nerve supply, which refers to electrical stimulation of adjacent or distant nerves connected to the muscle. Stimulation of a muscle via nerve supply is sometimes referred to as indirect muscle stimulation, while direct stimulation of a muscle is sometimes referred to as direct muscle stimulation.

[0049] Figure 2 shows an example of a human user's leg. Each muscle in the body contains one or more motor points 106. A motor point 106 is defined as an area of ​​skin over a muscle or its innervation that requires the minimum electrical stimulation to cause a single contraction or contraction of the muscle. In this specification, a muscle motor point 106 may refer to a point connected to a nerve that, when an electrical stimulus is applied to it, provides muscle contraction by innervation. For example, the calf muscle may contain multiple different motor points 106. By precisely targeting the user's motor points 106 for electrical stimulation, power can be saved in the ES device, thereby extending the lifespan of the system 100 of this disclosure before recharging is required. Furthermore, it has been found that electrical stimulation of motor points 106 reduces user discomfort compared to stimulating non-motor points. Electrical stimulation at a pair of motor points, as defined herein, can also provide increased blood flow in the user by providing muscle stimulation. In some examples, the optimal point for stimulation may not be the optimal point for achieving maximum possible muscle contraction or for the minimum possible current requirement for stimulation. Nevertheless, such selected points are also referred to herein as motor points because they provide the optimal desired result. It may be particularly advantageous to provide ES stimulation via the electrode closest to the motor point 106, in contrast to placing only a single electrode at the motor point 106 and a second electrode at a non-motor point location. It is possible to provide identification of an optimal pair of points for providing electrical stimulation to contract a muscle. This may provide a point on the body that is most comfortable for the user to be stimulated and uses the least energy to cause a desired degree of muscle contraction. In some cases, one or both of these points may not be identified as the motor point 106 using conventional methods, because conventional methods operate by manually searching for a single point relative to a fixed reference point, such as by using a motor point pen. In contrast, system 100 may define motor points by using a motor point scanning mode to search for one or more optimal pairs of points.In other words, a motor point as defined herein is a point that provides favorable results with respect to one or more desired stimulation parameters. These one or more desired stimulation parameters may include, but are not limited to, maximum muscle contraction, the minimum current required for a desired level of contraction, and maximum induced blood flow. Therefore, a motor point as defined herein can be considered the optimal stimulation point for achieving a desired effect.

[0050] In one or more instances, locations on muscles identified as motor points using conventional motor point identification techniques, such as by using a motor point pen, may not be identified as motor points using the approaches disclosed herein. In some cases, the conventional approach, which reuses the same standard reference electrode for each measurement to find a single motor point, may not offer the same flexibility in identifying the optimal pair of locations. Indeed, in some instances, motor points identified by the motor point scanning mode may select two completely different locations for a motor point compared to the conventional approach.

[0051] Figure 3 shows an exemplary leg of a user and the arrangement of the electrode array 104 on it. The electrode array 104 includes a plurality of electrodes configured to electrically contact the user's skin during use. This generally means that the electrodes are in direct physical contact with the user's skin, but it will be understood that in other embodiments, one or more conductive materials may be placed between each electrode and the skin during use.

[0052] The electrode array 104 can be arranged in any manner suitable for stimulating multiple different points on the muscle. In one or more embodiments, the electrodes may be arranged in a matrix arrangement, as shown in Figure 3. In a matrix arrangement, the electrodes may be arranged in a regular grid pattern to provide comprehensive coverage of the targeted muscle. Each electrode in the electrode array 104 may be individually addressable so that a voltage can be applied to each electrode, isolated from each other. Each electrode in the electrode array 104 may be electrically isolated from each of the other electrodes when the electrode is not in electrical contact with a conductive medium such as skin, and when in contact via skin, a high resistivity contact is made between them. When no voltage is applied to the electrodes as a result of signaling from the controller 101, the electrodes may be disconnected from the voltage source or ground of the ES system 102, for example, by opening a switch. This eliminates any possibility of current flowing between the wrong electrodes. The isolation of each unconnected electrode may be controlled by the controller 101. The electrode array 104 may comprise, for example, 10, 20, 50, 100, 225, or any other number of electrodes.

[0053] The controller 101 may provide signaling to the ES system 102 to selectively operate the electrode array 104 in one of several modes, such as detection mode, stimulation mode, motor point scanning mode, or calibration mode. In any of these three modes, a potential difference is applied between at least two different electrodes in the electrode array 104. The application of the potential difference between these two electrodes can be configured to induce stimulation of one muscle at a target body location, either directly or indirectly, where the target body location is at or between the two electrodes. If alternative parameters are selected, the application of the potential difference between these two electrodes can be configured to avoid inducing muscle stimulation at the target body location. For example, when operating in detection mode, the controller 101 may be configured to cause the electrical stimulation system 102 to avoid stimulating a muscle at the target body location by selecting appropriate parameters. When operating in motor point scanning mode, the controller 101 may be configured to cause the electrical stimulation system 102 to stimulate a muscle to a lower degree than in stimulation mode. When operating in stimulation mode, the controller 101 may be configured to stimulate muscles at a target body location to a greater extent than in the motor point scanning mode by applying multiple stimulation pulses to the electrical stimulation system 102.

[0054] The voltages may be applied with opposite polarity, i.e., with respect to a reference voltage such as the ground voltage, one voltage is positive and the second voltage is negative. The reference voltage may be considered to be an intermediate voltage between two different voltages applied to the first and second electrodes, and therefore the voltages may be of opposite polarity. It should be understood that with respect to another reference voltage, the voltages may be measured as having other values ​​such as 0V and +5V. Regardless of the selected reference voltage, it should be understood that it is the presence of a potential difference between the electrodes that provides the electrical stimulation. Electrodes to which no voltage is applied as a result of signaling provided by the controller 101 may be considered to be substantially at a reference voltage such as the ground voltage, or those electrodes may be completely disconnected from the circuit. In some examples, the voltages applied to the electrodes may be applied simultaneously in order to generate an electrical potential difference between the selected electrodes.

[0055] The controller 101 can provide signaling to the ES system 102 to selectively operate the electrode array 104 in detection mode, and can detect body movement by applying a potential difference between electrode pairs. This is done by transmitting low-intensity electrical pulses between two electrodes in the electrode array 104 through or across the user's body. The path taken by the pulses can be characterized by the detection parameters. When the body moves, the relative positions of the electrodes may change relative to each other, and the electrodes may also move relative to the body itself (e.g., by sliding across the skin). This changes the path taken by the detection pulses between those electrodes, and then changes the values ​​of the detection parameters. Thus, a change over time or a period of high variability in the detection parameters measured between two electrodes may indicate body movement.

[0056] For example, two electrodes in electrode array 104 may be positioned on the upper and lower front sides of the user's knee, respectively. When the user's leg is straight, the detection pulse between the pairs may pass mainly across the user's skin without significantly penetrating into the tissue. As the user's leg bends, the primary electrical path taken by the detection pulse may pass through more of the user's leg muscles or nerves. The detection pulse sent between the electrode pairs when the leg is straight measures different detection parameter values ​​compared to the pulse passing through the bent leg. This allows for the detection of knee movement. In other examples, the movement of the body to which the electrodes are physically attached may not change the path the detection pulse travels, but the contact resistance between the electrodes and the skin may change as the body moves relative to the electrodes.

[0057] Using the detection mode that utilizes the electrodes of the electrode array 104 offers several advantages. Firstly, the ES system 102 can provide highly sensitive and high-resolution motion detection. Even small movements and single muscle contractions are known to generate detectable changes by the electrodes to which detection pulses are applied. By generating electrical parameter detection bursts between multiple different combinations of electrodes, the controller 101 can collect enough data to accurately localize and identify the user's movements. Additionally, the same electrode array 104 can be used for both stimulus and motion detection, which means there is no need for an expensive set of additional sensors that must be integrated around each other.

[0058] The detection mode can also be used to check whether the electrode array is properly positioned on the user's body. If the electrodes are not positioned close to the user's skin, there is no electrical path between the electrodes, and the resistance calculated between any pair of electrodes will be infinite. Therefore, if infinite resistance is calculated for all pairs of electrodes in the electrode array, it is likely that the array is not properly positioned relative to the user. Similarly, if infinite resistance is calculated for an electrode pair containing electrodes within a particular region of the electrode array, it is likely that that region of the electrode array is not properly positioned relative to the user's body.

[0059] The detection period is a period during which detection of one or more detection parameters indicating the degree of muscle movement can be performed. Generally, the detection period does not overlap with the application of stimulation pulses, because lower intensity detection pulses can be masked by higher intensity stimulation pulses between the same or adjacent electrodes. However, in some embodiments, detection may be performed between one subset of electrodes in the electrode array 104 while another subset of electrodes is being used for stimulation. The detection period is also distinct from a low-power period during which the controller 101 and / or the ES system 102 may be configured in standby mode. During the detection period, the controller 101 may be configured to receive and record detection parameters from the electrode array 104 in order to calculate the electrical parameters for each electrode pair. Detection parameters and electrical parameters are discussed further below. The values ​​of the electrical parameters may be calculated simultaneously during the detection period, or alternatively, to reduce the computational load, the detection parameters may be recorded and the electrical parameter values ​​may be calculated following the detection period.

[0060] Referring to Figure 4, the signaling provided by the controller 101 during detection mode causes the ES system to provide multiple electrical parameter detection bursts 401 between pairs of electrodes 402. Each electrical parameter detection burst 401 contains one or more detection pulses. The electrical parameter detection bursts 401 may be provided sequentially, such that an electrical parameter detection burst 401ab is provided first between electrodes 402a and 402b, followed by an electrical parameter detection burst 401ac between electrodes 402a and 402c, and then an electrical parameter detection burst 401ad between electrodes 402a and 402d. The controller 101 may also provide the electrical parameter detection bursts 401 simultaneously. This reduces the time required to perform electrical parameter detection bursts between all possible electrode pairs. However, care must be taken to ensure that the discharges from simultaneous electrical parameter detection bursts 401 do not interfere with each other, as this may distort the detection parameter measurements. Therefore, if an electrical parameter detection burst 401 is provided between a first pair of electrodes both located in one region of the array 104, then a second electrical parameter detection burst 401 should only be provided simultaneously between two electrodes both located distal to that region. For example, since electrodes 402a and 402b are both located distal to electrodes 402x and 402y, an electrical parameter detection burst 401ab between electrodes 402a and 402b can be provided simultaneously with an electrical parameter detection burst 401xy between electrodes 402x and 402y. However, since electrodes 402a and 402b, and 402c are located in close proximity together, an electrical parameter detection burst 401ab should not be provided simultaneously with an electrical parameter detection burst 401ac between electrodes 402a and 402c.

[0061] In addition to the detection pulse, the electrical parameter detection burst 401 may include discrete time intervals for recording or calculating the measured values ​​of the detection parameters.

[0062] Multiple electrical parameter detection bursts 401 may be provided between a single pair of electrodes during the detection period. This allows for the detection of changes (and resulting movements) in the detection parameters from a single detection period. However, the electrical parameter detection bursts 401 will always be provided between at least two different pairs of electrodes in the electrode array during a single detection period.

[0063] Figure 5 is a graph showing the relative voltage applied between a pair of electrodes, with time plotted along the x-axis and the relative voltage plotted along the y-axis. In this example, the electrode array 104 is first configured to operate selectively in stimulation mode based on signaling received by the ES system 102 from the controller 101. In the ES system 102, the electrical stimulation applied during stimulation mode may be provided to the user multiple times in succession to provide muscle contraction and increased blood flow.

[0064] Each stimulation pulse 501 can be applied over a stimulation duration 502a. The stimulation pulses 501 may be applied in a continuous and uninterrupted manner such that a subsequent second stimulation pulse begins immediately after the completion of the first stimulation pulse. In other examples, one or more or each stimulation pulse may be separated by a pause 502b during which no stimulation pulses 501 are applied. While operating in stimulation mode, a single stimulation cycle 502 can be defined as the period from the start of the first stimulation pulse to the start of the second stimulation pulse following the first stimulation pulse 501. In examples where there is no pause 502b between stimulation pulses 501, the duration of the stimulation cycle 502 is equal to the stimulation duration. In examples where the pause 502b is provided during a continuous stimulation duration 502a, the duration of the stimulation cycle is equal to the stimulation duration 502a plus the duration of the pause 502b.

[0065] The application of a stimulation pulse 501 involves applying a stimulation potential difference between a first stimulation electrode and a second stimulation electrode. Each stimulation pulse 501 may be separated by a rest period 502b, which is a period in which no stimulation pulses are present. Thus, each stimulation pulse 501 may be described as the application of a stimulation signal, each stimulation signal including the application of a first stimulation voltage to the first stimulation electrode and a second stimulation voltage to the second stimulation electrode in order to provide electrical stimulation to the muscle or its innervation through the skin between the first and second stimulation electrodes. The first stimulation voltage is different from the second stimulation voltage in order to provide a stimulation potential difference. It will be understood that the number of stimuli applied to the muscle will vary depending on the user and the desired effect.

[0066] The controller 101 is configured to signal the ES system 102 so that the stimulation signal is applied as a single-phase or two-phase waveform. A two-phase waveform can be generated by applying a voltage VS1 to the first electrode while the second electrode is held at a reference voltage V0, which may be the ground voltage. Following the application of voltages VS1 and V0, a ​​voltage VS2 is applied to the second electrode, while the first electrode is held at the reference voltage V0. The magnitudes of the first and second stimulation voltages VS1 and VS2 may be the same or different. The controller 101 may be configured to signal the ES system 102 so that the first stimulation voltage VS1 and the second stimulation voltage VS2 are applied as square waves of opposite polarity. This can provide particularly stable and consistent electrical stimulation. Alternatively, the stimulation voltage providing the stimulation potential difference between the electrodes may be provided as a sinusoidal AC voltage, where each new application of the stimulation signal corresponds to a sine wave passing through a reference voltage that may be relatively 0 volts.

[0067] The controller 101 may be configured to provide the application of a stimulation signal at a fixed rate so that the stimulation pulses 501 have a consistent pulse frequency and pulse duration. For example, the rate of stimulation signal application may be 1 to 100 Hz. Specifically, the rate of stimulation signal application may be 30 to 40 Hz, and more specifically, the rate of stimulation signal application may be 36 Hz. As described above, each stimulation pulse 501 may have a stimulation duration 502a and be separated from adjacent stimulation pulses 501 by a pause period 502b. The stimulation duration 502a is determined by the pulse frequency of the stimulation pulse 501 and the duration of the pause period 502b used. It will be understood that the pulse frequency (number of stimulation pulses per second) is effectively equal to the number of stimulation cycle frequencies 502 (number of stimulation cycles 502 per second). For example, if the stimulation pulse frequency is 36 Hz and the stimulation signals are separated by a pause period of 27.7 ms, the stimulation duration 502a will be 0.175 ms. The proportion of the stimulation cycle to which the stimulation pulse 501 is applied can be referred to as the signal duty cycle. Thus, if the stimulation signal is applied over half of the stimulation cycle, the stimulation mode may operate on a 50% duty cycle.

[0068] The controller 101 may be further configured to provide control over one or more other parameters related to the application of the stimulus signal 501 or the electrical parameter detection burst. For example, the controller 101 may provide control over phase duration and interphase duration. The controller 101 may also provide control over ramp-up time and ramp-down time, which correspond to the amount of time it takes to reach and descend from desired first and second voltages, respectively. The controller may also provide control over plateau time when neither ramp-up time nor ramp-down time is specified.

[0069] The ES system may operate in detection mode during the pause period 502b, and as a result, the detection period can be defined as the period during which multiple electrical parameter detection bursts 503 are applied between detection electrode pairs in the electrode array. The detection electrodes may be the same electrodes as the stimulation electrodes, or they may be different electrodes. The minimum duration of the detection period may be determined by the speed of the processor used by the controller and the number of electrodes in the electrode array 104 used for detection. The relationship between the detection period and the processor speed of the controller exists because therapeutic or other effects are undesirable when electrical parameter detection bursts are applied to the user. Instead, only electrical parameter measurements, such as resistance measurements between two detection electrodes, may be performed. In one example, the minimum duration of the detection period, expressed in seconds, is given by (1 / (processor frequency / 2)) × ((N(N-1)) / 2), where N is the number of detection electrodes in the electrode array 104. If the electrode array 104 has 64 electrodes used for detection and the processor frequency is 480 MHz, a detection period of 8.4 microseconds is required to allow the detection pulses to pass between all possible pairs of electrodes. The maximum duration of the detection period may be the same as the duration of the pause period 502b, so that the stimulation pulses 501 can be interspersed throughout the detection period.

[0070] Each electrical parameter detection burst 504 contains one or more detection pulses 503. The example shown in Figure 5 shows only a single detection pulse 503 per electrical parameter detection burst 504. In other examples, each electrical parameter detection burst 504 may contain multiple detection pulses 503, such that each electrical parameter detection burst is a wave packet of detection pulses 503. The detection pulse duration is generally determined by the processing speed of the controller 101, where pulse duration 504a is the shortest possible time for the controller to generate the detection pulse 503. The electrical parameter detection bursts 504 may be separated by an interval between bursts 504b. For example, if the controller 101 can generate an electrical parameter detection burst 503 containing a single detection pulse with a pulse duration of 1 ms, the pulse frequency would be 1000 Hz if there is no interval between bursts. Detection pulses may be provided at a lower frequency but with the same duration per pulse by providing an extended interval between bursts between electrical parameter detection bursts, or by providing an interval between pulses in a single electrical parameter detection burst. For example, two electrical parameter detection bursts, each containing a single detection pulse with a duration of 1 ms, can be generated with an interval between bursts having a duration of 98 ms. Generally, the detection pulse frequency may be between 10 Hz and 100 MHz.

[0071] Similar to the stimulation pulse 501, the detection pulse may consist of a two-phase square wave having a maximum potential difference VD1 and a minimum potential difference VD2. Each electrical parameter detection burst 504 is configured not to provide muscle stimulation (muscle activation such that the muscle fibers "contract"). That is, each electrical parameter detection burst is configured to have at least one of the signal amplitude, frequency, and / or waveform set to a level insufficient to cause muscle activation-inducing stimulation at the target body location. In particular, at least one of the signal amplitude, frequency, and waveform may be selected so that they are insufficient to cause muscle stimulation at the target body location. That is, stimulation is avoided by the selection of appropriate waveform parameters. In particular, the electrical parameter bursts are configured not to provide muscle activation that induces muscle stimulation at the target location when provided in isolation. In Figure 5, the absolute potential difference |VD1-VD2| of the detection pulse 503 is smaller than the absolute potential difference |VS1-VS2| of the stimulation pulse 501, and as a result, the detection pulse 503 does not cause muscle activation-inducing stimulation. For example, one parameter to avoid muscle stimulation might be to maintain the current supplied between each pair of detection electrodes during each detection pulse 503 at 0.1 mA or less.

[0072] Alternatively, calibration may be performed for each patient to determine the intensity of the stimulation 501 and detection pulse 503. For example, pulses of progressively higher intensity may be applied to the user, starting with a low intensity (an intensity below the minimum expected intensity to elicit stimulation) until muscle activation is observed at a specific threshold intensity. The stimulation pulse 501 is then set to have an intensity above this threshold, while the detection pulse 503 is set to have an intensity below the threshold.

[0073] The electrical parameter detection burst 504 may be intentionally provided simultaneously with another signal, such as a stimulation signal, which may provide stimulation to a nerve or muscle at a target body location, either alone or in combination with the electrical parameter detection burst. Such embodiments are still within the scope of the disclosure. In other examples, the electrical parameter detection burst 504 may be provided separately from the stimulation pulse 501.

[0074] By interspersing stimulation pulses 501 and electrical parameter detection bursts 504, changes in electrical parameter values ​​in response to stimulation can be calculated. For clarity, as shown in Figure 5, there may be a delay between the end of the stimulation pulse 501 and the start of the detection period. Alternatively, the detection period may start immediately after the end of the stimulation pulse. In one or more embodiments, the electrical parameter may be calculated multiple times during the detection period to monitor changes in the electrical parameter during the detection period. For example, the electrical parameter may be calculated from a first electrical parameter detection burst 503 and then recalculated from subsequent electrical parameter detection bursts. This makes it possible to detect changes in the electrical parameter between a pair of electrodes.

[0075] As shown in the illustration, both the stimulation pulse 501 and the individual detection pulses 503 of the electrical parameter detection burst 504 are two-phase square waves. However, alternatively, either or both of the stimulation pulse and detection pulses may be single-phase. In other examples, the stimulation and detection pulses may have single-phase or two-phase sinusoidal waveforms, sawtooth waveforms, or other waveform shapes.

[0076] Controller 101 is further configured to detect one or more detection parameters indicating the degree of body movement associated with each electrical parameter detection burst. That is, the controller may receive signaling from the detection electrodes indicating at least one of the following: electrical resistivity, electrical resistance, conductivity, electrical conductance, electrical impedance, and electrical admittance. The listed electrical parameters may indicate the degree of body movement relative to the detection pulse, since any of these parameters provides an indicator of the charge moving through the body. For example, the electrical resistance of the charge moving through the body (current through the body) during a detection pulse depends on several factors, including at least transcutaneous resistance, transcutaneous resistance, or transmuscular resistance, and contact resistance between the electrodes and the body. By obtaining a measurement of electrical resistance, an indicator of the change in contact resistance can be obtained, and thus it is possible to know whether or not a muscle is moving. In this example, the detection parameter may be the current passing through nerves, muscles, or any other tissue located in the electrical path between the detection electrodes.

[0077] Providing a signaling, which may be referred to as measurement signaling, can be easily done by providing the controller 101 with a voltage indicating a measurement when the electrode array 104 is in electrical contact with the controller 101. In other embodiments, the measurement signaling may include, for example, a radio signal transmitted to the controller 101 by the ES system controller.

[0078] The controller 101 is further configured to calculate electrical parameter values ​​between each pair of detection electrodes based on one or more detection parameter values. For example, the controller may be configured to calculate the resistance (electrical parameter) between two detection electrodes based on the current (detection parameter) that flows through the muscle, nerve, or any other tissue located in the electrical path between the detection electrodes as a result of a potential difference being applied between the two electrodes of the pair of detection electrodes.

[0079] As defined herein, a pair of electrodes refers to a combination of a first detection electrode and a second detection electrode. At least one subsequent electrical parameter detection burst is not provided between the same two detection electrodes combined during a given detection period, but rather between different combinations of two electrodes in the array. For example, if electrodes A and B have a potential difference applied between them to provide a first electrical parameter detection burst, at least one subsequent electrical parameter detection burst in a plurality of electrical parameter detection bursts will not use electrodes A and B during the same given detection period, but rather they will use electrodes A and C, B and C, or electrodes C and D during the same given detection period. This description does not entirely limit the possibility that repeated measurements are performed, but that multiple measurements are performed on different electrode pairs to provide electrical parameter detection bursts that effectively determine the electrical parameters of multiple electrode pairs.

[0080] In one or more embodiments, the electrode array 104 may be operated in detection mode such that all combinations of electrode pairs in the electrode array 104 have a potential difference applied across them in the form of individual measurements during the course of a single detection period. The controller may be configured to select a first electrode and then sequentially transmit electrical parameter detection bursts between that electrode and every other electrode in the array 104, repeating this process over all possible electrode pairs. The controller then selects a second electrode and transmits electrical parameter detection bursts between the second electrode and every other electrode in the array 104 except the first electrode. This process is repeated until the electrical parameter detection bursts have passed through all possible electrode pairs in the array. In other examples, the order in which electrode pairs are selected may follow a different ordering, or the order may be randomized.

[0081] By providing measurements between each definable electrode pair in the electrode array, the maximum possible number of sensors in detection mode may be provided, thereby providing the maximum possible measurement resolution available through this technology. In one or more embodiments, the controller 101 may be configured to provide signaling to the ES system so that the ES system provides electrical parameter detection bursts between at least 50% of the detectable electrode pairs that can be defined in the electrode array, and in correspondingly so that one or more detectable parameters that themselves indicate an electrical parameter indicating the degree of body movement are detected. Alternatively, the percentage of activated possible electrode pairs may be at least 30%, at least 40%, at least 60%, at least 70%, at least 80%, or at least 90%. By performing a large number of measurements between different pairs of electrodes that can be defined in the array, a corresponding number of sensors can be effectively created, which can provide improved accuracy, reliability, and location specificity compared to, for example, using a small number of flex sensors instead.

[0082] The maximum resolution in detection mode can be achieved by providing electrical parameter detection bursts between all possible pairs of electrodes. For an electrode array 104 containing a total of N electrodes, the number of possible pairs is given by a binomial coefficient C(N,2) equal to N! / (2!(N-2)!)=(N-1)(N / 2). For example, in a 2×2 array, there are six unique electrode pairs that can be defined. The number of electrode pair combinations increases rapidly as the number of electrodes in the electrode array 104 increases. For example, an electrode array 104 with 10 electrodes has 45 possible electrode pairs, an electrode array 104 with 100 electrodes has 4950 possible electrode pairs, and an electrode array 104 with 150 electrodes has 11175 possible electrode pairs. Therefore, for electrode arrays 104 larger than a certain size, providing electrical parameter detection bursts between all possible electrode pairs may become impractical. Instead, electrical parameter detection bursts may be transmitted between groups of electrodes or between subsets of possible pairs.

[0083] The electrode array 104 may be divided into a first subarray and a second subarray, each corresponding to a different portion of muscle to which the electrodes of the electrode array are expected to make contact. In these embodiments, each electrode of the first subarray forms an electrode pair with each electrode of the second subarray, such that each electrode pair comprises one electrode from each subarray. This may provide avoidance of testing electrode pairs expected to be associated with the same motor point 106, thereby providing sensors that are further spaced apart from each other, which may, for example, allow for more reliable measurements of muscle movement.

[0084] By providing signaling from the controller 101 to operate the ES system in detection mode, a system is provided that can effectively create numerous sensors distributed throughout the entire body to which electrode arrays are attached, without the need to add extra components that occupy both space and power. This enables the provision of a more compact and comfortable ES system for the user, which leads to consistently improved compliance by the user.

[0085] Figure 6 shows an exemplary electrode array 104 defining a 4x4 group electrode 601, a 2x2 group electrode 602, and a motion point 106. The electrode array 104 may be configured to define larger group electrodes 601, 602 by applying voltages to multiple individual electrodes simultaneously. The voltages applied to group electrodes 601, 602 may be substantially identical. The electrical continuity of the electrodes allows for the simulation of a single large electrode, and the electrodes may be defined in any shape suitable for stimulating a motion point. Such group electrodes may be used as either or both stimulating electrodes and / or sensing electrodes. In one or more examples, the group electrodes may be substantially spot-like, as opposed to defining a line of electrodes. For example, group electrodes 601, 602 may be defined by a substantially square or circular grid, such as a 4x4 grid of electrodes 601 in a regular matrix electrode array 104. One or more group electrodes 601, 602 may be used to improve the efficiency of detecting muscle or nerve responses to electrical stimulation, or to provide stimulation to a larger area on the body during a stimulation mode. Alternatively or additionally, one or more group electrodes 601, 602 may be used to detect the degree of muscle movement associated with the group electrode without the need to induce stimulation. For specific muscle groups, the group electrodes may provide improved muscle stimulation by using multiple individual electrodes to provide stimulation to a single motor point 106.

[0086] Using group electrodes for detection offers several advantages. Searching for all combinations of electrodes in array 104 is time-consuming and becomes increasingly difficult as the number of electrodes in array 104 increases. Using group electrodes can significantly reduce total measurement and processing time while providing sufficiently high resolution to detect muscle movement resulting from muscle stimulation.

[0087] Group electrode detection may also be used as part of an algorithmic search pattern to more efficiently detect and identify motion. For example, electrode array 104 may be divided into large group electrodes. An initial set of electrical parameter detection bursts is provided between the group electrodes, and the calculated electrical parameters are used to provide an index of the motion level associated with each group electrode. Group electrodes with high motion levels are divided into smaller group electrodes, and electrical parameter detection bursts are provided between the smaller group electrodes. This process continues until the controller identifies the location of individual electrodes or small group electrodes associated with high motion levels, thereby identifying the location of motion. This approach may be more efficient than simply sending electrical parameter detection bursts between all possible combinations of electrode pairs.

[0088] Instead of using a single electrode to stimulate a motor point 106 during a stimulation mode, several muscles may be better stimulated by providing stimulation over an area larger than that of a single electrode. Therefore, the controller 101 may be configured to identify a first stimulation group electrode and a second stimulation group electrode, each group electrode aligned with a different motor point 106 of the user's muscle. The controller 101 may then be configured to provide signaling to cause the ES system 102 to operate the electrode array 104 in group electrode stimulation mode, by which multiple stimulation signals are applied to the first and second stimulation group electrodes. Each stimulation signal may include the application of a first stimulation voltage to the first stimulation group electrode and a second stimulation voltage to the second stimulation group electrode to provide electrical stimulation to the muscle or its innervation through the skin between the electrode pairs, the first stimulation voltage having a different polarity from the second stimulation voltage. It will be understood that the group electrode stimulation mode is directly similar to the stimulation modes described above, except that it has a significantly larger electrode. Similarly, a group electrode detection mode may be provided.

[0089] To prevent problems caused by user inactivity, the controller 101 may be configured to detect user inactivity, and if the user has been inactive for a predetermined period, the controller 101 may be configured to initiate at least a stimulation mode. In particular, the controller 101 may be configured to operate the ES system 102 in detection mode even if the ES system has not recently operated in stimulation mode. This detection mode may be called passive detection mode, but operates in the same way as the detection mode already described (which may be called active detection mode). In detection mode, the controller 101 is configured not to provide signaling that causes the ES system 102 to apply a voltage to one of the electrodes at a level sufficient to cause stimulation of either or both muscles and nerves. In detection mode, the controller 101 is further configured to receive signaling from the ES system 102 indicating detection parameters, either continuously or periodically. It will be understood that either continuous or periodic monitoring of user activity can provide valuable monitoring of user activity. The ES system 102 may operate in this detection mode by default when not operating in another mode.

[0090] User-induced stimuli refer to muscle contractions caused by the user intentionally using the muscle in question. A movement may be considered a user-induced stimulus only if the controller 101 determines, based on the signaling received during the detection period, that the contraction is within a predetermined threshold of the calibration signal. Calibration signaling is the signaling that indicates muscle contractions by the user during calibration mode. That is, small movements by the user (below the muscle response threshold or the calibration signaling threshold) may not be sufficient stimuli to provide the desired blood flow or muscle movement. In such situations, it may be desirable to operate the ES system 102 in stimulation mode.

[0091] If the controller 101 does not receive an indication of a user-induced stimulus within the detection period of the passive detection mode, the controller 101 may be configured to operate the ES system 102 in an alternative mode, such as the stimulation mode. Other alternative modes may include a calibration mode for determining baseline electrical parameter values ​​or a motion point scanning mode configured to identify preferred motion points for stimulation. The detection period in the passive detection mode may be, for example, 30 minutes, 1 hour, 2 hours, 3 hours, or any other preferred time based on the user's needs. The controller 101 may also be configured to operate the ES system 102 in detection mode during or after the system has been operating in the stimulation mode.

[0092] In some cases, recorded muscle contractions below a predetermined threshold for calibration signaling over a predetermined upper limit of contraction duration may be recorded as user-induced stimuli because they may represent small movements over a sufficiently long period to eliminate the need for additional stimulation by the electrode array 104. That is, small (below threshold) user movements over a long period may be considered acceptable to produce the desired blood flow, movement, or other stimulatory effect on the user, so that stimulation by the ES system 102 is deemed unnecessary.

[0093] The controller can be configured to generate an electrical parameter map representing the spatial distribution of electrodes in an electrode array, the electrical parameter value map containing multiple elements arranged in a grid, each element containing an element value based on one or more electrical parameters calculated by the controller 101. In other words, the electrical parameter map is a two-dimensional numerical representation of the two-dimensional plane of the electrode array based on electrical parameters calculated between electrode pairs. The grid layout of the electrical parameter map facilitates the detection of patterns in element values ​​and allows for the identification of movement of specific types and positions. The electrical parameter map can be easily stored as a matrix or array on a computer-readable storage medium, thereby allowing instances of the electrical parameter map calculated from different electrical parameter detection bursts to be compared with one another.

[0094] In one embodiment, each element of the electrical parameter map corresponds to an electrode in an electrode array, and the element value of the element in the electrical parameter map is based on the sum or average of each calculated electrical parameter using the corresponding electrode. For example, the value of the element in the first row, first column of the electrical parameter map may correspond to the electrode in the first row, first column of the electrode array 104. The value of that element may then be set as the sum of the resistance values ​​(resistance is an exemplary electrical parameter) calculated between that electrode and every other electrode in the electrode array 104.

[0095] It will be understood that there may not be a one-to-one correlation between each element of the electrical parameter map and each electrode in the electrode array. For example, to reduce the size of the electrical parameter map or to increase its robustness, each element of the electrical parameter map may correspond to a cluster of electrodes. In this way, a 4×4 electrode array 104 can be represented by a 2×2 electrical parameter map. Conversely, in yet another embodiment, the spatial range represented by each element may be smaller than that of a single electrode, and therefore the spatial range of each electrode may be represented by multiple elements.

[0096] The electrical parameter map described above makes it easy to identify the location of specific movements. For example, if an electrode changes position slightly relative to the user's skin due to user movement, the path between that electrode and all other electrodes changes over time. The resistance between this electrode and the other electrodes changes more significantly than the resistance between electrode pairs whose positions have not changed. Therefore, a larger change in the value of an element in the electrical parameter map may indicate that there was localized user movement near the electrode represented by that element. Similarly, a large change in the values ​​of multiple elements representing electrodes within a particular region of the electrode array 104 may indicate user movement across the entire area covered by that region of the electrode array.

[0097] To track changes in element values ​​stored in the elements of the electrical parameter map, the controller 101 may be configured to calculate the electrical parameter map from electrical parameters measured during the current detection period, and the element values ​​of the electrical parameter map are based on the difference between the element values ​​calculated during the current detection period and the element values ​​calculated during a preceding detection period taken at a time prior to the current detection period. In other words, each element of the electrical parameter map represents the difference or delta between electrical parameters measured over a certain time interval. Therefore, a larger absolute value of any element compared to a preceding detection period indicates the user's movement around the electrode that the element represents. The preceding detection period may be the most recent detection period taken in comparison to the current detection period. That is, the preceding detection period may be a detection period preceding the current detection period, which may be immediately before the current detection period, separated from the current detection period by a time delay, or separated from the current detection period by one or more stimulation durations during which stimulation pulses are applied to the user.

[0098] Instead of comparing the electrical parameter values ​​from the current detection period to those from the preceding detection period, the electrical parameter values ​​can be compared to predefined element values. These predefined baseline electrical parameters may, for example, be electrical parameters acquired during calibration measurements performed at a past point in time during calibration mode. Alternatively, the baseline electrical parameters may be standardized values ​​not based on measurements taken by the electrical stimulation system, and comparisons to these values ​​are used to detect abnormal deviations.

[0099] The controller 101 can generate an electrical parameter map in which each element of the electrical parameter map corresponds to a pair of electrodes in an electrode array. The value of each element of the electrical parameter map may be the value of the electrical parameter calculated for the corresponding electrode pair. As described above, the element value of an electrical parameter element may be based on the difference between the electrical parameter calculated between the pair during an electrical parameter detection burst and the electrical parameter calculated between the pair during a previous electrical parameter detection burst. An element of the electrical parameter map may correspond to multiple pairs, and the value of that element is calculated as the sum or average of the electrical parameters between each of the corresponding pairs. This makes it possible to identify different types of movements. For example, one element of the electrical parameter map may correspond to an electrode pair separated by a short distance, and another element may correspond to an electrode pair separated by a greater distance. Movements that cause a change in transmuscular resistance but not a change in transcutaneous resistance (such as small muscle spasms) will cause a larger change in the value of the second element than in the first element.

[0100] The controller 101 may be configured to determine, based on the electrical parameter map, whether to signal the ES system to operate the electrode array in detection mode or to signal the ES system to operate in an alternative mode, such as stimulation mode. It will be understood that the values ​​in the electrical parameter map indicate changes in electrical parameters over time and across the spatial distribution represented by the electrical parameter map. Movement of the body location to which the electrodes are coupled will result in changes in the element values ​​of the electrical parameter map. Thus, the controller may use the element values ​​in the electrical parameter map as an indicator of whether the user of the system has been physically active over a particular period, such as the period between a preceding detection period and the current detection period. As described above, element values ​​can be defined in one of many different ways, such as the difference between a previous value and a current value or a predefined value, the ratio between a previous value and a current value or a predefined value, the sum between a previous value and a current value or a predefined value, or any number of other ways of defining element values. Thus, there are many corresponding ways of defining situations in which element values ​​indicate non-movement of the user. For example, the controller may be configured to provide signaling to the electrical stimulation system to operate the electrode array in detection mode or stimulation mode based on whether one or more element values ​​are above or below a predetermined threshold. Alternatively, the controller may be configured to detect whether a change in an element value is greater than or less than a predetermined threshold change. In yet another example, the controller 101 may be configured to provide signaling to the ES system 102 to operate the electrode array 104 in detection mode or stimulation mode if a predetermined number of consecutive changes in element values ​​are greater than or less than a predetermined threshold.

[0101] It is known that skin resistance and impedance decrease as the frequency of the applied electrical signal increases. When a stimulation pulse is applied at a relatively low frequency (tens of Hz), skin resistance is high (hundreds to thousands of ohms). This high resistance causes high local energy dissipation, increasing user discomfort and increasing the energy requirements of the ES system 102. This can be mitigated by applying a skin resistance reduction pulse while operating in stimulation mode, which is applied at a higher frequency and lower intensity than the stimulation pulse. Although not bound by theory, it is thought that the skin resistance reduction pulse realigns ions in the user's skin, increasing skin conductivity and reducing energy dissipation.

[0102] Referring to Figure 7, the controller may be configured to cause the ES system to apply multiple skin resistance reduction pulses 702 while operating in stimulation mode. Figure 7(a) shows the representation of the skin resistance reduction pulses 702 plotted as voltage against time, without the stimulation pulse. The skin resistance reduction pulses 702 are generated by creating an additional potential difference VR1 at one stimulation electrode relative to the voltage V0 of the other stimulation electrode, and then holding the first electrode at V0 while the other electrode is held at voltage VR2. The skin resistance reduction pulses 702 are of lower intensity than the stimulation pulses (i.e., the skin resistance reduction pulses 702 have a lower voltage amplitude |VR2-VR1| than the voltage amplitude of the stimulation pulses), but are applied at a higher frequency than the stimulation pulses. The skin resistance reduction pulses 702 are applied in skin resistance reduction bursts 701. The skin resistance reduction pulses 702 are two-phase square waveforms, but may alternatively be single-phase or two-phase sinusoidal, sawtooth, or other waveform shapes.

[0103] As shown in Figure 7(b), the skin resistance reduction pulse 702 can be superimposed on the stimulation pulse 501. As can be understood, this would result in constructive interference, providing a combined waveform with a high-frequency repeating waveform on top of a lower-frequency and higher-magnitude waveform. The skin resistance reduction burst 701b, in its entirety, overlaps with and precedes the stimulation duration 502a of the stimulation pulse 501. Instead of having a burst 701b, the sequence of skin resistance reduction pulses 702 may be continuous while the ES system is operating in stimulation mode.

[0104] In one or more embodiments, the skin resistance reduction pulse 702 may carry a current of 0.1 mA or less per pulse and have a frequency of 1 to 100,000 Hz. This ensures that the skin resistance reduction pulse has a frequency high enough to significantly reduce the skin resistance of the stimulation pulse 501 without significantly affecting the intensity of the stimulation pulse 501.

[0105] As shown in Figure 7(c), instead of superimposing the skin resistance reduction pulse 702 to coincide with the stimulation duration 502a of the stimulation pulse 501, the controller can alternatively be configured to synchronize the skin resistance reduction pulse 702 so as not to overlap with the stimulation pulse 501. That is, the skin resistance reduction burst 701c is applied during the interval between stimulation pulses 501.

[0106] Figure 8 shows a deprivation pulse 801 synchronized with the stimulation pulse 501 in the same manner as the skin resistance reduction pulse 702 in Figure 7(b). The deprivation pulse 801 may also be superimposed with either or both of the stimulation pulse 501 or the skin resistance reduction pulse 702.

[0107] The deprivation pulse 801 reduces the discomfort experienced by the user when the stimulation pulse 501 is applied. When the stimulation pulse 501 is applied, high-intensity signals may be generated in the user's sensory nerves. These then travel through the spinal cord to the brain, where they are experienced as pain. The deprivation pulse 801 generates low-intensity nerve signals instead, blocking the transmission of high-intensity pain signals to the brain by signals transmitted through the sensory nerves at the spinal cord level when the stimulation pulse 501 is applied. In this sense, the deprivation pulse 801 functions similarly to rubbing an area of ​​the body after a minor injury such as a bruise or abrasion. The rubbing sensation "blocks" the pain from the injury, and the individual feels less pain as a result. The deprivation pulse 801 can be applied through multiple electrode pairs surrounding the pair of electrodes used for stimulation. For example, the deprivation pulse 801 can be applied through a group of electrodes surrounding the stimulation electrodes, generating low-intensity blocking signals over a wide area of ​​skin that blocks the pain signals.

[0108] The deprivation pulse 801 is generally less intense than the stimulation pulse 501, but generally more intense and lower in frequency than the skin resistance reduction pulse. In one example, the deprivation pulse 801 is applied at a pulse frequency of 0.1 to 150 Hz. In another example, the deprivation pulse 801 carries a current of 1 to 10 mA, which is lower than the current carried by the stimulation pulse 501. In yet another example, the current carried by the deprivation pulse 801 is calibrated for the user. The deprivation pulse 801 is initially applied to the user at a current of 0.1 mA or more, and then the current is increased until the user begins to experience pain relief due to the deprivation effect.

[0109] Next, with reference to Figure 9, a method 900 for providing ES to a user's muscles using the system 100 described above will be described. The method includes the step (901) of the controller providing signaling to the ES system to operate the electrode array in detection mode during a detection period, the signaling being configured to cause the ES system to provide a plurality of electrical parameter detection bursts during at least one detection period, each electrical parameter detection burst comprising one or more detection pulses, and each electrical parameter detection burst not providing muscle stimulation. The method further includes the controller detecting one or more detection parameters indicating the degree of body movement associated with each electrical parameter detection burst (902). Each electrical parameter detection burst is provided by applying a potential difference between different pairs of electrodes. A pair of electrodes refers to a combination of a first detection electrode and a second detection electrode selected from any electrodes in the electrode array, such that when the controller provides a subsequent electrical parameter detection burst, the corresponding electrode pair for the subsequent electrical parameter detection burst includes any two electrodes in the pair of electrodes in the electrode array, except for any electrode pair corresponding to a previously provided electrical parameter detection burst in detection mode. The consideration of avoiding the use of the same two electrodes in an electrode array will be understood to refer to repeated use during a given rest period, or a single implementation form of operation in detection mode. The method further includes the controller calculating the electrical parameters between each pair of detection electrodes based on one or more detection parameters (903).

[0110] Figure 10 shows a more detailed exemplary embodiment of a method for providing electrical stimulation to a user's muscles. The system is first configured for an alternate mode, such as a standby mode (1001). Next, the controller 101 provides signaling to the ES system 102 to operate the electrode array 104 in detection mode (1002) during a detection period. The controller 101 may also be triggered by a timer to enter the detection period, for example, 30 minutes after entering the detection period in standby mode.

[0111] While operating in detection mode, the controller 101 selects a first electrode pair from the electrode array 104 (1003). The controller then provides signaling to the ES system 102 to provide multiple electrical parameter detection bursts during at least one detection period (1004), each electrical parameter detection burst containing one or more detection pulses, and each electrical parameter detection burst is configured not to provide stimulation to one or both muscles and nerves at a target body location. The controller 101 detects and measures one or more detection parameters that indicate the body's response associated with each electrical parameter detection burst (1005). The controller then calculates one or more electrical parameters based on one or more measured detection parameters (1006).

[0112] Following (or simultaneously with) the electrical parameter detection burst, the controller 101 selects a second electrode pair, which may be any electrode pair of the electrode array 104 other than the previously selected electrode pair, and steps 1004, 1005, and 1006 are repeated. Once the controller 101 evaluates that all required electrical parameters have been calculated (1007), it may analyze the electrical parameters (1008) to identify motion. High levels of changes in electrical parameters over time indicate motion, while low levels of changes indicate inactivity.

[0113] If motion is detected, the controller 101 may configure the system 100 to enter standby mode and begin a countdown until the next detection period. If no motion is detected, the controller may configure the system 100 to an alternative mode such as stimulation mode (1009). In stimulation mode, the controller provides signaling to the ES system to provide a plurality of stimulation pulses separated by pause periods, each stimulation pulse comprising applying a stimulation potential difference between a first stimulation electrode and a second stimulation electrode of an electrode array, the resulting stimulation potential difference configured to provide stimulation to a target body location, and each pause period comprising a period without stimulation pulses.

[0114] Figure 11 shows a computer-readable medium containing computer program code configured to cause a controller, comprising a processor and memory, to operate as described herein.

Claims

1. A controller for providing and receiving signaling to at least one electrical stimulation, ES, system, wherein the ES system comprises an electrode array including a plurality of electrodes for applying electrical stimulation to the user's muscles, the electrodes further configured to measure an electrical parameter between any one electrode of the electrode array and any one other electrode of the electrode array, and the controller, The present invention provides signaling to the ES system to operate the electrode array in detection mode during the detection period, wherein the signaling causes the ES system to provide a plurality of electrical parameter detection bursts, each electrical parameter detection burst comprising one or more detection pulses, and each electrical parameter detection burst being configured not to provide muscle stimulation. It is configured to detect one or more detection parameters indicating the degree of muscle movement associated with each electrical parameter detection burst, Each electrical parameter detection burst is provided by applying a potential difference between different pairs of the plurality of electrodes, and the pair of electrodes refers to a combination of a first detection electrode and a second detection electrode selected from any electrodes of the electrode array, such that when the controller provides a subsequent electrical parameter detection burst, the corresponding electrode pair for the subsequent electrical parameter detection burst includes any two electrodes of the electrode array, except for any electrode pair corresponding to an electrical parameter detection burst previously provided in the detection period. The controller is configured to calculate the electrical parameters between each pair of detection electrodes based on the one or more detection parameters.

2. The controller is configured to provide signaling to the ES system to operate the electrode array in a stimulation mode, the signaling to cause the ES system to provide a plurality of stimulation pulses separated by pauses, Each stimulation pulse includes applying the stimulation potential difference between a first stimulation electrode and a second stimulation electrode of the electrode array such that the stimulation potential difference provides stimulation to the muscle, The controller according to claim 1, wherein each pause includes a period in which no stimulation pulses are present.

3. The controller according to claim 2, wherein the detection period occurs during a pause period such that one or more detection parameters are measured during the application of the stimulation pulse.

4. The controller according to any one of claims 1 to 3, wherein the controller is configured to provide signaling to the ES system to cause the ES system to provide electrical parameter detection bursts between at least 50% of the detection electrode pairs that can be defined in the electrode array, and in corresponding to cause the ES system to detect one or more detection parameters indicating the degree of the body movement associated with each electrical parameter detection burst.

5. The controller according to any one of claims 1 to 4, further configured to determine, based on the electrical parameters calculated between each pair of detection electrodes, whether to signal the ES system to operate the electrode array in the detection mode or to signal the ES system to operate in an alternative mode.

6. The controller according to claim 1, wherein the detection parameter is the current between a pair of electrodes during each electrical parameter detection burst.

7. The calculated electrical parameters are: Electrical resistivity, Electrical resistance, conductivity, Electrical conductance, Electrical impedance, and A controller according to any one of claims 1 to 6, wherein the controller is at least one of the following: an electrical admittance.

8. The controller according to any one of claims 1 to 7, further configured to generate an electrical parameter map representing the spatial distribution of the electrodes of the electrode array, wherein the electrical parameter map includes a plurality of elements arranged in a grid, each element including an element value based on one or more electrical parameters calculated by the controller.

9. The controller according to claim 8, wherein each element of the electrical parameter map corresponds to an electrode of the electrode array, and the element value of the element of the electrical parameter map is based on the sum of each calculated electrical parameter using the corresponding electrode.

10. The controller according to claim 8, wherein each element of the electrical parameter map corresponds to an electrode of the electrode array, and the element value of the element of the electrical parameter map is based on the average of each calculated electrical parameter using the corresponding electrode.

11. The controller is configured to acquire an electrical parameter map for the electrodes of the electrode array acquired during the current detection period, and the element values ​​of the electrical parameter map are the element values ​​calculated during the current detection period, The element values ​​calculated during the preceding detection period taken at a time prior to the current detection period, and A controller according to any one of claims 8 to 10, based on the difference between one of a predefined element value and the other.

12. The controller according to claim 8, wherein each element of the electrical parameter map corresponds to a pair of electrodes of the electrode array, and the element value of the electrical parameter element is based on the difference between an electrical parameter calculated between the pair during the electrical parameter detection burst and an electrical parameter calculated between the pair during a previous electrical parameter detection burst.

13. The controller according to any one of claims 8 to 11, further configured to determine, based on the electrical parameter map, whether to provide signaling to the ES system to operate the electrode array in the detection mode or to provide signaling to the ES system to operate in an alternative mode.

14. The controller according to any one of claims 1 to 13, wherein the electrical parameter detection burst includes a plurality of detection pulses, each having a pulse frequency of 10 Hz to 100 MHz.

15. The controller according to any one of claims 2 to 14, wherein the current supplied between each pair of detection electrodes for detecting a detection parameter is 0.1 mA or less.

16. The controller according to claim 2, wherein the controller is configured to apply a plurality of skin resistance reduction pulses to the ES system during a stimulation period, the skin resistance reduction pulses comprising a higher frequency and lower intensity compared to the plurality of stimulation pulses.

17. The controller according to claim 16, wherein the plurality of skin resistance reduction pulses are superimposed on the plurality of stimulation pulses.

18. The controller according to claim 16 or 17, wherein the skin resistance reduction pulse carries a current of 0.1 mA or less per pulse and has a frequency of 1 to 100,000 Hz.

19. The controller according to claim 2, wherein the controller is configured to cause the ES system to apply a plurality of deprivation pulses while operating in the stimulation mode, the deprivation pulses having an intensity lower than the intensity of the stimulation pulses.

20. The controller according to claim 19, wherein the sensory deprivation pulse has a frequency of 0.1 to 150 Hz.

21. An electrical stimulation, ES, and system for receiving signaling from and providing signaling to a controller according to any one of claims 1 to 20.

22. The ES system according to claim 21, further comprising clothing, the clothing being configured to provide a support for the relative arrangement of the electrodes in the electrode array and to distribute the electrodes at least over at least a portion of the user's body.

23. A computer-readable medium comprising computer program code configured to operate a controller according to any one of claims 1 to 22.

24. A method for providing electrical stimulation to a user's muscle using at least one electrical stimulation, ES, or system, wherein the ES system comprises a controller and an electrode array including a plurality of electrodes for applying the electrical stimulation to the muscle, the electrodes being further configured to measure an electrical parameter between any one electrode of the electrode array and any one other electrode of the electrode array, and the method is The steps include: the controller providing signaling to the ES system to operate the electrode array in detection mode during a detection period, wherein the signaling causes the ES system to provide a plurality of electrical parameter detection bursts during at least one detection period, each electrical parameter detection burst comprising one or more detection pulses, and each electrical parameter detection burst being configured not to provide muscle stimulation; The steps include: the controller detecting one or more detection parameters indicating the degree of muscle movement associated with each electrical parameter detection burst, each electrical parameter detection burst being provided by applying a potential difference between different pairs of the plurality of electrodes, the pair of electrodes referring to a combination of a first detection electrode and a second detection electrode selected from any electrodes of the electrode array, such that when the controller provides a subsequent electrical parameter detection burst, the corresponding electrode pair for the subsequent electrical parameter detection burst includes any two electrodes of the electrode array, except for any electrode pair corresponding to an electrical parameter detection burst previously provided in the detection period; A method comprising the step of the controller calculating the electrical parameter between each pair of detection electrodes based on the one or more detection parameters.

25. The controller further includes the step of providing signaling to the ES system to operate the electrode array in a stimulation mode, the signaling causing the ES system to provide a plurality of stimulation pulses separated by rest periods. Each stimulation pulse includes applying the stimulation potential difference between a first stimulation electrode and a second stimulation electrode of the electrode array such that the stimulation potential difference provides stimulation to the muscle, The method according to claim 24, wherein each rest period includes a period in which no stimulation pulses are present.

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