Pengembangan Praktikal Wearable FES System Berbasis Cycle-to-Cycle Control untuk Tujuan Telerehabilitasi Gerakan Knee-Ankle Joint pada Pasien Hemiplegia

Kusumawati, Wiwik (2026) Pengembangan Praktikal Wearable FES System Berbasis Cycle-to-Cycle Control untuk Tujuan Telerehabilitasi Gerakan Knee-Ankle Joint pada Pasien Hemiplegia. Other thesis, Institut Teknologi Sepuluh Nopember.

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Abstract

Stroke sering kali mengakibatkan hemiplegia dengan komplikasi berupa foot drop dan pola berjalan yang tidak stabil. Penelitian ini bertujuan mengembangkan purwarupa wearable Functional Electrical Stimulation (FES) berbasis cycle-to-cycle control yang terintegrasi platform telerehabilitasi IoT untuk memperbaiki pergerakan knee–ankle joint. Sistem ini dikendalikan oleh mikrokontroler dual-core Arduino Giga R1, di mana Core M7 mengonstruksi akuisisi data sensor kinematik-plantar (4,5 kHz), sementara Core M4 mengisolasi algoritma hantaran stimulasi demi keselamatan pasien. Estimasi sudut sendi yang stabil diperoleh melalui fusi sensor IMU (ADXL335 dan ENC-03RC) menggunakan Kalman Filter, sedangkan fase gait dideteksi lewat respons gaya sensor Force Sensing Resistor (FSR). Parameter deviasi sudut diproses secara closed-loop melalui Fuzzy Logic Controller (FLC) konfigurasi MISO dan SISO untuk memperbarui durasi stimulasi secara adaptif antar-siklus pada otot Tibialis Anterior, Gastrocnemius, Vastus, serta Hamstring (BFSH dan BFLH). Pengujian statis membuktikan hantaran tegangan boost converter hingga 178 V (15 kHz) aman dan efektif menembus resistensi spastisitas otot pasien. Pengujian dinamis menunjukkan FES adaptif berhasil memulihkan ritme melangkah, ditandai dengan durasi siklus jalan (TCycle) yang memendek dan lebih konsisten dari 2.40±1.06 detik menjadi 2.24±0.20 detik. Perbaikan kinematika lutut yang signifikan tercapai pada ekstensi menumpu maksimum (MKEst) dari kondisi menekuk kaku -{11.7}^{\circ }\pm {0.8}^{\circ } menjadi ekstensi fungsional -{3.8}^{\circ }\pm {3.1}^{\circ } (mendekati rujukan normal {2.9}^{\circ }\pm {3.3}^{\circ }). Pada fase mengayun, sudut dorsofleksi maksimum pergelangan kaki (MADsw) disesuaikan menjadi {10.6}^{\circ }\pm {5.9}^{\circ } pada ketepatan waktu 77.1%±6.6% cycle sehingga mampu mencegah fenomena kaki menyeret. Seluruh data biomekanik ditransmisikan secara real-time via WiFi ke server fes.arifin.tech. Pengembangan selanjutnya dapat dilakukan penggabungan multijoint antara hip-knee-ankle, memperbanyak percobaan variasi ke subjek, melakukan percobaan pada pasien dengan kondisi 90 hari post stroke untuk mencegah spastisitas gerak. ======================================================================================================================================
Stroke frequently results in hemiplegia, often complicated by foot drop and gait instability. This study aims to develop a wearable Functional Electrical Stimulation (FES) prototype based on cycle-to-cycle control, integrated with an IoT telerehabilitation platform to improve knee–ankle joint movement. The system is controlled by an Arduino Giga R1 dual-core microcontroller, where the M7 Core executes kinematic-plantar sensor data acquisition (4.5 kHz), while the M4 Core isolates the stimulation delivery algorithm for patient safety. Stable joint angle estimation is achieved through the fusion of IMU sensors (ADXL335 and ENC-03RC) using a Kalman Filter, while gait phases are detected via the force response of Force Sensing Resistor (FSR) sensors. Angle deviation parameters are processed in a closed-loop manner using a Fuzzy Logic Controller (FLC) in MISO and SISO configurations to adaptively update stimulation duration between cycles for the Tibialis Anterior, Gastrocnemius, Vastus, and Hamstring (BFSH and BFLH) muscles. Static testing demonstrated that the boost converter voltage delivery of up to 178 V (15 kHz) is safe and effective in overcoming the patient's muscle spasticity resistance. Dynamic testing showed that the adaptive FES successfully restored walking rhythm, characterized by a shorter and more consistent gait cycle duration (TCycle), decreasing from 2.40±1.06 seconds to 2.25±0.30 seconds. Significant improvement in knee kinematics was achieved in maximal knee extension during stance (MKEst), moving from an abnormally flexed condition of -{11.7}^{\circ }\pm {0.8}^{\circ } to a functional extension of -{3.5}^{\circ }\pm {2.3}^{\circ } (approaching the normal reference of {2.9}^{\circ }\pm {3.3}^{\circ }). During the swing phase, the maximal ankle dorsiflexion angle (MADsw) was adjusted to {13.2}^{\circ }\pm {6.1}^{\circ } at a cycle timing accuracy of 80.0%±7.7% cycle, effectively preventing the foot dragging phenomenon. All biomechanical data are transmitted in real-time via WiFi to the server fes.arifin.tech. Future work includes multi-joint integration (hip-knee-ankle), expanding subject testing variations, and conducting trials on post-stroke patients within the 90-day window to prevent movement spasticity.

Item Type:	Thesis (Other)
Uncontrolled Keywords:	Cycle-to-Cycle Control, Wearable Functional Electrical Stimulation, Fuzzy Logic Controller, Hemiplegia, Telerehabilitasi. Cycle-to-Cycle Control, Functional Electrical Stimulation, Fuzzy Logic Controller, Hemiplegia, Telerehabilitation.
Subjects:	R Medicine > RM Therapeutics. Pharmacology > RM871 Electric stimulation.
Divisions:	Faculty of Intelligent Electrical and Informatics Technology (ELECTICS) > Biomedical Engineering > 11410-(S1) Undergraduate Thesis
Depositing User:	Wiwik Kusumawati
Date Deposited:	01 Aug 2026 03:33
Last Modified:	01 Aug 2026 03:33
URI:	http://repository.its.ac.id/id/eprint/141261

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