# Automatic Control of Standing Balance and Gait with Implanted Neuroprostheses

> **NIH NIH R01** · CASE WESTERN RESERVE UNIVERSITY · 2021 · $510,712

## Abstract

The overall goal of the proposed research is to develop a new control system to
maintain standing balance at various task-dependent, user-specified postures, and
enable dynamically stable reciprocal stepping in persons paralyzed by spinal cord
injuries (SCI) with an implanted motor system neuroprosthesis (NP) and prepare for
ensuing home-going trials and clinical dissemination. A system that automatically
modulate neural stimulation to maintain standing balance and generate successive
reactive steps to achieve effective reciprocal gait will be translated to the Networked
Neural Prosthesis System (NNPS). Each module of the NNPS contains internal sensors
that would eliminate the need for external devices and cabling. The project will
determine the feasibility of a safe and functional LE motor system NP that can be
realized with a fully implantable system suitable for home and community use.
 Aim 1 will determine effective and efficient methods to estimate whole body center of
mass (CoM) kinematics and evaluate suitability for real-time control with the NNPS. This
will entail estimating CoM from external sensors attached to able-bodied volunteers and
current recipients of standing and stepping NPs at the anticipated surgical location of
modules of the NNPS. We will implement our existing biologically-inspired standing
balance and stepping controllers with NNPS simulated signals in volunteers with SCI
and evaluate their performance in response to internally generated and externally
applied disturbances. Aim 2 will extend the control system to automatically generate
successive reactive steps, and enhance inter-limb loading and dynamic balance during
stance phases of gait. A system that enables forward progression of the CoM to
maintain balance in the medio-lateral direction, optimizes forward propulsion, and
ensures proper swing limb foot placement during successive reactive steps will be
developed in simulation, and experimentally validated with able-bodied volunteers and
recipients of implanted NPs. Our existing control systems for bipedal stance and
reactive stepping will be adapted to maintain balance and achieve smooth translation of
CoM during walking and recent development in the field of walking robots will be
applied. We expect that walking with the extended biologically-inspired control system
will be smoother, more efficient and more resilient to potential destabilizing influences
than conventional pre-programmed stimulation. Aim 3 will create the resources
required to translate the standing and walking controllers to the new NNPS platform in
preparation for clinical implementation and ensuing home-going trials. Work will
develop, document and verify operation of lower extremity-specific software and
clinical/user interfaces to the NNPS. We will prepare and submit an Investigation Device
Exemption to the USFDA for a new feasibility study of LE applications of the NNPS in
preparation for ensuing clinical trials of safety and effectiveness.

## Key facts

- **NIH application ID:** 10231225
- **Project number:** 5R01NS040547-16
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Musa L Audu
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $510,712
- **Award type:** 5
- **Project period:** 2000-09-21 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10231225

## Citation

> US National Institutes of Health, RePORTER application 10231225, Automatic Control of Standing Balance and Gait with Implanted Neuroprostheses (5R01NS040547-16). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10231225. Licensed CC0.

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