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PII: S1350-4533(97)00035-0

Med. Eng. Phys. Vol. 19, No. 8, pp. 755758, 1997


1997 IPEM Published by Elsevier Science Ltd
Printed in Great Britain
13504533/97 $17.00 + 0.00

Technical Note

A battery-powered constant current stimulator for


motor end-point detection
M. P. Bolton and J. R. Kulkarni
Clinical Engineering Department and Younger Disabled Unit, Withington
Hospital, Manchester M20 2LR, UK
Received 20 March 1997, accepted 17 July 1997

ABSTRACT
The device described was developed as an external electrical stimulator to assist in the accurate location of motor
end-points prior to the injection of nerve blocking agents in the treatment of spasticity. Monophasic pulses are
produced with a duration of 10100 s and a current from 0 to 10 mA. The current is maintained over a wide
range of electrode impedance and is independent of battery voltage. 1997 IPEM Published by Elsevier Science Ltd
Keywords: Stimulator, motor end-point, constant current
Med. Eng. Phys., 1997, Vol. 19, 755758, December

1. INTRODUCTION
The device described was developed as an external electrical stimulator to assist in the accurate
location of muscle motor end-points prior to the
injection of nerve blocking agents in the treatment of spasticity1. However, it can act equally
well in any application where a low power external
stimulator with adjustable current and pulse width
is required and is also suitable for use with
needle electrodes.
The stimulator is a compact, hand-held device
with internal battery power. The circuitry has
been optimised for a long battery life with warning of a battery low condition. The user can
adjust the current with a slider control over the
range 010 mA and the pulse width from 10 to
100 s. These controls allow for fine reduction in
pulse energy as the motor end-point is
approached. The current and pulse width range
was based on the experience of J. Keenan using
a mains-powered EMG stimulator2. The physical
layout is such that the parameters can be varied
with the device held in one hand, while the stimulating electrode is manipulated with the other. The
pulse repetition rate is fixed at approx. 1 pulse/s.
Visual indication of a pulse is given with a light
emitting diode (LED).
The indifferent electrode is a commercially
Correspondence to: M. P. Bolton.

available conducting plastic type (95 mm


47 mm) as used with TENS devices and the active
electrode consists of a custom-made probe with a
stainless steel ball end, 8 mm in diameter, surrounded by surgical swab material. The swab is
soaked in either physiological saline or ordinary
water. The system is illustrated in Figure 1.
Unlike many simple stimulators which vary the
output through a potentiometer, this device provides true current pulses with a very wide compliance. The current will be closely maintained
at the set value in spite of large changes in skin
resistance or variable contact with the stimulating
electrode. This leads to an improvement in
repeatability and quantification of the technique,
as motor end-point localisation necessitates moving the stimulation electrode over the skin with
inherent changes in contact resistance. Also, sudden reductions in resistance will not lead to painful stimuli as may happen with voltage sources.
2. CIRCUIT DESCRIPTION
The basic pulse generation is provided by a dual
timer circuit (CMOS 556), U1A and U1B. U1A is a
free-running asymmetric astable with a repetition
rate of approx. 1 s, determined by R1 and C2. The
output pulse duration is approx. 50 ms set by R2
and C2. The timing values of the astable are not
critical. The output pulse on pin 5 is active low
and flashes the pulse LED through R3. The 555

A battery-powered constant current stimulator for motor end-point detection: M. P. Bolton and J. R. Kulkarni

Figure 1 Hand-held stimulator and electrodes.

style timer requires a trigger pulse which is shorter


than the output so C3, R12 and catch diode D1
differentiate the 50 ms pulse to provide a short
trigger for the monostable section U1B. This
monostable generates the stimulation pulse and
the minimum duration is set by R4 and C4 to
10 s. R4 is selected to give the correct minimum
pulse width. The width is adjusted by VR1 and R3
is a trimming resistor setting the maximum width
to 100 s.
The monostable output on pin 9 is normally
low. The short, positive going pulse turns on the
MOSFET switch Q1, so creating a linear rise in
current in the primary of T1. The primary inductance limits the current to approx. 2 A with a pulse
duration of 100 s and the core does not saturate.
The high current pulse is supplied by the capacitor C5 rather than the battery and the charge is
recovered slowly through R6. Diode D2 clamps
the flyback voltage when the transistor switches
off. T1 has a step-up ratio of 60:1 so a high voltage
is created at the secondary. R8 provides some
damping for the secondary and the reservoir
capacitor C9 is charged up to the peak voltage
(about 400 v) through D3. (If the pulse width is
set low, C9 will take a number of pulses to
charge fully.)
One of the main objectives of the stimulator is
to provide calibrated current pulses to the subject.
Transistor Q2 acts as a high voltage current sink
with the current being set by the base voltage and
resistor R11. The output current I out = Ve/R11,
where Ve is the emitter voltage of Q2 and Ve =
(Vb 0.6). The monostable output pulse is fed
to the base of Q2, but the peak voltage is set by
the voltage at the wiper of VR2. The pulse voltage
is clamped by diode D4 so the peak value of Ve
is the same as the wiper voltage, with the drop
across D4 cancelling out the base-emitter diode
drop. As the current depends on the supply to

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VR2, this is derived from a low current, low dropout regulator providing a fixed 5 V independent
of the battery voltage. The resistor R9 is selected
to give a maximum current of 10 mA. The current
range could be increased if required by reducing
the value of this resistor. In the unlikely failure of
Q2 resulting in a collectoremitter short, current
control would be lost and painful stimuli could be
administered. The excessive current would flow
through R11 and the subsequent voltage rise
would trigger the SCR (D7), so shorting out the
high voltage instantly. The threshold for the SCR
is set by VR3.
The integrated circuit U2 senses the battery
voltage with the threshold set by R5 and R7. When
the voltage falls below the preset threshold level,
the output on pin 5 goes low for 200 ms. In this
circuit, the voltage sensed is not that of the battery
directly, but the value across the capacitor C5. The
voltage drops slightly with each stimulator pulse
so the first indication of a low battery state is a
200 ms flash with each pulse. Only when the
maximum value (rather than the minimum value)
across C5 drops below the threshold does the light
remain on permanently. This gives a useful early
indication of battery state while the stimulator
remains within specification. The threshold is set
at approx. 6 V, whereas regulator U3 does not
drop out till 5.2 V.
The whole circuit is enclosed in a plastic case
and it was not felt necessary to create a fully
floating output, as would be the situation with
mains-powered stimulators (see Figure 2 and
Table 1).
3. PERFORMANCE
Figure 3 shows the linear relationship between voltage and resistance at a current of 10 mA. Linearity
is maintained to within 0.5% up to the com-

A battery-powered constant current stimulator for motor end-point detection: M. P. Bolton and J. R. Kulkarni

Figure 2

Circuit diagram.

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A battery-powered constant current stimulator for motor end-point detection: M. P. Bolton and J. R. Kulkarni
Table 1 Components list
Resistors

Capacitors

R1 1M2
R2 120K
R3 820R
R4 10K
R5 1M2
R6 1K
R7 330K
R8 10K
R9 2K2*
R10 2K2
R11 390R
R12 4K7
R13 270K*
R14 10M
R15 2K2
R16 4K7

C1 100 F 10v elec.


C2 1 F 63v polyester
C3 1 nF 50v ceramic
C4 1 nF 63v polyester
C5 1000 F 10v elec.
C6 100 F 10v elec.
C7 0.1 F 50v ceramic
C9 0.15 F 400v polyester
C10 0.1 F 50v ceramic

VR1 100K slider


VR2 10K slider
VR3 10K trimpot
Integrated circuits
U1 TS 556CN
U2 MAX700CPA
U3 LM2936Z-5

Diodes
D1
D2
D3
D4
D5
D6
D7

1N4148
UF4006
UF4006
1N4148
1N4148
UF4006
P0201NA SCR

Figure 4

100 s pulse.

Figure 5

10 s pulse.

Transistors
Q1 BUZ10 Power MOSFET
Q2 BUX87 450v NPN
LEDs

Transformer
T1 RM10250 core 60:1 ratio
Primary 32 turns 0.5 mm dia.
Secondary 1920 turns 0.1 mm
dia.

LED1 Yellow
LED2 Red

*Resistors R9 and R13 are selected to set the maximum current and
pulse width, respectively.

Figures 4 and 5 are waveforms recorded on a


digital storage oscilloscope for pulse widths of 10
and 100 S at 10 mA. With a current source, the
pulse rise and fall times are largely determined by
the stray capacitance in parallel with the load.
The device has been used successfully in a local
trial of Botulinum toxin as a means of controlling spasticity.
REFERENCES
Figure 3 Constant current relationship of output.

pliance limit of 400 V, giving a useable electrode


resistance range from zero to 40 k.

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1. Skeil, D. A. and Barnes, M. P., The local treatment of spasticity. Clinical Rehabilitation, 1994, 8, 240246.
2. Copp, E. P., Harris, R. and Keenan, J., Peripheral nerve
block and motor point block with phenol in the management of spasticity. Proc. Roy. Soc. Med., 1970, 63, 937938.

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