Neurostimulator

1. A neurostimulator device comprising:

a stimulation assembly connectable to a plurality of electrodes, wherein the plurality of electrodes are configured to stimulate a spinal cord using an applied complex stimulation pattern;

an interface configured to receive movement data indicative of a response related to stimulation of the spinal cord; and

a processor configured to modify the applied complex stimulation pattern to create a modified complex stimulation pattern for subsequent stimulation of the spinal cord by

processing the movement data, and

performing an optimization algorithm that includes a predicted mean and a variance of a motor performance function for a plurality of candidate complex stimulation patterns, including the applied complex stimulation pattern, based on at least on one of (i) previous movement data including the received movement data, and (ii) stimulation study movement data that is derived from a stimulation study,

wherein the optimization algorithm includes an upper confidence bound rule for applying a weight for modifying the applied complex stimulation pattern based on a number of times movement data is received regarding stimulation of the spinal cord, and

wherein the upper confidence bound rule causes the applied complex stimulation pattern to be modified through convergence of the optimization algorithm toward an optimal candidate complex stimulation pattern.

2. The neurostimulator device of claim 1 , wherein the movement data includes at least one of motion data, metabolic data, or physiological data, and the interface is configured to receive the movement data from at least one of an electromyography sensor, an evoked potential sensor, a joint angle sensor, a flex sensor, an accelerometer, a gyroscope sensor, a flow sensor, a pressure sensor, a load sensor, a temperature sensor, or a combination thereof.

3. The neurostimulator device of claim 1 , wherein the interface is configured to receive the movement data from at least one of a support platform, a support stand, an external bracing system, an in shoe sensor system, a therapy machine, or a combination thereof.

4. The neurostimulator device of claim 1 , wherein the interface is configured to receive the movement data from at least one of a clinician computer, a remote computing device, a motion capture system, a video-based system, or a combination thereof.

5. The neurostimulator device of claim 1 , wherein at least one of the movement data or the motor performance function is based on at least one of voluntary movement of muscles involved in standing, voluntary movement of muscles involved in stepping, voluntary movement of muscles involved in reaching, voluntary movement of muscles involved in grasping, voluntarily changing positions of one or both legs, voluntarily changing positions of one or both arms, voiding a bladder, sexual function, voiding a bowel, postural activity, locomotor activity, cardiovascular function, respiratory function, digestive function, autonomic function, motor function, vasomotor function, cognitive function, body temperature, metabolic processes, or a combination thereof.

6. The neurostimulator device of claim 1 configured to aid a patient having a neurologically derived paralysis in a portion of the patient's body affected by a lesion to the spinal cord, wherein the spinal cord includes at least one selected spinal circuit that has a first stimulation threshold representing a minimum amount of stimulation required to activate the at least one selected spinal circuit, and a second stimulation threshold representing an amount of stimulation above which the at least one selected spinal circuit is fully activated.

7. The neurostimulator device of claim 6 , wherein at least one of the applied complex stimulation pattern, the modified complex stimulation pattern, or the plurality of candidate complex stimulation patterns, is below the second stimulation threshold such that the at least one selected spinal circuit is at least partially activatable by the addition of at least one of (a) neurological signals originating from the portion of the patient's body having the paralysis, and (b) supraspinal signals.

8. The neurostimulator device of claim 1 , wherein at least one of the applied complex stimulation pattern, the modified complex stimulation pattern, or the plurality of candidate complex stimulation patterns is configured to stimulate the spinal cord and improve or restore voluntary movement, an autonomic function, a motor function, a metabolic function, or a combination thereof.

9. The neurostimulator device of claim 1 , wherein the plurality of electrodes includes at least four groups of electrodes.

10. The neurostimulator device of claim 9 , wherein at least one of the applied complex stimulation pattern or the modified complex stimulation pattern comprises different electrical stimulation for each of the groups of electrodes.

11. The neurostimulator device of claim 1 , wherein one electrode of the plurality of electrodes is located at neural tissue and another electrode of the plurality of electrodes is located at an end organ.

12. A method of operating a neurostimulator device that includes a stimulation assembly connectable to a plurality of electrodes for stimulating a portion of a patient, the method comprising:

applying a first complex stimulation pattern to the portion of the patient using the stimulation assembly;

receiving, via an interface, response data that is related to stimulation of the portion of the patient; and

modifying, via a processor, the first complex stimulation pattern to create a second complex stimulation pattern for subsequent stimulation of the portion of the patient by

processing the response data, and

performing an optimization algorithm that includes a predicted mean and a variance of a motor performance function for a plurality of candidate complex stimulation patterns, including the first complex stimulation pattern, based on at least on one of (i) previous response data including the received response data, and (ii) stimulation study response data that is derived from a stimulation study,

wherein the optimization algorithm includes an upper confidence bound rule for applying a weight for modifying the first complex stimulation pattern based on a number of times response data is received regarding stimulation of the portion of the patient, and

wherein the upper confidence bound rule modifies the first complex stimulation pattern through convergence of the optimization algorithm toward an optimal candidate complex stimulation pattern.

13. The method of claim 12 , further comprising controlling, via the processor, a training device to subject the patient to physical training before or during application of at least one of the first complex stimulation pattern or the second complex stimulation pattern.

14. The method of claim 12 , wherein the response data is recorded by at least one of an electromyography sensor, an evoked potential sensor, a joint angle sensor, a flex sensor, an accelerometer, a gyroscope sensor, a flow sensor, a pressure sensor, a load sensor, a temperature sensor, a support platform, a support stand, an external bracing system, an in shoe sensor system, a therapy machine, a clinician computer, a remote computing device, a motion capture system, a video-based system, or a combination thereof.

15. The method of claim 12 , wherein stimulation of the portion of the patient is configured to improve or restore at least one of voluntary movement of muscles involved in standing, voluntary movement of muscles involved in stepping, voluntary movement of muscles involved in reaching, voluntary movement of muscles involved in grasping, voluntarily changing positions of one or both legs, voluntarily changing positions of one or both arms, voiding the patient's bladder, sexual function, voiding the patient's bowel, postural activity, locomotor activity, cardiovascular function, respiratory function, digestive function, autonomic function, motor function, vasomotor function, cognitive function, body temperature, metabolic processes, or a combination thereof.

16. The method of claim 12 , wherein at least one of the first complex stimulation pattern, the second complex stimulation pattern, or the plurality of candidate complex stimulation patterns is below a stimulation threshold such that the portion of the patient is at least partially activatable by addition of at least one of (a) neurological signals originating from the portion of the patient's body having the paralysis, and (b) supraspinal signals.

17. The method of claim 12 , further comprising applying an adjustment to the second complex stimulation pattern provided by a clinician.

18. The method of claim 12 , wherein at least one of the first complex stimulation pattern, the second complex stimulation pattern, or the plurality of candidate complex stimulation patterns includes a stimulation parameter specifying at least one of a waveform shape, an amplitude, a waveform period, or a waveform frequency.

19. The method of claim 12 , wherein at least one of the first complex stimulation pattern, the second complex stimulation pattern, or the plurality of candidate complex stimulation patterns includes a stimulation timing that indicates that stimulation is to be applied to each of the plurality of electrodes.

20. The method of claim 12 , wherein at least one of the first complex stimulation pattern, the second complex stimulation pattern, or the plurality of candidate complex stimulation patterns includes a transition parameter that specifies how a respective pattern is adapted over time to transition to another pattern.