Impaired Motor Function: Functional Electrical Stimulation

Functional electrical stimulation (FES) has been studied and clinically applied to restoring or assisting motor functions lost due to spinal cord injury or cerebrovascular disease. Electrical stimulation without control of functional movements is also used for therapy or in rehabilitation training. In recent years, one of the main focuses of FES studies has been its application for rehabilitation of motor function. In this review, the authors first present the basics of applying electrical stimulation to the neuromuscular system for motor control. Then, two methods of FES control are discussed: controllers for FES based on feedback error learning (FEL) and on cycle-to-cycle control of limb movements. The FEL-FES controller can be practical in FES applications that need to control the musculoskeletal system that involves various nonlinear characteristics and delay in its responses to electrical stimulation. The cycle-to-cycle control is expected to be effective in controlling repetitive movements for rehabilitation training. Finally, a study on ankle dorsiflexion control during the swing phase using an integrated system of FES control and motion measurement with wearable sensors for rehabilitation is presented.

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Functional electrical stimulation early after stroke improves lower limb motor function and ability in activities of daily living

Neurorehabilitation ◽

10.3233/nre-141129 ◽

2014 ◽

Vol 35 (3) ◽

pp. 381-389 ◽

Cited By ~ 8

Author(s):

Guoqing You ◽

Huiying Liang ◽

Tiebin Yan

Keyword(s):

Electrical Stimulation ◽

Activities Of Daily Living ◽

Motor Function ◽

Functional Electrical Stimulation ◽

Lower Limb ◽

Daily Living

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Real-time and wearable functional electrical stimulation system for volitional hand motor function control using the electromyography bridge method

Neural Regeneration Research ◽

10.4103/1673-5374.197139 ◽

2017 ◽

Vol 12 (1) ◽

pp. 133 ◽

Cited By ~ 2

Author(s):

Zhi-gong Wang ◽

Hai-peng Wang ◽

Zheng-yang Bi ◽

Yang Zhou ◽

Yu-xuan Zhou ◽

...

Keyword(s):

Electrical Stimulation ◽

Real Time ◽

Motor Function ◽

Functional Electrical Stimulation ◽

Bridge Method ◽

Stimulation System

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Critically appraised paper: A program of functional electrical stimulation cycling, goal-directed training and adapted cycling improves gross motor function in children with cerebral palsy [commentary]

Journal of Physiotherapy ◽

10.1016/j.jphys.2020.11.002 ◽

2021 ◽

Vol 67 (1) ◽

pp. 63

Author(s):

Noula Gibson

Keyword(s):

Cerebral Palsy ◽

Electrical Stimulation ◽

Motor Function ◽

Functional Electrical Stimulation ◽

Gross Motor ◽

Gross Motor Function ◽

Children With Cerebral Palsy

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Effect of functional electrical stimulation on the proprioception, motor function of the paretic upper limb, and patient quality of life: A case report

Journal of Hand Therapy ◽

10.1016/j.jht.2016.06.012 ◽

2016 ◽

Vol 29 (4) ◽

pp. 507-514 ◽

Cited By ~ 6

Author(s):

Carlos Bustamante ◽

Francisco Brevis ◽

Sebastián Canales ◽

Sebastián Millón ◽

Rodrigo Pascual

Keyword(s):

Quality Of Life ◽

Electrical Stimulation ◽

Case Report ◽

Motor Function ◽

Upper Limb ◽

Functional Electrical Stimulation

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Effectiveness of Functional Electrical Stimulation in Improving Clinical Outcomes in the Upper Arm following Stroke: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2015/729768 ◽

2015 ◽

Vol 2015 ◽

pp. 1-14 ◽

Cited By ~ 42

Author(s):

Amir K. Vafadar ◽

Julie N. Côté ◽

Philippe S. Archambault

Keyword(s):

Electrical Stimulation ◽

Motor Function ◽

Functional Electrical Stimulation ◽

Meta Analysis ◽

Final Analysis ◽

Stroke Patients ◽

Upper Arm ◽

Significant Difference ◽

Evidence Database ◽

Meta Analyses

Background.Different therapeutic methods are being used to prevent or decrease long-term impairments of the upper arm in stroke patients. Functional electrical stimulation (FES) is one of these methods, which aims to stimulate the nerves of the weakened muscles so that the resulting muscle contractions resemble those of a functional task.Objectives.The objective of this study was to review the evidence for the effect of FES on (1) shoulder subluxation, (2) pain, and (3) upper arm motor function in stroke patients, when added to conventional therapy.Methods.From the 727 retrieved articles, 10 (9 RCTs, 1 quasi-RCT) were selected for final analysis and were rated based on the PEDro (Physiotherapy Evidence Database) scores and the Sackett’s levels of evidence. A meta-analysis was performed for all three considered outcomes.Results.The results of the meta-analyses showed a significant difference in shoulder subluxation in experimental groups compared to control groups, only if FES was applied early after stroke. No effects were found on pain or motor function outcomes.Conclusion.FES can be used to prevent or reduce shoulder subluxation early after stroke. However, it should not be used to reduce pain or improve upper arm motor function after stroke.

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Cortical Re-organization After Traumatic Brain Injury Elicited Using Functional Electrical Stimulation Therapy: A Case Report

Frontiers in Neuroscience ◽

10.3389/fnins.2021.693861 ◽

2021 ◽

Vol 15 ◽

Author(s):

Matija Milosevic ◽

Tomoya Nakanishi ◽

Atsushi Sasaki ◽

Akiko Yamaguchi ◽

Taishin Nomura ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Electrical Stimulation ◽

Brain Injury ◽

Motor Function ◽

Upper Limb ◽

Functional Electrical Stimulation ◽

Male Participant ◽

Electrical Stimulation Therapy ◽

Improve Motor Function

Functional electrical stimulation therapy (FEST) can improve motor function after neurological injuries. However, little is known about cortical changes after FEST and weather it can improve motor function after traumatic brain injury (TBI). Our study examined cortical changes and motor improvements in one male participant with chronic TBI suffering from mild motor impairment affecting the right upper-limb during 3-months of FEST and during 3-months follow-up. In total, 36 sessions of FEST were applied to enable upper-limb grasping and reaching movements. Short-term assessments carried out using transcranial magnetic stimulation (TMS) showed reduced cortical silent period (CSP), indicating cortical and/or subcortical inhibition after each intervention. At the same time, no changes in motor evoked potentials (MEPs) were observed. Long-term assessments showed increased MEP corticospinal excitability after 12-weeks of FEST, which seemed to remain during both follow-ups, while no changes in CSP were observed. Similarly, long-term assessments using TMS mapping showed larger hand MEP area in the primary motor cortex (M1) after 12-weeks of FEST as well as during both follow-ups. Corroborating TMS results, functional magnetic resonance imaging (fMRI) data showed M1 activations increased during hand grip and finger pinch tasks after 12-weeks of FEST, while gradual reduction of activity compared to after the intervention was seen during follow-ups. Widespread changes were seen not only in the M1, but also sensory, parietal rostroventral, supplementary motor, and premotor areas in both contralateral and ipsilateral hemispheres, especially during the finger pinch task. Drawing test performance showed improvements after the intervention and during follow-ups. Our findings suggest that task-specific and repetitive FEST can effectively increase cortical activations by integrating voluntary motor commands and sensorimotor network through functional electrical stimulation (FES). Overall, our results demonstrated cortical re-organization in an individual with chronic TBI after FEST.

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