scholarly journals Improvement of hand functions of spinal cord injury patients with electromyography-driven hand exoskeleton: A feasibility study

2020 ◽  
Vol 1 ◽  
Author(s):  
Youngmok Yun ◽  
Youngjin Na ◽  
Paria Esmatloo ◽  
Sarah Dancausse ◽  
Alfredo Serrato ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Degrees Of Freedom ◽  
Standardized Test ◽  
Hand Function ◽  
Severe Disabilities ◽  
Finger Movements ◽  
Control Approach ◽  
Cord Injury ◽  
Hand Exoskeleton

Abstract We have developed a one-of-a-kind hand exoskeleton, called Maestro, which can power finger movements of those surviving severe disabilities to complete daily tasks using compliant joints. In this paper, we present results from an electromyography (EMG) control strategy conducted with spinal cord injury (SCI) patients (C5, C6, and C7) in which the subjects completed daily tasks controlling Maestro with EMG signals from their forearm muscles. With its compliant actuation and its degrees of freedom that match the natural finger movements, Maestro is capable of helping the subjects grasp and manipulate a variety of daily objects (more than 15 from a standardized set). To generate control commands for Maestro, an artificial neural network algorithm was implemented along with a probabilistic control approach to classify and deliver four hand poses robustly with three EMG signals measured from the forearm and palm. Increase in the scores of a standardized test, called the Sollerman hand function test, and enhancement in different aspects of grasping such as strength shows feasibility that Maestro can be capable of improving the hand function of SCI subjects.

scholarly journals Function of the nucleus accumbens in motor control during recovery after spinal cord injury

Science ◽  
2015 ◽  
Vol 350 (6256) ◽  
pp. 98-101 ◽  
Author(s):  
Masahiro Sawada ◽  
Kenji Kato ◽  
Takeharu Kunieda ◽  
Nobuhiro Mikuni ◽  
Susumu Miyamoto ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Nucleus Accumbens ◽  
High Frequency ◽  
Neuronal Damage ◽  
Recovery Period ◽  
Oscillatory Activity ◽  
Finger Movements ◽  
Early Recovery ◽  
Cord Injury

Motivation facilitates recovery after neuronal damage, but its mechanism is elusive. It is generally thought that the nucleus accumbens (NAc) regulates motivation-driven effort but is not involved in the direct control of movement. Using causality analysis, we identified the flow of activity from the NAc to the sensorimotor cortex (SMC) during the recovery of dexterous finger movements after spinal cord injury at the cervical level in macaque monkeys. Furthermore, reversible pharmacological inactivation of the NAc during the early recovery period diminished high-frequency oscillatory activity in the SMC, which was accompanied by a transient deficit of amelioration in finger dexterity obtained by rehabilitation. These results demonstrate that during recovery after spinal damage, the NAc up-regulates the high-frequency activity of the SMC and is directly involved in the control of finger movements.

A critical reappraisal of corticospinal tract somatotopy and its role in traumatic cervical spinal cord syndromes

2021 ◽  
pp. 1-7
Author(s):  
Allan D. Levi ◽  
Jan M. Schwab
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Extremity ◽  
Corticospinal Tract ◽  
Cervical Spinal Cord ◽  
Hand Function ◽  
Cervical Spinal Cord Injury ◽  
Pathophysiological Mechanism ◽  
Cord Injury ◽  
Central Cord Syndrome

The corticospinal tract (CST) is the preeminent voluntary motor pathway that controls human movements. Consequently, long-standing interest has focused on CST location and function in order to understand both loss and recovery of neurological function after incomplete cervical spinal cord injury, such as traumatic central cord syndrome. The hallmark clinical finding is paresis of the hands and upper-extremity function with retention of lower-extremity movements, which has been attributed to injury and the sparing of specific CST fibers. In contrast to historical concepts that proposed somatotopic (laminar) CST organization, the current narrative summarizes the accumulated evidence that 1) there is no somatotopic organization of the corticospinal tract within the spinal cord in humans and 2) the CST is critically important for hand function. The evidence includes data from 1) tract-tracing studies of the central nervous system and in vivo MRI studies of both humans and nonhuman primates, 2) selective ablative studies of the CST in primates, 3) evolutionary assessments of the CST in mammals, and 4) neuropathological examinations of patients after incomplete cervical spinal cord injury involving the CST and prominent arm and hand dysfunction. Acute traumatic central cord syndrome is characterized by prominent upper-extremity dysfunction, which has been falsely predicated on pinpoint injury to an assumed CST layer that specifically innervates the hand muscles. Given the evidence surveyed herein, the pathophysiological mechanism is most likely related to diffuse injury to the CST that plays a critically important role in hand function.

scholarly journals Design and Experimental Evaluation of a Vertical Lift Walker for Sit-to-Stand Transition Assistance

2012 ◽  
Vol 6 (1) ◽  
Author(s):  
Thomas C. Bulea ◽  
Ronald J. Triolo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Lower Extremity ◽  
Grip Force ◽  
Hand Function ◽  
Electrical Power ◽  
Lower Extremity Weakness ◽  
Sit To Stand ◽  
Cord Injury ◽  
Vertical Lift

A walker capable of providing vertical lift support can improve independence and increase mobility of individuals living with spinal cord injury (SCI). Using a novel lifting mechanism, a walker has been designed to provide sit-to-stand assistance to individuals with partially paralyzed lower extremity muscles. The design was verified through experiments with one individual with SCI. The results show the walker is capable of reducing the force demands on the upper and lower extremity muscles during sit-to-stand transition compared to standard walkers. The walker does not require electrical power and no grip force or harness is necessary during sit-to-stand operation, enabling its use by individuals with limited hand function. The design concept can be extended to aid other populations with lower extremity weakness.

Nerve transfers for the restoration of hand function after spinal cord injury

2012 ◽  
Vol 117 (1) ◽  
pp. 176-185 ◽  
Author(s):  
Susan E. Mackinnon ◽  
Andrew Yee ◽  
Wilson Z. Ray
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Single Case ◽  
Motor Nerve ◽  
Hand Function ◽  
Public Health Problem ◽  
Nerve Transfers ◽  
Cord Injury ◽  
Significant Public Health Problem ◽  
Significant Public Health

Spinal cord injury (SCI) remains a significant public health problem. Despite advances in understanding of the pathophysiological processes of acute and chronic SCI, corresponding advances in translational applications have lagged behind. Nerve transfers using an expendable nearby motor nerve to reinnervate a denervated nerve have resulted in more rapid and improved functional recovery than traditional nerve graft reconstructions following a peripheral nerve injury. The authors present a single case of restoration of some hand function following a complete cervical SCI utilizing nerve transfers.

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