EEG-controlled functional electrical stimulation for hand opening and closing in chronic complete cervical spinal cord injury

2018 ◽  
Vol 4 (6) ◽  
pp. 065005 ◽  
Author(s):  
Katie Gant ◽  
Santiago Guerra ◽  
Lauren Zimmerman ◽  
Brandon A Parks ◽  
Noeline W Prins ◽  
...  
2008 ◽  
Vol 18 (2) ◽  
pp. 53-61 ◽  
Author(s):  
Rosalynn Miller ◽  
Milos Popovic ◽  
Adam Thrasher ◽  
Molly Verrier

OBJECTIVE AND IMPORTANCE: To present case studies of two individuals with chronic cervical spinal cord injury (SCI) who participated in functional electrical stimulation (FES) therapy with the objective to restore voluntary grasp function. CLINICAL PRESENTATION: Both individuals (right hand dominant males, age 24 and 31) had a sustained a cervical SCI (C6 and C4-5, respectively) at least 8 years prior to participation in this study. INTERVENTION: Both individuals participated in an individualized FES therapy program for 6 weeks. FES therapy was administered through a regimen of three, one-hour sessions, per week for three months. A single arm of each participant (n = 2) was treated. FES therapy is an integrative intervention strategy combining muscle strengthening, functional movement training and stretching. The participant's hand movement abilities were assessed pre and post FES therapy using the Manual Muscle Test (MMT), a modified Sollerman Hand Function Test (mSHFT), and the Reach, Grasp, Transport and Release Task (RGTR). DISCUSSION: As the injuries of participants in the current study were chronic and thus neurologically stable, no spontaneous improvements/recovery in hand function was expected. However, FES as part of an integrated therapeutic approach affected restoration and improvement of hand function in both participants. CONCLUSION: The concurrent improvement in strength, integrated motor function and object contact following FES therapy, demonstrated that there is potential for affecting change in hand function of individuals with chronic SCI.


2020 ◽  
Author(s):  
B. Barra ◽  
S. Conti ◽  
M.G. Perich ◽  
K. Zhuang ◽  
G. Schiavone ◽  
...  

SUMMARYRegaining arm motor control is a high priority for people with cervical spinal cord injury1. Unfortunately, no therapy can reverse upper limb paralysis. Promising neurotechnologies stimulating muscles to bypass the injury enabled grasping in humans with SCI2,3 but failed to sustain whole arm functional movements that are necessary for daily living activities. Here, we show that electrical stimulation of the cervical spinal cord enabled three monkeys with cervical SCI to execute functional, three-dimensional, arm movements. We designed a lateralized epidural interface that targeted motoneurons through the recruitment of sensory afferents within the dorsal roots and was adapted to the specific anatomy of each monkey. Simple stimulation bursts engaging single roots produced selective joint movements. We then triggered these bursts using movement-related intracortical signals, which enabled monkeys with arm motor deficits to perform an unconstrained, three-dimensional reach and grasp task. Our technology increased muscle activity, forces, task performance and quality of arm movements. Finally, analysis of intra-cortical neural data showed that a synergistic interaction between spared descending pathways and electrical stimulation enabled this restoration of voluntary motor control. Spinal cord stimulation is a mature clinical technology4–7, which suggests a realistic path for our approach to clinical applications.


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