scholarly journals Neuroprosthetic Technology «Bioness» (Exorobot) in the Process of Restoring Motor and Vegetative-Trophic Disorders in Central Paresis of the Upper Limb

2020 ◽  
Vol 99 (5) ◽  
pp. 62-69
Author(s):  
I.A. Vozniuk ◽  
A.V. Polyakova ◽  
D.V. Tokareva

Disability after a stroke or brain injury is most often associated with impaired movement, speech, swallowing, and reduced cognitive abilities. By the end of the acute period of stroke, paresis in the arm and leg of varying degrees is observed in 80-90 % of survivors.In case of severe paresis, it is advisable to support the function of the limb at the early stages of recovery using modern specialized modifiable devices and methods that provide functional and multimodal stimulation and partial prosthetics. Aim of the study: evaluation of the efficacy of functional electrical stimulation (FES) in a complex of multimodal effects in restoring movement in Stroke patients with upper limb paresis (palcy).Methods. Stimulation and neuroprosthetic methods (FES - “Bioness H200”, RTMs) were used as the main therapeutic program of rehabilitation treatment for patients with motor disorders of the upper limb after an ischemic stroke (n=140). The median period of stroke was 25 [13; 56] days, median age 52 [48; 69] years. The standard methods of diagnosis and treatment of patients with stroke in accordance to the protocol of the Ministry of health of the Russian Federation No. 928 n and 1705 n (2012) were used, as well as scales and questionnaires for assessing the loss of strength and volume of motor disorders, assessing depression and motivation for treatment (Motricity Index), Fugl-Meyer AR, Medical Research Council Weakness Scale, Modified Ashworth Scale (MAS), Beck Depression Inventory; Beck At, Recovery Locus of Control, Patridge C., Johnstone M. Results. The effectiveness of personalized therapy with the use of a neuroprosthesis (“Bioness H200”) in patients in the acute period of ischemic stroke was shown, with the Motrisight index, Fugle-Meier scale being the most sensitive scales. the results depend on thebasic disease characteristics, the most relevant of which were - focus, degree of neurological deficit, personal motivation. The addition using of botulinum toxin allowed eliminating the inhibitory effect of spasticity, which prepared patients for intensive methods of physical rehabilitation. During the follow-up period, no complications were revealed. In 90% of cases, an increase in daily activity was noted. Functional electrical stimulation has significantly increased their level of self-care. The disability complex was initially equally pronounced in all patients, but positive reinforcement in the form of movement of the paretic hand against the background of FES led to a decrease in the severity of depression. In 100%, there was a high motivation to continue the treatment program with neuroprosthetics. Conclusion. The use of a complex of stimulating personalized techniques in the acute period of stroke is justified and safe. The useof FES significantly increases the range of motion in the hand, helps to overcome power paresis, coordination disorders, increases the general level of physical activity of patients after a stroke, motivation for the recovery process and improves the quality of life.

Author(s):  
Rupa Zanwar ◽  
Pooja Motar ◽  
Minal Holani

Background: Literature shows that intensive Functional Electrical Stimulation facilitates upper limb motor recovery after Stroke. Aim: To assess the effects of 4 weeks of FES therapy on right upper limb motor functions in patient with Chronic Stroke. Materials and Methods: The participant was thirty year old male Right Hemiparesis who had experienced Chronic Ischemic Stroke. FES therapy was given for forty five minutes per session, three sessions a week for complete four weeks. The pre and post intervention score were measured with Fugl Meyer Assessment, Voluntary Control Grading and MAS. Results: The Fugl Meyer Assessment score for right upper limb showed improvement with progression in stage of VCG for right upper limb and hand. Also improved MAS score was noted for right shoulder, elbow and hand muscles. Conclusion: The current study confirms that application of FES therapy improves upper limb motor functions in Chronic stage of Stroke after 4 weeks.


2016 ◽  
Vol 26 (2) ◽  
Author(s):  
Deepesh Kumar ◽  
Sunny Verma ◽  
Sutapa Bhattacharya ◽  
Uttama Lahiri

Neurological disorders often manifest themselves in the form of movement deficit on the part of the patient. Conventional rehabilitation often used to address these deficits, though powerful are often monotonous in nature. Adequate audio-visual stimulation can prove to be motivational. In the research presented here we indicate the applicability of audio-visual stimulation to rehabilitation exercises to address at least some of the movement deficits for upper and lower limbs. Added to the audio-visual stimulation, we also use Functional Electrical Stimulation (FES). In our presented research we also show the applicability of FES in conjunction with audio-visual stimulation delivered through VR-based platform for grasping skills of patients with movement disorder.


2018 ◽  
Vol 18 (16) ◽  
pp. 6812-6821 ◽  
Author(s):  
Yu Zhou ◽  
Yinfeng Fang ◽  
Kai Gui ◽  
Kairu Li ◽  
Dingguo Zhang ◽  
...  

Author(s):  
Ashley M. Stewart ◽  
Christopher G. Pretty ◽  
Mark Adams ◽  
XiaoQi Chen

Hybrid exoskeletons are a recent development, combining electrically controlled actuation with functional electrical stimulation, which potentially offers great benefits for muscular rehabilitation. This chapter presents a review on the state of the art of upper-limb hybrid exoskeletons with a particular focus on stroke rehabilitation. The current needs of the stroke rehabilitation field are discussed and the ability of hybrid exoskeletons to provide a solution to some of the gaps in this field is explored. Due to the early stage of development which most hybrid exoskeletons are in, little research has yet been done in control methods used for them. In particular, more investigation is needed with regards to the potential benefit of hybrid exoskeletons as a patient-monitoring and rehabilitation assist-as-need tool.


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