An Implanted Neuroprosthesis for Restoring Arm and Hand Function in People with High Level Tetraplegia

Arch Phys Med Rehabil, 2014 · DOI: 10.1016/j.apmr.2014.01.028 · Published: June 1, 2014

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study describes the development, surgical installation, and functional outcomes of an implanted neuroprosthesis in two individuals with high tetraplegia. The neuroprosthesis uses electrical stimulation to restore arm and hand function. The system includes implanted stimulators and electrodes placed in the shoulder, arm, and hand muscles. Myoelectric recording electrodes are placed in the head and neck to control the stimulation. The implanted system allows the patients to perform activities of daily living, like eating, but may require assistance from a mobile arm support to compensate for limited shoulder strength.

Study Duration

At least 2.5 years

Participants

Two individuals with spinal cord injuries at or above the C4 motor level.

Evidence Level

Case study

Key Findings

1
The neuroprosthesis system was successfully implanted in both individuals, and it has functioned properly for at least 2.5 years post-implant.
2
Hand, wrist, forearm, elbow, and shoulder movements were achieved through the implanted system.
3
One individual could perform several activities of daily living with some limitations, while the other could partially complete two activities.

Research Summary

The study evaluated an implanted neuroprosthesis to restore arm and hand function in individuals with high-level tetraplegia. The neuroprosthesis system, consisting of implanted stimulators and electrodes, was successfully implanted in two individuals, allowing for various arm and hand movements. The implanted system shows promise for restoring some ADLs, though limitations such as spasticity and muscle denervation require further investigation and the use of assistive devices like mobile arm supports.

Practical Implications

Restoration of Function

Implanted neuroprostheses can restore arm and hand function to individuals with high tetraplegia, improving their independence and quality of life.

Technological Advancement

Spiral nerve cuff electrodes can be successfully used for chronic upper extremity applications.

Further Research

Future research should focus on improving shoulder strength, reducing spasticity, and developing more sophisticated control strategies to enhance the functionality and usability of implanted neuroprostheses.

Study Limitations

1
Generalizability of the results is limited as this study describes a neuroprosthetic system that was implanted in two subjects with high tetraplegia.
2
Spasticity and muscle denervation affected the shoulder function in the subjects.
3
Neither subject was able to support the weight of the arm against gravity using only stimulation.

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