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  4. Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia

Selective neural electrical stimulation restores hand and forearm movements in individuals with complete tetraplegia

Journal of NeuroEngineering and Rehabilitation, 2020 · DOI: https://doi.org/10.1186/s12984-020-00676-4 · Published: April 1, 2020

Spinal Cord InjuryRehabilitationBiomedical

Simple Explanation

This study explores using electrical stimulation of nerves to restore hand movement in people with complete tetraplegia. The researchers hypothesized that stimulating the radial and median nerves could activate functional hand movements. Unlike previous methods that targeted up to 12 muscles, this approach aims to minimize implanted electrodes while providing necessary hand movements. The goal is to provide a minimally invasive solution for grasping and releasing objects, using only two cuff electrodes above the elbow.

Study Duration
2016-2018 (inclusion period)
Participants
8 male subjects with C5 complete motor cervical injury
Evidence Level
Not specified

Key Findings

  • 1
    Selective stimulation using multicontact cuff electrodes can provide isolated, compound, functional, and strong movements in individuals with tetraplegia.
  • 2
    Upper limb nerves have muscle-specific fascicles, enabling the activation of isolated movements through selective stimulation.
  • 3
    Researchers demonstrated isolated fingers or thumb flexion, Key Grip, and Power and Hook Grips in different patients through selective nerve stimulation.

Research Summary

The study investigated selective neural electrical stimulation of radial and median nerves to restore hand function in individuals with complete tetraplegia. The results demonstrated that selective stimulation with multicontact cuff electrodes could elicit isolated, compound, and functional movements, including various grips. The findings suggest that this approach could provide a minimally invasive solution for restoring object grasping and releasing abilities in patients with tetraplegia.

Practical Implications

Restoration of Hand Function

This technology could offer a less invasive method for restoring hand grasping capabilities in individuals with complete tetraplegia, improving their autonomy and quality of life.

Minimally Invasive Solution

The use of only two cuff electrodes above the elbow represents a significant reduction in the number of implanted components compared to previous FES systems.

Selective Muscle Activation

The discovery of muscle-specific fascicles within upper limb nerves allows for more precise and targeted muscle activation through selective stimulation techniques.

Study Limitations

  • 1
    The clinical trial was conducted during scheduled surgeries, limiting the experimental time window to approximately 30 minutes.
  • 2
    The study did not stimulate the ulnar nerve, which could provide additional flexions for the 4th and 5th fingers.
  • 3
    Grip force could not be measured during the study, and the quality of combined movements was not accurately controlled.

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