Automated FES for Upper Limb Rehabilitation Following Stroke and Spinal Cord Injury

IEEE TRANSACTIONS ON NEURAL SYSTEMS AND REHABILITATION ENGINEERING, 2018 · DOI: 10.1109/TNSRE.2018.2816238 · Published: May 8, 2018

Neurology Biomedical

Simple Explanation

This paper introduces a new device that uses Functional Electrical Stimulation (FES) to help people with stroke and spinal cord injury (SCI) regain movement in their upper limbs. The device is designed to be low-cost and easy to use at home, allowing patients to practice reach-to-grasp movements repeatedly with minimal therapist supervision. Pilot studies showed that participants found the device usable and experienced some improvement in their ability to manipulate objects after training with the device.

Study Duration

1-2 weeks

Participants

4 stroke and 7 SCI participants

Evidence Level

Pilot study

Key Findings

1
Participants with stroke and SCI showed good compliance with the automated FES device, completing a high number of repetitions during training sessions.
2
Stroke participants demonstrated an average improvement in ARAT scores that was maintained for at least one month after the intervention period.
3
SCI participants showed a statistically significant improvement in ARAT scores on the trained side compared to the untrained side.

Research Summary

This study presents a novel automated FES device designed for upper limb rehabilitation following stroke and SCI, which delivers assistive stimulation contingent on users’ self-initiated movements. Pilot data demonstrated the device's usability and positive feedback from participants with upper limb weakness, along with modest functional benefits observed after a short intervention period. The findings suggest that this automated FES device offers a promising and readily translatable therapy for upper limb rehabilitation, warranting further studies to establish its clinical and cost-effectiveness over longer training durations.

Practical Implications

Home-Based Rehabilitation

The device's design allows for repeated practice at home with minimal therapist input, potentially increasing the dosage of therapy received by patients.

Cost-Effective Therapy

The low-cost nature of the device makes it a potentially viable option for widespread clinical and home use.

Neuroplasticity Induction

The automated FES system may promote neuroplastic changes in motor circuits through the pairing of cortical and peripheral activity.

Study Limitations

1
The study involved a small number of participants in a pilot setting.
2
Further studies are required to establish the clinical and cost-effectiveness of longer durations of training.
3
The device does not allow the same level of ﬂexibility as a physiotherapist led session.

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