An Implanted Myoelectrically-Controlled Neuroprosthesis for Upper Extremity Function in Spinal Cord Injury

A second generation implantable neuroprosthesis has been developed which provides improved control of grasp-release, forearm pronation, and elbow extension for individuals with cervical level spinal cord injury. In addition to the capacity to stimulate twelve muscles, the key technological feature of the advanced system is the capability to transmit data out of the body. This allows the use of myoelectric signal recording via implanted electrodes, thus minimizing the required external components. Clinical studies have been initiated with a second generation neuroprosthesis that consists of twelve stimulating electrodes, two myoelectric signal recording electrodes, an implanted stimulator-telemeter device and an external control unit and transmit/receive coil. This system has now been implemented in nine arms in seven C5/C6 spinal cord injured individuals. The results from these subjects demonstrate that myoelectric signals can be recorded from voluntary muscles in the presence of electrical stimulation of nearby muscles. The functional results show that the neuroprosthesis provides significantly increased pinch force and grasp function for each subject. All subjects have demonstrated increased independence and improved function in activities of daily living. We believe that these results indicate that implanted myoelectric control is a desirable option for neuroprostheses

[1]  R. Betz,et al.  Outcomes of upper-extremity tendon transfers and functional electrical stimulation in an adolescent with C-5 tetraplegia. , 1997, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[2]  S. Wood-Dauphinée,et al.  Reintegration to Normal Living as a proxy to quality of life. , 1987, Journal of chronic diseases.

[3]  K. Kilgore,et al.  Satisfaction with and usage of a hand neuroprosthesis. , 1999, Archives of physical medicine and rehabilitation.

[4]  P H Peckham,et al.  A comparison between control methods for implanted FES hand-grasp systems. , 1998, IEEE transactions on rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society.

[5]  P. H. Peckham,et al.  An Implanted Upper-Extremity Neuroprosthesis. Follow-up of Five Patients* , 1997, The Journal of bone and joint surgery. American volume.

[6]  M. Keith,et al.  Development of a quantitative hand grasp and release test for patients with tetraplegia using a hand neuroprosthesis. , 1994, The Journal of hand surgery.

[7]  S. Wood-Dauphinée,et al.  Assessment of global function: The Reintegration to Normal Living Index. , 1988, Archives of physical medicine and rehabilitation.

[8]  K. Kilgore,et al.  Efficacy of an implanted neuroprosthesis for restoring hand grasp in tetraplegia: a multicenter study. , 2001, Archives of physical medicine and rehabilitation.

[9]  J. Ware,et al.  The structure of psychological distress and well-being in general populations , 1983 .

[10]  A. Foote,et al.  Hope, Social Support and Self‐Esteem of Patients with Spinal Cord Injuries , 1991, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[11]  L. D. de Witte,et al.  Key dimensions of client satisfaction with assistive technology: a cross-validation of a Canadian measure in The Netherlands. , 2001, Journal of rehabilitation medicine.

[12]  Brian T. Smith,et al.  Psychometric rigor of the Grasp and Release Test for measuring functional limitation of persons with tetraplegia: a preliminary analysis. , 2004, The journal of spinal cord medicine.