Implanted Neuroprostheses for Restoration of Hand Function in Tetraplegic Patients

Abstract Restoration of hand function through functional electrical stimulation allows tetraplegic patients to use existing abilities to control paralyzed muscles. In patients with C5 or C6 spinal cord injuries, implanted upper extremity neuroprostheses use functional electrical stimulation technology to power hand and arm muscles. A variety of devices, often using contralateral shoulder motion, sends signals via a small external controller and transmitting coil to an implanted stimulator. The stimulator powers designated upper extremity muscles via implanted electrodes. The surgical procedure is minimally invasive and easily reversed. Palmar and lateral grasp, among other functions, can be reliably restored, leading to significant improvements in functional capacity. High user satisfaction, low complication rates, and recent advances in technology and control systems contribute to the success of this technology in the treatment of devastating spinal cord injuries.

[1]  R. Betz,et al.  An implantable upper extremity neuroprosthesis in a growing child with a C5 spinal cord injury , 2001, Spinal Cord.

[2]  J. Wolpaw,et al.  Multichannel EEG-based brain-computer communication. , 1994, Electroencephalography and clinical neurophysiology.

[3]  E. Marsolais,et al.  Restoration of key grip and release in the C6 tetraplegic patient through functional electrical stimulation. , 1980, The Journal of hand surgery.

[4]  M. Keith,et al.  Functional evaluation of quadriplegic patients using a hand neuroprosthesis. , 1990, Archives of physical medicine and rehabilitation.

[5]  P. Hunter Peckham,et al.  The choice of pulse duration for chronic electrical stimulation via surface, nerve, and intramuscular electrodes , 1974, Annals of Biomedical Engineering.

[6]  S. Pourmehdi,et al.  An externally powered, multichannel, implantable stimulator-telemeter for control of paralyzed muscle , 1998, IEEE Transactions on Biomedical Engineering.

[7]  M. Keith.  Neuroprostheses for the upper extremity , 2001, Microsurgery.

[8]  G. vanOvereemHansen.  EMG-controlled functional electrical stimulation of the paretic hand. , 1979 .

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

[10]  Pattern of use and user satisfaction of Neuro Control Freehand system , 2001, Spinal Cord.

[11]  G. van Overeem Hansen.  EMG-controlled functional electrical stimulation of the paretic hand. , 1979, Scandinavian journal of rehabilitation medicine.

[12]  S. Carroll,et al.  Australian experience with the Freehand System for restoring grasp in quadriplegia. , 2000, The Australian and New Zealand journal of surgery.

[13]  A. Prochazka,et al.  The bionic glove: an electrical stimulator garment that provides controlled grasp and hand opening in quadriplegia. , 1997, Archives of physical medicine and rehabilitation.

[14]  P H Peckham,et al.  Reduction of Costs of Disability Using Neuroprostheses , 2000, Assistive technology : the official journal of RESNA.

[15]  Percutaneous Freehand™ System Intramuscular Electrode Placement , 2002, Journal of hand surgery.

[16]  P. Taylor,et al.  Restoration of Tetraplegic Hand Function by Use of the Neurocontrol Freehand System , 2001, Journal of hand surgery.

[17]  M. Keith,et al.  New concepts on treatment of the upper limb in the tetraplegic. Surgical restoration and functional neuromuscular stimulation. , 1988, Hand clinics.

[18]  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.

[19]  M. Keith,et al.  Functional neuromuscular stimulation neuroprostheses for the tetraplegic hand. , 1988, Clinical orthopaedics and related research.

[20]  W. Donovan,et al.  The International Standards Booklet for Neurological and Functional Classification of Spinal Cord Injury , 1994, Paraplegia.

[21]  E. Moberg,et al.  Third International Conference on Surgical Rehabilitation of the Upper Limb in Tetraplegia (quadriplegia). , 1986, The Journal of hand surgery.

[22]  E. Moberg.  Upper limb surgery in tetraplegia. , 1977, The Hand.

[23]  J. Chae,et al.  Neuromuscular stimulation for upper extremity motor and functional recovery in acute hemiplegia. , 1998, Stroke.

[24]  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.

[25]  P. H. Peckham,et al.  Controlled prehension and release in the C5 quadriplegic elicited by functional electrical stimulation of the paralyzed forearm musculature , 2006, Annals of Biomedical Engineering.

[26]  M J Mulcahey,et al.  Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation. , 1997, Archives of physical medicine and rehabilitation.

[27]  P. Peckham,et al.  Evaluation of shoulder movement as a command control source , 1990, IEEE Transactions on Biomedical Engineering.

[28]  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.

[29]  R. Betz,et al.  Evaluation of the lower motor neuron integrity of upper extremity muscles in high level spinal cord injury , 1999, Spinal Cord.

[30]  N. Hoshimiya,et al.  A multichannel FES system for the restoration of motor functions in high spinal cord injury patients: a respiration-controlled system for multijoint upper extremity , 1989, IEEE Transactions on Biomedical Engineering.

[31]  B. Smith,et al.  In-line lead connector for use with implanted neuroprosthesis , 1991, IEEE Transactions on Biomedical Engineering.

[32]  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.

[33]  W Girsch,et al.  Electromyogram-controlled functional electrical stimulation for treatment of the paralyzed upper extremity. , 1999, Artificial organs.

[34]  G. Snoek,et al.  Use of the NESS Handmaster to restore handfunction in tetraplegia: clinical experiences in ten patients , 2000, Spinal Cord.

[35]  H Hummelsheim,et al.  The functional value of electrical muscle stimulation for the rehabilitation of the hand in stroke patients. , 1997, Scandinavian journal of rehabilitation medicine.

[36]  R. Triolo,et al.  The application of a modified neuroprosthetic hand system in a child with a C7 spinal cord injury. Case report , 1992, Paraplegia.

[37]  Dennis D. Roscoe,et al.  An Externally Powered, Multichannel, Implantable Stimulator for Versatile Control of Paralyzed Muscle , 1987, IEEE Transactions on Biomedical Engineering.

[38]  P H Peckham,et al.  EEG-based control of a hand grasp neuroprosthesis. , 1999, Neuroreport.

[39]  P. Kennedy,et al.  Restoration of neural output from a paralyzed patient by a direct brain connection , 1998, Neuroreport.

[40]  K.L. Kilgore,et al.  Synthesis of hand grasp using functional neuromuscular stimulation , 1989, IEEE Transactions on Biomedical Engineering.

[41]  K. Kilgore,et al.  Implantable functional neuromuscular stimulation in the tetraplegic hand. , 1989, The Journal of hand surgery.

[42]  Patient selection for an upper extremity neuroprosthesis in tetraplegic individuals , 1997, Spinal Cord.

[43]  J. House,et al.  Split flexor pollicus longus tendon transfer for stabilization of the thumb interphalangeal joint: a cadaveric and clinical study. , 1999, The Journal of hand surgery.