Abstract
BackgroundFunctional electrical stimulation (FES) applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions. To improve the stimulation effectiveness of conventional FES, we introduce multi-pad electrodes and a new stimulation paradigm.MethodsThe new FES system comprises an electrode composed of small pads that can be activated individually. This electrode allows the targeting of motoneurons that activate synergistic muscles and produce a functional movement. The new stimulation paradigm allows asynchronous activation of motoneurons and provides controlled spatial distribution of the electrical charge that is delivered to the motoneurons. We developed an automated technique for the determination of the preferred electrode based on a cost function that considers the required movement of the fingers and the stabilization of the wrist joint. The data used within the cost function come from a sensorized garment that is easy to implement and does not require calibration. The design of the system also includes the possibility for fine-tuning and adaptation with a manually controllable interface.ResultsThe device was tested on three stroke patients. The results show that the multi-pad electrodes provide the desired level of selectivity and can be used for generating a functional grasp. The results also show that the procedure, when performed on a specific user, results in the preferred electrode configuration characteristics for that patient. The findings from this study are of importance for the application of transcutaneous stimulation in the clinical and home environments.
Highlights
Functional electrical stimulation (FES) applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions
Functional Electrical Stimulation (FES) provides control signals to peripheral motor systems that are compromised after a central nervous system lesion
To evaluate the selection algorithm, we performed hand opening and closing using the pads and current intensities indicated as Conclusion This pilot study in three patients clearly shows that INTelligent Functional Electrical Stimulation (INTFES) allows wrist stabilization and selective activation of muscles that are required for hand opening and closing
Summary
Functional electrical stimulation (FES) applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions. Functional Electrical Stimulation (FES) provides control signals to peripheral motor systems that are compromised after a central nervous system lesion (stroke, spinal cord injury, etc.). The use of FES combined with a splint for grasp control was introduced by Long and Masciarelli [1] to assist patients with tetraplegia. This research led to the first therapeutic application of FES, which resulted in significant carryover effects [4]. The results of these studies and many others. A therapeutic FES system comprised four pairs of relatively large surface electrodes as an interface between the electronic stimulator and tissues
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