Why Is Functional Electrical Stimulation Therapy Capable of Restoring Motor Function Following Severe Injury to the Central Nervous System?

Abstract

Injury to the central nervous system (CNS) often results in the loss of motor and sensory activity with a tragic impact on quality of life. The anatomic and cellular complexity of the nervous system limits its ability to repair itself, making the effects of the injury permanent. To date, the majority of attempts to restore normal function after damage to the brain or spinal cord have been unsuccessful. Recent studies have demonstrated significant improvements in voluntary motor function in patients with chronic and subacute stroke and spinal cord injury (SCI) using functional electrical stimulation (FES) therapy. In this therapy, patients are asked to perform multitudes of specific motor tasks. During each session, the therapist instructs patients to perform a specific movement at a time, and, after a few seconds of trying, highly controlled electrical stimulation is applied to facilitate that specific movement of the paralyzed limb. After completing this therapy program, individuals are often able to perform the tasks voluntarily, i.e., unassisted by the FES system. Using this approach, we have been able to assist patients with complete and incomplete spinal cord injuries, severe stroke, and pediatric stroke to recover the ability to reach, grasp, stand, and walk. In this chapter, we explain why we believe FES has achieved such extraordinary results.