Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: a review

Márquez-Chin, César; Popović, Miloš R.

doi:10.1186/s12938-020-00773-4

Cited by 195 publications

(183 citation statements)

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“…The combination of MI-based BCIs with FES or VR has shown promising results in stroke survivors. The FES combined with other therapies seems effective for upper limb motor rehabilitation after stroke (Howlett et al, 2015;Marquez-Chin and Popovic, 2020), and could be a helpful feedback mechanism with MI BCIs. For example, Biasiucci et al (2018) studied the importance of coherent feedback.…”

Section: Introductionmentioning

confidence: 99%

Brain Computer Interface Treatment for Motor Rehabilitation of Upper Extremity of Stroke Patients—A Feasibility Study

et al. 2020

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Introduction: Numerous recent publications have explored Brain Computer Interfaces (BCI) systems as rehabilitation tools to help subacute and chronic stroke patients recover upper extremity movement. Recent work has shown that BCI therapy can lead to better outcomes than conventional therapy. BCI combined with other techniques such as Functional Electrical Stimulation (FES) and Virtual Reality (VR) allows to the user restore the neurological function by inducing the neural plasticity through improved real-time detection of motor imagery (MI) as patients perform therapy tasks. Methods: Fifty-one stroke patients with upper extremity hemiparesis were recruited for this study. All participants performed 25 sessions with the MI BCI and assessment visits to track the functional changes before and after the therapy. Results: The results of this study demonstrated a significant increase in the motor function of the paretic arm assessed by Fugl-Meyer Assessment (FMA-UE), FMA-UE = 4.68 points, P < 0.001, reduction of the spasticity in the wrist and fingers assessed by Modified Ashworth Scale (MAS), MAS-wrist =-0.72 points (SD = 0.83), P < 0.001, MAS-fingers =-0.63 points (SD = 0.82), P < 0.001. Other significant improvements in the grasp ability were detected in the healthy hand. All these functional improvements achieved during the BCI therapy persisted 6 months after the therapy ended. Results also showed that patients with Motor Imagery accuracy (MI) above 80% increase 3.16 points more in the FMA than patients below this threshold (95% CI; [1.47-6.62], P = 0.003). The functional improvement was not related with the stroke severity or with the stroke stage. Conclusion: The BCI treatment used here was effective in promoting long lasting functional improvements in the upper extremity in stroke survivors with severe, moderate and mild impairment. This functional improvement can be explained by improved neuroplasticity in the central nervous system.

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Section: Introductionmentioning

confidence: 99%

Brain Computer Interface Treatment for Motor Rehabilitation of Upper Extremity of Stroke Patients—A Feasibility Study

et al. 2020

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“…The goal of this manuscript is not to explore the mechanism of improvement in individuals with stroke and spinal cord injury following FES as this is a methods paper and as such these mechanisms have been widely discussed in literature (Quandt and Hummel, 2014;Hara, 2015;Luo et al, 2020;Marquez-Chin and Popovic, 2020). We do, however, recommend some basic principles of FES application on the widely accepted belief that mechanism of improvement with this therapy is based on the principles of neuroplasticity (Nagai et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Functional Electrical Stimulation Therapy for Retraining Reaching and Grasping After Spinal Cord Injury and Stroke

2020

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Neurological conditions like hemiplegia following stroke or tetraplegia following spinal cord injury, result in a massive compromise in motor function. Each of the two conditions can leave individuals dependent on caregivers for the rest of their lives. Once medically stable, rehabilitation is the main stay of treatment. This article will address rehabilitation of upper extremity function. It is long known that moving the affected limb is crucial to recovery following any kind of injury. Overtime, it has also been established that just moving the affected extremities does not suffice, and that the movements have to involve patient's participation, be as close to physiologic movements as possible, and should ideally stimulate the entire neuromuscular circuitry involved in producing the desired movement. For over four decades now, functional electrical stimulation (FES) is being used to either replace or retrain function. The FES therapy discussed in this article has been used to retrain upper extremity function for over 15 years. Published data of pilot studies and randomized control trials show that FES therapy produces significant changes in arm and hand function. There are specific principles of the FES therapy as applied in our studies: (i) stimulation is applied using surface stimulation electrodes, (ii) there is minimum to virtually no pain during application, (iii) each session lasts no more than 45-60 min, (iv) the technology is quite robust and can make up for specificity to a certain extent, and (v) fine motor function like two finger precision grip can be trained (i.e., thumb and index finger tip to tip pinch). The FES therapy protocols can be successfully applied to individuals with paralysis resulting from stroke or spinal cord injury.

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“…Bei der funktionellen Elektrostimulation (FES) werden durch elektrische Stimulation von peripheren Motoneuronen sequenzielle Muskelkontraktionen erzeugt, die koordinierte und zielgerichtete Bewegungen ermöglichen [68]. Die Stimulation kann entweder im passiven Ruhezustand (neuromuskuläre Elektrostimulation) oder während einer aktiv intendierten willentlichen Bewegung (funktionelle Elektrostimulation) erfolgen.…”

Section: Funktionelle Elektrostimulationunclassified

Wearables in der Schlaganfallmedizin

Baumgartner¹,

Baumgartner²,

Pirker-Kees³

et al. 2021

Klinische Neurophysiologie

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Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: a review

Cited by 195 publications

References 61 publications

Brain Computer Interface Treatment for Motor Rehabilitation of Upper Extremity of Stroke Patients—A Feasibility Study

Brain Computer Interface Treatment for Motor Rehabilitation of Upper Extremity of Stroke Patients—A Feasibility Study

Functional Electrical Stimulation Therapy for Retraining Reaching and Grasping After Spinal Cord Injury and Stroke

Wearables in der Schlaganfallmedizin

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