Home use of a functional electrical stimulation system for standing and mobility in adolescents with spinal cord injury

Moynahan, Megan; Mullin, Cecilia; Cohn, Joy C.; Burns, Carolyn A.; Halden, Esther E.; Triolo, Ronald J.; Betz, Randal R.

doi:10.1016/s0003-9993(96)90060-x

Cited by 43 publications

(16 citation statements)

References 22 publications

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“…For a self-administered therapy in a home setting, adherence is affected by familiarity with the involved technology and availability due to competing commitments of users [54,55]. Indeed a study showed that adolescents with SCI were unable to dedicate time to home-based functional electrical stimulation for standing and had issues with some aspects of the technology considering the therapy as a separate occasional activity [55]. A home-based therapy programme implemented using a user friendly technology which incorporates normal daily activities and does not involve excessive time commitment has the potential for high user adherence.…”

Section: Discussionmentioning

confidence: 99%

Home-based rehabilitation using a soft robotic hand glove device leads to improvement in hand function in people with chronic spinal cord injury:a pilot study

Osuagwu

Timms

Peachment

et al. 2020

J NeuroEngineering Rehabil

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Background: Loss of hand function following high level spinal cord injury (SCI) is perceived as a high priority area for rehabilitation. Following discharge, it is often impractical for the specialist care centre to provide ongoing therapy for people living with chronic SCI at home, which can lead to further deterioration of hand function and a direct impact on an individual's capability to perform essential activities of daily living (ADL). Objective: This pilot study investigated the therapeutic effect of a self-administered home-based hand rehabilitation programme for people with cervical SCI using the soft extra muscle (SEM) Glove by Bioservo Technologies AB. Methods: Fifteen participants with chronic cervical motor incomplete (AIS C and D) SCI were recruited and provided with the glove device to use at home to complete a set task and perform their usual ADL for a minimum of 4 h a day for 12 weeks. Assessment was made at Week 0 (Initial), 6, 12 and 18 (6-week follow-up). The primary outcome measure was the Toronto Rehabilitation Institute hand function test (TRI-HFT), with secondary outcome measures including pinch dynamometry and the modified Ashworth scale. Results: The TRI-HFT demonstrated improvement in hand function at Week 6 of the therapy including improvement in object manipulation (58.3 ±3.2 to 66.9 ±1.8, p ≈ 0.01), and palmar grasp assessed as the length of the wooden bar that can be held using a pronated palmar grip (29.1 ±6.0 cm to 45.8 ±6.8 cm, p <0.01). A significant improvement in pinch strength, with reduced thumb muscle hypertonia was also detected. Improvements in function were present during the Week 12 assessment and also during the follow-up. Conclusions: Self-administered rehabilitation using the SEM Glove is effective for improving and retaining gross and fine hand motor function for people living with chronic spinal cord injury at home. Retention of improved hand function suggests that an intensive activity-based rehabilitation programme in specific individuals is sufficient to

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Section: Discussionmentioning

confidence: 99%

Home-based rehabilitation using a soft robotic hand glove device leads to improvement in hand function in people with chronic spinal cord injury:a pilot study

Osuagwu

Timms

Peachment

et al. 2020

J NeuroEngineering Rehabil

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“…Applying external electrical currents to the intact lower motor neurons innervating the paralyzed lower extremity musculature can generate powerful contractions of the knee, hip, and trunk extensors to facilitate the transition from a seated position to erect stance. This approach not only allows access to manipulate objects at elevated surfaces [Rohde, Bonder et al 3, Moynahan, Mullin et al 6, Triolo, Bevelheimer et al 7] and significant assistance with seating transfers [Rohde, Bonder et al 3, Triolo, Bailey et al 4], it is also a mode of exercise that can offer significant therapeutic, physiological [Jaeger 8, Kobetic, Triolo et al 9, Marsolais and Kobetic 10] and psychosocial benefits over wheelchair use alone [Andrews and Wheeler 11]. …”

Section: - Overviewmentioning

confidence: 99%

Restoring standing capabilities with feedback control of functional neuromuscular stimulation following spinal cord injury

Nataraj

Audu

Triolo

2017

Medical Engineering & Physics

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This paper reviews the field of feedback control for neuroprosthesis systems that restore advanced standing function to individuals with spinal cord injury. Investigations into closed-loop control of standing by functional neuromuscular stimulation (FNS) have spanned three decades. The ultimate goal for FNS standing control systems is to facilitate hands free standing and enabling the user to perform manual functions at self-selected leaning positions. However, most clinical systems for home usage currently only provide basic upright standing using preprogrammed stimulation patterns. To date, online modulation of stimulation to produce advanced standing functions such as balance against postural disturbances or the ability to assume leaning postures have been limited to simulation and laboratory investigations. While great technological advances have been made in biomechanical sensing and interfaces for neuromuscular stimulation, further progress is still required for finer motor control by FNS. Another major challenge is the development of sophisticated control schemes that produce the necessary postural adjustments, adapt against accelerating muscle fatigue, and consider volitional actions of the intact upper-body of the user. Model-based development for novel control schemes are proven and sensible approaches to prototype and test the basic operating efficacy of potentially complex and multi-faceted control systems. The major considerations for further innovation of such systems are summarized in this paper prior to describing the evolution of closed-loop FNS control of standing from previous works. Finally, necessary emerging technologies to for implementing FNS feedback control systems for standing are identified. These technological advancements include novel electrodes that more completely and selectively activate paralyzed musculature and implantable sensors and stimulation modules for flexible neuroprosthesis system deployment.

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“…Walking is realized by the repeated execution of MT step to advance forward [5]- [10], [14], [24]. Only three groups have also investigated ascending or descending to or from an elevated level or climbing stairs [4], [30], [31].…”

Section: State Of the Artmentioning

confidence: 99%

Walking with WALK!

Fuhr¹,

Quintern

Riener

et al. 2008

IEEE Eng. Med. Biol. Mag.

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The goal of this paper is to design WALK! a cooperative, patient-driven neuroprosthetic (NP) system. In implementing sensor-supervised events to switch to subsequent medical prosthetics, NP users were able to actively control the timing of their movements. Performance and usability of WALK! was appreciated by the NP users because they were able to perceive the activities of the NP to actually support their movements. The future of NP will be based on fully implanted systems. To justify the high efforts, risks, and costs of an implantation to both NP users and health care providers, NPs have to offer true functionality that can only be achieved by a sophisticated and yet practicable control system. We believe that the WALK! control approach presented in this article can be considered a valuable contribution to the development of future neuroprosthetic systems for locomotion.

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Home use of a functional electrical stimulation system for standing and mobility in adolescents with spinal cord injury

Cited by 43 publications

References 22 publications

Home-based rehabilitation using a soft robotic hand glove device leads to improvement in hand function in people with chronic spinal cord injury:a pilot study

Home-based rehabilitation using a soft robotic hand glove device leads to improvement in hand function in people with chronic spinal cord injury:a pilot study

Restoring standing capabilities with feedback control of functional neuromuscular stimulation following spinal cord injury

Walking with WALK!

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