Review of devices used in neuromuscular electrical stimulation for stroke rehabilitation

Abstract

Neuromuscular electrical stimulation (NMES), specifically functional electrical stimulation (FES) that compensates for voluntary motion, and therapeutic electrical stimulation (TES) aimed at muscle strengthening and recovery from paralysis are widely used in stroke rehabilitation. The electrical stimulation of muscle contraction should be synchronized with intended motion to restore paralysis. Therefore, NMES devices, which monitor electromyogram (EMG) or electroencephalogram (EEG) changes with motor intention and use them as a trigger, have been developed. Devices that modify the current intensity of NMES, based on EMG or EEG, have also been proposed. Given the diversity in devices and stimulation methods of NMES, the aim of the current review was to introduce some commercial FES and TES devices and application methods, which depend on the condition of the patient with stroke, including the degree of paralysis.

Rewiring the Lesioned Brain: Electrical Stimulation for Post-Stroke Motor Restoration

“…Neuromuscular electrical stimulation (NMES) has mainly two forms in motor rehabilitation after stroke, particularly, functional electrical stimulation (FES) has been used to facilitate voluntary movement, while therapeutic electrical stimulation was used for strengthening muscle, reducing spasticity, and inducing motor recovery in paralyzed stroke patients. 13,19 Transcutaneous electrical nerve stimulation (TENS) on the nerves also enhanced neural motor control and paretic limb functions in stroke subjects. 100…”

“…It generates muscle contractions through the skin surface, percutaneous or implanted electrodes. 13 Typical NMES parameters include the pulse frequency (10 to 100 Hz), amplitude (10 to 120 ms), and pulse width (200 µs to 1 ms). NMES of higher frequencies generates larger forces, but quickly leads to muscle fatigue and fast reduction of contraction force.…”

“…Post-stroke motor restoration is challenging due to genetic, pathophysiologic, sociodemographic, and other clinical factors. 13 Hence, manipulating related neural circuits and rewiring the lesioned brain might be critical factors for post-stroke motor recovery. In 1949, neuropsychologist Donald Hebb 14 proposed the rule that "Neurons that fire together, wire together."…”

Electrotactile Feedback in a Virtual Hand Rehabilitation Platform: Evaluation and Implementation

“…Also, the clinical applications of tactile feedback in rehabilitation are still limited, although some efforts have been devoted to the device development and exploring the impact of tactile feedback [22] [23]. Few of the commercial hand prostheses provide tactile feedback, neither the rehabilitation system for their users.…”

Functional Neurorehabilitation using the Hybrid Assistive Limb (HAL): A First Experience in the United States

“…The generally accepted timeframe for plateauing after functional interventions is three months [1][2][3][4].…”