Article

OBJECTIVE: To develop and apply an implanted neuroprosthesis to restore arm and
hand function to individuals with high level tetraplegia.
DESIGN: Case study.
SETTING: Clinical research laboratory. PARTICIPANTS: Individuals with spinal cord
injuries (N=2) at or above the C4 motor level. INTERVENTIONS:
The individuals
were each implanted with 2 stimulators (24 stimulation channels and 4 myoelectric
recording channels total). Stimulating electrodes were placed in the shoulder and
arm, being, to our knowledge, the first long-term application of spiral nerve
cuff electrodes to activate a human limb. Myoelectric recording electrodes were
placed in the head and neck areas. MAIN OUTCOME MEASURES: Successful installation
and operation of the neuroprosthesis and electrode performance, range of motion,
grasp strength, joint moments, and performance in activities of daily living.
RESULTS: The neuroprosthesis system was successfully implanted in both
individuals. Spiral nerve cuff electrodes were placed around upper extremity
nerves and activated the intended muscles. In both individuals, the
neuroprosthesis has functioned properly for at least 2.5 years postimplant. Hand,
wrist, forearm, elbow, and shoulder movements were achieved. A mobile arm support
was needed to support the mass of the arm during functional activities. One
individual was able to perform several activities of daily living with some
limitations as a result of spasticity. The second individual was able to
partially complete 2 activities of daily living. CONCLUSIONS: Functional
electrical stimulation is a feasible intervention for restoring arm and hand
functions to individuals with high tetraplegia. Forces and movements were
generated at the hand, wrist, elbow, and shoulder that allowed the performance of
activities of daily living, with some limitations requiring the use of a mobile
arm support to assist the stimulated shoulder forces.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS