Journal of Rehabilitation Research & Development (JRRD)

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Volume 49 Number 10, 2012
   Pages 1505 — 1516

Abstract — Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study

Jayme S. Knutson, PhD;1–4* John Chae, MD;1–4 Ronald L. Hart, MS;3,5 Michael W. Keith, MD;1,3,5–6 Harry A. Hoyen, MD;3,5–6 Mary Y. Harley, OTR/L;4 Terri Z. Hisel, OTR/L;4 Anne M. Bryden, OTR/L;3,5 Kevin L. Kilgore, PhD;1,3,5–6 Hunter Peckham, PhD1,3,5–6

1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH; 2Physical Medicine and Rehabilitation, Case Western Reserve University, Cleveland, OH; 3Center of Excellence in Functional Electrical Stimulation, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; 4Physical Medicine and Rehabilitation, MetroHealth Medical Center, Cleveland, OH; 5Orthopedics, MetroHealth Medical Center, Cleveland, OH; 6Orthopedics, Case Western Reserve University, Cleveland, OH

Abstract–Loss of arm and hand function is common after stroke. An implantable, 12-channel, electromyogram (EMG)-controlled functional electrical stimulation neuroprosthesis (NP) may be a viable assistive device for upper-limb hemiplegia. In this study, a research participant 4.8 yr poststroke underwent presurgical screening, surgical installation of the NP, training, and assessment of upper-limb impairment, activity limitation, and satisfaction over a 2.3 yr period. The NP increased active range of finger extension from 3 to 96 degrees, increased lateral pinch force from 16 to 29 N, increased the number of objects from 1 to 4 out of 6 that the participant could grasp and place in a Grasp-Release Test, and increased the Arm Motor Abilities Test score by 0.3 points. The upper-limb Fugl-Meyer score increased from 27 at baseline to 36 by the end of the study. The participant reported using the NP at home 3–4 d/wk, up to 3 h/d for exercise and household tasks. The effectiveness of the NP to assist with activities of daily living was dependent on the degree of flexor tone, which varied with task and level of fatigue. The EMG-based control strategy was not successfully implemented; button presses were used instead. Further advancements in technology may improve ease of use and address limitations caused by muscle spasticity.

Key words: assistive device, FES, functional electrical stimulation, hemiplegia, implant, medical device, neuroprosthesis, rehabilitation, stroke rehabilitation, upper limb.


View HTML  ¦  View PDF  ¦  Contents Vol. 49, No. 10
This article and any supplemental material should be cited as follows:
Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):1505–16.
http://dx.doi.org/10.1682/JRRD.2011.09.0171
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Last Reviewed or Updated  Wednesday, February 13, 2013 2:35 PM

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