Electrophysiological orthosis for the upper extremity in hemiplegia: feasibility study

A versatile two channel stimulator with cutaneous electrodes was designed and built to test the feasibility of multi-channel upper extremity functional electrical stimulation in hemiplegic patients. Preliminary experiments led to the choice of stimulation for hand opening (extensor carpi radialis and ulnaris, extensor digitorum communis) and elbow extension (triceps). Three channel stimulation including the deltoideus muscle was attempted successfully in one patient. Five of eight patients showed substantial improvement with the orthosis and three of these five showed some therapeutic effect over a period of two months. The stimulation was proportionally controlled by the patient by means of movement of the nonaffected shoulder. Functional tasks such as the shifting of an object between two specified areas on a desk were used for evaluation of performance. Tasks that were impossible without stimulation were easily performed with stimulation and after minimal training. The results obtained were significant for the functional rehabilitation of hemiplegic subjects. It is concluded that a more extensive clinical evaluation program including regular long term training of the subjects is justified.