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Persons with C5 or C6 tetraplegia achieve selected functional gains using a neuroprosthesis
1Department of Physical Therapy, University of Maryland, School of Medicine, Baltimore, MD 21201-1082, USA. galon@som.umaryland.edu
Objective:
To test the efficacy and safety of the NESS Handmaster neuroprosthesis with subjects with C5 or C6 tetraplegia.
Design:
Interventional, nonrandomized case series.
Setting:
Subjects' residence and university research laboratory.
Participants:
Men, 3 to 17 years after C5 (n=5) and C6 (n=2) spinal cord injury (SCI).
Intervention:
Subjects practiced with the neuroprosthesis daily to regain grasp, hold, and release ability and to restore selected functions of 1 of the 2 paralyzed hands. Subjects were observed 2 to 3 times weekly for 3 weeks.
Main Outcome Measures:
Three activities of daily living (ADL) tasks: (1) pick up a telephone, (2) eat food with a fork, and (3) perform 1 individually selected ADL task and 2 grasp, hold, and release tasks (lift a videocassette, lift a 150-g weight). Secondary outcomes were grip strength, electrically induced finger motion, and Fugl-Meyer spherical grasp. Nonparametric data were analyzed with the Wilcoxon signed-rank test, and parametric data (grip strength and finger motion) were analyzed by analysis of variance. All tests were considered significant at P equal to.01.
Results:
At study completion, all 7 subjects were 100% successful at using the Handmaster in the studied ADL and grasp, hold, and release tasks. Significant improvements occurred in grip strength (from.57+/-.98N at baseline to 16.5+/-4.4N), finger linear motion (from 0.0cm at baseline to 8.4+/-3.2cm), and Fugl-Meyer scores. No safety issues were encountered. Six of 7 subjects rated their overall performance as "excellent."
Conclusions:
The Handmaster is a safe, noninvasive neuroprosthesis that improves hand function of selected subjects with C5 or C6 SCI.