Implanted functional electrical stimulation hand system in adolescents with spinal injuries: an evaluation

Area of Science:

• Biomedical Engineering
• Rehabilitation Medicine
• Neuroscience

Background:

• Adolescents with tetraplegia often experience significant loss of hand function due to spinal cord injuries.
• Restoring grasp and release is crucial for improving independence and quality of life in this population.
• Existing assistive technologies have limitations in providing intuitive and effective hand control.

Purpose of the Study:

• To evaluate the effectiveness and functional benefits of an implanted functional electrical stimulation (FES) system for hand grasp and release.
• To assess the impact of FES combined with surgical reconstruction on hand function in adolescents with tetraplegia.
• To determine the level of independence and user preference for the FES system in activities of daily living.

Main Methods:

• An intervention study with a before-after trial design was conducted.
• Five adolescents (16-18 years) with C5-C6 tetraplegia underwent implantation of an FES hand system.
• Surgical reconstruction (tendon transfers, joint stabilization) was performed to augment FES function, followed by rehabilitation and training.

Main Results:

• Implanted FES system significantly increased lateral and palmar grasp forces (p = .043).
• FES enabled manipulation of heavy objects and increased independence in 25 of 30 assessed activities of daily living.
• 37 out of 40 electrodes maintained excellent function, and surgical procedures enhanced FES utility.

Conclusions:

• The combination of FES and surgical reconstruction successfully restored active grasp and release in adolescents with tetraplegia.
• The FES system demonstrated significant improvements in pinch force, object manipulation, and independence in ADLs.
• Adolescents generally preferred FES for most daily tasks, though further research is needed on real-world benefits.