Patient selection for an upper extremity neuroprosthesis in tetraplegic individuals

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Traumatic tetraplegia presents significant upper extremity functional limitations.
• Neuroprosthetic devices offer potential for restoring grasp function in individuals with spinal cord injuries.

Purpose of the Study:

• To determine the eligibility of new-onset traumatic tetraplegia patients for an upper extremity neuroprosthesis.
• To estimate the potential number of candidates for a functional electrical stimulation (FES) hand grasp system.

Main Methods:

• Screening of 120 consecutive new-onset traumatic tetraplegia patients admitted to a rehabilitation service.
• Application of strict inclusion criteria: ASIA impairment scale A, B, or C injuries at the C5 or C6 level.
• Exclusion criteria included various neurological syndromes, injury levels, denervation, medical, and psychosocial factors.

Main Results:

• 106 patients were excluded, with the most common reasons being injury level (54 patients) and central cord syndrome (27 patients).
• 14 patients (11.7% of all tetraplegic individuals) met the strict inclusion criteria.
• This represents 50% of patients with C5 or C6 ASIA Impairment Scale A, B, or C injuries.

Conclusions:

• Under current protocols, approximately 12,200 Americans with tetraplegia could be candidates for the FES neuroprosthetic hand grasp system.
• Expansion of protocols and further research may increase the applicability of this neuroprosthesis to a larger population.
• This technology holds promise for improving hand function and independence in individuals with spinal cord injuries.