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Case Reports
. 2012;49(10):1505-16.
doi: 10.1682/jrrd.2011.09.0171.

Implanted neuroprosthesis for assisting arm and hand function after stroke: a case study

Jayme S Knutson  1 , John Chae, Ronald L Hart, Michael W Keith, Harry A Hoyen, Mary Y Harley, Terri Z Hisel, Anne M Bryden, Kevin L Kilgore, Hunter Peckham
Affiliations
Case Reports

Implanted neuroprosthesis for assisting arm and hand function after stroke: a case study

Jayme S Knutson et al. J Rehabil Res Dev. 2012.

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.

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Figures

Figure 1
Figure 1
Surgical Plan
Figure 2
Figure 2
Participant using the NP at home for meal preparation (a) and gardening tasks (b). NP allows impaired (left) hand to be used as an effective support to allow bimanual tasks that were not otherwise possible.
Figure 2
Figure 2
Participant using the NP at home for meal preparation (a) and gardening tasks (b). NP allows impaired (left) hand to be used as an effective support to allow bimanual tasks that were not otherwise possible.
See this image and copyright information in PMC

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