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Efficacy of an implanted neuroprosthesis for restoring hand grasp in tetraplegia: A multicenter study
Abstract
Objective To evaluate an implanted neuroprosthesis that allows tetraplegic users to control grasp and release in 1 hand.Design Multicenter cohort trial with at least 3 years of follow-up. Function for each participant was compared before and after implantation, and with and without the neuroprosthesis activated.Setting Tertiary spinal cord injury (SCI) care centers, 8 in the United States, 1 in the United Kingdom, and 1 in Australia.Participants Fifty-one tetraplegic adults with C5 or C6 SCIs.Intervention An implanted neuroprosthetic system, in which electric stimulation of the grasping muscles of 1 arm are controlled by using contralateral shoulder movements, and concurrent tendon transfer surgery. Assessed participants' ability to grasp, move, and release standardized objects; degree of assistance required to perform activities of daily living (ADLs), device usage; and user satisfaction.Main outcome measures Pinch force; grasp and release tests; ADL abilities test and ADL assessment test; and user satisfaction survey.Results Pinch force was significantly greater with the neuroprosthesis in all available 50 participants, and grasp-release abilities were improved in 49. All tested participants (49/49) were more independent in performing ADLs with the neuroprosthesis than they were without it. Home use of the device for regular function and exercise was reported by over 90% of the participants, and satisfaction with the neuroprosthesis was high.Conclusions The grasping ability provided by the neuroprosthesis is substantial and lasting. The neuroprosthesis is safe, well accepted by users, and offers improved independence for a population without comparable alternatives.
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“It has been found suitable and reliable in both upper and lower extremity applications in various clinical studies [27, 28].”
From Interfaces with the peripheral nervous system for the control of a neuroprosthetic limb: a review (2020) · cites this paper as [27]
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“Though the technology was highly advanced and many recipients benefited significantly (225), the device was discontinued in 2002 (see Barriers section).”
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Rizzoglio, F., Altan, E., Ma, X., Bodkin, K. L., Dekleva, B. M., Solla, S. A., Kennedy, A., & Miller, L. E. (2023) · Journal of Neural Engineering · doi:10.1088/1741-2552/ad038e · Cited by 12
“…to improve stance and walking (Granat et al 1993, Thrasher et al 2006, Daly et al 2011) as well as grasping (Peckham et al 1980, Snoek et al 2000, Peckham et al 2001, Popovic et al 2002) following stroke or SCI. Patients with C5-C6 SCI were able to use their preserved voluntary shoulder…”
BackgroundOttoboni, G., Porta, F. L., Piperno, R., Chattat, R., Bosco, A., Fattori, P., & Tessari, A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0266702 · Cited by 11
STIMGRASP: A Home-Based Functional Electrical Stimulator for Grasp Restoration in Daily Activities
Barelli, R. G., Avelino, V. F., & Castro, M. C. F. (2022) · Sensors · doi:10.3390/s23010010 · Cited by 8
Sammut, S., Koh, R. G. L., & Zariffa, J. (2021) · Sensors · doi:10.3390/s21020506 · Cited by 9
Fattal, C., Teissier, J., Geffrier, A., da Fonseca, L. O., William, L., Andreu, D., Guiraud, D., & Coste, C. (2022) · Journal of Neurotrauma · doi:10.1089/neu.2021.0381 · Cited by 11
“In addition, it requires less energy, considerably decreases the number of implanted parts, and reduces the risk of complications 15 (infection, failure, and surgical risk through less invasive surgery).”
Sensors for motor neuroprostheses
Kilgore, K. (2013) · Elsevier eBooks · doi:10.1533/9780857096289.3.401 · Cited by 5
Self-citationExploring selective neural electrical stimulation for upper limb function restoration
Tigra, W., Guiraud, D., Andreu, D., Coulet, B., Gélis, A., Fattal, C., Maciejasz, P., Picq, C. A., Rossel, O., Teissier, J., et al. (2016) · European Journal of Translational Myology · doi:10.4081/ejtm.2016.6035 · Cited by 8
“Moving paralyzed limbs after such trauma becomes possible [5]–[9].”
Neural Interfaces for Implanted Stimulators
Liu, X., Demosthenous, A., & Donaldson, N. (2011) · Springer eBooks · doi:10.1007/978-3-540-74658-4_37 · Cited by 8
Nason, S. R., Mender, M. J., Kennedy, E., Lambrecht, J. M., Kilgore, K. L., Chiravuri, S., Kumar, N. G., Kung, T. A., Willsey, M. S., Chestek, C. A., et al. (2023) · Journal of Neural Engineering · doi:10.1088/1741-2552/accf36 · Cited by 10
“By delivering electrical current to partially or completely non-functional musculature, commercial devices like the Freehand System [7, 8] have already been used with people with upper extremity paralysis to restore movement of native arms and hands.”
MethodSelf-citationBrain-machine interfaces for motor rehabilitation: Is recalibration important?
López-Larraz, E., Trincado-Alonso, F., & Montesano, L. (2015) · International Conference on Rehabilitation Robotics · doi:10.1109/icorr.2015.7281203 · Cited by 11
“Different studies have successfully applied such devices for rehabilitation of paralyzed patients with spinal cord injury (SCI) or stroke [1], [2], [3].”
The impact of task context on predicting finger movements in a brain-machine interface
Mender, M. J., Nason, S. R., Temmar, H., Costello, J. T., Wallace, D. M., Willsey, M. S., Kumar, N. G., Kung, T. A., Patil, P. G., & Chestek, C. A. (2023) · eLife · doi:10.7554/elife.82598 · Cited by 7
Kleih, S. C., Lukito, S., & Kübler, A. (2012) · Ergonomics design and management · doi:10.1201/b13019-12 · Cited by 7
Orlin, M. N., Pierce, S. R., Laughton, C. A., Smith, B. T., Johnston, T. E., Shewokis, P. A., & McCarthy, J. J. (2007) · Developmental Medicine & Child Neurology · doi:10.1111/j.1469-8749.2005.tb01054.x · Cited by 7
Percutaneous Freehand™ System Intramuscular Electrode Placement
Hausman, M. R., & Masters, J. (2002) · Journal of Hand Surgery (European Volume) · doi:10.1054/jhsb.2002.0775 · Cited by 7
“Restoration of grasp and pinch profoundly improve the prospects for gainful employment and independence in critical tasks such as grooming, catheter maintenance and simple food preparation (Freehafer, 1998; Hashizume and Fukuji, 1994; Kiyono et al., 2000; Lo et al., 1998; Peckham et al., 2001).”
BackgroundFunctional electrical stimulation in neurorehabilitation
Gorman, P. H., Alon, G., & Peckham, P. H. (2006) · Cambridge University Press eBooks · doi:10.1017/cbo9780511545078.011 · Cited by 7
Self-citationDevelopment of less invasive neuromuscular electrical stimulation model for motor therapy in rodents
Kanchiku, T., Kato, Y., Suzuki, H., Imajo, Y., Yoshida, Y., Moriya, A., Taguchi, T., & Jung, R. (2012) · Journal of Spinal Cord Medicine · doi:10.1179/2045772312y.0000000009 · Cited by 6
Anderson, K. D., Bryden, A. M., & Moynahan, M. (2019) · Spinal Cord Series and Cases · doi:10.1038/s41394-019-0213-9 · Cited by 6
Rehabilitation in spinal cord injury
Cardenas, D. D., & Warms, C. A. (2006) · Cambridge University Press eBooks · doi:10.1017/cbo9780511545078.039 · Cited by 6
Cramer, S. C., & Nudo, R. J. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511777547.017 · Cited by 6
Flexible adaptation to an artificial recurrent connection from muscle to peripheral nerve in man
Kato, K. H., Sasada, S., & Nishimura, Y. (2015) · Journal of Neurophysiology · doi:10.1152/jn.00143.2015 · Cited by 6
“…FES systems, the patient uses switches (Brandell 1982, Burridge et al. 1997) or muscle activity (Frigo et al. 2000; Muraoka 2002; O’Keeffe and Lyons 2002; Peckham et al. 2001; Popovic et al. 2001) to trigger preprogrammed patterned stimulation of paralyzed muscles to produce stereotyped movements.”
Backgroundda Fonseca, L. O., Bó, A. P. L., Guiraud, D., Navarro, B., Gélis, A., & Coste, C. (2018) · Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC) · doi:10.1109/embc.2018.8513418 · Cited by 6
Klein, C. S., Liu, H., Zhao, C. N., & Yang, X. (2021) · Spinal Cord · doi:10.1038/s41393-021-00653-1 · Cited by 6
Lyapunov-based Model Predictive Control of an Input Delayed Functional Electrical Simulation
Sun, Z., Bao, X., & Sharma, N. (2019) · IFAC-PapersOnLine · doi:10.1016/j.ifacol.2019.01.037 · Cited by 6
Functional Electrical Stimulation
Venkatasubramanian, G., Jung, R., & Sweeney, J. (2006) · Wiley eBooks · doi:10.1002/0471732877.emd119 · Cited by 6
NEW-GENERATION FULLY PROGRAMMABLE CONTROLLER FOR FUNCTIONAL ELECTRICAL STIMULATION APPLICATIONS
Agnello, D. (2011) · TSpace (University of Toronto) · Cited by 6
Impaired Motor Function: Functional Electrical Stimulation
(2012) · Springer eBooks · doi:10.1007/springerreference_143732 · Cited by 6
Abreu, J., Crowder, D. C., & Kirsch, R. F. (2023) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2023.3285983 · Cited by 5
Metadata
- Authors
- Peckham, P. H., Keith, M. W., Kilgore, K. L., Grill, J. H., Wuolle, K. S., Thrope, G. B., Gorman, P., Hobby, J., Mulcahey, M. J., Carroll, S., Hentz, V. R., & Wiegner, A.
- Affiliations
- The University of Melbourne (AU)
- United States Department of Veterans Affairs (US)
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2001-10
- Volume
- 82
- Issue
- 10
- Pages
- 1380-1388
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2044493647
- Cited by
- 319
- References
- 36
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 6 · 2023: 14 · 2022: 14 · 2021: 12 · 2020: 14 · 2019: 22 · 2018: 16 · 2017: 12 · 2016: 13 · 2015: 11 · 2014: 19 · 2013: 9 · 2012: 13
- FWCI
- 9.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Center for Research Resources (M01RR000080, 5M01RR 00080)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Spinal Cord Injury Research
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neural Engineering
- Keywords
- tetraplegia, spinal cord injury, hand grasp, grasp and release, tendon transfer, pinch strength, activities of daily living, user satisfaction, upper limb prosthesis
- MeSH terms
- Adult, Electric Stimulation, Electrodes, Implanted, Female, Follow-Up Studies, Hand, Humans, Male, Prosthesis Design, Quadriplegia, Cohort Studies, Hand Strength, Prostheses and Implants
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