Functional Rehabilitation of the Paralyzed Upper Extremity After Spinal Cord Injury by Noninvasive Hybrid Neuroprostheses

Abstract

For individuals with high spinal cord injury (SCI), restoring missing grasping function is a high priority. Neuroprostheses based on functional electrical stimulation (FES) can partly compensate the loss of upper extremity function in people suffering from tetraplegia. With noninvasive, multichannel neuroprostheses a pinch and power grasp can be accomplished for everyday use. Hybrid systems combining FES with active orthoses hold promise for restoring a completely lost arm function. Novel control interfaces are needed to make full use of the many degrees of freedom of complex hybrid neuroprostheses. Motor imagery (MI)-based brain-computer interfaces (BCIs) are an emerging technology that may serve as a valuable adjunct to traditional control interfaces for neuroprosthetic control. Shared control and context-specific autonomy are most effective for reducing the users' workload. The modularity of upper extremity neuroprostheses as well as their associated control interfaces enable customization of the systems to adapt to the impairment and needs of each individual end user. This work provides an overview of the application of noninvasive hybrid BCI-controlled upper extremity neuroprostheses in individuals with high SCI with a strong focus on the results from the European Integrated Project Tools for Brain-Computer Interaction and will describe the challenges and promises for the future.