Tetraplegia-An Implanted Neuroprosthesis for Restoring Arm and Hand Function in People with High Level Tetraplegia

An Implanted Neuroprosthesis for Restoring Arm and Hand Function in People with High Level Tetraplegia

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Researchers at Case Western Reserve University and the Veterans Affairs Medical Center have successfully developed an implanted neuroprosthesis to restore arm and hand function in people with high level tetraplegia. The neuroprosthesis system consists of two implanted stimulators, each with 12 channels of stimulation and 2 EMG recording channels. Spiral nerve cuff electrodes were also used to activate upper extremity nerves and intended muscles. The system was successfully implanted in two individuals and has functioned properly for at least 2.5 years post-implant. The participants were able to achieve movements in the hand, wrist, forearm, elbow, and shoulder, however, a mobile arm support was needed to assist the stimulated shoulder forces. The researchers found that functional electrical stimulation is a feasible intervention for restoring arm and hand functions to individuals with high tetraplegia. The implanted neuroprosthesis system demonstrated selectivity in muscle activation and was more easily donned and maintained than surface or percutaneous systems. The subjects were able to use the implanted EMG electrodes for proportional and state control of joint movements at the hand, wrist, forearm, elbow, and shoulder. Although there were limitations in the clinical impact for these two subjects, further development and refinement of the neuroprosthesis system could potentially lead to improved functional outcomes for individuals with high tetraplegia.

Keywords

implanted neuroprosthesis

arm and hand function

high level tetraplegia

stimulators

EMG recording channels

spiral nerve cuff electrodes

upper extremity nerves

functional electrical stimulation

muscle activation

implanted EMG electrodes