Intention-driven functional electrical stimulation therapy using a wearable high-density electrode sleeve in chronic stroke: a case report
Abstract
Background: Functional electrical stimulation (FES) has been recognized for decades as a method to retrain the motor system after stroke. Benefits of FES rehabilitation can be enhanced by (1) combining FES with task-oriented therapy (i.e. FES therapy (FEST)), (2) timing FES with the user's volitional motor intention and (3) incorporating multiple trained tasks, as opposed to high repetitions of single tasks. Using a novel wearable FES technology, we tested therapy incorporating these elements in two chronic stroke survivors.
Methods: Our group has developed the NeuroLife Sleeve, a wearable forearm sleeve that contains a high-density grid of embedded FES electrodes, that may be controlled by an operator or by the wearer's own electromyographic (EMG) signals. The system enables rapid software-based switching between stimulation configurations for different functional movements without repeated electrode repositioning. During eight weeks of FEST, intention-driven FES enabling multiple movements was delivered via operator control twice weekly and EMG control once weekly.
Results: At the end of the therapy period, subjects A and B had both improved their scores: Box and Blocks Test (A: +5, B: +7), the Action Research Arm Test (A: +7, B: +12), the Fugl Meyer Upper Extremity section (A: +11, B: +9), and the 9-Hole Peg Test (A: 158 s, B: 54 s, both previously unable). Clinical improvements persisted during the 10-week follow-up period, during which FES exposure was reduced by more…
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