Selectivity and resolution of surface electrical stimulation for grasp and release.

Electrical stimulation of arm and hand muscles can be a functional tool for patients with motor dysfunction. Sufficient stimulation of finger and thumb musculature can support natural grasping function. Yet it remains unclear how different grasping movements can be selectively supported by electrical stimulation. The goal of this study is to determine to what extent activation of individual fingers is possible with surface electrical stimulation for the purpose of rehabilitation following stroke. The extensor digitorum communis (EDC) muscle, flexor pollicis longus (FPL) muscle, and the thenar muscle group, all involved in grasp and release, were selected for stimulation. The evoked forces in individual fingers were measured. Stimulation thresholds and selective ranges were determined for each subject. Electrode locations where the highest selective range occurred were compared between subjects and influences of different isometric wrist positions were assessed. In all subjects selective stimulation of middle finger extension and thumb flexion was possible. In addition, selective stimulation of index and ring finger extension was possible in most cases. In nine out of the ten EDC subjects we were able to stimulate three or all four fingers selectively. However, large variability in electrode locations for high selectivity was observed between the subjects. Within the designs of grasping prostheses and grasping rehabilitation devices, the variability of electrode locations should be taken into account. The results of our study facilitate the optimization of such designs and favour a design which allows individualized stimulation locations.