Anelise Ventura1, João Marcos Peron Bataglia2, Gabriel Ginja1, Renato Varoto2,3, Alberto Cliquet4,5,6. 1. Bioengineering, University of São Paulo (USP), São Carlos, SP, Brazil. 2. Electrical & Computer Engineering Department, University of São Paulo (USP), São Carlos, SP, Brazil. 3. Orthopedics & Traumatology Department, Faculty of Medical Sciences, State University of Campinas (UNICAMP), São Carlos, SP, Brazil. 4. Bioengineering, University of São Paulo (USP), São Carlos, SP, Brazil. cliquet@usp.br. 5. Electrical & Computer Engineering Department, University of São Paulo (USP), São Carlos, SP, Brazil. cliquet@usp.br. 6. Orthopedics & Traumatology Department, Faculty of Medical Sciences, State University of Campinas (UNICAMP), São Carlos, SP, Brazil. cliquet@usp.br.
Abstract
STUDY DESIGN: Proof of concept. OBJECTIVES: Standard Functional Electrical Stimulation (FES) systems can enhance motor learning in people with tetraplegia and are widely delivered by self-adhesive electrodes. Their limitations are dexterity, specific knowledge to place the electrodes on muscles, need to fix electrodes when they lose the gel layer, and time. We designed a new FES system, using an existing protocol of drinking-like movements, to the upper limb of a person with tetraplegia C5 that fits in any anthropometry and can be easily produced. Furthermore, we tested the system to assess its effectiveness and users' perception during FES rehabilitation. SETTING: São Carlos, SP, Brazil. METHODS: A shell was designed with parametric design and fast-fabrication methods, and a stimulation unit and a smartphone application were developed. Questionnaires assessed the perceptions of a patient and a physiotherapist, about the usability of the new system in relation to standard FES. Kinematic data of drinking-like movements were collected from the patient wearing both systems and compared with data from an aged-matched control subject. RESULTS: The results are a personalized shell and an intuitive FES system, overcoming the limitations of standard FES. The new system suggested better wrist-flexion control shown by the mean angles (-18.93°), then the other system (-59.35°), and compared with the control (-10.97°). CONCLUSIONS: Fast-fabrication with parametric design offers a promising alternative for personalizing FES systems, with potential for home use. Further studies are required including randomized clinical trials.
STUDY DESIGN: Proof of concept. OBJECTIVES: Standard Functional Electrical Stimulation (FES) systems can enhance motor learning in people with tetraplegia and are widely delivered by self-adhesive electrodes. Their limitations are dexterity, specific knowledge to place the electrodes on muscles, need to fix electrodes when they lose the gel layer, and time. We designed a new FES system, using an existing protocol of drinking-like movements, to the upper limb of a person with tetraplegia C5 that fits in any anthropometry and can be easily produced. Furthermore, we tested the system to assess its effectiveness and users' perception during FES rehabilitation. SETTING: São Carlos, SP, Brazil. METHODS: A shell was designed with parametric design and fast-fabrication methods, and a stimulation unit and a smartphone application were developed. Questionnaires assessed the perceptions of a patient and a physiotherapist, about the usability of the new system in relation to standard FES. Kinematic data of drinking-like movements were collected from the patient wearing both systems and compared with data from an aged-matched control subject. RESULTS: The results are a personalized shell and an intuitive FES system, overcoming the limitations of standard FES. The new system suggested better wrist-flexion control shown by the mean angles (-18.93°), then the other system (-59.35°), and compared with the control (-10.97°). CONCLUSIONS: Fast-fabrication with parametric design offers a promising alternative for personalizing FES systems, with potential for home use. Further studies are required including randomized clinical trials.
Authors: Andrei Patriciu; Ken Yoshida; Johannes J Struijk; Tim P DeMonte; Michael L G Joy; Hans Stødkilde-Jørgensen Journal: IEEE Trans Biomed Eng Date: 2005-12 Impact factor: 4.538
Authors: Milos R Popovic; Naaz Kapadia; Vera Zivanovic; Julio C Furlan; B Cathy Craven; Colleen McGillivray Journal: Neurorehabil Neural Repair Date: 2011-02-08 Impact factor: 3.919
Authors: Petra Palanova; Veronika Mrkvicova; Marta Nedbalkova; Michaela Sosikova; Petr Konecny; Jiri Jarkovsky; Emmanuel Marques; Marie Novakova; Michal Pohanka; Miroslav Soucek; Petr Dobsak Journal: Artif Organs Date: 2019-02-11 Impact factor: 3.094
Authors: Enio Walker Azevedo Cacho; Roberta de Oliveira; Rodrigo L Ortolan; Renato Varoto; Alberto Cliquet Journal: Int J Rehabil Res Date: 2011-03 Impact factor: 1.479