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An implanted upper-extremity neuroprosthesis using myoelectric control.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Kilgore, Kevin L. Hoyen, Harry A. Bryden, Anne M. Hart, Ronald L. Keith, Michael W. Peckham, P. Hunter
Description	Country affiliation: United States Author Affiliation: Kilgore KL ( MetroHealth Medical Center, Cleveland, OH, USA. klk4@case.edu)
Abstract	PURPOSE: The purpose of this study was to evaluate the potential of a second-generation implantable neuroprosthesis that provides improved control of hand grasp and elbow extension for individuals with cervical level spinal cord injury. The key feature of this system is that users control their stimulated function through electromyographic (EMG) signals. METHODS: The second-generation neuroprosthesis consists of 12 stimulating electrodes, 2 EMG signal recording electrodes, an implanted stimulator-telemeter device, an external control unit, and a transmit/receive coil. The system was implanted in a single surgical procedure. Functional outcomes for each subject were evaluated in the domains of body functions and structures, activity performance, and societal participation. RESULTS: Three individuals with C5/C6 spinal cord injury received system implantation with subsequent prospective evaluation for a minimum of 2 years. All 3 subjects demonstrated that EMG signals can be recorded from voluntary muscles in the presence of electrical stimulation of nearby muscles. Significantly increased pinch force and grasp function was achieved for each subject. Functional evaluation demonstrated improvement in at least 5 activities of daily living using the Activities of Daily Living Abilities Test. Each subject was able to use the device at home. There were no system failures. Two of 6 EMG electrodes required surgical revision because of suboptimal location of the recording electrodes. CONCLUSIONS: These results indicate that a neuroprosthesis with implanted myoelectric control is an effective method for restoring hand function in midcervical level spinal cord injury.
File Format	HTM / HTML
ISSN	03635023
e-ISSN	15316564
DOI	10.1016/j.jhsa.2008.01.007
Journal	The Journal of Hand Surgery
Issue Number	4
Volume Number	33
Language	English
Publisher	Elsevier
Publisher Date	2008-04-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Discipline Surgery Artificial Limbs Physiopathology Prosthesis Design Quadriplegia Rehabilitation Recovery Of Function Physiology Spinal Cord Injuries Complications Activities Of Daily Living Cervical Vertebrae Cohort Studies Electrodes, Implanted Electromyography Hand Strength Etiology Clinical Trial Research Support, N.i.h., Extramural Research Support, U.s. Gov't, Non-p.h.s. Research Support, U.s. Gov't, P.h.s.
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery

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