using healthy muscles to control electrical implants to stimulate muscles

[JCampbell]

I'm a C5C6 incomplete. I have the typical function of a C6, as well as excellent movement of my left foot and toes ( why couldn't it be my fingers!)

Lately I've been wondering if there is any research or current medical solutions that would allow me to use my foot to activate electrical stimulation that would open and close one of my hands. I think I read somewhere that the future involves rerouting nerves and that they are doing trials in China. In the meantime, I'm just wondering if there is anything out there like what I describe.

If anyone knows of anything, I'd appreciate it.

[wildwilly]

I think it is definitely a possibility but I'm not sure what the plastic effects would be on your motor cortex in the long term (what would happen to the area that represents your wrist, fingers...). Here are a few abstracts that look at the application of functional electrical stimulation.

Spinal Cord. 2004 Mar;42(3):146-55.

Implantation of the Freehand System during initial rehabilitation using minimally invasive techniques.

Mulcahey MJ, Betz RR, Kozin SH, Smith BT, Hutchinson D, Lutz C.

Shriners Hospitals for Children, Philadelphia, PA 19140, USA.

STUDY DESIGN: Series of four single subjects with and without intervention design. OBJECTIVES: To describe a minimally invasive surgical technique used to implant the Freehand System during initial spinal cord injury (SCI) rehabilitation and to report rehabilitation outcomes of four recently injured adolescents using the Freehand System. SETTING: Nonprofit children's hospital specializing in orthopedic and SCI care. METHODS: Four subjects with C5 tetraplegia between 13 and 16 years of age and between 9 and 16 weeks following traumatic SCI underwent implantation of the Freehand System using minimally invasive surgical techniques. Outcomes on muscle strength, pinch force, hand function, performance of activities of daily living and satisfaction with and without the Freehand System were collected. RESULTS: Each subject was successfully implanted with the Freehand System without perioperative complications and employed the Freehand System during therapy services and ad lib on the rehabilitation floor. At the last follow-up, every subject remained a motor candidate for the Freehand System. With the Freehand System, average lateral and palmar pinch force was 1.8 and 1.6 kg respectively; average pinch force without functional electrical stimulation (FES) was 0.29 kg. With the Freehand System, three subjects improved their rate of performance on The Upper Extremity Capabilities Questionnaire. All subjects increased their level of independence on The Quadriplegia Index of Function. On the Canadian Occupational Performance Measure (COPM) with the Freehand System, average performance and satisfaction scores improved for every patient. Three of the four subjects continued to use the system at home. CONCLUSION: This case series demonstrates that the Freehand System can vastly improve hand function and performance of rehabilitation activities within days after a minimally invasive implant procedure during initial SCI rehabilitation. Satisfaction with the Freehand System beyond initial rehabilitation is evidenced by continued use at home.

http://www.ncbi.nlm.nih.gov/pubmed/15001979?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=4&log$=relatedarticles& logdbfrom=pubmed



Med Eng Phys. 2003 Jan;25(1):29-40.

Biopotentials as command and feedback signals in functional electrical stimulation systems.

Sinkjaer T, Haugland M, Inmann A, Hansen M, Nielsen KD.

Center for Sensory-Motor Interaction, Aalborg University, Fredrik Bajers Vej 7D-3, DK-9220 Aalborg, Denmark. ts@smi.auc.dk

Today Functional Electrical Stimulation (FES) is available as a clinical tool in muscle activation used for picking up objects, for standing and walking, for controlling bladder emptying, and for breathing. Despite substantial progress in development and new knowledge, many challenges remain to be resolved to provide a more efficient functionality of FES systems. The most important task of these challenges is to improve control of the activated muscles through open loop or feedback systems. Command and feedback signals can be extracted from biopotentials recorded from muscles (Electromyogram, EMG), nerves (Electroneurogram, ENG), and the brain (Electroencephalogram (EEG) or individual cells). This paper reviews work in which EMG, ENG, and EEG signals in humans have been used as command and feedback signals in systems using electrical stimulation of motor nerves to restore movements after an injury to the Central Nervous System (CNS). It is concluded that the technology is ready to push for more substantial clinical FES investigations in applying muscle and nerve signals. Brain-computer interface systems hold great prospects, but require further development of faster and clinically more acceptable technologies.

http://www.ncbi.nlm.nih.gov/pubmed/1...ubmed_RVDocSum


Med Eng Phys. 2004 Jul;26(6):449-58.

Implementation of natural sensory feedback in a portable control system for a hand grasp neuroprosthesis.

Inmann A, Haugland M.

Center for Sensory-Motor Interaction, Aalborg University, Denmark. andreas.inmann@advancedbionics.com

This paper presents the design and implementation of the first generation of a portable system for a hand grasp neuroprosthesis that is controlled by means of signals from natural sensors in the skin of the index finger. To reduce development time and costs, we based our design on readily available, standardised modules such as a 486DX100 compatible CPU, a data acquisition board, a flash disk storage unit, and a high-efficiency DC/DC switch-mode power supply. Additionally, we designed and built a telemeter to supply an implanted muscle stimulator with power and control data. The signal from the natural sensors was recorded with a cuff electrode implanted around the palmar digital nerve innervating the radial aspect of the index finger. For amplification of the recorded nerve signal, we added an external low-noise nerve signal amplifier. For pre-processing of the recorded nerve signal, an optimised band-pass filter was used. A data-recording unit allowed storage and off-line analysis of the stimulator command and the recorded nerve signal. The portable system was used by a tetraplegic volunteer to test the feasibility of including natural sensors in a hand grasp neuroprosthesis for activities of daily living. The flexibility of the presented system allows rapid prototyping of experimental FES hand grasp systems intended for portable use.

http://www.ncbi.nlm.nih.gov/pubmed/15234681?ordinalpos=1&itool=EntrezSystem2.PEntrez. Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.P ubmed_Discovery_RA&linkpos=5&log$=relatedarticles& logdbfrom=pubmed