Critical Reviews™ in Physical and Rehabilitation Medicine

ISSN for PRINT: 0896-2960

For Online Access

2000, Volume12

Issue 1

96 pages

Issue price - $163.00

John Chae, M.D.
Center for Physical Medicine and Rehabilitation, Case Western Reserve University, and Department of Physical Medicine and Rehabilitation, Rehabilitation Engineering Center, Department of Orthopedics, Metrohealth Medical Center, Cleveland, OH

Kevin Kilgore
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH; Rehabilitation Engineering Center, Department of Orthopedics, MetroHealth Medical Center, Cleveland, OH

Ronald Triolo
Dept. of Orthopedics, Dept. of Biomedical Engineering, Case Western Reserve University, Cleveland; Rehabilitation Engineering Center, Dept. of Orthopedics, MetroHealth Medical Center, Cleveland; Cleveland Veterans Affairs Medical Center, Cleveland, OH

David Yu, M.D.
Dept.of Rehabilitation Medicine,University of Washington; Harborview Medical Center,Seattle,WA;Center for Physical Medicine and Rehabilitation,Case Western Reserve University,Dept.of Orthopedics,MetroHealth Medical Center,Cleveland,OH

Functional neuromuscular stimulation (FNS) is defined as the use of electrical stimulation to activate paralyzed or paretic muscles in precise sequence and intensity to assist in the performance of activities of daily living (ADL). Devices or systems that provide FNS are also appropriately called neuroprostheses because they substitute for lost muscle function due to paralysis. The focus of this article is to review the development of neuroprostheses systems for hemiplegia. The physiology of neuromuscular stimulation and the evolution of FNS system components and designs are reviewed. The clinical implementation of FNS for the hemiplegia population will be discussed with respect to upper and lower extremity applications. Clinically deployed hand neuroprostheses systems are now available for the tetraplegia population. Thus, it is reasonable to transfer this technology to the hemiplegia population. However, the development of hand neuroprostheses in hemiplegia has been hampered by the significant differences in motor control dysfunction and functional specifications between hemiplegia and tetraplegia. Lower extremity neuroprostheses for the spinal cord injury population has been under development for decades with limited clinical deployment. However, due to the less rigorous technical demands and potential for significant functional yield, the development of lower extremity neuroprostheses systems for hemiplegia should be more aggressively pursued. Perspectives on the future developments and directions are presented.

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