Stimulation for Return of Upper and Lower Extremity Function

TLDR: The implanted motor neuroprosthetic systems have been shown to restore function that cannot be obtained through any other means, and can also improve health and quality of life due to the benefits of muscle conditioning, exercise, and joint movement.

Abstract: Publisher Summary This chapter focuses on the implanted motor neuroprosthetic systems, which have been shown to restore function that cannot be obtained through any other means. Historically, neuroprostheses have been implemented with individuals who had complete (ASIA A) spinal cord injuries. In a complete injury it is usually straightforward to separate the function provided by the electrical stimulation and the function under voluntary control. In many incomplete injuries, stimulated and voluntary functions are intertwined, making outcome assessment more difficult. Despite this, recent advances in system design have made neuroprostheses more applicable to incomplete injuries. Individuals with tetraplegia can gain control of grasp and release, enabling them to perform various activities of daily living, such as eating, drinking, and brushing teeth, as well as other tasks such as writing and taking money out of a wallet. Individuals with paraplegia can gain the ability to stand, enabling the individual to retrieve objects from shelves or to work at a counter. In addition, the ability to stand can simplify transfers in and out of the wheelchair, reducing the strain on an attendant. Walking function has also been demonstrated, including the ability to go up and down steps. Further, the impact of motor neuroprosthetics on rehabilitation is not only limited to improved function, but can also improve health and quality of life due to the benefits of muscle conditioning, exercise, and joint movement.