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The Scientific World Journal
Volume 2013, Article ID 836959, 7 pages
http://dx.doi.org/10.1155/2013/836959
Clinical Study

A Noninvasive Neuroprosthesis Augments Hand Grasp Force in Individuals with Cervical Spinal Cord Injury: The Functional and Therapeutic Effects

1IRCCS-Fondazione Don Carlo Gnocchi, Via Capecelatro 66, 20148 Milan, Italy
2Spinal Unit, Ospedale Niguarda Ca’ Granda, Piazza dell’Ospedale Maggiore 3, 20162 Milan, Italy
3Spinal Unit, Ospedale Morelli, Via A. Zubiani 33, Sondalo, 23035 Sondrio, Italy
4Laboratory of Neurological Disorders, Istituto Mario Negri, Via La Masa 19, 20156 Milan, Italy

Received 30 August 2013; Accepted 5 October 2013

Academic Editors: W. Schupp and B. Unver

Copyright © 2013 Rune Thorsen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. The primary purpose of this study was to evaluate myoelectrically controlled functional electrical stimulation (MeCFES) for enhancing the tenodesis grip in people with tetraplegia. The second aim was to estimate the potential number of candidates for the MeCFES device. The application of MeCFES provides the user with direct control of the grasp force as opposed to triggered FES systems. Methods. Screening 253 medical records of C5 to C7 spinal cord injury resulted in 27 participants who trained activities of daily living for 12 × 2 hours, using the MeCFES. Hand function was evaluated by the Action Research Arm Test (ARAT). Primary outcome was the ARAT change score with/without the device, before/after the intervention period. Secondary outcome was the number of positive or clinically relevant change scores with respect to the cohort. Results. The MeCFES improved hand test score in 63% of the subjects at first application. Training resulted in a significant therapeutic effect, which resulted in an overall increase of hand function in 89% of the participants and 30% experienced a clinically relevant change (6 points or more). Conclusions. Clinical relevance was found both as an assistive aid and as a therapeutic tool in rehabilitation. The therapeutic effect deserves further investigation in clinical studies.