Post-stroke upper extremity rehabilitation with FES

Hemiparesis is paralysis affecting the limbs on one side of the body. It occurs due to neurological injuries such as cerebrovascular accidents (CVA) and if left untreated by rehabilitation professionals can lead to joint fixations, chronic pain, deformities and limitations in functionality. Hemiparesis represents a high rate of motor disability. The paralysis it causes in the upper limb makes it difficult to carry out activities of daily living (ADL), such as eating, hygiene, dressing, among others, greatly impacting the quality of life of the person in all its dimensions.

Following a stroke, the muscle activation required to perform a movement is disrupted due to neural lesions involved in the transmission of motor and sensory signals. A major challenge for rehabilitation is to re-establish normal modes of muscle activation by restoring overall motor control, otherwise the motor system may compensate for deficits through task control substitution strategies.

To address these motor difficulties, occupational therapists provide patients with training in fine motor skills, coordination and muscle power dosage. A complement to this therapy that has proven to be optimal is Functional Electrostimulation (FES), which promotes the muscle contraction and coordination needed to perform functional movements. It is non-invasive and can be used in the person's own home.

The TrainFES intelligent movement sensor allows you to easily coordinate muscle contractions and generate functional motor patterns.

A study by Dr. Yukihiro Hara of Chiba Hokusoh Hospital in Japan found that the use of FES in conjunction with conventional training delivers better results and facilitates motor relearning, and that daily use of FES can show significantly greater improvements in voluntary and functional arm and hand movement in people with sequelae of stroke.

The use of FES in post-stroke upper extremity functional rehabilitation has also shown immediate and short-term favourable results, as reported in a study conducted by therapists at Shanghai Jiao Tong University in Shanghai, China. The results of this study on the instantaneous effects of FES-supported therapy showed that it was effective in increasing maximal hand speed in different tasks. In the short-term intervention, pre- and post-FES assessments showed improvements in both Fugl-Meyer scores (a scale measuring sensorimotor impairment post-stroke) and movement kinematics. The patients' muscle synergy also tended to evolve towards values similar to those of people without pathology. These results provide promising evidence for the benefits of using synergy-based FES for post-stroke upper limb rehabilitation.

To bring FES technology closer to people, TrainFES has developed high quality models that are easy to use for both patients and therapists. These devices allow 6 muscles to be worked simultaneously and coordinated to generate functional movement patterns, such as reaching, grasping and approaching objects. Thanks to its intelligent movement sensor, TrainFES has become a very useful complement to contralateral motor exercises, as it not only provides visual input to the user, but also sensory and motor input and facilitates nerve transmission to the cortical areas involved in each activity.

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