Wednesday, March 1, 2017

CCFES Devices for Stroke Rehabilitation


Each year, 800,000 people have strokes and that is the leading cause of adult disability in the U.S. Survivors that have Chronic Hemiplegia where both halves of the body and their motor function have altered.  Partial loss of movement occurs in the fingers, forearms, hands, and feet. Contralaterally controlled functional electrical stimulation (CCFES) is a newly discovered therapy created in order to recover the paretic limbs that are affected after a stroke occurs.
                   The CCFES model involves the rehability and relearning of motor functioning in paralytic limbs. CCFES allows the brain to have control over the benumbed limbs through direct intense stimulation and integrating motor impulsion and motor response together so both the central and peripheral neural activity are put in sync. The stimulation of the paretic limbs are in control because the patients begin to have control of their motor functioning.
                The device used in this paradigm consists of surface electrodes, a glove, a sock, and a stimulator. To modify the different ranges of stimulation, each pattern of pulse duration can be itemized for each stimulus channel. For each input from the sock or glove, the stimulation would increase. In this study, 21 patients underwent different functional tasks. Some tasks include repetitive hand opening, elbow extension, and simultaneously hand opening and reaching an object twice a week with the CCFES device. All of the participants were able to use the CCFES system at home for two hours a day too and most of the participants were highly satisfied with the hand CCFES device. Overall, 91% of participants felt that the therapy, hand device, and exercise improved their hand function.

                In the future, researchers hope to create more control tasks and interactive games to develop environments that welcomed cognitive engagement that occurred during the CCFES-mediated exercises. They are even considering to form virtual reality tasks where stroke patients can engage in motor control exercises from their homes. These different forms of therapy consist of tasks that drive motor skills and recovery of neural activity.  
                 Stroke victims not only undergo behavioral changes, but chemical imbalances also occur in their brain. Dr. Vincent Chen presented on these issues and discussed how sensory and motor functioning could allow us to recover from neurological disorders and maybe we could even recover faster all with the use of peripheral nerve stimulation. Dr. Chen and his team have agreed that electrical stimulation could assist in neurorehabilitation for patients who have suffered from strokes. However, he hasn't work on patients, but he has worked on rabbits. Overall, it is confirmed that electrical stimulation on certain specific regions does allow one to recover from neurological disorders.

                    References
Knutson J.S., Harley M.Y., Hisel T.Z., Makowski N.S., Fu M.J., & Chae J. (2012). Contralaterally Controlled Functional Electrical Stimulation for Stroke Rehabilitation. Conf Proc IEEE Eng Med Biol Soc. 2012, 314-317. doi: 10.1109/EMBC.2012.6345932.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3561720/pdf/nihms428527.pdf

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