title: Efficacy of an implanted neuroprosthesis for restoring hand grasp in tetraplegia: a multicenter study.
abstract: OBJECTIVE
  To evaluate an implanted neuroprosthesis that allows tetraplegic users to control grasp and release in 1 hand.
  
  
  METHODS
  Multicenter cohort trial with at least 3 years of follow-up. Function for each participant was compared before and after implantation, and with and without the neuroprosthesis activated.
  
  
  METHODS
  Tertiary spinal cord injury (SCI) care centers, 8 in the United States, 1 in the United Kingdom, and 1 in Australia.
  
  
  METHODS
  Fifty-one tetraplegic adults with C5 or C6 SCIs.
  
  
  METHODS
  An implanted neuroprosthetic system, in which electric stimulation of the grasping muscles of 1 arm are controlled by using contralateral shoulder movements, and concurrent tendon transfer surgery. Assessed participants' ability to grasp, move, and release standardized objects; degree of assistance required to perform activities of daily living (ADLs), device usage; and user satisfaction.
  
  
  METHODS
  Pinch force; grasp and release tests; ADL abilities test and ADL assessment test; and user satisfaction survey.
  
  
  RESULTS
  Pinch force was significantly greater with the neuroprosthesis in all available 50 participants, and grasp-release abilities were improved in 49. All tested participants (49/49) were more independent in performing ADLs with the neuroprosthesis than they were without it. Home use of the device for regular function and exercise was reported by over 90% of the participants, and satisfaction with the neuroprosthesis was high.
  
  
  CONCLUSIONS
  The grasping ability provided by the neuroprosthesis is substantial and lasting. The neuroprosthesis is safe, well accepted by users, and offers improved independence for a population without comparable alternatives.
authors.affiliation: Department of Veterans Affairs, Rehabilitation Research and Development Services, Cleveland, OH, USA. pxp2@po.cwru.edu
authors.forename: P H
authors.initials: PH
authors.lastname: Peckham
authors.forename: M W
authors.initials: MW
authors.lastname: Keith
authors.forename: K L
authors.initials: KL
authors.lastname: Kilgore
authors.forename: J H
authors.initials: JH
authors.lastname: Grill
authors.forename: K S
authors.initials: KS
authors.lastname: Wuolle
authors.forename: G B
authors.initials: GB
authors.lastname: Thrope
authors.forename: P
authors.initials: P
authors.lastname: Gorman
authors.forename: J
authors.initials: J
authors.lastname: Hobby
authors.forename: M J
authors.initials: MJ
authors.lastname: Mulcahey
authors.forename: S
authors.initials: S
authors.lastname: Carroll
authors.forename: V R
authors.initials: VR
authors.lastname: Hentz
authors.forename: A
authors.initials: A
authors.lastname: Wiegner
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000294:innervation*; D018737:Hand Strength; D006801:Humans; D008297:Male; D019736:Prostheses and Implants; D011474:Prosthesis Design; D011782:Quadriplegia / Q000601:surgery*