title: An advanced neuroprosthesis for restoration of hand and upper arm control using an implantable controller.
abstract: An advanced neuroprosthesis that provides control of grasp-release, forearm pronation, and elbow extension to persons with cervical level spinal cord injury is described. The neuroprosthesis includes implanted and external components. The implanted components are a 10-channel stimulator-telemeter, leads and electrodes, and a joint angle transducer; the external components are a control unit and transmitter-receiver coil. The system has completed preclinical testing and has been implanted fully in 3 persons and partially in 1 person, all with tetraplegia caused by spinal cord injury at C5 and C6. The minimum follow-up time for any system component is 16 months. All subjects had improvements in grasp strength, range of motion, and ability to grasp objects and increased independence in activities of daily living. Each subject became a regular user of the neuroprosthesis and is satisfied with it. The implanted components have not caused any medical complications. The operation of the electrodes and sensors has been stable. The data show that this advanced neuroprosthetic system is safe and can provide grasping and reaching ability to individuals with cervical level spinal cord injury.
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland Veterans Affairs Medical Center, Cleveland, OH 44109, USA.
authors.forename: P Hunter
authors.initials: PH
authors.lastname: Peckham
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Kilgore
authors.forename: Michael W
authors.initials: MW
authors.lastname: Keith
authors.forename: Anne M
authors.initials: AM
authors.lastname: Bryden
authors.forename: Niloy
authors.initials: N
authors.lastname: Bhadra
authors.forename: Fred W
authors.initials: FW
authors.lastname: Montague
mesh_terms: D000203:Activities of Daily Living; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D018737:Hand Strength; D006801:Humans; D009048:Motor Skills; D011474:Prosthesis Design; D019919:Prosthesis Implantation / Q000379:methods; D011782:Quadriplegia / Q000503:physiopathology / Q000534:rehabilitation* / Q000601:surgery*; D016059:Range of Motion, Articular; D016896:Treatment Outcome