The functional impact of the Freehand System on tetraplegic hand function. Clinical Results.
METHODS
A B design with subjects acting as their own control when the device is turned off.


OBJECTIVE
Evaluation of the efficacy of the NeuroControl Freehand System.


METHODS
A supra regional spinal unit in the UK.


METHODS
The Freehand system is an implanted Functional Electrical Stimulation (FES) device for restoration of lateral and palmar grasps following C5 or C6 tetraplegia. Its use was assessed using the Grasp Relies Test (GRT), Activities of Daily Living (ADL), Grip strength and two-point discrimination.


RESULTS
Seven out of nine subjects are currently daily users of the device. There were statistically significant increases in the number of types of task achieved and the number of repetitions of those tasks in the Grasp Release Test. The system produced a functionally strong grasp where no grip strength at all was possible prior to implantation. Three of the four subjects who had sensory ability prior to implant showed improvements in two-point discrimination. Most of the selected tasks were achieved in the ADL assessment indicating a significant improvement in independence.


CONCLUSIONS
The Freehand system can significantly improve the functional ability of C5 and C6 lesion tetraplegics.


BACKGROUND
This study was funded by the charity INSPIRE.
Taylor
P
P
Department of Medical Physics and Biomedical Engineering, Salisbury District Hospital, Salisbury, Wiltshire SP2 8BJ, UK.
Esnouf
J
J
Hobby
J
J
D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D003248:Constipation / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006225:Hand / Q000294:innervation / Q000503:physiopathology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D019736:Prostheses and Implants / Q000009:adverse effects / Q000639:trends*; D011597:Psychomotor Performance / Q000502:physiology; D011782:Quadriplegia / Q000503:physiopathology / Q000534:rehabilitation*; D020425:Radial Neuropathy / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D020127:Recovery of Function / Q000502:physiology; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome