title: A multi-pad electrode based functional electrical stimulation system for restoration of grasp.
abstract: BACKGROUND
  Functional electrical stimulation (FES) applied via transcutaneous electrodes is a common rehabilitation technique for assisting grasp in patients with central nervous system lesions. To improve the stimulation effectiveness of conventional FES, we introduce multi-pad electrodes and a new stimulation paradigm.
  
  
  METHODS
  The new FES system comprises an electrode composed of small pads that can be activated individually. This electrode allows the targeting of motoneurons that activate synergistic muscles and produce a functional movement. The new stimulation paradigm allows asynchronous activation of motoneurons and provides controlled spatial distribution of the electrical charge that is delivered to the motoneurons. We developed an automated technique for the determination of the preferred electrode based on a cost function that considers the required movement of the fingers and the stabilization of the wrist joint. The data used within the cost function come from a sensorized garment that is easy to implement and does not require calibration. The design of the system also includes the possibility for fine-tuning and adaptation with a manually controllable interface.
  
  
  RESULTS
  The device was tested on three stroke patients. The results show that the multi-pad electrodes provide the desired level of selectivity and can be used for generating a functional grasp. The results also show that the procedure, when performed on a specific user, results in the preferred electrode configuration characteristics for that patient. The findings from this study are of importance for the application of transcutaneous stimulation in the clinical and home environments.
authors.affiliation: Tecnalia Serbia Ltd., Belgrade, Serbia. nebojsa.malesevic@tecnalia.com
authors.forename: Nebojša M
authors.initials: NM
authors.lastname: Malešević
authors.forename: Lana Z
authors.initials: LZ
authors.lastname: Popović Maneski
authors.forename: Vojin
authors.initials: V
authors.lastname: Ilić
authors.forename: Nikola
authors.initials: N
authors.lastname: Jorgovanović
authors.forename: Goran
authors.initials: G
authors.lastname: Bijelić
authors.forename: Thierry
authors.initials: T
authors.lastname: Keller
authors.forename: Dejan B
authors.initials: DB
authors.lastname: Popović
mesh_terms: D000465:Algorithms; D011211:Electric Power Supplies; D004558:Electric Stimulation / Q000295:instrumentation* / Q000379:methods; D004566:Electrodes; D025461:Feedback, Physiological / Q000502:physiology; D005260:Female; D005385:Fingers / Q000502:physiology; D006225:Hand / Q000294:innervation / Q000502:physiology; D018737:Hand Strength / Q000502:physiology*; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009068:Movement; D018482:Muscle, Skeletal / Q000502:physiology; D011474:Prosthesis Design; D020127:Recovery of Function; D012984:Software; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D059015:Wireless Technology; D014955:Wrist Joint / Q000502:physiology