Functional Electrical Stimulation Therapy for Grasping in Spinal Cord Injury: An Overview

Upper limb rehabilitation strategies for individuals with spinal cord injury (SCI) have evolved greatly over the last few decades. Amongst these strategies, functional electrical stimulation (FES) approaches have been widely recognized as the most promising. To date, 2 FES-based approaches for improving upper limb function in individuals with SCI have emerged. One approach proposes the use of FES as a permanent orthotic device that patients have to use all the time to grasp and release objects. In this application, the FES systems for grasping are better known as neuroprostheses for grasping. The second approach has emerged only recently, and it proposes the use of FES as a short-term therapeutic intervention with an objective to help the damaged central nervous system relearn how to execute the grasping function voluntarily. More specifically, after the therapy is completed and the FES system is permanently removed, the patients are able to grasp and release objects on their own, that is, without the help of FES device. In its first embodiment, FES technology is used as a permanent orthosis; in its second embodiment, it is used as a therapeutic tool.