Personalized protocol and scoring scale for functional electrical stimulation of the hand: A pilot feasibility study

Article type: Research Article

Authors: Camacho-Zavala, Jessica K.^{a; 1} | Perez-Medina, Ana L.^{a; 1} | Mercado-Gutierrez, Jorge A.^{b; *} | Gutierrez, Mario I.^c | Gutierrez-Martinez, Josefina^b | Aguirre-Güemez, A. Valeria^d | Quinzaños-Fresnedo, Jimena^d | Perez-Orive, Javier^{a; e; *}

Affiliations: [a] Facultad de Ingeniería, Universidad Nacional Autónoma de México, Cd. de México, México | [b] División de Investigación en Ingeniería Médica, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Cd. de México, México | [c] CONACYT-Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Cd. de México, México | [d] División de Rehabilitación Neurológica, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Cd. de México, México | [e] División de Neurociencias, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Cd. de México, México

Correspondence: [*] Corresponding authors: Javier Perez-Orive, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, 14389 Cd. de México, México. Tel.: +52 55 59991000, Ext. 19213; E-mail: jperezorive.inr@gmail.com. Jorge A. Mercado-Gutierrez, Medical Engineering Research Division, Instituto Nacional de Rehabilitación “Luis Guillermo Ibarra Ibarra”, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, 14389 Cd. de México, México. Tel.: +52 55 59991000, Ext. 19019; E-mail: mercado.jorgea@gmail.com.

Note: [1] These authors contributed equally to this work and share first authorship.

Abstract: BACKGROUND: Complex personalized Functional Electrical Stimulation (FES) protocols for calibrating parameters and electrode positioning have been proposed, most being time-consuming or technically cumbersome for clinical settings. Therefore, there is a need for new personalized FES protocols that generate comfortable, functional hand movements, while being feasible for clinical translation. OBJECTIVE: To develop a personalized FES protocol, comprising electrode placement and parameter selection, to generate hand opening (HO), power grasp (PW) and precision grip (PG) movements, and compare in a pilot feasibility study its performance to a non-personalized protocol based on standard FES guidelines. METHODS: Two FES protocols, one personalized (P1) and one non-personalized (P2), were used to produce hand movements in twenty-three healthy participants. FES-induced movements were assessed with a new scoring scale which comprises items for selectivity, functionality, and comfort. RESULTS: Higher FES-HSS scores were obtained with P1 for all movements: HO (p= 0.00013), PW (p= 0.00007), PG (p= 0.00460). Electrode placement time was significantly shorter for P2 (p= 0.00003). Comfort scores were similar for both protocols. CONCLUSIONS: The personalized protocol for electrode placement and parameter selection enabled functional FES-induced hand movements and presented advantages over a non-personalized protocol. This protocol warrants further investigation to confirm its suitability for developing upper-limb rehabilitation interventions with clinical translational potential.

Keywords: Electric stimulation, upper extremity, motor activity, electrodes, rehabilitation, technology

DOI: 10.3233/THC-213016

Journal: Technology and Health Care, vol. 30, no. 1, pp. 51-63, 2022