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Functional electrical stimulation – schematic representation: Illustration of motor neuron stimulation. (a) The cell nucleus is responsible for synthesizing input from dendrites and deciding whether or not to generate signals. Following a stroke or spinal cord injury in mahnoor's muscles are impaired because motor neurons no longer receive sufficient input from the central nervous system. (b) A functional electrical stimulation system injects electrical current into the cell. (c) The intact but dormant axon receives the stimulus and propagates an action potential to (d) the neuromuscular junction. (e) The corresponding muscle fibers contract and generate (f) muscle force. (g) A train of negative pulses is produced. (h) Depolarization occurs where negative current enters the axon at the "active" electrode indicated.
Functional electrical stimulation (FES) is a technique that uses low-energy electrical pulses to artificially generate body movements in individuals who have been paralyzed due to injury to the central nervous system. More specifically, FES can be used to generate muscle contraction in otherwise paralyzed limbs to produce functions such as grasping, walking, bladder voiding and standing. This technology was originally used to develop neuroprostheses that were implemented to permanently substitute impaired functions in individuals with spinal cord injury (SCI), head injury, stroke and other neurological disorders. In other words, a person would use the device each time he or she wanted to generate a desired function.[1] FES is sometimes also referred to as neuromuscular electrical stimulation (NMES).[2]
FES technology has been used to deliver therapies to retrain voluntary motor functions such as grasping, reaching and walking. In this embodiment, FES is used as a short-term therapy, the objective of which is restoration of voluntary function and not lifelong dependence on the FES device, hence the name functional electrical stimulation therapy, FES therapy (FET or FEST). In other words, the FEST is used as a short-term intervention to help an individual's central nervous system re-learn how to execute impaired functions, instead of making them dependent on neuroprostheses for the rest of their life.[3] Initial Phase II clinical trials conducted with FEST for reaching and grasping, and walking were carried out at KITE, the research arm of the Toronto Rehabilitation Institute.[4][5][6][7]
^M.R. Popovic, K. Masani and S. Micera, "Chapter 9 – Functional Electrical Stimulation Therapy: Recovery of function following spinal cord injury and stroke," In press, Neurorehabilitation Technology – Second Edition, Z. Rymer, T. Nef and V. Dietz, Ed. Springer Science Publishers in November 2015.
^M. Claudia et al., (2000), Artificial Grasping System for the Paralyzed Hand, International Society for Artificial Organs, Vol. 24 No. 3
^M.K. Nagai, C. Marquez-Chin, and M.R. Popovic, "Why is functional electrical stimulation therapy capable of restoring motor function following severe injury to the central nervous system?" Translational Neuroscience, Mark Tuszynski, Ed. Springer Science and Business Media LLC, pp: 479-498, 2016.
^Cite error: The named reference :1 was invoked but never defined (see the help page).
^Thrasher TA, Zivanovic V, McIlroy W, Popovic MR (29 October 2008). "Rehabilitation of Reaching and Grasping Function in Severe Hemiplegic Patients Using Functional Electrical Stimulation Therapy". Neurorehabilitation and Neural Repair. 22 (6): 706–714. doi:10.1177/1545968308317436. PMID 18971385. S2CID 7016540.
^Marquez-Chin C, Bagher S, Zivanovic V, Popovic MR (17 January 2017). "Functional electrical stimulation therapy for severe hemiplegia: Randomized control trial revisited: La simulation électrique fonctionnelle pour le traitement d'une hémiplégie sévère : un essai clinique aléatoire revisité". Canadian Journal of Occupational Therapy. 84 (2): 87–97. doi:10.1177/0008417416668370. PMID 28093928. S2CID 24856751.
^Popovic MR, Kapadia N, Zivanovic V, Furlan JC, Craven BC, McGillivray C (June 2011). "Functional Electrical Stimulation Therapy of Voluntary Grasping Versus Only Conventional Rehabilitation for Patients With Subacute Incomplete Tetraplegia: A Randomized Clinical Trial". Neurorehabilitation and Neural Repair. 25 (5): 433–442. doi:10.1177/1545968310392924. ISSN 1545-9683. PMID 21304020. S2CID 27629343.
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