Functional Electrical Therapy (FET) for Enhancing Reaching and Grasping in Hemiplegic Individuals

We will further evaluate the new therapeutic modality called Functional Electrical Therapy (FET) for treatment of post-stroke hemiplegic individuals. FET is the therapeutic modality that integrates the patterned four-channel electrical stimulation of the forearm and hand sensory-motor systems and task oriented voluntary exercise by the paretic arm in post-stroke hemiplegic individuals. The technology for FET was transferred to Neurodan A/S, Aalborg, Denmark, that was during the year 2005 acquired by Otto Bock, Germany.
The clinical study that is the basis for the research was partly done in the Rehabilitation Institute “Dr. Miroslav Zotović” in Belgrade, SCG, and partly in the Hammel Rehabilitation Center, Hammel, Denmark. The work done in Belgrade was funded by the research grants that Dejan Popović and Mirjana Popović received form the Ministry of Science and Environmental Protection of Serbia, Belgrade, SCG.
The clinical studies (results published in three journal papers) of FET in hemiplegic individuals indicated that exercise and stimulation improved the functioning; yet, that the period of three weeks was not sufficient to lead to significant recovery in chronic patients. In parallel, the application of FET that stimulates only four muscles was not sufficient for individuals who had no control of the wrist and finger extensors against the gravity. This requires further studies and research that will result with the technology that provides electrically assisted movements of the upper arm and forearm. The major research issue is the development of hierarchical hybrid control that allows control of manipulation based on mimicking able-bodied kinematic synergies typical for daily activities. The research initially included two M.Sc. students from the Department of Health Science and Technology, Aalborg University, and some important findings were published in the IEEE Transactions for Neural Engineering and Rehabilitation in the December issue of 2005 (Iftime et al. 2005). In the future a new Ph.D. student will look into the possible interfaces that are suitable for commands of complex movements, sensory systems that are suitable for sensory-driven control, and better mappings between the kinematics and needed sensory-motor inputs.