Funktionel Elektrisk Terapi (FET) i hemiplegi-patienter / Functional Electrical Therapy (FET) in hemiplegic subjects

Patterned and timed electrical stimulation of forearm and hand muscles combined with the task dependent exercise is called Functional Electrical Therapy. This rehabilitation method carries potentials for promoting recovery of humans with paralysed extremities. The aim of this project is to design an effective programme that could help as many humans as possible with paralysed or paretic arm/hand to regain functional reaching and grasping. The design encompasses the following: 1) development of a new stimulator that is suitable for hospital treatment as well as for home usage; 2) development of a new control method that allows mimicking of normal reaching and grasping; 3) blinded, randomised clinical evaluation in various groups of hemiplegic subjects. During FET, in addition to conventional therapy, subjects perform 30-minute long exercise with paretic arm/hand every day during three consecutive weeks. The exercise is assisted with a four channel electronic stimulator that controls the opening, grasping, and releasing functions by mimicking natural movement. The pattern and timing of the stimulation are programmed to clone the slowed down normal-like prehension, grasp, and release phases of the grasp typical for normal hand palmar, lateral and precision grasps. Four channels of electrical stimulation are applied via self-adhesive surface electrodes positioned over the following muscle groups: finger flexors (Flexor Digitorum Profundus m. and Flexor Digitorum Superficialis m.), finger extensors (Extensor Digitorum Communis m.), thumb extensor (Extensor Pollicis Longus m.), and the Thenar muscle group (Abductor Pollicis m. and M. Opponens). We started applying FET to recover reaching and grasping. The preliminary results in more than 50 acute and chronic hemiplegic subjects assigned to two groups based on their functioning at the beginning of the study indicate that FET is contributing significantly to the long-term recovery of reaching and grasping. This study should be extended and include more subjects in order to minimise the inter-subject variations and study carry-over effects during longer time. Funded by the Danish Research Foundation. (Dejan Popovic, Mirjana Popovic, Thomas Sinkjær, Clemens Eder; Neurodan A/S; Hammel Neurorehabilitation Center; Brønderslev Rehabilitation Center; Institute for Rehabilitation ?Dr. Miroslav Zotovic?, Belgrade, FRY)