The combined use of Neuro Muscular Electrical Stimulation (NMES) and interactive objects is advocated to improve rehabilitation outcomes after stroke. TNE developed a multiarray hand rehabilitation system consisting of lightweight electrode sleeves with optional hand orthoses. The hand orthosis is equipped with inertial sensors and force sensors aimed at providing wrist-hand constraining and support for moderate distal flaccidity or spasticity. NMES is integrated in the system to provide support in opening and closing the hand through wearable, dynamically reconfigurable, multiresolution electrode-arrays. NMES is triggered based on the current hand status – finger kinematics, and grasp force – and the expected interaction with the rehabilitation workspace and the objects in it. In order to encourage the active involvement of the patient, hand kinematics and grasp force are continuously monitored, and NMES intervenes only to compensate for insufficient volitional muscle activation. The control interface of the system provides a GUI and multiple software tools to organize rehabilitation exercises and monitor rehabilitation progress. A randomized clinical trial aimed at evaluating the effectiveness of the system to improve the motor hand function, and to evaluate the sensory and cognitive changes was completed with the 9 weeks long training of 60 chronic stroke patients. A randomized controlled trial with 68 sub-acute stroke patients, aimed at evaluating the effectiveness of the system to improve the hand function in goal directed tasks, is ongoing.
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Andrea Crema ([email protected])