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This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM,

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Presentation on theme: "This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM,"— Presentation transcript:

1 This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):XXX–XXX. http://dx.doi.org/10.1682/JRRD.2011.09.0171 Slideshow Project DOI:10.1682/JRRD.2011.09.0171JSP Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study Jayme S. Knutson, PhD; John Chae, MD; Ronald L. Hart, MS; Michael W. Keith, MD; Harry A. Hoyen, MD; Mary Y. Harley, OTR/L; Terri Z. Hisel, OTR/L; Anne M. Bryden, OTR/L; Kevin L. Kilgore, PhD; Hunter Peckham, PhD

2 This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):XXX–XXX. http://dx.doi.org/10.1682/JRRD.2011.09.0171 Slideshow Project DOI:10.1682/JRRD.2011.09.0171JSP Aim – Describe 1st individual with poststroke hemiplegia to receive implanted neuroprosthesis (NP) for assisting arm and hand function. – Evaluate feasibility of NP as assistive device for poststroke upper-limb function. Relevance – Such an NP may be viable solution for stroke patients who do not regain arm and hand function with other rehabilitation techniques.

3 This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):XXX–XXX. http://dx.doi.org/10.1682/JRRD.2011.09.0171 Slideshow Project DOI:10.1682/JRRD.2011.09.0171JSP Methods Participant: – 57 yr old female – 5 yr poststroke with left-side hemiparesis. NP: – Implantable stimulator- telemeter. – 12 intramuscular stimulating electrodes. – 2 epimysial electro- myogram (EMG)- recording electrodes. – External control unit. Outcome Assessments: – 41-item NP Satisfaction and Usage Questionnaire. – Modified Ashworth scale. – Upper-limb Fugl-Meyer Assessment (FMA). – Active range of motion at shoulder, elbow, wrist, finger. – Lateral and palmar pinch force. – Grasp-Release Test (GRT). – Arm Motor Abilities Test (AMAT).

4 This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):XXX–XXX. http://dx.doi.org/10.1682/JRRD.2011.09.0171 Slideshow Project DOI:10.1682/JRRD.2011.09.0171JSP Results EMG control strategy failed to provide easy-to- use NP control for participant. – At 10 mo visit, replaced with push-button control. NP increased: – Active range of finger extension. – Lateral pinch force. – Number of objects in GRT. – AMAT score. – FMA score. Participant used NP at home 3–4 d/wk, up to 3 h/d for exercise, household tasks.

5 This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):XXX–XXX. http://dx.doi.org/10.1682/JRRD.2011.09.0171 Slideshow Project DOI:10.1682/JRRD.2011.09.0171JSP Results Questionnaire – Participant said: She would have NP implanted again if given chance. She benefited from NP. She felt more confident performing activities with NP. She could do some tasks faster with NP. NP positively affected her life. She disagreed that NP positively affected actual homemaking or home maintenance. She was neutral as to whether NP improved quality of life.

6 This article and any supplementary material should be cited as follows: Knutson JS, Chae J, Hart RL, Keith MW, Hoyen HA, Harley MY, Hisel TZ, Bryden AM, Kilgore KL, Peckham H. Implanted neuroprosthesis for assisting arm and hand function after stroke: A case study. J Rehabil Res Dev. 2012;49(10):XXX–XXX. http://dx.doi.org/10.1682/JRRD.2011.09.0171 Slideshow Project DOI:10.1682/JRRD.2011.09.0171JSP Conclusion NP enabled participant to perform some bimanual tasks in laboratory and at home. Even without NP, overall upper-limb motor impairment improved (FMA score). – May be carry-over effect of NP usage. Flexor spasticity reduced NP effectiveness. This study clarified obstacles that remain and represents landmark step toward development of advanced enabling technology.

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