Useless, nothing here tells about the efficacy and results of using FES. NO protocols referenced or created.
User-centered practicability analysis of two identification strategies in electrode arrays for FES induced hand motion in early stroke rehabilitation
- Christina Salchow-HömmenEmail authorView ORCID ID profile,
- Natalie Jankowski,
- Markus Valtin,
- Laura Schönijahn,
- Sebastian Böttcher,
- Frank Dähne and
- Thomas Schauer
Journal of NeuroEngineering and Rehabilitation201815:123
© The Author(s) 2018
- Received: 27 April 2018
- Accepted: 12 November 2018
- Published: 29 December 2018
Abstract
Background
Surface electrode arrays have become
popular in the application of functional electrical stimulation (FES) on
the forearm. Arrays consist of multiple, small elements, which can be
activated separately or in groups, forming virtual electrodes (VEs). As
technology progress yields rising numbers of possible elements, an
effective search strategy for suitable VEs in electrode arrays is of
increasing importance. Current methods can be time-consuming, lack user
integration, and miss an evaluation regarding clinical acceptance and
practicability.
Methods
Two array identification procedures with
different levels of user integration—a semi-automatic and a fully
automatic approach—are evaluated. The semi-automatic method allows
health professionals to continuously modify VEs via a touchscreen while
the stimulation intensities are automatically controlled to maintain
sufficient wrist extension. The automatic approach evaluates stimulation
responses of various VEs for different intensities using a cost
function and joint-angles recordings. Both procedures are compared in a
clinical setup with five sub-acute stroke patients with moderate hand
disabilities. The task was to find suitable VEs in two arrays with 59
elements in total to generate hand opening and closing for a
grasp-and-release task. Practicability and acceptance by patients and
health professionals were investigated using questionnaires and
interviews.
Results
Both identification methods yield
suitable VEs for hand opening and closing in patients who could tolerate
the stimulation. However, the resulting VEs differed for both
approaches. The average time for a complete search was 25% faster for
the semi-automatic approach (semi-automatic: 7.3min, automatic:
10.5min). User acceptance was high for both methods, while no clear
preference could be identified.
Conclusions
The semi-automatic approach should be
preferred as the search strategy in arrays on the forearm. The observed
faster search duration will further reduce when applying the system
repeatedly on a patient as only small position adjustments for VEs are
required. However, the setup time will significantly increase for
generation of various grasp types and adaptation to different arm
postures. We recommend different levels of user integration in FES
systems such that the search strategy can be chosen based on the users’
preferences and application scenario.
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