Functional electrical stimulation (FES) to support upper limb recovery following a stroke
After stroke, many people cannot use their affected hand and arm. The limited availability of physiotherapists and the poor uptake of technology in clinical practice leads to very low “doses” of therapy, so that the majority of patients live with long term upper limb problems. Hence there is an important need to increase arm and hand therapy without increasing the burden on therapists. Functional Electrical Stimulation (FES) uses electrical pulses to stimulate weak or paralysed muscles in such a way as to support performance of functional tasks, and could enable stroke physiotherapists to look after several patients simultaneously. Although there are FES systems already on the market, these are too inflexible and insufficiently automated to support challenging, engaging and task-focused practice; which we know from a large body of research is necessary to promote functional recovery.
Our research has culminated in the design and test of a new system that allows FES to be used by the patient for challenging, engaging and task-focused practice, but with limited support from physiotherapists. The new system comprises:
- A five channel stimulator.
- Setup and session management software running on a tablet computer.
- Movement sensors and an instrumented object. We tested the system in 3 different clinical settings, recruiting 22 people who had arm problems resulting from a stroke and 11 therapists. We found that therapists were able to use the system with a wide range of patients, performing a number of different functional tasks
Dr Mingxu Sun, the postdoc who carried out the software design work, has set up a spin-out company, Bet R Medical, in Jinan, China, developing upper limb FES products for the Chinese market. His company has recently sponsored a Salford PhD student, Jasmine Sarwar, to develop a more automated system, further reducing the demands on physiotherapists
Funder: NIHR, the EU framework programme, and industry.
Team: Prof David Howard, Prof Laurence Kenney, Dr Mingxu Sun, Dr Chris Smith (now @ Sheffield Hallam University), Karen Waring, Helen Luckie (now @ Sheffield Hallam University), Jasmine Sarwar; with Odstock Medical and Bet R Medical.