After stroke, many people cannot use their affected hand and arm, and this has considerable impact on their quality of life. The limited availability of physiotherapists means that people receive very low doses of therapy in the critical early few weeks post stroke, much of which is focused on restoration of mobility. Perhaps unsurprisingly, approximately 50% of patients are left with long term upper limb problems. So there is an important need to increase arm and hand therapy without increasing the burden on therapists. Functional Electrical muscle Stimulation (FES) is a low cost solution which could enable stroke physiotherapists to look after several patients simultaneously. Furthermore, because it leads to natural muscle driven movement, and the associated sensations, it can be very effective in promoting recovery. 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, as we know from a large body of research, is necessary to promote functional recovery.
In the project, and in collaboration with Odstock Medical Ltd., we have developed a new upper limb FES system. The system allows therapists to set up task- and patient-specific state machine FES controllers (1), thereby supporting patients to perform functional tasks they would otherwise not be able to manage without support. The system comprises a 5 channel programmable stimulator, movement sensors, an instrumented object and a setup and feedback software running on a tablet computer.
The system is currently being trialled at 3 clinical sites in an MHRA-approved clinical investigation.
The upper limb FES system.