A new study presented this week at the Association of Academic Physiatrists Annual Meeting in Atlanta found that a person with a spinal cord injury could improve their ability to grip and move household objects by using an electrical stimulation device controlled by their own thoughts. The study suggests that this new technology could one day allow people with disabilities to live more independently and enhance their quality of life.
People with tetraplegia have lost upper limb strength and dexterity, which has a severe impact on their independence and quality of life. New technology that connects a person's brain to an implanted functional electrical stimulation orthotics device on their hands could restore manual dexterity and grip strength so they could perform simple daily tasks like holding a toothbrush without help.
"Individuals with cervical spinal cord injury identify recovery of the use of their hands as the single most impactful way that neurotechnology could change their lives," says Lead Investigator in the study, Marcie Bockbrader, MD, PhD; assistant professor, Physical Medicine and Rehabilitation; The Ohio State University Wexner Medical Center in Columbus. "Giving a person back their hands reduces dependence on others. It makes it possible to do the little things – like cutting food, or opening a door – that are so essential to being able to take care of oneself."
To test how well this thought-controlled, brain-computer interface system works in real life to improve hand strength and dexterity, Dr. Bockbrader and her research team surgically implanted one of these devices into the hand of a 26-year-old man with C5-level, nonspastic tetraplegia following a spinal cord injury. He practiced using the device three times a week for four hours each session for more than 1,000 days. The research team ran him through standardized tests of upper limb motor ability and functional participation to see how well the system improved his grip strength, quickness and other basic skills.
By using this device, the man's upper limb motor ability improved dramatically according to several standardized tests. He was able to improve his ability to grip and manipulate basic objects, and even showed that he could perform ordinary tasks with his hands at the speed and dexterity levels of healthy individuals. He could move objects of different sizes and weights. With practice, he was able to improve his ability to manipulate smaller household objects like a toothbrush or hairbrush. He also demonstrated that he could imagine different hand positions to proportionally adjust and control different hand movements.
"Our study demonstrated that patients with tetraplegia might be able to restore some of their skilled hand function with an implanted device that allows them to control movements with their own thoughts," says Dr. Bockbrader of the findings. "Although this technology must be refined and tested before it can go from the lab to the public, it may one day offer people with disabilities a way to live and work more independently, and enable them to perform daily tasks like brushing their teeth or making breakfast on their own."
"The BCI-FES system did not improve one of his standardized test scores, so more research and development is needed to refine these orthotics, says. Dr. Bockbrader. Our next steps are to work with our partners at Battelle and Blackrock to make the technology portable, wearable, and even better able to control fine precision grips for small or delicate objects. We are also working on grants and other ways to bring this technology into people's homes, to promote independence and reduce burden of care associated with spinal cord injury."
Study defines three subtypes of Chiari type-1 malformation to guide treatment