FES-UPP : a flexible functional electrical stimulation system to support upper limb functional activity practice

Sun, M ORCID: https://orcid.org/0000-0003-1514-1490, Smith, C, Howard, D ORCID: https://orcid.org/0000-0003-1738-0698, Kenney, LPJ ORCID: https://orcid.org/0000-0003-2164-3892, Luckie, HM, Waring, K, Taylor, P, Merson, E and Finn, S 2018, 'FES-UPP : a flexible functional electrical stimulation system to support upper limb functional activity practice' , Frontiers in Neuroscience, 12 (449) .

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There is good evidence supporting highly intensive, repetitive, activity-focused, voluntary-initiated practice as a key to driving recovery of upper limb function following stroke. Functional electrical stimulation (FES) offers a potential mechanism to efficiently deliver this type of therapy, but current commercial are too inflexible and/or insufficiently automated, in some cases requiring engineering support. In this paper, we report a new, flexible upper limb FES system, FES-UPP, which addresses the issues above.

The FES-UPP system consists of a 5-channel stimulator running a flexible FES finite state machine (FSM) controller, the associated setup software that guides therapists through the setup of FSM controllers via five setup stages, and finally the Session Manager used to guide the patient in repeated attempts at the activities(s) and provide feedback on their performance. The FSM controller represents a functional activity as a sequence of movement phases. The output for each phase implements the stimulations to one or more muscles. Progression between movement phases is governed by user-defined rules.

As part of a clinical investigation of the system, nine therapists used the FES-UPP system to set up FES-supported activities with twenty two patient participants with impaired upper-limbs. Therapists with little or no FES experience and without any programming skills could use the system in their usual clinical settings, without engineering support. Different functional activities, tailored to suit the upper limb impairment levels of each participant were used, in up to 8 sessions of FES-supported therapy per participant. The efficiency of delivery of the therapy using FES-UPP was promising when compared with published data on traditional face-face therapy.

The FES-UPP system described in this paper has been shown to allow therapists with little or no FES experience and without any programming skills to set up state-machine FES controllers bespoke to the patient’s impairment patterns and activity requirements, without engineering support. The clinical results demonstrated that the system can be used to efficiently deliver high intensity, activity focused therapy. Nevertheless, further work to reduce setup time is still required.

Item Type: Article
Schools: Schools > School of Computing, Science and Engineering
Schools > School of Health and Society > Centre for Health Sciences Research
Journal or Publication Title: Frontiers in Neuroscience
Publisher: Frontiers Media
ISSN: 1662-453X
Related URLs:
Funders: NIHR Invention for Innovation
Depositing User: USIR Admin
Date Deposited: 04 Jul 2018 10:01
Last Modified: 15 Feb 2022 23:23
URI: https://usir.salford.ac.uk/id/eprint/47308

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