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Functional electrical stimulation (FES) is a technique that uses low-energy electrical pulses to artificially generate body movements in individuals who have been paralyzed due to injury to the central nervous system. More specifically, FES can be used to generate muscle contraction in otherwise paralyzed limbs to produce functions such as grasping, walking, bladder voiding and standing. This technology was originally used to develop neuroprostheses that were implemented to permanently substitute impaired functions in individuals with spinal cord injury (SCI), head injury, stroke and other neurological disorders. In other words, a person would use the device each time he or she wanted to generate a desired function. FES is sometimes also referred to as neuromuscular electrical stimulation (NMES).
A spinal cord injury (SCI) is damage to the spinal cord that causes temporary or permanent changes in its function. It is a destructive neurological and pathological state that causes major motor, sensory and autonomic dysfunctions.
The International Neuromodulation Society (INS) is a non-profit group of clinicians, scientists and engineers dedicated to the scientific development and awareness of neuromodulation – the alteration of nerve activity through the delivery of electromagnetic stimulation or chemical agents to targeted sites of the body. Neuromodulation is a burgeoning field – analysts forecast a double-digit annual growth rate through 2026. Founded in 1989 and based in San Francisco, CA, the INS educates and promotes the field through meetings, its bimonthly, peer-reviewed journal Neuromodulation: Technology at the Neural Interface and chapter websites.
Kessler Foundation, established in 1985, is a nonprofit in the field of rehabilitation research for people with disabilities. Kessler Foundation has its roots in the Kessler Institute, founded in 1949 to improve medical outcomes and employment of people disabled by brain or spinal injury. Kessler Foundation conducts rehabilitation research with the goal of increasing function for cognition, mobility, and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord.
Spinal locomotion results from intricate dynamic interactions between a central program in lower thoracolumbar spine and proprioceptive feedback from body in the absence of central control by brain as in complete spinal cord injury (SCI). Following SCI, the spinal circuitry below the lesion site does not become silent; rather, it continues to maintain active and functional neuronal properties, although in a modified manner.
Neurostimulation is the purposeful modulation of the nervous system's activity using invasive or non-invasive means. Neurostimulation usually refers to the electromagnetic approaches to neuromodulation.
A powered exoskeleton is a mobile machine that is wearable over all or part of the human body, providing ergonomic structural support and powered by a system of electric motors, pneumatics, levers, hydraulics or a combination of cybernetic technologies, while allowing for sufficient limb movement with increased strength and endurance. The exoskeleton is designed to provide better mechanical load tolerance, and its control system aims to sense and synchronize with the user's intended motion and relay the signal to motors which manage the gears. The exoskeleton also protects the user's shoulder, waist, back and thigh against overload, and stabilizes movements when lifting and holding heavy items.
A gait trainer is a wheeled device that assists a person who is unable to walk independently to learn or relearn to walk safely and efficiently as part of gait training. Gait trainers are intended for children or adults with physical disabilities, to provide the opportunity to improve walking ability. A gait trainer offers both unweighting support and postural alignment to enable gait practice. It functions as a support walker and provides more assistance for balance and weight-bearing, than does a traditional rollator walker, or a walker with platform attachments. It also provides opportunities to stand and to bear weight in a safe, supported position.
Ekso Bionics Holdings Inc. is a company that develops and manufactures powered exoskeleton bionic devices that can be strapped on as wearable robots to enhance the strength, mobility, and endurance of industrial workers and people experiencing paralysis and mobility issues after a brain injury, stroke, multiple sclerosis (MS) or spinal cord injury. They enable individuals with any amount of lower extremity weakness, including those who are paralyzed, to stand up and walk.
When treating a person with a spinal cord injury, repairing the damage created by injury is the ultimate goal. By using a variety of treatments, greater improvements are achieved, and, therefore, treatment should not be limited to one method. Furthermore, increasing activity will increase his/her chances of recovery.
The Center for Neurotechnology (CNT) is an Engineering Research Center funded by the National Science Foundation to create devices to restore the body's capabilities for sensation and movement. The center is based at the University of Washington. The center's core partner organizations are Massachusetts Institute of Technology and San Diego State University.
Neuromodulation is "the alteration of nerve activity through targeted delivery of a stimulus, such as electrical stimulation or chemical agents, to specific neurological sites in the body". It is carried out to normalize – or modulate – nervous tissue function. Neuromodulation is an evolving therapy that can involve a range of electromagnetic stimuli such as a magnetic field (rTMS), an electric current, or a drug instilled directly in the subdural space. Emerging applications involve targeted introduction of genes or gene regulators and light (optogenetics), and by 2014, these had been at minimum demonstrated in mammalian models, or first-in-human data had been acquired. The most clinical experience has been with electrical stimulation.
A lumbar anterior root stimulator is a type of neuroprosthesis used in patients with a spinal cord injury or to treat some forms of chronic spinal pain. More specifically, the root stimulator can be used in patients who have lost proper bowel function due to damaged neurons related to gastrointestinal control and potentially allow paraplegics to exercise otherwise paralyzed leg muscles.
Craig Hart Neilsen was an American gaming industry executive who founded Ameristar Casinos, Inc. and formed the Craig H. Neilsen Foundation to fund scientific research and quality of life programs for people living with spinal cord injuries.
Although spinal cord injury (SCI) often causes sexual dysfunction, many people with SCI are able to have satisfying sex lives. Physical limitations acquired from SCI affect sexual function and sexuality in broader areas, which in turn has important effects on quality of life. Damage to the spinal cord impairs its ability to transmit messages between the brain and parts of the body below the level of the lesion. This results in lost or reduced sensation and muscle motion, and affects orgasm, erection, ejaculation, and vaginal lubrication. More indirect causes of sexual dysfunction include pain, weakness, and side effects of medications. Psycho-social causes include depression and altered self-image. Many people with SCI have satisfying sex lives, and many experience sexual arousal and orgasm. People with SCI may employ a variety of adaptations to help carry on their sex lives healthily, by focusing on different areas of the body and types of sexual acts. Neural plasticity may account for increases in sensitivity in parts of the body that have not lost sensation, so people often find newly sensitive erotic areas of the skin in erogenous zones or near borders between areas of preserved and lost sensation.
Spinal cord injury research seeks new ways to cure or treat spinal cord injury in order to lessen the debilitating effects of the injury in the short or long term. There is no cure for SCI, and current treatments are mostly focused on spinal cord injury rehabilitation and management of the secondary effects of the condition. Two major areas of research include neuroprotection, ways to prevent damage to cells caused by biological processes that take place in the body after the injury, and neuroregeneration, regrowing or replacing damaged neural circuits.
Jocelyne Bloch is a Swiss neuroscientist and a neurosurgeon at Lausanne University Hospital and at EPFL.
Sandra M. Garraway is a Canadian-American neuroscientist and assistant professor of physiology in the Department of Physiology at Emory University School of Medicine in Atlanta, Georgia. Garraway is the director of the Emory Multiplex Immunoassay Core (EMIC) where she assists researchers from both academia and industry to perform, analyze, and interpret their multiplexed immunoassays. Garraway studies the neural mechanisms of spinal nociceptive pain after spinal cord injury and as a postdoctoral researcher she discovered roles for both BDNF and ERK2 in pain sensitization and developed novel siRNA technology to inhibit ERK2 as a treatment for pain.
Grégoire Courtine is a French neuroscientist and a professor at the École Polytechnique Fédérale de Lausanne (EPFL), where he is the co-director of the Defitech center for interventional neurotherapies (NeuroRestore). His research focuses on the field of neurotechnology, with the aim to restore locomotor functions in patients with central nervous system disorders such as spinal cord injuries.
Chet T. Moritz is an American neural engineer, neuroscientist, physiologist, and academic researcher. He is a Professor of Electrical and Computer Engineering, and holds joint appointments in the School of Medicine departments of Rehabilitation Medicine, and Physiology & Biophysics at the University of Washington.
References
- 1 2 "Rutgers New Jersey Medical School". njms-web.njms.rutgers.edu. Retrieved 2019-01-29.
- 1 2 3 4 5 "Gail Forrest, PhD". Kessler Foundation. Retrieved 2023-02-21.
- ↑ "New collaborative work wins Neuromod Prize to accelerate the development of neuromodulation therapies". News-Medical.net. 2022-07-22. Retrieved 2022-10-21.
- ↑ "Department of Health | New Jersey Commission on Spinal Cord Research | 2002 Research Directory". www.state.nj.us. Retrieved 2019-01-29.
- ↑ Ramanujam, A.; Husain, S. R.; Momeni, K.; Garbarini, E.; Augustine, J.; Forrest, G. F. (November 2017). "Effects of longitudinal powered exoskeleton training on overground walking for SCI: A case study". 2017 International Symposium on Wearable Robotics and Rehabilitation (WeRob). pp. 1–2. doi:10.1109/WEROB.2017.8383822. ISBN 978-1-5386-4377-8. S2CID 49193867.
- ↑ Saleh, S.; Ramanujam, A.; Momeni, K.; Hoxha, A.; Husain, S. R.; Allexandre, D.; Yue, G.; Forrest, G. F. (November 2017). "Cortical control of walking with and without powered exoskeleton assistance: An EEG pilot study". 2017 International Symposium on Wearable Robotics and Rehabilitation (WeRob). pp. 1–2. doi:10.1109/WEROB.2017.8383865. ISBN 978-1-5386-4377-8. S2CID 49190831.
- ↑ "Epidural Stimulation Program – Victory Over Paralysis" . Retrieved 2022-10-21.
- ↑ "Research team wins NIH prize for plan to accelerate advances in spinal stimulation through autonomic neuromodulation". EurekAlert!. Retrieved 2022-10-21.
- ↑ "Kessler Foundation receives major funding from the Craig H. Neilsen Foundation to advance research in spinal cord injury and fellowship education". EurekAlert!. Retrieved 2022-10-21.