Neuromodulation : journal of the International Neuromodulation Society
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Neuroprostheses enabling patients to ascend and descend stairs can provide real functional gain. A novel finite state control scheme is presented and validated experimentally. The motion tasks Ascent and Descent are specified by sequences of motion phases for each leg separately. ⋯ Feasibility of the approach has been successfully demonstrated. Future work will concentrate on improved foot clearance during Ascent and closed loop controlled muscle activation in selected motion phases of both Ascent and Descent. The approach is also suited for implanted lower extremity neuroprostheses.
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The objectives of this study were to assess the effectiveness of cervical spinal cord stimulation in the management of intractable pain syndromes affecting the upper limb and face and to assess the reliability of a specific electrode system in this mobile environment. Forty-one patients, aged 26-76 years (median 48) with neuropathic or ischemic pain underwent the cervical epidural implantation of identical dual two-contact paddle (four contacts per system) laminectomy electrodes. Follow-up (from 5 months to 11 years, 3 months; median 4 years, 7 months) was by multiple consultations carried out by the surgeon and/or in a nurse-led specialist clinic. ⋯ Lead fracture rate was 15% of the original (11% of the total including replacements) and only 7% (5%) became dislodged. We conclude that the electrode system described provides reliable and sustained cervical cord stimulation. The outcomes are comparable with thoracic cord stimulation for neuropathic and ischemic syndromes.
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The objective of this research was to demonstrate the potential of using peroneal nerve activity to derive timing control for stimulation in foot drop correction and to attempt recording and stimulation through the same electrode. Two subjects were implanted with cuff electrodes on the peroneal nerve. ⋯ The switching circuit successfully allowed for simultaneous recording and stimulation through the same cuff electrode. We conclude that the peroneal nerve can potentially be used to record sensory information for derivation of a stimulator control signal in a foot drop application, while at the same time being stimulated to activate foot dorsiflexors.
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This is a retrospective study of four patients suffering from brachial plexus root avulsion of traumatic origin. Spinal cord stimulation was used to treat pain in all patients. ⋯ A stimulation trial was performed for 2 weeks and during this period the patients showed significant pain relief, so the system was permanently implanted. A significant difference of more than three points in the pain between the first and the last follow-up (0-9 months) on the Visual Analog Scale was obtained with a steady and progressive decrease of the pain scores.