OrthoJacket: an active FES-hybrid orthosis for the paralysed upper extremity

Abstract

The loss of the grasp function in cervical spinal cord injured (SCI) patients leads to life-long dependency on caregivers and to a tremendous decrease of the quality of life. This article introduces the novel non-invasive modular hybrid neuro-orthosis OrthoJacket for the restoration of the restricted or completely lost hand and arm functions in high tetraplegic SCI individuals. The primary goal of the wearable orthosis is to improve the paralysed upper extremity function and, thus, to enhance a patient's independence in activities of daily living. The system combines the advantage of orthotics in mechanically stabilising joints together with the possibilities of functional electrical stimulation for activation of paralysed muscles. In patients with limited capacity, for force generation, flexible fluidic actuators are used to support the movement. Thus, the system is not only intended for functional restoration but also for training. Several sensor systems together with an intelligent signal processing allow for automatic adaptation to the anatomical and neurological individualities of SCI patients. The integration of novel user interfaces based on residual muscle activities and detection of movement intentions by real-time data mining methods will enable the user to autonomously control the system in a natural and cooperative way.

The influence of functional electrical stimulation on hand motor recovery in stroke patients: a review

“…Future research should further optimize multi-pad systems towards an individual adjustment regarding electrode size, shape, position and stimulation pattern. Moreover, efforts are made to incorporate electrodes into a predefined fabric sleeve reducing the amount of time needed to install the electrode set-up [22]. Another approach to enhance the functionality of stimulation is by combining the FES-based neuroprothesic system with an orthosis providing stability and guidance of the joints [23,24].…”

Hand-in-hand advances in biomedical engineering and sensorimotor restoration

“…In this vein, the new challenge in the production of home-activity oriented and non-stationary systems is the fusion of active exoskeletons (for joint support) with non-invasive FES (for muscular activity) (e.g. the "OrthoJacket"; Schill et al, 2011). However, before implementing non-invasive FES systems in standard rehabilitation procedures, future research on non-invasive solutions will have to address the limitations due to low selectivity in muscular stimulation, weakness in deep muscles' activation, difficulty in movement repeatability, and pain.…”

Human-Machine Interface for the Control of Multi-Function Systems Based on Electrocutaneous Menu: Application to Multi-Grasp Prosthetic Hands

“…For example, reaching and grasping, which are especially complex motor tasks characterized by dexterous movements around multiple degrees of freedom (DoF), can be assisted/restored using arm or hand exoskeletons [1,2] neuroprostheses [3], hybrid systems [3,4], and robotic prostheses [5]. Due to the maturation of the technology, these systems are nowadays designed to match as close as possible the capabilities of the human motor system.…”