Functional Electrical Stimulation Therapy: Mechanisms for Recovery of Function Following Spinal Cord Injury and Stroke

Abstract

Electrical stimulation is a tool that applies low-energy electrical pulses to artificially generate muscle contractions. If electrical stimulation is used to enable functional movements, such as walking and grasping, then this intervention is called functional electrical stimulation (FES). When FES is used as therapy instead of being used as an orthosis, it is called FES therapy or FET. In this chapter, we introduce recent findings and advances in the field of FET. The findings to date clearly show that FET for reaching and grasping is a therapeutic modality that should be implemented in every rehabilitation institution that is treating individuals with stroke and Spinal Cord Injury (SCI). There is also considerable evidence to support the use of FET as a therapeutic modality to treat drop-foot problem in stroke and incomplete populations. Although phase I randomized control trials have been completed with chronic SCI population using this new FET technology and preliminary findings are encouraging, further research and development are required before the multichannel FET for walking will be ready for clinical implementation. Finally, emerging evidence for the beneficial use of brain-computer interface (BCI) combined with FET (BCI-FET) for improving upper and lower limb function will also be presented.