Upper limb neuroprostheses: Recent advances and future directions

Abstract

This review covers the main issues related to the various therapeutic modalities that aim to immediately recover the lost/diminished motor function or resulting carryover effects in patients after a central nervous system lesion caused by injury or disease. The presentation concentrates on upper extremities; yet, most therapeutic modalities are appropriate and applicable for the lower extremities. We critically present the state-of-the-art of methods used for indirect and direct stimulation of the central nervous system, stimulation of peripheral sensory-motor systems, the use of exoskeleton and other robotic platforms for rehabilitation, and the combination of robotic and stimulation systems. The review summarizes who could benefit from the new technologies and what the limitations of the neuroprostheses available today are. We illustrate the methodology by 2 examples: a patient after spinal cord injury and a patient suffering from tremors. These examples were selected to show that the current development of technologies and improved knowledge from the life sciences open new horizons. The message to take home is that an improved therapy that applies the appropriate therapy at the right time after the injury has the chance to improve the quality of life of many humans that become victims due to accidents, lifestyle, and many other reasons. The other message that must be the motto of clinicians and researchers is: Get a smile and a happy face back to the patient.