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1.
Neuromodulation ; 17(8): 794-9; discussion 799, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24612356

RESUMO

OBJECTIVES: The objective of this study is to develop a fully implanted, intramuscular, bipolar, myoelectric signal (IM-MES) recording electrode for functional electrical stimulation (FES), prosthetic myoelectric control, and other permanently implantable systems. MATERIALS AND METHODS: An existing fully implanted intramuscular stimulating electrode was modified at each end to allow bipolar recording. The design change also required a modification of the implantation method. Mechanical and in vivo testing was performed on the novel components of the electrode. The first clinical application also is described. RESULTS: The electrode design modifications did not create any areas of excess mechanical strain on the wires at the distal end where the leads were wound into electrode surfaces. In vivo testing showed that the IM-MES electrode recorded myoelectric signals that were equivalent to an existing epimysial MES electrode. The modified implantation method was simple to implement. The IM-MES electrode was used in an upper extremity FES system in an individual with a spinal cord injury and provided signals that were suitable for a command signal. CONCLUSIONS: A fully implanted, bipolar intramuscular recording electrode (IM-MES) was developed. Implantation of the IM-MES is straightforward, and almost any muscle can be targeted. Testing has been performed to demonstrate the suitability of the IM-MES electrode for clinical use. Initial clinical applications were successful.


Assuntos
Estimulação Elétrica/métodos , Eletrodos Implantados , Músculo Esquelético/fisiologia , Próteses e Implantes , Animais , Gatos , Eletromiografia , Potencial Evocado Motor , Humanos , Estimulação Física
2.
J Rehabil Res Dev ; 40(6): 457-68, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-15077658

RESUMO

Implanted neuroprosthetic systems have been successfully used to provide upper-limb function for over 16 years. A critical aspect of these implanted systems is the safety, stability, and-reliability of the stimulating electrodes and leads. These components are (1) the stimulating electrode itself, (2) the electrode lead, and (3) the lead-to-device connector. A failure in any of these components causes the direct loss of the capability to activate a muscle consistently, usually resulting in a decrement in the function provided by the neuroprosthesis. Our results indicate that the electrode, lead, and connector system are extremely durable. We analyzed 238 electrodes that have been implanted as part of an upper-limb neuroprosthesis. Each electrode had been implanted at least 3 years, with a maximum implantation time of over 16 years. Only three electrode-lead failures and one electrode infection occurred, for a survival rate of almost 99 percent. Electrode threshold measurements indicate that the electrode response is stable over time, with no evidence of electrode migration or continual encapsulation in any of the electrodes studied. These results have an impact on the design of implantable neuroprosthetic systems. The electrode-lead component of these systems should no longer be considered a weak technological link.


Assuntos
Terapia por Estimulação Elétrica/métodos , Eletrodos Implantados , Quadriplegia/reabilitação , Extremidade Superior/inervação , Adulto , Estudos de Coortes , Feminino , Força da Mão , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Prognóstico , Desenho de Prótese , Falha de Prótese , Recuperação de Função Fisiológica , Estudos Retrospectivos , Medição de Risco , Traumatismos da Medula Espinal/diagnóstico , Traumatismos da Medula Espinal/reabilitação , Resultado do Tratamento
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