Neuroprosthesis and Functional Electrical Stimulation (Peripheral)

A neuroprosthesis (NP) externally controls sensory and motor systems in persons with diminished sensation and movement control after a central nervous system injury or disease. An NP, based on peripheral functional electrical stimulation (FES) activates the ascending and descending neural pathways, thereby activates directly and reflexively muscles and activates centers in the CNS. The FES has an orthotic effect on paralyzed muscles and a carryover effect by decreasing the sensory and motor impairment. The carryover effect is maximized when FES is integrated into the mental and physical exercise of functional tasks during the acute phase of the disability. FES-based NP sends bursts of electrical charge pulses via electrodes and creates the pulsating electrical field in the targeted zones of the body. The externally generated pulsatile electrical field activates peripheral nerves that pass through these zones. These externally generated action potentials travel along the peripheral nerves to muscles and to the central nervous system. The most apparent FES results when applied to the peripheral nervous system (PNS) are the restoration of the standing and walking (postural control), generation of cyclic movements suitable for pedaling, and manipulation and grasping. The activation of afferent neural pathways contributes to the increased inflow of action potentials to the central nervous system and increases the central nervous system (CNS) excitability. The significant effect of FES of peripheral nerves is the prevention and reduction of secondary complications of paralysis (e.g., cardiovascular deterioration, loss of muscle bulk and strength, decubitus, diminished gastric and urinary functioning, reduced range of movement in joints, spasticity, etc.).