The goal of this project is to investigate the feasibility of restoring upper extremity function to individuals with high tetraplegia (neurological level of C1-C4) using functional neuromuscular stimulation(FNS) This is the most disabling population of individuals with spinal cord injury, with shoulder shrug typically being the only remaining voluntary arm function. Therefore, restoration of just a few simple functions (e.g. simple self-feeding and grooming activities) would significantly increase the independence and quality of life for these individuals. However, restoring movement function to these individuals has been quite challenging for two primary reasons. First, the number of retained voluntary functions is so low that there is minimal opportunity to substitute for lost functions or even to use these motions to control external devices. Second, individuals with high tetraplegia may exhibit extensive denervation (i.e. lower motor neuron injury) of the shoulder and elbow muscles, which could limit the possibility of using functional neuromuscular stimulation of these muscles to restore movement. We will explore the feasibility of FNS in this population by implanting stimulating electrodes in several upper limb muscles of these individuals and quantifying the increase in strength and movement range produced over the course of several weeks by an FNS-mediated exercise regimen.
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