Myoelectric signal from below the level of spinal cord injury as a command source for an implanted upper extremity neuroprosthesis - a case report.
Elizabeth Heald, Kevin Kilgore, Ronald Hart and 2 others
PMID 31375143WHAT IT FOUND
In a person with C6 spinal cord injury, an electrical signal from a foot muscle below the injury controlled an implanted hand grasp device.
On a grasp-release object test, success matched his usual shoulder control, but this was a single case.
Key findings
01An electrical signal from the participant's left flexor digitorum brevis muscle could command the implanted hand grasp device.
02On the grasp-release test, success with this control matched success with the participant's usual shoulder control.
03The participant completed fork, weight, can, and tape with foot-muscle control, and could not complete those objects without the neuroprosthesis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This is a single case report, so it cannot show what will happen in other patients or how many people with spinal cord injury have usable below-injury signals. The participant had used his shoulder-controlled neuroprosthesis daily for over 20 years, so his quick adjustment to foot-muscle control may not apply to a new user. The study did not measure cognitive load or learning time compared with usual control. The authors did not suggest replacing above-injury control and did not conclude that below-injury control is superior. Only one below-injury muscle was tested, and signal strength, reliability, and training effects were not studied.
Declared interests
No conflict-of-interest statement is included in the supplied text. The publication types list NIH extramural and non-U.S. government support.
The easy way to misread this
Do not read this as evidence that foot-muscle EMG control improves hand function or should replace usual control. It was a single case, and grasp-release test success with this control was the same as success with the participant's existing shoulder control.