Functional electrical stimulation of the upper extremities of persons with quadriplegia

Abstract

Introduction. Traumatic injury to the cervical segment of the spinal cord causes disability and quadriplegia. Upper extremity mobility and restoration of hand function for people with quadriplegia is a priority. With coordinated electrical stimulation of peripheral muscles and nerves, known as functional electrical stimulation (FES), this is possible. Upper limb stimulators are designed to increase the physical function and are controlled by users through preserved, uncoupled and limited voluntary movements. Aim. By reviewing the available literature, the aim of the paper was to prove the importance of FES in motor control and functional ability of the upper limbs of people with quadriplegia. Material and method. Using the keywords "quadriplegia", "FES", "upper extremity", "functional ability", "motor control" and "traumatic injury", the three authors searched the databases PubMed, EMBASE, SciELO, BMC, Academia according to pre-established criteria. Edu, Web of Science and Science & Technology (November 2021 - March 2022). Potential papers were selected using the Jovell and Navarro-Rubio classification of study design. Papers older than five years, papers that were not available in their entirety, or in English, were excluded. Fifty-seven papers were classified, and six were included in the research. Results. Functional electrical stimulators improved the functional ability of the upper extremities shortly after application. They cause neurophysiological changes in the central nervous system and cortical reorganization depending on the synchronization of the voluntary command and the successful execution of the planned task. Sensory stimulation is important in the preservation of neurological function because by synchronizing the voluntary command and successfully executing the planned task, neuroplasticity is stimulated. Conclusion. With the emergence of more research and analysis of the obtained results, we can expect the creation of new programs to improve the recovery process of the upper extremities, a greater degree of independence in daily life activities, and a better quality of life for people with quadriplegia.

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