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New approaches in the rehabilitation of upper extremity motor functions in SCI and stroke

The improvement of upper extremity motor functions is one of the more important goals in the rehabilitation of subjects with a central nervous system (CNS) lesion as it increases their independence in daily life activities. The applied treatments or techniques have to take into account the special natures of the different pathologies of unilateral brain injury, e.g. stroke, or spinal cord injury (SCI). Specific treatments and the needed technology are still in development. Two different promising approaches are presented in this talk: neuroprostheses (NP) for grasping and computer assisted isometric training. NP for grasping are systems that generate finger movements by electrically stimulating the motor nerves of the actuating muscles. In order to have the possibility to apply this technology as early as possible in rehabilitation we have developed a system that uses surface stimulation technology combined with flexibly adjustable stimulation patterns and control schemes. Results from 11 SCI subjects have shown that depending on the neurological level of lesion and the impairment scale (ASIA) the NP for grasping can improve the subjects’ grasp performance either by using it in a functional training therapy or as a permanent aid. The transfer of this technology to subjects affected by hemiparetic stroke could be successfully shown in cases of moderate function loss. More severely affected subjects first need an improvement of their reaching capabilities. It could be shown that abnormal movement synergies are often most debilitating with respect to functional recovery following stroke. The result of these abnormal muscle synergies is a coupling between shoulder abduction and elbow flexion which significantly reduces a stroke subject’s reaching space when he/she lifts up the weight of the impaired arm against gravity. With an individually adapted computer assisted training paradigm, which uses visualized torque feedback the subject can learn to correct for the abnormal torque patterns and increase his/her reaching space. In an eight week training the subjects (n=8) learned to progressively deviate from their abnormal torque synergies.
Type of Seminar:
Special Series on Rehabilitation Engineering
Dr. sc. techn. ETH Thierry Keller
Northwestern University, The Feinberg Medical School, Dept. of Physical Therapy & Human Movement Sciences // & Rehabilitation Institute of Chicago, Sensory Motor Performance Program, Chicago, USA
Nov 21, 2002   10:15

ETH Zentrum, Gloriasstrasse 35, Building ETZ , Room E6
Contact Person:

Prof. M. Morari
No downloadable files available.
Biographical Sketch:
Thierry Keller was born in Bern, Switzerland in 1968. He received his Doctorate (Dr. sc. techn.) and his Dipl. Ing. degree in electrical engineering (M.Sc.E.E.) from the Swiss Federal Institute of Technology Zurich (ETHZ), Switzerland in 2001 and 1995, respectively. He is currently working as a visiting research scholar at the Department of Physical Therapy and Human Movement Science, Northwestern University, Chicago and the Sensory Motor Performance Program, Rehabilitation Institute of Chicago. In addition he is in charge of leading the Rehabilitation Engineering Group at ETHZ and the Paraplegic Center of University Hospital Balgrist, Zurich, where he had a position as research engineer and later as research associate between 1995 and 2002. He developed various neuroprostheses that are used to improve walking and grasping functions in spinal cord injured and stroke subjects. His research interests are the development and application of rehabilitation technology. In 2002 he was awarded with a Swiss National Science Foundation (SNF) fellowship for advanced researchers and in 1997 together with Dr. Milos R. Popovic he received the Technology Transfer Award - 1st place.