Rune Asbjørn Thorsen

• M.Sc.e.e, Ph.D.
• Fondazione Don Carlo Gnocchi

Background Task-oriented training (TOT) is a commonly used intervention to improve upper extremity function after stroke. However, predictors of response to rehabilitation for performance and participation remain poorly understood. Aim To identify baseline predictors of clinically significant upper extremity (UE) recovery across impairment, perfor...

This paper describes the results of using a parametric design platform to configure and 3D print assistive devices (AD) and how they compare with a commercial counterpart (CommAD). The configurable AD (ConfAD) was a fork/spoon holder. Five subjects with cerebral palsy participated in the study and each had a ConfAD made to fit their dominant hand....

Purpose: Digital fabrication, like 3D printing, is a new opportunity for rehabilitation professionals to produce customized assistive devices. It allows for empowerment and collaboration in device procurement, but practical implementations are scarcely described. We describe the workflow, discuss feasibility and propose directions for future work....

Myoelectrically Controlled Functional Electrical Stimulation (MeCFES) has proven to be a useful tool in the rehabilitation of the hemiplegic arm. This paper reports the steps involved in the development of a wearable MeCFES device (FITFES) through a user-centered design. We defined the minimal viable features and functionalities requirements for th...

Background: Functional recovery of the plegic upper limb in post-stroke patients may be enhanced by sequentially applying a myoelectrically controlled FES (MeCFES), which allows the patient to voluntarily control the muscle contraction during a functional movement and robotic therapy which allows many repetitions of movements. Objective: Evaluat...

People with tetraplegia are often lacking grip strength, causing impairment in activities of daily living. For them, improving hand function is a priority because it is important for autonomy and participation in daily life. A tendon transfer surgery may be an option to improve the tenodesis grip, but it is an invasive procedure. Alternatively a si...

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Commercially available assistive devices (AD) may not always match individual needs of the patient. Sometimes substantial customizations or a new design is needed. New ideas, arising by involving the patient, could help many, but product development and marketing is hard. We hypothesize that digital fabrication (DF), e.g. 3D printing, may be an opp...

Purpose Motor recovery of persons after stroke may be enhanced by a novel approach where residual muscle activity is facilitated by patient-controlled electrical muscle activation. Myoelectric activity from hemiparetic muscles is then used for continuous control of functional electrical stimulation (MeCFES) of same or synergic muscles to promote re...

Objectives . The primary purpose of this study was to evaluate myoelectrically controlled functional electrical stimulation (MeCFES) for enhancing the tenodesis grip in people with tetraplegia. The second aim was to estimate the potential number of candidates for the MeCFES device. The application of MeCFES provides the user with direct control of...

Physical therapy interventions are resource demanding and subject to many confounding factors. Patient compliance and dose-response relationship are issues that are largely untargeted by research. The guidelines do not explicit the intensity, but states that “we do not know the minimum level of treatment, below which the rehabilitative approach doe...

The objective of this randomized controlled pilot study was to assess the feasibility and effectiveness of myoelectrically controlled functional electrical stimulation (MeCFES) for rehabilitation of the upper limb in poststroke subjects. Eleven poststroke hemiparetic subjects with residual proximal control of the arm, but impaired volitional openin...

Background: Few epidemiological data are available regarding distribution of cervical spinal cord injury with respect to level of lesion and the relationship between the neurological level of lesion and residual hand function. Such data are important to evaluate the relevance of innovative therapeutic approaches, and to plan prospective clinical t...

A multicenter trial of myoelectrically-controlled FES (MeCFES) for assisting hand function in subjects with C5-C7 myelopathy and tetraplegia is described. The aim of the study is to test the incidence of potential users, the effectiveness as an orthotic device and the utility for activities of daily living (ADL). Myoelectric signal from the wrist e...

Surface Functional Electrical Stimulation (FES) requires high stimulation voltages. A step-up transformer in the output stage of the stimulation circuit is often used. In the present technical paper a voltage controlled current source (VCCS) is presented as an alternative to the transformer coupling. Two (master-slave) coupled transconductance ampl...

A multicenter trial of Myoelectrically controlled FES (MeCFES) for assisting hand function in subjects with tetraplegia (C4 incomplete-C7) is described. The objectives of the study are: to estimate the percentage of potential users among the tetraplegic population, the effectiveness as an orthotic device and the utility for activities of daily livi...

A quantitative and objective method based on the optoelectronic kinematic analysis of hand segments and on the calculation of global and partial parameters, which provide measures of the degree of long finger and thumb extension is proposed for the evaluation of the hand's voluntary range of motion and maximal opening of the fingers and thumb. To t...

We demonstrated a method for enhancing the tenodesis grip in individuals with sustained tetraplegia at the 6th cervical vertebra neurological level. Subjects used the myoelectric activity from wrist extensor muscles to directly control the electrical stimulation of the extrinsic finger and thumb flexors (flexor pollicis longus and flexor digitorum...

Objective The purpose of this study was to test if the F-response can be repressed volitionally. Normally, the F-response is used for clinical diagnostics but it also has an important influence on the design of a neural prosthesis involving functional electrical stimulation (FES) and the use of volitional myoelectric signal (MES) for control. Metho...

The objective of this study was to test myoelectrically controlled functional electrical stimulation of the same muscle (AutoMCS) on patients with either stroke or spinal cord injury. The paretic anterior tibialis (TA) muscle was stimulated with an amplitude controlled continuously by the volitional myoelectric signal from the same muscle. Surface...

Functional electrical stimulation (FES) of upper limbs can be used for the recovery of some hand functions on patients with CNS lesions. This study deals with the control of FES by means of myoelectrical activity detected from voluntarily activated paretic muscles. The specific aim of this paper is to evaluate the accuracy of myoelectrical control...

In this study of nine subjects with dropped foot, as a result of hemiplegia following stroke, myo-electric signals (EMG) from the anterior tibial muscle (TA) have been used to control functional electrical stimulation (FES) of the same - anterior tibial muscle group. The technique has been termed Auto-Myo-electric Control of FES (AutoMeCFES). Myo-e...

The surface EMG signal detected from voluntarily activated muscles can be used as a control signal for functional neuromuscular electrical stimulation. A proper positioning of the recording electrodes in relation to the stimulation electrodes, and a proper processing of the recorded signals is required to reduce the stimulus artefact and the non-vo...

An amplifier for recording myoelectric signals using surface electrodes has been developed. The special features are suppression of stimulation artefacts and motion artefacts from electrodes. It is designed for recording of myoelectric signals from a muscle that is being stimulated with short impulses. The artifact suppression is achieved by using...

A microprocessor controlled device (MeCFES) was used for the investigation of the possibility of restoring hand function in C5 tetraplegics with paralysis of the hand. To date, 3 tetraplegics have been testing the system. The myoelectric signals from wrist extension were recorded and used as control signals for functional electrical stimulation (FE...

In the present study a procedure to select the optimal muscle and the control law for continuous Myo- electric control of FES by supralesional muscle is developed. The application on the recovery of standing up movements in paraplegic subjects is considered. From the initial results on healthy subjects, it is shown that erector spinae muscles are g...

The F-wave is a randomly occurring response to electric stimulation of the motor nerve that normally is only of clinical interest as a diagnostic tool. It's impact on functional electrical stimulation (FES) has generally not been considered. However it has significant influence on the myoelectrical signal (MES) registered from the stimulated muscle...

The F-wave is a recurrent discharge of an antidromically activated motor neurone and has received little attention in the FES literature. It though may have important influence on the design of neural prosthesis. It is found in the myoelectric signal from the 16Hz stimulated tibialis anterior muscle with a mean latency (tFstart) of 35ms and an end...

A quantitative and objective method for the evaluation of hand voluntary range of motion after a FES rehabilitation program on the upper limb is proposed to obtain a numeric index which provides a global measure of fingers aperture in hemiplegic hand. The hand index (FAI) is computed as the sum of the metacarpophalangeal (MPFi, i=2,..,5) and first...

A method for enhancing the grasp has been tested on selected C6/C7 tetraplegic subjects. Myoelectric activity detected from the wrist extensor muscles was used to proportionally control electrical stimulation delivered to the finger flexors using a specially devised system (MeCFES - Myoelectrically Controlled Functional Electrical Stimulator). Func...