Automated determination of peripheral nerve stimulation parameters to achieve desired effector response - a procedural routine, preliminary studies and proposal of improvements.

Background: The feasibility of selectively stimulating fascicles and fibers within peripheral nerves has been demonstrated by a number of groups. Although various multi-contact electrodes have been developed for this purpose, the lack of procedures for fast determination of stimulation parameters to produce the desired effector activity hampers the clinical application of these techniques.In this paper, we propose an automated search routine that may facilitate the determination of stimulation parameters.

Three methods for investigating, assessing and supporting the normal and pathological gait and manipulation activity.

Three methods to describe biped locomotion as well as manipulation activity are presented. Methods using so-called couple oscillators as rhythm generators are described. Based on a mathematical model, results of computer simulation of biped locomotion are presented.

An apparatus making possible restoration of simple functions of the tetraplegic hand.

In the Rehabilitation Institute at Konstancin investigations and clinical tests have been carried out over the last ten years with a view to restoring the tetraplegic hand function by means of implanted stimulation of the peripheral nerves of the upper extremity. Lately, an apparatus for a tetraplegic has been constructed, based on patient controlled stimulation of the median and radial nerves. In this report the principle of the apparatus and also the initial clinical tests are discussed.

Electrostimulation of the median nerve in tetraplegics by means of implanted stimulators.

The effect of direct electrostimulation of the median nerve in a group of tetraplegic patients is described. In all cases there was an increase in the force, and a prolongation of the period of maintenance, of the maximum movement developed by the stimulated muscles. The method was considered to be sufficiently effective to indicate that programmed stimulation by implanted electrodes would permit functional use of the hand.

Electrostimulation of the median nerve in tetraplegics by means of implanted stimulators.

Since 1971 we studied on the possibility of utilization of implanted stimulators in tetraplegics caused by spinal cord injury of the cervical segment. Restoration to tetraplegic patients of the ability to perform some grasping functions of the hand may make them recover some independence and reduce the degree of disability. The examination conducted so far supplied much valuable information regarding reactions of a neuromuscular system at implanted stimulators as well the influence of systematic stimulation training on functions of the hand.