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Knowledge

Upper limb

Home > Knowledge Base > FES Treatment Types > Upper limb

Research Evidence
  • Ultrasound Guided Shoulder Rehabilitaion Programme in People with Stroke

    An informative presentation on the use of ultra sound to help infom the rehabilitation programme for shoulder problems post stroke.

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  • The FES-UPP project

    FES Userday April 2017  The FES-UPP project is developing a new FES system that uses multi-channel FES to enable mass practice of functional tasks.

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  • New FES publications Dec 2011

     There have been two new journal articles published

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  • Accelerometer-Triggered electrical stimulation for reach and grasp in chronic stroke patients: A pilot study (Journal abstract)

    This paper describes the pilot study for the REAcH stimulator.  15 people who had chronic stroke used a two channel stimulator for hand opening and elbow extension triggered by movement of the arm.  There was a significant improvement in hand function over the 12 ...

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  • The REAcH Project Participant Information

    The Re-education of arm and Hand function (REAcH) study aims to investigate accelerometer-controlled electrical stimulation of the upper limb in stroke patients.  This patient information document describes who was eligable to participate and what to expect from study.  

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  • A pilot study to investigate the effects of electrical stimulation on recovery of hand function and sensation in subacute stroke patients (Journal abstract)

    This pilot study compared cyclical electrical stimulation of the forearm and elbow extensors to passive stretching.  It looked at the affect of these interventions on hand function and sensation in CVA patients.  The full article is published in Neuromodulation 2005 ...

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  • Clinical experience of the neurocontrol Freehand neuro prosthesis for tetraplegic hand function (Journal article summary)

    This paper gives some of the clinical results from the first 5 people to receive the Freehand system in Salisbury.  The Freehand was an implanted device for the provision of hand function in tetraplegics.  The device went out of production in around 2002.

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  • Clinical experience of the upper limb neurocontrol Freehand system (Conference abstract)

    This paper describes the results of tetraplegic patients who used the implanted FES system, the “Freehand”.  It outlines the changes in hand function and activities of daily living seen in users of the Freehand system.  The device went out of production in ...

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  • Variation in system gain when using voluntary EMG to control electrical stimulation of the same muscle (Conference paper)

    This abstract describes the modulation of EMG activity in the presence of electrical stimulation.  The results indicate that a period of time after the pulse before a sample of EMG can be taken that is representative of voluntary effort varies with stimulation intensity.&...

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  • Can treatment with upper limb electrical stimulation be justified in the severely disabled acute stroke patient? (Conference publication)

    Patients with no upper limb function post-stroke were treated with electrical stimulation over their wrist extensors for eight weeks in addition to their usual therapy.  These patients were compared to a similar group of patients post-stroke who had their usual therapy only.  ...

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  • A pilot study to inform sample-size calculations for an investigation into the effects of Electrical Stimulation on recovery of hand sensation and function in stroke patients

    A preliminary report desrcibing the sample size needed for a larger study investigating the use of FES (Microstim stimulator) in upper limb rehabilitation for CVA patients.

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  • The combined effect of dynamic splinting and neuromuscular electrical stimulation in reducing wrist and elbow contractures in six children with Cerebral Palsy (Journal abstract)

    The aim of this pilot study was to investigate the feasibility of applying the combination of Dynamic splinting (DS) and Neuromuscular electrical stimulation (NMES) in order to improve wrist and elbow function, and range of motion, in children with upper limb contractures due to ...

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  • Restoration of tetraplegic hand function by use of the NeuroControl Freehand System (Journal abstract)

    This paper describes the clinical and surgical implementation of the Freehand system to assist tetraplegic patients with hand function.  This article is published in Journal of Hand Surg Br. 2001 Oct;26(5):459-64.  

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  • Pattern of use and user satisfaction of Neuro Control Freehand System (Journal abstract)

    A questionnaire based study of users of the Freehand upper limb implanted electrical stimulation system.  This device restores lateral and palmar grasp for C5/6 tetraplegics.  The report shows how the device was used and gives the opinions of patients with a&...

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  • Electrical stimulation exercises in the upper limb

    A description of the clinical techniques used in the FES clinic for training upper limb function following stroke (CVA) and spinal cord injury (SCI).  This includes pictures to help with electrode placement and desribes using the microstim exercise stimulator and the ...

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  • A portable system for closed loop control of the paralysed hand using functional electrical stimulation (Journal abstract)

    An introduction to an upper limb electrical stimulation system designed to improve hand function for people with C5/6 tetraplegia.  This article is published in Medical Engineering and Physics 20 (1998) 70-76.  

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  • Sensory Amplification By Cutaneous Electrical Stimulation For Retraining Proprioception

    This paper describes a system for retraining upper limb sensory function following stroke, specifically in the hand.  In this case study, improvements were shown in both sensation and motor function.

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Clinical Guidelines
  • NICE Guidelines: Long Term Rehabilitation After Stroke

    NICE have published a summary of their recommendations for stroke rehabilitation which incorporate guidelines for electrical stimulation(ES) for both upper limb and lower limb.  While stating the ES for the upper limb is not routinely used for all patients, recommendations are given ...

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  • Upper limb video and SIGN guidelines

    This article links to videos showing upper limb electrode placement around the shoulder and upper arm and also links to The Scottish Intercollegiate Guidelines Network (SIGN), document which recommends the use of electrical stimulation in stroke patients, at risk of developing shoulder subluxation.

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Clinical Advice
  • Upper Limb FES positions From Birmingham Clinic April 2017 FES User Day

    FES Userday 2017 A selection of upper limb electrode positions 

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  • Upper limb tips and tricks

    FES Userday April 2017  Presentation slides showing the standard treatment pathways and stimulation techniques for upper limb therapies.

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  • Upper Limb Service Queen Mary’s Hospital, London

    This presentation was part of the Upper Limb workshop that took place on a User Day.  This presentation outlines the service provision at Queen’s Mary Hospital, the service pathway, outcome measures used and the limitations within the service.

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  • Referral Criteria and contraindications for FES

    This article describes the referral criteria and contraindications for people wishing to receive FES treatment at OML.

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  • Salisbury FES service- iFESs FES Workshop Korea 2009

    A summary of a workshop given at the 2009 IFESS meeting in Korea.  The talk gave a practical description of the clinical FES treatments provided in Salisbury including FES in gait (ODFS III, two-channel, STIMuSTEP) and upper limb rehabilitation (including the REaCH stimultor).

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  • Full referral criteria and clinical pathway

    A summary document providing all the essential information for clinicians making a referral for FES treatment.  An introduction is given to FES and the main research evidence described.  The referral criteria and clinical procedures are then described for both FES for walking and upper ...

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  • Splinting and FES in the upper limb

    This article briefly discusses the use of splinting to assist upper limb electrical stimulation and covers some examples used in Salisbury.  Splints were mainly used around the hand, although a small number of elbow drop-out casts were also used.

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