A Novel Computational Approach to Stroke Rehabilitation with Synergy-Based Functional Electrical Stimulation

Functional electrical stimulation (FES) has shown promising potential as a therapy for motor function recovery in stroke survivors. Yet over years of clinical exploration, the evidence of clinical efficacy has been inconsistent with limited benefits at best. One of the challenges for FES therapy is that the pathology varies for each post-stroke patient, thus an arbitrary FES paradigm could not optimally recruit the remaining neural resources of patients for functional reorganization. We hypothesize that the computational motor modularity provides a neural compatible way to optimize targeted multi-muscle FES. We further hypothesize that a synergy-based FES therapy with precise assistance to muscles could maximally engage the impaired motor system for restructuring. We tested these hypotheses in our recent clinical studies with the novel synergy-based FES therapy in a task-oriented-training (TOT). This paper presents promising evidence that reveals the underlying neural reformation leading to upper extremity functional recovery.