Functional Impact of a Closed-loop Controlled Grasping Neuroprosthesis in Post-stroke Patients (PREHENSTROKE)

Inclusion criteria

• The patient must have given free and informed consent and signed the consent;
• The patient must be an affiliate or a beneficiary of a health insurance plan;
• The patient is hospitalized as part of routine care and available for at least 3 consecutive days of follow-up during hospitalization;
• Motor deficiency of the upper limb due to a hemorrhagic or ischemic stroke;
• Stroke more than one months old;
• Inability to perform an active extension of the long fingers (opening of the hand) to voluntarily seize an empty glass with a palmar grip (grasping task in the ARAT scale), while the subject can hold the previously placed glass passively in the hand; and / or
• Inability to perform an active thumb extension to voluntarily grasp the handle of a tablespoon (flat, like a key) with a pulpo-lateral thumb-index or key-grip (grasping task in the Wolf Motor Function Scale Test), while the subject can hold the spoon previously placed passively between thumb and index;
• Ability to sit on a chair for at least 2 hours.

Exclusion criteria

• The subject participates in another interventional study;
• The subject is in an exclusion period determined by a previous study;
• The subject is under the protection of justice, guardianship or curatorship;
• The subject refuses to sign or give consent;
• It is not possible to give the subject enlightened information.
• The patient is pregnant, parturient, or breastfeeding;
• Patient with pacemaker;
• Unstable epilepsy;
• Unstable cardiovascular pathology (coronary heart disease, major hypertension, heart failure);
• Dermatological problems counter-indicating the application of surface electrodes;
• Musculotendinous retractions or joint stiffness of the fingers and wrist preventing passive opening of the hand sufficient to perform the functional tasks evaluated;
• Active elbow extension limited to not reaching the ipsilateral knee, the subject sitting (limitation of the approach);
• Upper limb pain limiting movements;
• Major sensory disorders corresponding to a score of the Modified Erasmus Nottingham Sensory Assessment English version of the upper limb <10/44;
• Severe aphasia with aphasia severity scale of the Boston Diagnostic Severity Aphasia Examination <= 3, indicating that there may be a clear decrease in verbal fluency or ease and speed of understanding, with no significant limitation expression or communication;
• Unilateral spatial negligence highlighted with the bell test if the difference between omissions in the left and right fields is greater than or equal to 6;
• Common extensor digitorum muscle and / or extensor thumb muscle non-stimulable with the neuroprosthesis.