Upper Extremity Functional Electrical Stimulation (FES) for Restoration of Upper Extremity Function After Spinal Cord Injury (SCI)

Inclusion criteria

• Neurological Injury:

• Traumatic spinal cord injury (SCI): neurological level at or above T1 spinal cord level; AIS A, B, C or D impairment grade

• Group 1 (Acute SCI): Deemed medically stable by medical practitioner, less than 6 months post-injury.
• Group 2 (Chronic SCI): More than 6 months post-injury.

or

• Peripheral nerve injury (PNI), with or without SCI, who are pre- or post- upper extremity (UE) nerve transfer surgery

• Group 3 (Acute Pre- or Post-UE nerve transfer surgery): Deemed medically stable and safe/appropriate to participate in MyndMove UE FES therapy intervention by referring neurosurgeon within 6 months pre- or post-UE nerve transfer surgery.
• Group 4 (Chronic Post-UE nerve transfer surgery): Deemed medically stable and safe/appropriate to participate in MyndMove UE FES therapy intervention by referring neurosurgeon 6 months or more post-UE nerve transfer surgery.

• Has detectable residual connection in upper-limb muscles in at least one of the neurologically affected sides confirmed by a visible contraction when functional electrical stimulation (FES) is applied in at least one upper extremity muscle at baseline.

• Has detectable motor function in at least 1 upper extremity muscle on 1 neurologically affected side confirmed by voluntary electromyography (EMG) or detectable motor evoked potential (MEP) at the baseline assessment. 5. (Aim 2 only) Able to commit to intervention and assessment sessions over a maximum duration of 4 months.

Exclusion criteria

• Traumatic brain injury, stroke, multiple sclerosis, or other disorders that could affect neuromotor function.
• Severe spasticity that could prevent the study protocol as determined by the investigator.
• Major executive dysfunction, dementia, depression, neurocognitive impairments, or other major medical co-morbidities.
• Has contraindications for transcutaneous stimulation using FES such as breakdown of skin in the area that will come into contact with electrodes, thrombosis, or skin disease
• Poorly managed autonomic dysreflexia that could be triggered by FES.
• Unhealed upper extremity fracture, contracture, or pressure sore.
• Implanted neurostimulator (e.g., deep brain stimulation (DBS), epidural/subdural, vagal nerve stimulation (VNS))
• Cardiac pacemaker or intracardiac lines.
• Individuals who require therapy or other care that could interfere with participation in the study.
• Individuals on investigational drugs or any other intervention known to have a potential impact on neuromotor function.
• Individuals with substance disorders, including alcoholism and drug abuse.
• Individuals who are pregnant, breastfeeding, or the desire to become pregnant during the study.
• In the opinion of the investigators, the study is not safe or appropriate for the participant.