For many stroke survivors, the road to recovery starts with the peroneal nerve located near the knee. Patients with severe muscle weakness can’t activate the ankle muscles to clear their toes, making it impossible for them to walk without dragging their toes.
Dr. John Chae, attending physician at MetroHealth Medical Center and an associate professor of physical medicine and rehabilitation and biomedical engineering at Case Western Reserve University, uses surface electrodes placed near a patient’s knees and small “switch” devices inserted in his or her shoes to stimulate the nerve. When the patient lifts a foot, the switch sends a signal to the electrode, the nerve responds and the ankle springs upward. The patient then can swing his or her leg forward to become minimally mobile.
To help stroke survivors with more severe impairments, Chae is leading a MetroHealth team at the Cleveland FES Center, which includes MetroHealth, Louis Stokes VA Medical Center and Case Western Reserve University, to develop implantable electrodes and stimulators that will contract paralyzed muscles, enabling patients to move their arms and legs for daily activities such as eating and bath-ing.
Dr. Gary Clark, MetroHealth Medical Center’s medical director for the Rehabilitation Institute of Ohio and chair of the department of physical medicine and rehabilitation at Case Medical School, has had success using FES to treat spinal-cord injuries. The U.S. Department of Education and the National Institute on Disability and Rehabilitation Research recently named Clark’s spinal-cord pro-gram as one of only 14 in the country — and the only one in Ohio — as a “model system site.” The designation comes with a $2.25 million award for clinical research and patient tracking over the next five years.
The technology has helped quadriplegics and paraplegics perform basic functions such as breath-ing without a ventilator, feeding themselves, moving from a bed to a chair and controlling urina-tion. “By improving specific functions for each patient, we improve their quality of life,” he says.
