Background: The most common chronic sequela after stroke is the loss of arm function, and functional electrical stimulation (FES) applied to the forearm muscles is one of the options to treat it. Surface multi‐field electrodes have emerged, showing a great potential to improve the selectivity of the stimulation, delay muscle fatigue, and provide easier donning and doffing. The muscular selectivity takes on special relevance in the rehabilitation of the upper extremity as hand dexterity requires a wide diversity of specific muscle actions.Methods: This pilot study analyses the movements generated in the wrist and fingers using a commercial multi‐field technology‐based FES device (Fesia Grasp). The study included five patients with hemiplegic subacute stroke, in which scanning of all cathodes of the electrode was carried out daily for 5 days, in two different forearm positions, with the resulting movements being labeled by experienced therapists.Results: The aim of this pilot study was to determine if there were differences between subjects and between forearm positions in terms of produced movements. Movements of the wrist (two movements) and the fingers (six movements) could be achieved in two different forearm positions.Conclusions: The multi‐field electrode of Fesia Grasp enables to generate a wide range of movements of the hand in different positions. This fact could allow to produce more physiological movement patterns during the rehabilitation process with FES, which could have a beneficial effect on the recovery of patients with neurological diseases.

We report a 69 year old who suffered a cardioembolic ischaemic stroke on 23 September 2019, which resulted in a left hemiplegia with motor impairment in upper and lower extremities that made impossible for her to use the affected arm in daily living activities. The person commenced her comprehensive physiotherapy programme based on functional electrical stimulation (FES) in Fesia Clinic rehabilitation centre in October 2020. A multifield technology-based FES device was used, which allowed to train different selective movements in isolation and combined with mirror therapy, achieving excellent functional outcomes.

This study investigates the use of multi-field electrostimulation with the Fesia Grasp device for hand rehabilitation in patients with Multiple Sclerosis (MS). This research aims to evaluate the effectiveness of this novel approach in improving hand function and dexterity in MS patients. A cohort of MS patients with varying degrees of hand impairment underwent a structured rehabilitation program using the Fesia Grasp device, which delivers targeted electrical stimulation to specific muscle groups. Outcome measures assessed multiple aspects of hand function, including gross and fine motor skills, strength, and functional independence, at baseline, post-intervention, and 1-month follow-up. The main finding was a sustained between-group improvement in gross manual dexterity, measured by the Box and Block Test, at 1-month follow-up (p = 0.008, η²ₚ = 0.429). Secondary analyses showed task-specific gains in the experimental group, with significant intragroup improvements in Jebsen–Taylor Hand Function Test items related to simulated feeding (p = 0.012) and lifting light objects (p = 0.036), and a trend toward better performance in stacking checkers (p = 0.069) and faster page-turning (p = 0.046) after the intervention. Other outcomes showed non-significant changes favoring the experimental group. This research contributes to the growing body of evidence supporting the use of advanced electrostimulation techniques in neurological rehabilitation and offers promising implications for enhancing the quality of life for individuals with MS-related hand dysfunction.

Background: Transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) are established interventions to enhance upper limb motor function (ULMF) in people with stroke (PwS). However, evidence supporting their combined use remains limited and inconsistent. This systematic review aims to evaluate the effectiveness of combined tDCS and FES for improving ULMF, activity, and participation in PwS. Methods: A systematic search was conducted across MEDLINE, CINAHL, SPORTDiscus, CENTRAL, SCOPUS, and Web of Science from inception to December 2024. Randomized and controlled clinical trials (RCTs) involving adults (≥18 years) with acute, subacute, or chronic stroke undergoing combined tDCS and FES interventions were included. Methodological quality was assessed with the PEDro scale, and risk of bias was evaluated using the Cochrane RoB2 tool. A qualitative synthesis was performed employing a five-level evidence grading system. Results: Five RCTs involving 148 participants (mean age range: 50.6–61.2 years; 26% female) were included. Stroke chronicity ranged from 7.6 days to 27.5 months post-onset. Four studies reported significant ULMF improvements with the combined intervention. However, activity and participation outcomes were inconsistently assessed, and results remained inconclusive. Methodological quality varied, with one study rated as excellent, two as good, one as fair, and one as poor. The risk of bias was rated high or with concerns in four out of five studies. Conclusions: Based on qualitative synthesis, moderate-level evidence supports the combined use of tDCS and FES for improving ULMF in PwS. However, high variability in protocols, small sample sizes, and the increased risk of bias in most studies limit the strength of these conclusions. Standardized protocols and larger high-quality RCTs are needed to confirm the effectiveness of this combined intervention.

Background: Motor imagery (MI) is a cognitive process that has been shown to be useful in the rehabilitation process after brain injury. Moreover, functional electrical stimulation (FES) and virtual reality (VR) have also been shown to be effective interventions in many parameters, and there is some evidence of their contribution to the improvement of MI capacity. Objective: This study aimed to compare the improvements in MI parameters, grip strength, and manual dexterity obtained using VR, FES, and selective FES based on multifield electrodes in healthy people. Methods: This clinical randomized controlled trial (RCT)with 4 branches will involve 80 healthy university students, with blinded third-party assessment. Participants will be divided into 4 groups: control (no intervention), selective FES (Fesia Grasp), traditional FES (Globus Elite), and Virtual Rehab Hands (Leap Motion sensor). Each group will receive 5 daily sessions, and assessments will be conducted at baseline, postintervention, and follow-up. The Movement Imagery Questionnaire-Revised (MIQ-RS) and chronometry will be used to assess MI, strength will be measured with a digital dynamometer, and manual dexterity will be evaluated with the Nine Hole Peg Test (NHPT) and the Box and Block Test (BBT). Statistical analyses will include 2-way repeated-measures ANOVA with post hoc Bonferroni correction to compare group differences over time, with nonparametric tests (eg, Kruskal-Wallis) being used if normality or variance assumptions are violated. The study will be organized into 3 phases: preparation, data collection, and analysis. The preparation phase will involve finalizing project protocols and obtaining ethical approvals. The data collection phase will consist of recruiting participants, randomizing them into 4 intervention groups, and conducting baseline assessments, followed by intervention sessions. Finally, the analysis phase will focus on evaluating the data collected from all groups and compiling the results for presentation. Results: The study received approval in July 2023, with recruitment and data collection starting in September 2023. The recruitment phase was expected to conclude by July 2024, and the entire study, including the 2-week follow-up, was set to finish in September 2024. As of July 2024, we had enrolled 100% of the sample (N=80 students). We plan to publish the study findings by the end of 2024. Conclusions: Improvements in MI and upper limb functionality are expected, particularly in the selective FES group. This RCT will identify which intervention is most effective in enhancing these skills, with potential benefits for patients with neurological motor disorders. Trial Registration: ClinicalTrials.gov NCT06109025; https://clinicaltrials.gov/study/NCT06109025 International Registered Report Identifier (IRRID): DERR1-10.2196/63329

Background: Stroke is commonly accompanied by motor disorders secondary to the initial injury, and at the mitochondrial level, there is an increase in oxidative stress, causing tissue damage and relating to alteration in motor function. Functional electrical stimulation (FES) therapies can be useful in stroke patients aimed at restoring motor function and improving life quality. Several studies have recently proposed that electrical stimulation modulates mitochondrial biogenesis and physiology; however, the effect of FES on individual complexes comprising the mitochondrial electron transport chain (mETC) remains unknown. Methods: To study the effect of FES therapy on the activity of the mETC, in vitro analyses were conducted using UV‐spectrophotometry of the activity of the complexes (I, II, and IV), glycerol‐3‐phosphate dehydrogenase (G3PDH), and monoamine oxidase (MAO) in peripheral blood mononuclear cells (PBMCs) obtained from stroke patients. Patients' activity of complex II and MAO was also determined in platelets. Analyses were measured before and after 12 rehabilitation sessions based on FES therapy combined with physical exercises. Results: The results showed that the activity of the mETC, G3PDH, and MAO was significantly reduced in pre‐intervention stroke patients compared to healthy volunteers, both in PBMCs and platelets, except for complex II in platelets and MAO in PBMCs. Interestingly, FES intervention increased the mETC, G3PDH, and MAO activity in both cell types of stroke patients. Conclusions: This preliminary study indicates that intervention can restore motor function and mitochondrial activity, which are damaged in stroke patients. However, more research is needed to determine if changes in mitochondrial activity can be used as biomarkers of the pathology and/or the efficacy of intervention.