Functional electrical stimulation (FES) is the use of low-power electric signals on muscle. It has been part of the spinal cord paralysis world for more than 30 years; back in the early 1980s people living with paralysis began to use FES to “ambulate,” while using walkers and braces – not practical or everyday functional, but quite mediagenic. FES is most commonly used today as a means of exercise. FES ergometry “bikes” using surface stimulation are common in rehabs and even some fitness centers.
Ohio, and in particular Cleveland, has always been the epicenter of the FES field. I recently toured the Cleveland FES Center. It was indeed a speed-visit, with 21 sit-downs in a single day. This included ten Ph.D. scientists and three medical doctors, all top hands in what they call neuroprosthetics. I was also introduced to a handful of people using FES in their daily lives, whether for grasping, standing, or coughing. As you might expect, these FES grads like their restored function very much.
It doesn’t take long to figure out that people here are FES geeks, and I mean that in a good, obsessive way. Turnover is low; apparently, they don’t ever let you leave. Smart young techs come here to break into medical engineering; they know a frontier opportunity when they see it. And because of the depth and breadth of the programs, this place is the center of the universe for people seeking non-biological nerve recovery.
The FES Center is a consortium of three institutional partners: Cleveland VA Medical Center, Case Western Reserve University, and MetroHealth Medical Center. The center is funded with a grant portfolio of about $45 million, which supports basic research, clinical research and clinical trials. About half of that comes from the Department of Veterans Affairs.
Hunter Peckham, Ph.D., the executive director for the FES Center, was my host for the day. He’s been around rehabilitation engineering since the slide rule days; he’s considered a titan in functional restoration and it was his competence and charisma that got the multidisciplinary FES Center going 22 years ago.