Prior to having a FES Hand Grasp system surgery the client must go through an entry survey and a series of physiological evaluations. Afterwards, a battery of test are done to determine if the paralyzed muscles will respond to electrical stimulation - this seemed more like an endurance test to me. If the muscles respond in a positive manner, it is then necessary to externally stimulate (exercise) the muscles to prepare them for the operation. This is done so that during the surgery the muscles will not fatigue. This allows the surgeon the best chance of finding the best location for the electrodes to be placed during the surgery.

If the muscles fail to respond to electrical stimulation, other options could be considered. In my situation, the doctor, therapist, and myself elected to have a tendon transfer (posterior deltoid to triceps) on my left arm and the FES electrodes placed in my left hand. Another type of tendon transfer (brachioradialis to flexor pollicis longus and an extensor carpi radialis longus to flexor digitorum profundus - in English this means I can now close my fingers and now have a thumb pinch without the use of electrical stimulation) was decided to be performed on my right hand.

In my situation this combination of FES and tendon transfers have complimented each other very well. Below are pictures of the electrode placement for muscle conditioning in my left hand and arm. This procedure is done daily, for 12 to 16 weeks prior to being admitted for surgery.

Electrode placement for the radial nerve

Electrode placement for the median nerve

Electrode placement for the ulnar nerve