ARCEX Helps Some Patients Regain Hand Function After Spinal Cord Injury
ARCEX therapy offers new hope for some people with spinal cord injuries by helping them regain hand function and greater independence.
Brushing your teeth, controlling a power wheelchair and using a computer can become major rehabilitation goals after a cervical spinal cord injury (SCI). At MetroHealth Rehabilitation Institute, a new device called ARCEX has helped some patients regain the ability to perform daily tasks like these by improving control of their arms and hands.
Since March, MetroHealth occupational therapists have used the noninvasive spinal cord stimulation system with about 10 outpatients. The treatment is available to adults with an incomplete C2-C8 spinal cord injury and a grade of B, C or D on a spinal cord injury assessment exam.
ARCEX is the first noninvasive spinal cord stimulation system specifically for people with spinal cord injuries.
MetroHealth is one of 110 clinics worldwide using the device, and the only one in Ohio offering ARCEX with the potential for insurance reimbursement.
How ARCEX Works
The U.S. Food and Drug Administration authorized ARCEX for use in the U.S. in December 2024. The authorization followed a study demonstrating the system’s safety and effectiveness in improving hand sensation and strength in people with cervical SCI.
The technology resembles functional electrical stimulation, which stimulates nerves or muscles that do not move voluntarily after an injury. ARCEX differs because therapists place the stimulation pads on the skin over the spinal cord, above and below the level of injury on the cervical spine.
“The goal is to excite the spinal cord in areas weakened or interrupted by the injury, so patients can better activate the muscles they still control to use their hands,” says Megan Anderson, MS, OTR/L, an occupational therapist in MetroHealth’s outpatient neurology program.
Patients begin with an evaluation to establish a baseline and identify functional goals. At the next visit, the occupational therapist places the stimulation pads and guides the patient through the same kinds of activities normally used in therapy, adding the stimulation. The team customizes each session based on the patient’s injury type and functional goals.
ARCEX can complement other treatments available at MetroHealth. For some patients, therapists may use it before or after procedures, such as nerve or tendon transfer surgery, pairing the stimulation with occupational therapy to support hand function and individual recovery goals.
Sessions last 45 to 90 minutes. The therapist removes the device before the patient leaves; patients do not wear it at home. The team usually reassesses progress after nine or 10 visits and then decides whether continued treatment is indicated.
Early Results Vary
MetroHealth clinicians have seen a wide range of responses. Some patients have improved their fine motor control or their ability to use both hands together.
Other patients have shown little or no change. Even when someone improves, progress may slow or plateau.
Because MetroHealth’s program is still new, the team does not know why some patients respond while others do not, how much benefit any one patient may gain or whether improvements will last after therapy ends.
“We haven’t had the time to see what happens and to see if the improved function lasts,” Anderson says. “That’s something we will evaluate as time goes on. But if ARCEX can help patients gain greater independence, we want to make it available to them.”
Getting Started
The occupational therapy team evaluates each patient, confirms that ARCEX fits their needs, and establishes functional goals for treatment. Physicians can refer patients directly to the program through Physical Medicine and Rehabilitation.