Sensory Feedback for Upper-Limb Prostheses:Opportunities and Barriers

The addition of sensory feedback to upper-limb prostheses has been shown to improve control, increase embodiment, and reduce phantom limb pain. However, most commercial prostheses do not incorporate sensory feedback due to several factors. This paper focuses on the major challenges of a lack of deep understanding of user needs, the unavailability of tailored, realistic outcome measures and the segregation between research on control and sensory feedback. The use of methods such as the Person-Based Approach and co-creation can improve the design and testing process. Stronger collaboration between researchers can integrate different prostheses research areas to accelerate the translation process

A Review of Non-Invasive Haptic Feedback stimulation Techniques for Upper Extremity Prostheses

A sense of touch is essential for amputees to reintegrate into their social and work life. The design of the next generation of the prostheses will have the ability to effectively convey the tactile information between the amputee and the artificial limbs. This work reviews non-invasive haptic feedback stimulation techniques to convey the tactile information from the prosthetic hand to the amputee’s brain. Various types of actuators that been used to stimulate the patient’s residual limb for different types of artificial prostheses in previous studies have been reviewed in terms of functionality, effectiveness, wearability and comfort. The non-invasive hybrid feedback stimulation system was found to be better in terms of the stimulus identification rate of the haptic prostheses’ users. It can be conclude that integrating hybrid haptic feedback stimulation system with the upper limb prostheses leads to improving its acceptance among users

Doctor of Philosophy

dissertationHands are so central to the human experience, yet we often take for granted the capacity to maneuver objects, to form a gesture, or to caress a loved-one’s hand. The effects of hand amputation can be severe, including functional disabilities, chronic phantom pain, and a profound sense of loss which can lead to depression and anxiety. In previous studies, peripheral-nerve interfaces, such as the Utah Slanted Electrode Array (USEA), have shown potential for restoring a sense of touch and prosthesis movement control. This dissertation represents a substantial step forward in the use of the USEAs for clinical careâ€"ultimately providing human amputees with widespread hand sensation that is functionally useful and psychologically meaningful. In completion of this ultimate objective, we report on three major advances. First, we performed the first dual-USEA implantations in human amputees; placing one USEA in the residual median nerve and another USEA in the residual ulnar nerve. Chapter 2 of this dissertation shows that USEAs provided full-hand sensory coverage, and that movement of the implant site to the upper arm in the second subject, proximal to nerve branch-points to extrinsic hand muscles, enabled activation of both proprioceptive sensory percepts and cutaneous percepts. Second, in Chapter 3, we report on successful use of USEA-evoked sensory percepts for functional discrimination tasks. We provide a comprehensive report of functional discrimination among USEA-evoked sensory percepts from three human subjects, including discrimination among multiple proprioceptive or cutaneous sensory percepts with different hand locations, sensory qualities, and/or intensities. Finally, in Chapter 4, we report on the psychological value of multiple degree of freedom prosthesis control, multisensor prosthesis sensation, and closed-loop control. This chapter represents the first report of prosthesis embodiment during closed-loop and open-loop prosthesis control by an amputee, as well as the most sophisticated closed-loop prosthesis control reported in literature to-date, including 5-degree-of-freedom motor control and sensory feedback from 4 hand locations. Ultimately, we expect that USEA-evoked hand sensations may be used as part of a take-home prosthesis system which will provide users with both advanced functional capabilities and a meaningful sense of embodiment and limb restoration

Dermal Sensory Regenerative Peripheral Nerve Interface for Reestablishing Sensory Nerve Feedback in Peripheral Afferents in the Rat

Background: Without meaningful, intuitive sensory feedback, even the most advanced myoelectric devices require significant cognitive demand to control. The dermal sensory regenerative peripheral nerve interface (DS-RPNI) is a biological interface designed to establish high-fidelity sensory feedback from prosthetic limbs. Methods: DS-RPNIs were constructed in rats by securing fascicles of residual sensory peripheral nerves into autologous dermal grafts, with the objectives of confirming regeneration of sensory afferents within DS-RPNIs and establishing the reliability of afferent neural response generation with either mechanical or electrical stimulation. Results: Two months after implantation, DS-RPNIs were healthy and displayed well-vascularized dermis with organized axonal collaterals throughout and no evidence of neuroma. Electrophysiologic signals were recorded proximal from DS-RPNI's sural nerve in response to both mechanical and electrical stimuli and compared with (1) full-thickness skin, (2) deepithelialized skin, and (3) transected sural nerves without DS-RPNI. Mechanical indentation of DS-RPNIs evoked compound sensory nerve action potentials (CSNAPs) that were like those evoked during indentation of full-thickness skin. CSNAP firing rates and waveform amplitudes increased in a graded fashion with increased mechanical indentation. Electrical stimuli delivered to DS-RPNIs reliably elicited CSNAPs at low current thresholds, and CSNAPs gradually increased in amplitude with increasing stimulation current. Conclusions: These findings suggest that afferent nerve fibers successfully reinnervate DS-RPNIs, and that graded stimuli applied to DS-RPNIs produce proximal sensory afferent responses similar to those evoked from normal skin. This confirmation of graded afferent signal transduction through DS-RPNI neural interfaces validate DS-RPNI's potential role of facilitating sensation in human-machine interfacing. Clinical Relevance Statement: The DS-RPNI is a novel biotic-abiotic neural interface that allows for transduction of sensory stimuli into neural signals. It is expected to advance the restoration of natural sensation and development of sensorimotor control in prosthetics.</p

Gamma Band Oscillation Response to Somatosensory Feedback Stimulation Schemes Constructed on Basis of Biphasic Neural Touch Representation

abstract: Prosthetic users abandon devices due to difficulties performing tasks without proper graded or interpretable feedback. The inability to adequately detect and correct error of the device leads to failure and frustration. In advanced prostheses, peripheral nerve stimulation can be used to deliver sensations, but standard schemes used in sensorized prosthetic systems induce percepts inconsistent with natural sensations, providing limited benefit. Recent uses of time varying stimulation strategies appear to produce more practical sensations, but without a clear path to pursue improvements. This dissertation examines the use of physiologically based stimulation strategies to elicit sensations that are more readily interpretable. A psychophysical experiment designed to investigate sensitivities to the discrimination of perturbation direction within precision grip suggests that perception is biomechanically referenced: increased sensitivities along the ulnar-radial axis align with potential anisotropic deformation of the finger pad, indicating somatosensation uses internal information rather than environmental. Contact-site and direction dependent deformation of the finger pad activates complimentary fast adapting and slow adapting mechanoreceptors, exhibiting parallel activity of the two associate temporal patterns: static and dynamic. The spectrum of temporal activity seen in somatosensory cortex can be explained by a combined representation of these distinct response dynamics, a phenomenon referred in this dissertation to “biphasic representation.” In a reach-to-precision-grasp task, neurons in somatosensory cortex were found to possess biphasic firing patterns in their responses to texture, orientation, and movement. Sensitivities seem to align with variable deformation and mechanoreceptor activity: movement and smooth texture responses align with potential fast adapting activation, non-movement and coarse texture responses align with potential increased slow adapting activation, and responses to orientation are conceptually consistent with coding of tangential load. Using evidence of biphasic representations’ association with perceptual priorities, gamma band phase locking is used to compare responses to peripheral nerve stimulation patterns and mechanical stimulation. Vibrotactile and punctate mechanical stimuli are used to represent the practical and impractical percepts commonly observed in peripheral nerve stimulation feedback. Standard patterns of constant parameters closely mimic impractical vibrotactile stimulation while biphasic patterns better mimic punctate stimulation and provide a platform to investigate intragrip dynamics representing contextual activation.Dissertation/ThesisDoctoral Dissertation Biomedical Engineering 201

Intracortical microstimulation of human somatosensory cortex as a source of cutaneous feedback

The field of brain computer interfaces (BCI) has been making rapid advances in decoding brain activity into control signals capable of operating neural prosthetic devices, such as dexterous robotic arms and computer cursors. Potential users of neural prostheses, including people with amputations or spinal cord injuries, retain intact brain function that can be decoded using BCIs. Recent work has demonstrated simultaneous control over up to 10 degrees-of-freedom, but the current paradigms lack a component crucial to normal motor control: somatosensory feedback. Currently, BCIs are controlled using visual feedback alone, which is important for many reaching movement and identifying target locations. However, as the actuators controlled by BCIs become more complex and include devices approximating the performance of human limbs, visual feedback becomes especially limiting, as it cannot convey information used during object manipulation, such as grip force. The objective of this work is to provide real-time, cutaneous, somatosensory feedback to users of dexterous prosthetic limbs under BCI control by applying intracortical microstimulation (ICMS) to primary somatosensory cortex (S1). Long-term microstimulation of the cortex with microelectrode arrays had never been attempted in a human prior to this work, and while this work is ultimately motivated by efforts to improve BCIs, this general approach also enables INTRACORTICAL MICROSTIMULATION OF HUMAN PRIMARY SOMATOSENSORY CORTEX AS A SOURCE OF CUTANEOUS FEEDBACK Sharlene Nicole Flesher, PhD University of Pittsburgh, 2017 v unprecedented access to the human cortex enabling investigations of more basic scientific issues surrounding cutaneous perception, its conscious components, and its role in motor planning and control. To this end, two microelectrode arrays were placed in human somatosensory cortex of a human participant. I first characterized qualities of sensations evoked via ICMS, such as percept location, modality, intensity and size, over a two-year study period. The sensations were found to be focal to a single digit, and increased in intensity linearly with pulse train amplitude, which suggests that ICMS will be a suitable means of relaying locations of object contact with single-digit precision, and a range of grasp forces can be relayed for each location. Additionally, I found these qualities to be stable over a two-year period, suggesting that delivering ICMS was not damaging the electrode-tissue interface. ICMS was then used as a real-time feedback source during BCI control of a robotic limb during tasks ranging from simple force-matching tasks to functional reach, grasp and carry tasks. Finally, we examined the relationship between pulse train parameters and conscious perception of sensations, an endeavor that until now could not have been undertaken. These results demonstrate that ICMS is a suitable means of relaying somatosensory feedback to BCI users. Adding somatosensory feedback to BCI users has the potential to improve embodiment and control of the devices, bringing this technology closer to restoring upper limb function

Neuromorphic hardware for somatosensory neuroprostheses

In individuals with sensory-motor impairments, missing limb functions can be restored using neuroprosthetic devices that directly interface with the nervous system. However, restoring the natural tactile experience through electrical neural stimulation requires complex encoding strategies. Indeed, they are presently limited in effectively conveying or restoring tactile sensations by bandwidth constraints. Neuromorphic technology, which mimics the natural behavior of neurons and synapses, holds promise for replicating the encoding of natural touch, potentially informing neurostimulation design. In this perspective, we propose that incorporating neuromorphic technologies into neuroprostheses could be an effective approach for developing more natural human-machine interfaces, potentially leading to advancements in device performance, acceptability, and embeddability. We also highlight ongoing challenges and the required actions to facilitate the future integration of these advanced technologies

Chronic Use of a Sensitized Bionic Hand Does Not Remap the Sense of Touch

Electrical stimulation of tactile nerve fibers can be used to restore touch through a bionic hand. Ortiz-Catalan et al. show that a mismatch between the location of the sensor on the bionic hand and the tactile experience is not resolved after long-term prosthesis use