A robot hand testbed designed for enhancing embodiment and functional neurorehabilitation of body schema in subjects with upper limb impairment or loss.

Many upper limb amputees experience an incessant, post-amputation "phantom limb pain" and report that their missing limbs feel paralyzed in an uncomfortable posture. One hypothesis is that efferent commands no longer generate expected afferent signals, such as proprioceptive feedback from changes in limb configuration, and that the mismatch of motor commands and visual feedback is interpreted as pain. Non-invasive therapeutic techniques for treating phantom limb pain, such as mirror visual feedback (MVF), rely on visualizations of postural changes. Advances in neural interfaces for artificial sensory feedback now make it possible to combine MVF with a high-tech "rubber hand" illusion, in which subjects develop a sense of embodiment with a fake hand when subjected to congruent visual and somatosensory feedback. We discuss clinical benefits that could arise from the confluence of known concepts such as MVF and the rubber hand illusion, and new technologies such as neural interfaces for sensory feedback and highly sensorized robot hand testbeds, such as the "BairClaw" presented here. Our multi-articulating, anthropomorphic robot testbed can be used to study proprioceptive and tactile sensory stimuli during physical finger-object interactions. Conceived for artificial grasp, manipulation, and haptic exploration, the BairClaw could also be used for future studies on the neurorehabilitation of somatosensory disorders due to upper limb impairment or loss. A remote actuation system enables the modular control of tendon-driven hands. The artificial proprioception system enables direct measurement of joint angles and tendon tensions while temperature, vibration, and skin deformation are provided by a multimodal tactile sensor. The provision of multimodal sensory feedback that is spatiotemporally consistent with commanded actions could lead to benefits such as reduced phantom limb pain, and increased prosthesis use due to improved functionality and reduced cognitive burden

Myoelectric forearm prostheses: State of the art from a user-centered perspective

User acceptance of myoelectric forearm prostheses is currently low. Awkward control, lack of feedback, and difficult training are cited as primary reasons. Recently, researchers have focused on exploiting the new possibilities offered by advancements in prosthetic technology. Alternatively, researchers could focus on prosthesis acceptance by developing functional requirements based on activities users are likely to perform. In this article, we describe the process of determining such requirements and then the application of these requirements to evaluating the state of the art in myoelectric forearm prosthesis research. As part of a needs assessment, a workshop was organized involving clinicians (representing end users), academics, and engineers. The resulting needs included an increased number of functions, lower reaction and execution times, and intuitiveness of both control and feedback systems. Reviewing the state of the art of research in the main prosthetic subsystems (electromyographic [EMG] sensing, control, and feedback) showed that modern research prototypes only partly fulfill the requirements. We found that focus should be on validating EMG-sensing results with patients, improving simultaneous control of wrist movements and grasps, deriving optimal parameters for force and position feedback, and taking into account the psychophysical aspects of feedback, such as intensity perception and spatial acuity

Artificial proprioceptive feedback for myoelectric control

The typical control of myoelectric interfaces, whether in laboratory settings or real-life prosthetic applications, largely relies on visual feedback because proprioceptive signals from the controlling muscles are either not available or very noisy. We conducted a set of experiments to test whether artificial proprioceptive feedback, delivered non-invasively to another limb, can improve control of a two-dimensional myoelectrically-controlled computer interface. In these experiments, participants’ were required to reach a target with a visual cursor that was controlled by electromyogram signals recorded from muscles of the left hand, while they were provided with an additional proprioceptive feedback on their right arm by moving it with a robotic manipulandum. Provision of additional artificial proprioceptive feedback improved the angular accuracy of their movements when compared to using visual feedback alone but did not increase the overall accuracy quantified with the average distance between the cursor and the target. The advantages conferred by proprioception were present only when the proprioceptive feedback had similar orientation to the visual feedback in the task space and not when it was mirrored, demonstrating the importance of congruency in feedback modalities for multi-sensory integration. Our results reveal the ability of the human motor system to learn new inter-limb sensory-motor associations; the motor system can utilize task-related sensory feedback, even when it is available on a limb distinct from the one being actuated. In addition, the proposed task structure provides a flexible test paradigm by which the effectiveness of various sensory feedback and multi-sensory integration for myoelectric prosthesis control can be evaluated

The Rice Haptic Rocker: Skin stretch haptic feedback with the Pisa/IIT SoftHand

Touch provides an important cue to perceive the physical properties of the external objects. Recent studies showed that tactile sensation also contributes to our sense of hand position and displacement in perceptual tasks. In this study, we tested the hypothesis that, sliding our hand over a stationary surface, tactile motion may provide a feedback for guiding hand trajectory. We asked participants to touch a plate having parallel ridges at different orientations and to perform a self-paced, straight movement of the hand. In our daily-life experience, tactile slip motion is equal and opposite to hand motion. Here, we used a well-established perceptual illusion to dissociate, in a controlled manner, the two motionestimates. According to previous studies, this stimulus produces a bias in the perceived direction of tactile motion, predicted by tactile flow model. We showed a systematic deviation in the movement of the hand towards a direction opposite to the one predicted by tactile flow, supporting the hypothesis that touch contributes to motor control of the hand. We suggested a model where the perceived hand motion is equal to a weighted sum of the estimate from classical proprioceptive cues (e.g., from musculoskeletal system) and the estimate from tactile slip

Hap-Pro: a wearable haptic device for proprioceptive feedback

Objective: Myolectric hand prostheses have reached a considerable technological level and gained an increasing attention in assistive robotics. However, their abandonment rate remains high, with unintuitive control and lack of sensory feedback being major causes. Among the different types of sensory information, proprioception, e.g. information on hand aperture, is crucial to successfully perform everyday actions. Despite the many attempts in literature to restore and convey this type of feedback, much remains to be done to close the action-perception loop in prosthetic devices. Methods: With this as motivation, in this work we introduce HapPro, a wearable, non-invasive haptic device that can convey proprioceptive information for a prosthetic hand. The device was used with an under-actuated, simple to control anthropomorphic robotic hand, providing information on the level of hand aperture by mapping it to the position of a wheel that can run on the user's forearm. Tests with 43 able bodied subjects and one amputee subject were conducted in order to quantify the effectiveness of HapPro as a feedback device. Results: HapPro provided a good level of accuracy for item discrimination. Participants also reported the device to be intuitive and effective in conveying proprioceptive cues. Similar results were obtained in the proof-of-concept experiment with an amputee subject. Conclusions: Results show that HapPro is able to convey information on the opening of a prosthetic hand in a non-invasive way. Significance: Using this device for proprioceptive feedback could improve usability of myoelectric prostheses, potentially reducing abandonment and increasing quality of life for their users

Reproducing tactile and proprioception based on the human-in-the-closed-loop conceptual approach

Prosthetic limb embodiment remains a significant challenge for many amputees due to traditional designs' lack of sensory feedback. To address this challenge, the effectiveness of non-invasive neuromuscular electrical stimulation (NMES) controlled by a hybrid proportional-differential (PD)-Fuzzy logic system was evaluated for providing real-time proprioception and tactile feedback. The study used a human-in-the-closed-loop approach with ten participants: five upper limb amputees and five non-disabled individuals as the control group. An applied force, the joint angle of a prosthetic hand's finger, and surface electromyography signals generated by the biceps muscle all regulate the intensity of sensory feedback. Additionally, the C6 and C7 myotomes were selected as elicitation sites. The average threshold for detecting action motion and force was around 21° and 1.524N, respectively. The participants successfully reproduced desired joint angles within the range of 0°-110° at five separate intervals. In the weight recognition experiment, the amputee participant's minimum number of false predictions was four. The highest accuracy achieved was 80.66% in detecting object size and stiffness. Additionally, unpaired t-tests were performed for the means of the results of the experiments to determine statistically significant differences between groups. The results suggest that stimulation of myotomes by NMES is an effective non-invasive method for delivering rich multimodal sensation information to individuals with disabilities, including upper limb amputees, without needing visual or auditory cues. These findings contribute to the development of non-invasive sensory substitution in prostheses

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