Novel Bidirectional Body - Machine Interface to Control Upper Limb Prosthesis

Objective. The journey of a bionic prosthetic user is characterized by the opportunities and limitations involved in adopting a device (the prosthesis) that should enable activities of daily living (ADL). Within this context, experiencing a bionic hand as a functional (and, possibly, embodied) limb constitutes the premise for mitigating the risk of its abandonment through the continuous use of the device. To achieve such a result, different aspects must be considered for making the artificial limb an effective support for carrying out ADLs. Among them, intuitive and robust control is fundamental to improving amputees’ quality of life using upper limb prostheses. Still, as artificial proprioception is essential to perceive the prosthesis movement without constant visual attention, a good control framework may not be enough to restore practical functionality to the limb. To overcome this, bidirectional communication between the user and the prosthesis has been recently introduced and is a requirement of utmost importance in developing prosthetic hands. Indeed, closing the control loop between the user and a prosthesis by providing artificial sensory feedback is a fundamental step towards the complete restoration of the lost sensory-motor functions. Within my PhD work, I proposed the development of a more controllable and sensitive human-like hand prosthesis, i.e., the Hannes prosthetic hand, to improve its usability and effectiveness. Approach. To achieve the objectives of this thesis work, I developed a modular and scalable software and firmware architecture to control the Hannes prosthetic multi-Degree of Freedom (DoF) system and to fit all users’ needs (hand aperture, wrist rotation, and wrist flexion in different combinations). On top of this, I developed several Pattern Recognition (PR) algorithms to translate electromyographic (EMG) activity into complex movements. However, stability and repeatability were still unmet requirements in multi-DoF upper limb systems; hence, I started by investigating different strategies to produce a more robust control. To do this, EMG signals were collected from trans-radial amputees using an array of up to six sensors placed over the skin. Secondly, I developed a vibrotactile system to implement haptic feedback to restore proprioception and create a bidirectional connection between the user and the prosthesis. Similarly, I implemented an object stiffness detection to restore tactile sensation able to connect the user with the external word. This closed-loop control between EMG and vibration feedback is essential to implementing a Bidirectional Body - Machine Interface to impact amputees’ daily life strongly. For each of these three activities: (i) implementation of robust pattern recognition control algorithms, (ii) restoration of proprioception, and (iii) restoration of the feeling of the grasped object's stiffness, I performed a study where data from healthy subjects and amputees was collected, in order to demonstrate the efficacy and usability of my implementations. In each study, I evaluated both the algorithms and the subjects’ ability to use the prosthesis by means of the F1Score parameter (offline) and the Target Achievement Control test-TAC (online). With this test, I analyzed the error rate, path efficiency, and time efficiency in completing different tasks. Main results. Among the several tested methods for Pattern Recognition, the Non-Linear Logistic Regression (NLR) resulted to be the best algorithm in terms of F1Score (99%, robustness), whereas the minimum number of electrodes needed for its functioning was determined to be 4 in the conducted offline analyses. Further, I demonstrated that its low computational burden allowed its implementation and integration on a microcontroller running at a sampling frequency of 300Hz (efficiency). Finally, the online implementation allowed the subject to simultaneously control the Hannes prosthesis DoFs, in a bioinspired and human-like way. In addition, I performed further tests with the same NLR-based control by endowing it with closed-loop proprioceptive feedback. In this scenario, the results achieved during the TAC test obtained an error rate of 15% and a path efficiency of 60% in experiments where no sources of information were available (no visual and no audio feedback). Such results demonstrated an improvement in the controllability of the system with an impact on user experience. Significance. The obtained results confirmed the hypothesis of improving robustness and efficiency of a prosthetic control thanks to of the implemented closed-loop approach. The bidirectional communication between the user and the prosthesis is capable to restore the loss of sensory functionality, with promising implications on direct translation in the clinical practice

Characterisation of the Clothespin relocation task as a functional assessment tool

Method: The Clothespin Relocation Task has been adapted from an arm training tool to create an instrument to measure hand function. It is based in the time to move three clothespins from a horizontal to a vertical bar, and back. To be generally useful, the measures need to have their psychometric properties investigated. This paper measures the characteristics of an able bodied population to gain an understanding of the underlying statistical properties of the test, in order that it can then be used to compare with different subject groups. Fifty adults (29 males, 21 females, mean age 31) were tested with five runs of three clothespins moved up and then down. Ten subjects returned twice more to observe repeatability. Results: There was a non-Gaussian range of times, from 2.5s to 7.37s. Mean time for Up was 4.1s, and was 4.0s for Down, with a skew towards the faster times of 0.57 for Up and 0.97 for Down. Over the three sessions there was a small (not significant) increase in speed 4.1+/-0.5s first run Down to 3.5 +/-0.4s for third. Conclusion: These initial tests confirm that it has potential to be used as a measurement of the performance of arm movement

Wearable Movement Sensors for Rehabilitation: From Technology to Clinical Practice

This Special Issue shows a range of potential opportunities for the application of wearable movement sensors in motor rehabilitation. However, the papers surely do not cover the whole field of physical behavior monitoring in motor rehabilitation. Most studies in this Special Issue focused on the technical validation of wearable sensors and the development of algorithms. Clinical validation studies, studies applying wearable sensors for the monitoring of physical behavior in daily life conditions, and papers about the implementation of wearable sensors in motor rehabilitation are under-represented in this Special Issue. Studies investigating the usability and feasibility of wearable movement sensors in clinical populations were lacking. We encourage researchers to investigate the usability, acceptance, feasibility, reliability, and clinical validity of wearable sensors in clinical populations to facilitate the application of wearable movement sensors in motor rehabilitation

Biceps brachii synergy and its contribution to target reaching tasks within a virtual cube

Ces dernières années, des travaux importants ont été observés dans le développement du contrôle prothétique afin d'aider les personnes amputées du membre supérieur à améliorer leur qualité de vie au quotidien. Certaines prothèses myoélectriques modernes des membres supérieurs disponibles dans le commerce ont de nombreux degrés de liberté et nécessitent de nombreux signaux de contrôle pour réaliser plusieurs tâches fréquemment utilisées dans la vie quotidienne. Pour obtenir plusieurs signaux de contrôle, de nombreux muscles sont requis mais pour les personnes ayant subi une amputation du membre supérieur, le nombre de muscles disponibles est plus ou moins réduit selon le niveau de l’amputation. Pour accroître le nombre de signaux de contrôle, nous nous sommes intéressés au biceps brachial, vu qu’anatomiquement il est formé de 2 chefs et que de la présence de compartiments a été observée sur sa face interne. Physiologiquement, il a été trouvé que les unités motrices du biceps sont activées à différents endroits du muscle lors de la production de diverses tâches fonctionnelles. De plus, il semblerait que le système nerveux central puisse se servir de la synergie musculaire pour arriver à facilement produire plusieurs mouvements. Dans un premier temps on a donc identifié que la synergie musculaire était présente chez le biceps de sujets normaux et on a montré que les caractéristiques de cette synergie permettaient d’identifier la posture statique de la main lorsque les signaux du biceps avaient été enregistrés. Dans un deuxième temps, on a réussi à démontrer qu’il était possible, dans un cube présenté sur écran, à contrôler la position d’une sphère en vue d’atteindre diverses cibles en utilisant la synergie musculaire du biceps. Les techniques de classification utilisées pourraient servir à faciliter le contrôle des prothèses myoélectriques.In recent years, important work has been done in the development of prosthetic control to help upper limb amputees improve their quality of life on a daily basis. Some modern commercially available upper limb myoelectric prostheses have many degrees of freedom and require many control signals to perform several tasks commonly used in everyday life. To obtain several control signals, many muscles are required, but for people with upper limb amputation, the number of muscles available is more or less reduced, depending on the level of amputation. To increase the number of control signals, we were interested in the biceps brachii, since it is anatomically composed of 2 heads and the presence of compartments was observed on its internal face. Physiologically, it has been found that the motor units of the biceps are activated at different places of the muscle during production of various functional tasks. In addition, it appears that the central nervous system can use muscle synergy to easily produce multiple movements. In this research, muscle synergy was first identified to be present in the biceps of normal subjects, and it was shown that the characteristics of this synergy allowed the identification of static posture of the hand when the biceps signals had been recorded. In a second investigation, we demonstrated that it was possible in a virtual cube presented on a screen to control online the position of a sphere to reach various targets by using muscle synergy of the biceps. Classification techniques have been used to improve the classification of muscular synergy features, and these classification techniques can be integrated with control algorithm that produces dynamic movement of myoelectric prostheses to facilitate the training of prosthetic control

Rehabilitation Engineering

Population ageing has major consequences and implications in all areas of our daily life as well as other important aspects, such as economic growth, savings, investment and consumption, labour markets, pensions, property and care from one generation to another. Additionally, health and related care, family composition and life-style, housing and migration are also affected. Given the rapid increase in the aging of the population and the further increase that is expected in the coming years, an important problem that has to be faced is the corresponding increase in chronic illness, disabilities, and loss of functional independence endemic to the elderly (WHO 2008). For this reason, novel methods of rehabilitation and care management are urgently needed. This book covers many rehabilitation support systems and robots developed for upper limbs, lower limbs as well as visually impaired condition. Other than upper limbs, the lower limb research works are also discussed like motorized foot rest for electric powered wheelchair and standing assistance device

Use of stance control knee-ankle-foot orthoses : a review of the literature

The use of stance control orthotic knee joints are becoming increasingly popular as unlike locked knee-ankle-foot orthoses, these joints allow the limb to swing freely in swing phase while providing stance phase stability, thus aiming to promote a more physiological and energy efficient gait. It is of paramount importance that all aspects of this technology is monitored and evaluated as the demand for evidence based practice and cost effective rehabilitation increases. A robust and thorough literature review was conducted to retrieve all articles which evaluated the use of stance control orthotic knee joints. All relevant databases were searched, including The Knowledge Network, ProQuest, Web of Knowledge, RECAL Legacy, PubMed and Engineering Village. Papers were selected for review if they addressed the use and effectiveness of commercially available stance control orthotic knee joints and included participant(s) trialling the SCKAFO. A total of 11 publications were reviewed and the following questions were developed and answered according to the best available evidence: 1. The effect SCKAFO (stance control knee-ankle-foot orthoses) systems have on kinetic and kinematic gait parameters 2. The effect SCKAFO systems have on the temporal and spatial parameters of gait 3. The effect SCKAFO systems have on the cardiopulmonary and metabolic cost of walking. 4. The effect SCKAFO systems have on muscle power/generation 5. Patient’s perceptions/ compliance of SCKAFO systems Although current research is limited and lacks in methodological quality the evidence available does, on a whole, indicate a positive benefit in the use of SCKAFOs. This is with respect to increased knee flexion during swing phase resulting in sufficient ground clearance, decreased compensatory movements to facilitate swing phase clearance and improved temporal and spatial gait parameters. With the right methodological approach, the benefits of using a SCKAFO system can be evidenced and the research more effectively converted into clinical practice