EMG-driven control in lower limb prostheses: a topic-based systematic review

Background The inability of users to directly and intuitively control their state-of-the-art commercial prosthesis contributes to a low device acceptance rate. Since Electromyography (EMG)-based control has the potential to address those inabilities, research has flourished on investigating its incorporation in microprocessor-controlled lower limb prostheses (MLLPs). However, despite the proposed benefits of doing so, there is no clear explanation regarding the absence of a commercial product, in contrast to their upper limb counterparts. Objective and methodologies This manuscript aims to provide a comparative overview of EMG-driven control methods for MLLPs, to identify their prospects and limitations, and to formulate suggestions on future research and development. This is done by systematically reviewing academical studies on EMG MLLPs. In particular, this review is structured by considering four major topics: (1) type of neuro-control, which discusses methods that allow the nervous system to control prosthetic devices through the muscles; (2) type of EMG-driven controllers, which defines the different classes of EMG controllers proposed in the literature; (3) type of neural input and processing, which describes how EMG-driven controllers are implemented; (4) type of performance assessment, which reports the performance of the current state of the art controllers. Results and conclusions The obtained results show that the lack of quantitative and standardized measures hinders the possibility to analytically compare the performances of different EMG-driven controllers. In relation to this issue, the real efficacy of EMG-driven controllers for MLLPs have yet to be validated. Nevertheless, in anticipation of the development of a standardized approach for validating EMG MLLPs, the literature suggests that combining multiple neuro-controller types has the potential to develop a more seamless and reliable EMG-driven control. This solution has the promise to retain the high performance of the currently employed non-EMG-driven controllers for rhythmic activities such as walking, whilst improving the performance of volitional activities such as task switching or non-repetitive movements. Although EMG-driven controllers suffer from many drawbacks, such as high sensitivity to noise, recent progress in invasive neural interfaces for prosthetic control (bionics) will allow to build a more reliable connection between the user and the MLLPs. Therefore, advancements in powered MLLPs with integrated EMG-driven control have the potential to strongly reduce the effects of psychosomatic conditions and musculoskeletal degenerative pathologies that are currently affecting lower limb amputees

Towards Bidirectional Lower Limb Prostheses: Restoring Proprioception Using EMG Based Vibrotactile Feedback

As a result, they do not effectively replace the lost limb. Electromyography (EMG) control has been widely implemented in upper limb prostheses but is still underdeveloped in lower limb prostheses. The aim of this thesis is to design, develop, and evaluate a novel vibrotactile feedback system in combination with an EMG-controlled powered knee or ankle prosthesis to restore proprioception. This thesis demonstrates that discrete localised vibrations enable proprioceptive sensing for the user through the described sensory feedback system. Three subjects with a major lower limb amputation performed level ground and inclined walking tests under various conditions. The experiments reported in the thesis compare the effects of EMG control with and without sensory feedback on temporal gait symmetry and psychosocial metrics, i.e. cognitive workload assessment, prosthesis embodiment, and confidence. The key results from this thesis are the following: temporal gait symmetry and psychosocial measures tended to improve within and between session, though the results varied widely between subjects. Interference in the rest EMG signal was found when the vibrotactors were activated. Further, subjects were able to distinguish between sensory feedback levels. EMG control initially reduced gait symmetry, but gait symmetry was later increased with sensory feedback. Higher symmetry scores were measured after sensory feedback was turned off, demonstrating learning retention. Similar trends were measured in psychosocial metrics, indicating that the sensory feedback system contributed to perceived improvements of the prosthesis. In summary, results show promising effects of using vibrotactile feedback in combination with EMG control in lower limb prostheses, despite the need to improve system robustness. Longer training with EMG and sensory feedback might improve quality of life of prosthesis users even more

Haptic wearables as sensory replacement, sensory augmentation and trainer - a review

Sensory impairments decrease quality of life and can slow or hinder rehabilitation. Small, computationally powerful electronics have enabled the recent development of wearable systems aimed to improve function for individuals with sensory impairments. The purpose of this review is to synthesize current haptic wearable research for clinical applications involving sensory impairments. We define haptic wearables as untethered, ungrounded body worn devices that interact with skin directly or through clothing and can be used in natural environments outside a laboratory. Results of this review are categorized by degree of sensory impairment. Total impairment, such as in an amputee, blind, or deaf individual, involves haptics acting as sensory replacement; partial impairment, as is common in rehabilitation, involves haptics as sensory augmentation; and no impairment involves haptics as trainer. This review found that wearable haptic devices improved function for a variety of clinical applications including: rehabilitation, prosthetics, vestibular loss, osteoarthritis, vision loss and hearing loss. Future haptic wearables development should focus on clinical needs, intuitive and multimodal haptic displays, low energy demands, and biomechanical compliance for long-term usage

Stochastic Resonance Reduces Sway and Gait Variability in Individuals With Unilateral Transtibial Amputation: A Pilot Study

Sub-threshold (imperceptible) vibration, applied to parts of the body, impacts how people move and perceive our world. Could this idea help someone who has lost part of their limb? Sub-threshold vibration was applied to the thigh of the affected limb of 20 people with unilateral transtibial amputation. Vibration conditions tested included two noise structures: pink and white. Center of pressure (COP) excursion (range and root-mean-square displacements) during quiet standing, and speed and spatial stride measures (mean and standard deviations of step length and width) during walking were assessed. Pink noise vibration decreased COP displacements in standing, and white noise vibration decreased sound limb step length standard deviation in walking. Sub-threshold vibration positively impacted aspects of both posture and gait; however, different noise structures had different effects. The current study represents foundational work in understanding the potential benefits of incorporating stochastic resonance as an intervention for individuals with amputation

Customized vibration generator for state of health monitoring of prosthetic implants and pseudo-bionic machine-human feedbacks

Modern industrial, household and other equipment include sophisticated power mechanisms and complicated control solutions that require tighter human-machine-human interactions to form the structures known as cyber-physical-human systems. Their significant parts are human-machine command links and machine-human feedbacks. Such systems are found in medicine, e.g., in orthopedics, where they are important for the operation and functional abilities of orthopedic devices-wheelchair, prosthesis, rehabilitation units, etc. The mentioned feedbacks may be implemented based on the haptic perceptions that requires vibration actuators. In orthopedics, such actuators can be used also for diagnostic purposes. This research brings forward the idea of the use of 3D printing in conjunction with high quality permanent magnets. This allows for the achievement of better efficiency, smaller size, and the developing of actuators individually for particular circumstances. The obtained simulation, experimental data, and data about 3D manufacturing generally confirm the above hypothesis. In particular, the stiffness coefficient of the actuator's membrane and attached mass, which can be changed easily during 3D printing, affects the frequency of maximal power output. Secondly, the 3D manufacturing process is quick, tunable and rather cheap. Finally, an elaboration of the design of the actuator that allows for the real-time modification of stiffness and mass in a program way is planned for future workspublishersversionPeer reviewe

Towards Natural Control of Artificial Limbs

The use of implantable electrodes has been long thought as the solution for a more natural control of artificial limbs, as these offer access to long-term stable and physiologically appropriate sources of control, as well as the possibility to elicit appropriate sensory feedback via neurostimulation. Although these ideas have been explored since the 1960’s, the lack of a long-term stable human-machine interface has prevented the utilization of even the simplest implanted electrodes in clinically viable limb prostheses.In this thesis, a novel human-machine interface for bidirectional communication between implanted electrodes and the artificial limb was developed and clinically implemented. The long-term stability was achieved via osseointegration, which has been shown to provide stable skeletal attachment. By enhancing this technology as a communication gateway, the longest clinical implementation of prosthetic control sourced by implanted electrodes has been achieved, as well as the first in modern times. The first recipient has used it uninterruptedly in daily and professional activities for over one year. Prosthetic control was found to improve in resolution while requiring less muscular effort, as well as to be resilient to motion artifacts, limb position, and environmental conditions.In order to support this work, the literature was reviewed in search of reliable and safe neuromuscular electrodes that could be immediately used in humans. Additional work was conducted to improve the signal-to-noise ratio and increase the amount of information retrievable from extraneural recordings. Different signal processing and pattern recognition algorithms were investigated and further developed towards real-time and simultaneous prediction of limb movements. These algorithms were used to demonstrate that higher functionality could be restored by intuitive control of distal joints, and that such control remains viable over time when using epimysial electrodes. Lastly, the long-term viability of direct nerve stimulation to produce intuitive sensory feedback was also demonstrated.The possibility to permanently and reliably access implanted electrodes, thus making them viable for prosthetic control, is potentially the main contribution of this work. Furthermore, the opportunity to chronically record and stimulate the neuromuscular system offers new venues for the prediction of complex limb motions and increased understanding of somatosensory perception. Therefore, the technology developed here, combining stable attachment with permanent and reliable human-machine communication, is considered by the author as a critical step towards more functional artificial limbs

An Underactuated Active Transfemoral Prosthesis With Series Elastic Actuators Enables Multiple Locomotion Tasks

Robotic lower limb prostheses have the power to revolutionize mobility by enhancing gait efficiency and facilitating movement. While several design approaches have been explored to create lightweight and energy-efficient devices, the potential of underactuation remains largely untapped in lower limb prosthetics. Taking inspiration from the natural harmony of walking, in this article, we have developed an innovative active transfemoral prosthesis. By incorporating underactuation, our design uses a single power actuator placed near the knee joint and connected to a differential mechanism to drive both the knee and ankle joints. We conduct comprehensive benchtop tests and evaluate the prosthesis with three individuals who have above-knee amputations, assessing its performance in walking, stair climbing, and transitions between sitting and standing. Our evaluation focuses on gathering position and torque data recorded from sensors integrated into the prosthesis and comparing these measurements to biomechanical data of able-bodied locomotion. Our findings highlight the promise of underactuation in advancing lower limb prosthetics and demonstrate the feasibility of our knee–ankle underactuated design in various tasks, showcasing its ability to replicate natural movement