Within-socket Myoelectric Prediction of Continuous Ankle Kinematics for Control of a Powered Transtibial Prosthesis

Objective. Powered robotic prostheses create a need for natural-feeling user interfaces and robust control schemes. Here, we examined the ability of a nonlinear autoregressive model to continuously map the kinematics of a transtibial prosthesis and electromyographic (EMG) activity recorded within socket to the future estimates of the prosthetic ankle angle in three transtibial amputees. Approach. Model performance was examined across subjects during level treadmill ambulation as a function of the size of the EMG sampling window and the temporal \u27prediction\u27 interval between the EMG/kinematic input and the model\u27s estimate of future ankle angle to characterize the trade-off between model error, sampling window and prediction interval. Main results. Across subjects, deviations in the estimated ankle angle from the actual movement were robust to variations in the EMG sampling window and increased systematically with prediction interval. For prediction intervals up to 150 ms, the average error in the model estimate of ankle angle across the gait cycle was less than 6°. EMG contributions to the model prediction varied across subjects but were consistently localized to the transitions to/from single to double limb support and captured variations from the typical ankle kinematics during level walking. Significance. The use of an autoregressive modeling approach to continuously predict joint kinematics using natural residual muscle activity provides opportunities for direct (transparent) control of a prosthetic joint by the user. The model\u27s predictive capability could prove particularly useful for overcoming delays in signal processing and actuation of the prosthesis, providing a more biomimetic ankle response

Proceedings of the first workshop on Peripheral Machine Interfaces: going beyond traditional surface electromyography

One of the hottest topics in rehabilitation robotics is that of proper control of prosthetic devices. Despite decades of research, the state of the art is dramatically behind the expectations. To shed light on this issue, in June, 2013 the first international workshop on Present and future of non-invasive PNS-Machine Interfaces was convened, hosted by the International Conference on Rehabilitation Robotics. The keyword PNS-Machine Interface (PMI) has been selected to denote human-machine interfaces targeted at the limb-deficient, mainly upper-limb amputees, dealing with signals gathered from the peripheral nervous system (PNS) in a non-invasive way, that is, from the surface of the residuum. The workshop was intended to provide an overview of the state of the art and future perspectives of such interfaces; this paper represents is a collection of opinions expressed by each and every researcher/group involved in it

Proceedings of the first workshop on Peripheral Machine Interfaces: going beyond traditional surface electromyography

abstract: One of the hottest topics in rehabilitation robotics is that of proper control of prosthetic devices. Despite decades of research, the state of the art is dramatically behind the expectations. To shed light on this issue, in June, 2013 the first international workshop on Present and future of non-invasive peripheral nervous system (PNS)–Machine Interfaces (MI; PMI) was convened, hosted by the International Conference on Rehabilitation Robotics. The keyword PMI has been selected to denote human–machine interfaces targeted at the limb-deficient, mainly upper-limb amputees, dealing with signals gathered from the PNS in a non-invasive way, that is, from the surface of the residuum. The workshop was intended to provide an overview of the state of the art and future perspectives of such interfaces; this paper represents is a collection of opinions expressed by each and every researcher/group involved in it

Fiber Bragg Gratings as e-Health Enablers: An Overview for Gait Analysis Applications

Nowadays, the fast advances in sensing technologies and ubiquitous wireless networking are reflected in medical practice. It provides new healthcare advantages under the scope of e-Health applications, enhancing life quality of citizens. The increase of life expectancy of current population comes with its challenges and growing health risks, which include locomotive problems. Such impairments and its rehabilitation require a close monitoring and continuous evaluation, which add financial burdens on an already overloaded healthcare system. Analysis of body movements and gait pattern can help in the rehabilitation of such problems. These monitoring systems should be noninvasive and comfortable, in order to not jeopardize the mobility and the day-to-day activities of citizens. The use of fiber Bragg gratings (FBGs) as e-Health enablers has presented itself as a new topic to be investigated, exploiting the FBGs’ advantages over its electronic counterparts. Although gait analysis has been widely assessed, the use of FBGs in biomechanics and rehabilitation is recent, with a wide field of applications. This chapter provides a review of the application of FBGs for gait analysis monitoring, namely its use in topics such as the monitoring of plantar pressure, angle, and torsion and its integration in rehabilitation exoskeletons and for prosthetic control

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

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

Residual Limb Health and Prosthetics

The residual limb of individuals with lower limb loss is dynamic tissue that is susceptible to both acute and chronic changes to limb volume and health over time. Changes in residual limb volume that affect socket fit may contribute to maladaptive gait patterns and deleterious changes to the socket/limb interface that increase harmful shear stress and contributes to residual limb skin injury. Current socket systems are static and lack the ability to provide end-users and prosthetists with patient-centric data about changes in socket fit over time. There is a need for objective clinical decision-making that results in greater prosthesis usage, improved residual limb health, and better comfort ratings for end-users. Among the socket systems available in the market, the elevated vacuum suspension system improves residual limb skin oxygenation, attenuates socket-induced reactive hyperemia and preserves skin barrier function. This suggests that such a system is compatible with imparting physiological benefits to the residual limb in people with lower limb amputations

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