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

Distributed Sensing and Stimulation Systems Towards Sense of Touch Restoration in Prosthetics

Modern prostheses aim at restoring the functional and aesthetic characteristics of the lost limb. To foster prosthesis embodiment and functionality, it is necessary to restitute both volitional control and sensory feedback. Contemporary feedback interfaces presented in research use few sensors and stimulation units to feedback at most two discrete feedback variables (e.g. grasping force and aperture), whereas the human sense of touch relies on a distributed network of mechanoreceptors providing high-fidelity spatial information. To provide this type of feedback in prosthetics, it is necessary to sense tactile information from artificial skin placed on the prosthesis and transmit tactile feedback above the amputation in order to map the interaction between the prosthesis and the environment. This thesis proposes the integration of distributed sensing systems (e-skin) to acquire tactile sensation, and non-invasive multichannel electrotactile feedback and virtual reality to deliver high-bandwidth information to the user. Its core focus addresses the development and testing of close-loop sensory feedback human-machine interface, based on the latest distributed sensing and stimulation techniques for restoring the sense of touch in prosthetics. To this end, the thesis is comprised of two introductory chapters that describe the state of art in the field, the objectives and the used methodology and contributions; as well as three studies distributed over stimulation system level and sensing system level. The first study presents the development of close-loop compensatory tracking system to evaluate the usability and effectiveness of electrotactile sensory feedback in enabling real-time close-loop control in prosthetics. It examines and compares the subject\u2019s adaptive performance and tolerance to random latencies while performing the dynamic control task (i.e. position control) and simultaneously receiving either visual feedback or electrotactile feedback for communicating the momentary tracking error. Moreover, it reported the minimum time delay needed for an abrupt impairment of users\u2019 performance. The experimental results have shown that electrotactile feedback performance is less prone to changes with longer delays. However, visual feedback drops faster than electrotactile with increased time delays. This is a good indication for the effectiveness of electrotactile feedback in enabling close- loop control in prosthetics, since some delays are inevitable. The second study describes the development of a novel non-invasive compact multichannel interface for electrotactile feedback, containing 24 pads electrode matrix, with fully programmable stimulation unit, that investigates the ability of able-bodied human subjects to localize the electrotactile stimulus delivered through the electrode matrix. Furthermore, it designed a novel dual parameter -modulation (interleaved frequency and intensity) and compared it to conventional stimulation (same frequency for all pads). In addition and for the first time, it compared the electrotactile stimulation to mechanical stimulation. More, it exposes the integration of virtual prosthesis with the developed system in order to achieve better user experience and object manipulation through mapping the acquired real-time collected tactile data and feedback it simultaneously to the user. The experimental results demonstrated that the proposed interleaved coding substantially improved the spatial localization compared to same-frequency stimulation. Furthermore, it showed that same-frequency stimulation was equivalent to mechanical stimulation, whereas the performance with dual-parameter modulation was significantly better. The third study presents the realization of a novel, flexible, screen- printed e-skin based on P(VDF-TrFE) piezoelectric polymers, that would cover the fingertips and the palm of the prosthetic hand (particularly the Michelangelo hand by Ottobock) and an assistive sensorized glove for stroke patients. Moreover, it developed a new validation methodology to examine the sensors behavior while being solicited. The characterization results showed compatibility between the expected (modeled) behavior of the electrical response of each sensor to measured mechanical (normal) force at the skin surface, which in turn proved the combination of both fabrication and assembly processes was successful. This paves the way to define a practical, simplified and reproducible characterization protocol for e-skin patches In conclusion, by adopting innovative methodologies in sensing and stimulation systems, this thesis advances the overall development of close-loop sensory feedback human-machine interface used for restoration of sense of touch in prosthetics. Moreover, this research could lead to high-bandwidth high-fidelity transmission of tactile information for modern dexterous prostheses that could ameliorate the end user experience and facilitate it acceptance in the daily life

Multichannel electrotactile feedback with spatial and mixed coding for closed-loop control of grasping force in hand prostheses

Providing somatosensory feedback to the user of a myoelectric prosthesis is an important goal since it can improve the utility as well as facilitate the embodiment of the assistive system. Most often, the grasping force was selected as the feedback variable and communicated through one or more individual single channel stimulation units (e.g., electrodes, vibration motors). In the present study, an integrated, compact, multichannel solution comprising an array electrode and a programmable stimulator was presented. Two co ding schemes (15 levels), spatial and mixed (spatial and frequency) modulation, were tested in able-bodied subjects, psychometrically and in force control with routine grasping and force tracking using real and simulated prosthesis. The results demonstrated that mixed and spatial coding, although substantially different in psychometric tests, resulted in a similar performance during both force control tasks. Furthermore, the ideal, visual feedback was not better than the tactile feedback in routine grasping. To explain the observed results, a conceptual model was proposed emphasizing that the performance depends on multiple factors, including feedback uncertainty, nature of the task and the reliability of the feedforward control. The study outcomes, specific conclusions and the general model, are relevant for the design of closed-loop myoelectric prostheses utilizing tactile feedback

Combined spatial and frequency encoding for electrotactile feedback of myoelectric signals

Electrotactile stimulation has been commonly used in human–machine interfaces to provide feedback to the user, thereby closing the control loop and improving performance. The encoding approach, which defines the mapping of the feedback information into stimulation profiles, is a critical component of an electrotactile interface. Ideally, the encoding will provide a high-fidelity representation of the feedback variable while being easy to perceive and interpret by the subject. In the present study, we performed a closed-loop experiment wherein discrete and continuous coding schemes are combined to exploit the benefits of both techniques. Subjects performed a muscle activation-matching task relying solely on electrotactile feedback representing the generated myoelectric signal (EMG). In particular, we investigated the performance of two different coding schemes (spatial and spatial combined with frequency) at two feedback resolutions (low: 3 and high: 5 intervals). In both schemes, the stimulation electrodes were placed circumferentially around the upper arm. The magnitude of the normalized EMG was divided into intervals, and each electrode was associated with one interval. When the generated EMG entered one of the intervals, the associated electrode started stimulating. In the combined encoding, the additional frequency modulation of the active electrode also indicated the momentary magnitude of the signal within the interval. The results showed that combined coding decreased the undershooting rate, variability and absolute deviation when the resolution was low but not when the resolution was high, where it actually worsened the performance. This demonstrates that combined coding can improve the effectiveness of EMG feedback, but that this effect is limited by the intrinsic variability of myoelectric control. Our findings, therefore, provide important insights as well as elucidate limitations of the information encoding methods when using electrotactile stimulation to convey a feedback signal characterized by high variability (EMG biofeedback)

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

Exploring Teleimpedance and Tactile Feedback for Intuitive Control of the Pisa/IIT SoftHand

This paper proposes a teleimpedance controller with tactile feedback for more intuitive control of the Pisa/IIT SoftHand. With the aim to realize a robust, efficient and low-cost hand prosthesis design, the SoftHand is developed based on the motor control principle of synergies, through which the immense complexity of the hand is simplified into distinct motor patterns. Due to the built-in flexibility of the hand joints, as the SoftHand grasps, it follows a synergistic path while allowing grasping of objects of various shapes using only a single motor. The DC motor of the hand incorporates a novel teleimpedance control in which the user's postural and stiffness synergy references are tracked in real-time. In addition, for intuitive control of the hand, two tactile interfaces are developed. The first interface (mechanotactile) exploits a disturbance observer which estimates the interaction forces in contact with the grasped object. Estimated interaction forces are then converted and applied to the upper arm of the user via a custom made pressure cuff. The second interface employs vibrotactile feedback based on surface irregularities and acceleration signals and is used to provide the user with information about the surface properties of the object as well as detection of object slippage while grasping. Grasp robustness and intuitiveness of hand control were evaluated in two sets of experiments. Results suggest that incorporating the aforementioned haptic feedback strategies, together with user-driven compliance of the hand, facilitate execution of safe and stable grasps, while suggesting that a low-cost, robust hand employing hardware-based synergies might be a good alternative to traditional myoelectric prostheses