Synthesis of Prosthesis Architectures and Design of Prosthetic Devices for Upper Limb Amputees

This chapter presents a procedure for the Determination of the Optimal Prosthesis Architecture for upper limb amputees (DOPA). The presented approach can consistently manage both the clinical aspects and the technical issues involved in the design of electromechanically actuated prostheses. The procedure is composed on one hand of algorithms useful for analyzing the patients\u2019 requirements and on the other hand of algorithms that perform kinematic and kinetostatic simulations of several architectures of artificial arms attempting to fulfil important activities of daily living. The systematic evaluation of the prosthesis models\u2019 performance can methodically guide designers in the synthesis of the optimal prosthesis that best suits the patients\u2019 requirements

Prototypical Arm Motions from Human Demonstration for Upper-Limb Prosthetic Device Control

Controlling a complex upper limb prosthesis, akin to a healthy arm, is still an open challenge due to the inadequate number of inputs available to amputees. Designs have therefore largely focused on a limited number of controllable degrees of freedom, developing a complex hand and grasp functionality rather than the wrist. This thesis investigates joint coordination based on human demonstrations that aims to vastly simplify the controls of wrist, elbow-wrist, and shoulder-elbow wrist devices.The wide range of motions performed by the human arm during daily tasks makes it desirable to find representative subsets to reduce the dimensionality of these movements for a variety of applications, including the design and control of robotic and prosthetic devices. Here I present the results of an extensive human subjects study and two methods that were used to obtain representative categories of arm use that span naturalistic motions during activities of daily living. First, I sought to identify sets of prototypical upper-limb motions that are functions of a single variable, allowing, for instance, an entire prosthetic or robotic arm to be controlled with a single input from a user, along with a means to select between motions for different tasks. Second, I decouple the orientation from the location of the hand and analyze the hand location in three ways and orientation in three reference frames. Both of these analyses are an application of data driven approaches that reduce the wide range of hand and arm use to a smaller representative set. Together these provide insight into our arm usage in daily life and inform an implementation in prosthetic or robotic devices without the need for additional hardware. To demonstrate the control efficacy of prototypical arm motions in upper-limb prosthetic devices, I developed an immersive virtual reality environment where able-bodied participants tested out different devices and controls. I coined prototypical arm motion control as trajectory control, and I found that as device complexity increased from 3 DOF wrist to 4 DOF elbow-wrist and 7 DOF shoulder-elbow-wrist, it enables users to complete tasks faster with a more intuitive interface without additional body compensation, while featuring better movement cosmesis when compared to standard controls

A novel musculoskeletal joint modelling for orthopaedic applications

This thesis was submitted for the degree of Docter of Philosophy and awarded by Brunel University.The objective of the work carried out in this thesis was to develop analytical and computational tools to model and investigate musculoskeletal human joints. It was recognised that the FEA was used by many researchers in modelling human musculoskeletal motion, loading and stresses. However the continuum mechanics played only a minor role in determining the articular joint motion, and its value was questionable. This is firstly due to the computational cost and secondly due to its impracticality for this application. On the other hand, there isn’t any suitable software for precise articular joint motion analysis to deal with the local joint stresses or non standard joints. The main requirement in orthopaedics field is to develop a modeller software (and its associated theories) to model anatomic joint as it is, without any simplification with respect to joint surface morphology and material properties of surrounding tissues. So that the proposed modeller can be used for evaluating and diagnosing different joint abnormalities but furthermore form the basis for performing implant insertion and analysis of the artificial joints. The work which is presented in this thesis is a new frame work and has been developed for human anatomic joint analysis which describes the joint in terms of its surface geometry and surrounding musculoskeletal tissues. In achieving such a framework several contributions were made to the 6DOF linear and nonlinear joint modelling, the mathematical definition of joint stiffness, tissue path finding and wrapping and the contact with collision analysis. In 6DOF linear joint modelling, the contribution is the development of joint stiffness and damping matrices. This modelling approach is suitable for the linear range of tissue stiffness and damping properties. This is the first of its kind and it gives a firm analytical basis for investigating joints with surrounding tissue and the cartilage. The 6DOF nonlinear joint modelling is a new scheme which is described for modelling the motion of multi bodies joined by non-linear stiffness and contact elements. The proposed method requires no matrix assembly for the stiffness and damping elements or mass elements. The novelty in the nonlinear modelling, relates to the overall algorithmic approach and handling local non-linearity by procedural means. The mathematical definition of joint stiffness is also a new proposal which is based on the mathematical definition of stiffness between two bodies. Based on the joint stiffness matrix properties, number of joint stiffness invariants was obtained analytically such as the centre of stiffness, the principal translational stiffnesses, and the principal rotational stiffnesses. In corresponding to these principal stiffnesses, their principal axes have been also obtained. Altogether, a joint is assessed by six principal axes and six principal stiffnesses and its centre of stiffness. These formulations are new and show that a joint can be described in terms of inherent stiffness properties. It is expected that these will be better in characterising a joint in comparison to laxity based characterisation. The development of tissue path finding and wrapping algorithms are also introduced as new approaches. The musculoskeletal tissue wrapping involves calculating the shortest distance between two points on a meshed surface. A new heuristic algorithm was proposed. The heuristic is based on minimising the accumulative divergence from the straight line between two points on the surface and the direction of travel on the surface (i.e. bone). In contact and collision based development, the novel algorithm has been proposed that detects possible colliding points on the motion trajectory by redefining the distance as a two dimensional measure along the velocity approach vector and perpendicular to this vector. The perpendicular distance determines if there are potentially colliding points, and the distance along the velocity determines how close they are. The closest pair among the potentially colliding points gives the “time to collision”. The algorithm can eliminate the “fly pass” situation where very close points may not collide because of the direction of their relative velocity. All these developed algorithms and modelling theories, have been encompassed in the developed prototype software in order to simulate the anatomic joint articulations through modelling formulations developed. The software platform provides a capability for analysing joints as 6DOF joints based on anatomic joint surfaces. The software is highly interactive and driven by well structured database, designed to be highly flexible for the future developments. Particularly, two case studies are carried out in this thesis in order to generate results relating to all the proposed elements of the study. The results obtained from the case studies show good agreement with previously published results or model based results obtained from Lifemod software, whenever comparison was possible. In some cases the comparison was not possible because there were no equivalent results; the results were supported by other indicators. The modelling based results were also supported by experiments performed in the Brunel Orthopaedic Research and Learning Centre

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

Visualisation of articular motion in orthopaedics

Shouder replacement surgery is difficult surgery, with a relatively large risk on limited post-operative range of motion for patients. Adaptations to the anatomy of joints by placing a prosthesis affects the articulation of the joint. In this thesis we present a software system that simulates and visualises these effects. By loading a CT-scan of the shoulder of a patient we can simulate the range of motion of the joint and visualize limitations as a result of rigid structures of the joint. Surgeons may set up an operation plan and see what the consequences of the operation will be for the range of motion of the patient. The thesis investigates aspects that are relevant for the system. We describe an algorithm to convert the scan data to bone models. In addition, a validation experiment is presented. A method for motion registration and visualisation of recorded kinematic data is presented. Finally, this thesis concerns the application of the system to different surgical problems, such as hip arthroplasty and shoulder fractures.Annafonds Biomet Nederland Clinical Graphics DePuy JTE Johnson & Johnson Dutch Arthritis Association Litos/ Motek Medical TornierUBL - phd migration 201

Experimental Study on Human Arm Reaching with and without a Reduced Mobility for Applications in Medical Human-Interactive Robotics

Along with increasing advances in robotic technologies, there are now significant efforts under way to improve the quality of life especially those with physical disabilities or impairments. Control of such medical human-interactive robotics (HIR) involves complications in its design and control due to uncertain human factors. This dissertation makes its efforts to resolve three main challenges of an advanced HIR controller development: 1) detecting the operator’s motion intent, 2) understanding human motor behavior from the robotic perspective, and 3) generating reference motion for the HIR. Our interests in such challenges are limited to the point-to-point reaching of the human arm for applications of their solutions in the control of rehabilitation exoskeletons, therapeutic haptic devices, and prosthetic arms. In the context of human motion intent detection, a mobile motion capture system (MCS) enhanced with myoprocessors is developed to capture kinematics and dynamics of human arm in reaching movements. The developed MCS adopts wireless IMU (inertial measurement unit) sensors to capture ADL (activities of daily life) motions in the real-life environment. In addition, measured muscle activation patterns from selected muscle groups are converted into muscular force values by myoprocessors. This allows a reliable motion intent detection by quantify one of the most frequently used driving signal of the HIR, EMG (electromyography), in a standardized way. In order to understand the human motor behavior from the robotic viewpoint, a computational model on reaching is required. Since such model can be constituted by experimental observations, this dissertation look into invariant motion features of reaching with and without elbow constraint condition to establish a foundation of the computational model. The HIR should generate its reference motions by reflecting motor behavior of the natural human reaching. Though the accurate approximation of such behavior is critical, we also need to take into account the computational cost, especially for real-time applications such as the HIR control. In this manner, a higher order kinematic synthesis of mechanical linkage systems is adopted to approximate natural human hand profiles. Finally, a novel control concept of a myo-prosthetic arm is proposed as an application of all findings and efforts made in this dissertation

A review on the usability,flexibility, affinity, and affordability of virtual technology for rehabilitation training of upper limb amputees

(1) Background: Prosthetic rehabilitation is essential for upper limb amputees to regain their ability to work. However, the abandonment rate of prosthetics is higher than 50% due to the high cost of rehabilitation. Virtual technology shows potential for improving the availability and cost-effectiveness of prosthetic rehabilitation. This article systematically reviews the application of virtual technology for the prosthetic rehabilitation of upper limb amputees.(2) Methods: We followed PRISMA review guidance, STROBE, and CASP to evaluate the included articles. Finally, 17 articles were screened from 22,609 articles.(3) Results: This study reviews the possible benefits of using virtual technology from four aspects: usability, flexibility, psychological affinity, and long-term affordability. Three significant challenges are also discussed: realism, closed-loop control, and multi-modality integration.(4) Conclusions: Virtual technology allows for flexible and configurable control rehabilitation, both during hospital admissions and after discharge, at a relatively low cost. The technology shows promise in addressing the critical barrier of current prosthetic training issues, potentially improving the practical availability of prosthesis techniques for upper limb amputees