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Abstract Advanced upper limb prostheses aim to restore coordinated hand and arm function. However, this objective can be difficult to quantify as coordinated movements require an intact visuomotor system. Eye tracking has recently been applied to study the visuomotor behaviours of upper limb prosthesis users by enabling the calculation of eye movement metrics. This scoping review aims to characterize the visuomotor behaviours of upper limb prosthesis users as described by eye tracking metrics, to summarize the eye tracking metrics used to describe prosthetic behaviour, and to identify gaps in the literature and potential areas for future research. A review of the literature was performed to identify articles that reported eye tracking metrics to evaluate the visual behaviours of individuals using an upper limb prosthesis. Data on the level of amputation, type of prosthetic device, type of eye tracker, primary eye metrics, secondary outcome metrics, experimental task, aims, and key findings were extracted. Seventeen studies were included in this scoping review. A consistently reported finding is that prosthesis users have a characteristic visuomotor behaviour that differs from that of individuals with intact arm function. Visual attention has been reported to be directed more towards the hand and less towards the target during object manipulation tasks. A gaze switching strategy and delay to disengage gaze from the current target has also been reported. Differences in the type of prosthetic device and experimental task have revealed some distinct gaze behaviours. Control factors have been shown to be related to gaze behaviour, while sensory feedback and training interventions have been demonstrated to reduce the visual attention associated with prosthesis use. Eye tracking metrics have also been used to assess the cognitive load and sense of agency of prosthesis users. Overall, there is evidence that eye tracking is an effective tool to quantitatively assess the visuomotor behaviour of prosthesis users and the recorded eye metrics are sensitive to change in response to various factors. Additional studies are needed to validate the eye metrics used to assess cognitive load and sense of agency in upper limb prosthesis users.

Reliable force control is especially important when using myoelectric upper-limb prostheses as the force defines whether an object will be firmly grasped, damaged, or dropped. It is known from human motor control that the grasping of non-disabled subjects is based on a combination of anticipation and feedback correction. Inspired by this insight, the present study proposes a novel approach to provide artificial sensory feedback to the user of a myoelectric prosthesis using vibrotactile stimulation to facilitate both predictive and corrective processes characteristic of grasping in non-disabled people. Specifically, the level of EMG was conveyed to the subjects while closing the prosthesis (predictive strategy), whereas the actual grasping force was transmitted when the prosthesis closed (corrective strategy). To investigate if this combined EMG and force feedback is indeed an effective method to explicitly close the control loop, 16 non-disabled and 3 transradial amputee subjects performed a set of functional tasks, inspired by the “Box and Block” test, with six target force levels, in three conditions: no feedback, only EMG feedback, and combined feedback. The highest overall performance in non-disabled subjects was obtained with combined feedback (79.6±9.9%), whereas the lowest was achieved with no feedback (53±11.5%). The combined feedback, however, increased the task completion time compared to the other two conditions. A similar trend was obtained also in three amputee subjects. The results, therefore, indicate that the feedback inspired by human motor control is indeed an effective approach to improve prosthesis grasping in realistic conditions when other sources of feedback (vision and audition) are not blocked.

Abstract Background Myoelectric prostheses are a popular choice for restoring motor capability following the loss of a limb, but they do not provide direct feedback to the user about the movements of the device—in other words, kinesthesia. The outcomes of studies providing artificial sensory feedback are often influenced by the availability of incidental feedback. When subjects are blindfolded and disconnected from the prosthesis, artificial sensory feedback consistently improves control; however, when subjects wear a prosthesis and can see the task, benefits often deteriorate or become inconsistent. We theorize that providing artificial sensory feedback about prosthesis speed, which cannot be precisely estimated via vision, will improve the learning and control of a myoelectric prosthesis. Methods In this study, we test a joint-speed feedback system with six transradial amputee subjects to evaluate how it affects myoelectric control and adaptation behavior during a virtual reaching task. Results Our results showed that joint-speed feedback lowered reaching errors and compensatory movements during steady-state reaches. However, the same feedback provided no improvement when control was perturbed. Conclusions These outcomes suggest that the benefit of joint speed feedback may be dependent on the complexity of the myoelectric control and the context of the task.

This paper presents the implementation of an intelligent real-time single-channel electromyography (EMG) signal classifier based on open-source hardware. The article shows the experimental design, analysis, and implementation of a solution to identify four muscle movements from the forearm (extension, pronation, supination, and flexion), for future applications in transradial active prostheses. An EMG signal acquisition instrument was developed, with a 20–450 Hz bandwidth and 2 kHz sampling rate. The signals were stored in a Database, as a multidimensional array, using a desktop application. Numerical and graphic analysis approaches for discriminative capacity were proposed for feature analysis and four feature sets were used to feed the classifier. Artificial Neural Networks (ANN) were implemented for time-domain EMG pattern recognition (PR). The system obtained a classification accuracy of 98.44% and response times per signal of 8.522 ms. Results suggest these methods allow us to understand, intuitively, the behavior of user information.

Abstract Background Cybathlon championship aims at promoting the development of prosthetic and assistive devices capable to meet users’ needs. This paper describes and analyses possible exploitation outcomes of our team’s (REHAB TECH) experience into the Powered Arm Prosthesis Race of the Cybathlon 2020 Global Edition, with the novel prosthetic system Hannes. In detail, we present our analysis on a concurrent evaluation conducted to verify if the Cybathlon training and competition positively influenced pilot’s performance and human-technology integration with Hannes, with respect to a non-runner Hannes user. Methods Two transradial amputees were recruited as pilots (Pilot 1 and Pilot 2) for the Cybathlon competition and were given the polyarticulated myoelectric prosthetic hand Hannes. Due to COVID-19 emergency, only Pilot 1 was trained for the race. However, both pilots kept Hannes for Home Use for seven weeks. Before this period, they both participated to the evaluation of functionality, embodiment, and user experience (UX) related to Hannes, which they repeated at the end of the Home Use and right after the competition. We analysed Pilot 1’s training and race outcomes, as well as changes in the concurrent evaluation, and compared these results with Pilot 2’s ones. Results The Cybathlon training gradually improved Pilot 1’s performances, leading to the sixth place with a single error in task 5. In the parallel evaluation, both pilots had an overall improvement over time, whereas Pilot 2 experienced a deterioration of embodiment. In detail, Pilot 1, who followed the training and raced the Cybathlon, improved in greater way. Conclusion Hannes demonstrated to be a valuable competitor and to perform grasps with human-like behaviors. The higher improvements of Pilot 1, who actively participated in the Cybathlon, in terms of functionality, embodiment and UX, may depend on his training and engagement in the effort of achieving a successful user-prosthesis interaction during the competition. Tasks based on Cybathlon’s ones could improve the training phase of a prosthetic user, stimulating dexterity, prosthetic integration, and user perception towards the prosthesis. Likewise, timed races or competitions could facilitate and accelerate the learning phase, improving the efficiency and efficacy of the process.

This study aimed to highlight the demand for upper limb compound motion decoding to provide a more diversified and flexible operation for the electromyographic hand. In total, 60 compound motions were selected, which were combined with four gestures, five wrist angles, and three strength levels. Both deep learning methods and machine learning classifiers were compared to analyze the decoding performance. For deep learning, three structures and two ways of label encoding were assessed for their training processes and accuracies; for machine learning, 24 classifiers, seven features, and a combination of classifier chains were analyzed. Results show that for this relatively small sample multi-target surface electromyography (sEMG) classification, feature combination (mean absolute value, root mean square, variance, 4th-autoregressive coefficient, wavelength, zero crossings, and slope signal change) with Support Vector Machine (quadric kernel) outstood because of its high accuracy, short training process, less computation cost, and stability (p < 0.05). The decoding result achieved an average test accuracy of 98.42 ± 1.71% with 150 ms sEMG. The average accuracy for separate gestures, wrist angles, and strength levels were 99.35 ± 0.67%, 99.34 ± 0.88%, and 99.04 ± 1.16%. Among all 60 motions, 58 showed a test accuracy greater than 95%, and one part was equal to 100%.

The myoelectric prosthesis is a promising tool to restore the hand abilities of amputees, but the classification accuracy of surface electromyography (sEMG) is not high enough for real-time application. Researchers proposed integrating sEMG signals with another feature that is not affected by amputation. The strong coordination between vision and hand manipulation makes us consider including visual information in prosthetic hand control. In this study, we identified a sweet period during the early reaching phase in which the vision data could yield a higher accuracy in classifying the grasp patterns. Moreover, the visual classification results from the sweet period could be naturally integrated with sEMG data collected during the grasp phase. After the integration, the accuracy of grasp classification increased from 85.5% (only sEMG) to 90.06% (integrated). Knowledge gained from this study encourages us to further explore the methods for incorporating computer vision into myoelectric data to enhance the movement control of prosthetic hands.

Abstract Background Research studies on upper limb prosthesis function often rely on the use of simulated myoelectric prostheses (attached to and operated by individuals with intact limbs), primarily to increase participant sample size. However, it is not known if these devices elicit the same movement strategies as myoelectric prostheses (operated by individuals with amputation). The objective of this study was to address the question of whether non-disabled individuals using simulated prostheses employ the same compensatory movements (measured by hand and upper body kinematics) as individuals who use actual myoelectric prostheses. Methods The upper limb movements of two participant groups were investigated: (1) twelve non-disabled individuals wearing a simulated prosthesis, and (2) three individuals with transradial amputation using their custom-fitted myoelectric devices. Motion capture was used for data collection while participants performed a standardized functional task. Performance metrics, hand movements, and upper body angular kinematics were calculated. For each participant group, these measures were compared to those from a normative baseline dataset. Each deviation from normative movement behaviour, by either participant group, indicated that compensatory movements were used during task performance. Results Results show that participants using either a simulated or actual myoelectric prosthesis exhibited similar deviations from normative behaviour in phase durations, hand velocities, hand trajectories, number of movement units, grip aperture plateaus, and trunk and shoulder ranges of motion. Conclusions This study suggests that the use of a simulated prosthetic device in upper limb research offers a reasonable approximation of compensatory movements employed by a low- to moderately-skilled transradial myoelectric prosthesis user.

Abstract Background Despite important advancements in control and mechatronics of myoelectric prostheses, the communication between the user and his/her bionic limb is still unidirectional, as these systems do not provide somatosensory feedback. Electrotactile stimulation is an attractive technology to close the control loop since it allows flexible modulation of multiple parameters and compact interface design via multi-pad electrodes. However, the stimulation interferes with the recording of myoelectric signals and this can be detrimental to control. Methods We present a novel compact solution for simultaneous recording and stimulation through dynamic blanking of stimulation artefacts. To test the system, a feedback coding scheme communicating wrist rotation and hand aperture was developed specifically to stress the myoelectric control while still providing meaningful information to the subjects. Ten subjects participated in an experiment, where the quality of closed-loop myoelectric control was assessed by controlling a cursor in a two degrees of freedom target-reaching task. The benchmark performance with visual feedback was compared to that achieved by combining visual feedback and electrotactile stimulation as well as by using electrotactile feedback only. Results There was no significant difference in performance between visual and combined feedback condition with regards to successfully reached targets, time to reach a target, path efficiency and the number of overshoots. Therefore, the quality of myoelectric control was preserved in spite of the stimulation. As expected, the tactile condition was significantly poorer in completion rate (100/4% and 78/25% for combined and tactile condition, respectively) and time to reach a target (9/2 s and 13/4 s for combined and tactile condition, respectively). However, the performance in the tactile condition was still good, with no significant difference in path efficiency (38/8%) and the number of overshoots (0.5/0.4 overshoots), indicating that the stimulation was meaningful for the subjects and useful for closed-loop control. Conclusions Overall, the results demonstrated that the developed system can provide robust closed-loop control using electrotactile stimulation. The system supports different encoding schemes and allows placing the recording and stimulation electrodes next to each other. This is an important step towards an integrated solution where the developed unit will be embedded into a prosthetic socket.

Wearing a myoelectric prosthesis is a basic way for limb amputees to restore their lost limb functions in the activities of daily living (ADLs). However, it is estimated that around 40% of amputees refuse the prosthesis. One of the primary reasons would be that the current prostheses lack appropriate sensory feedback. Currently, the amputees only depend on their visual feedback (Vis-FB) when using their arm prostheses. It would be difficult for them to accurately control the wrist position, which is vital for flexible manipulation in ADLs. This manuscript designed a myoelectric arm prosthesis with wrist position feedback (WP-FB). To study the effect level of position feedback on prosthetic control, two tests were performed. The vibrotactile perception range test aims to analyze the perception sensitivity of the vibration in humans and obtain the optimal perception range utilized in the sensory feedback test. The sensory feedback test analyzes the effectiveness of the position feedback by comparing three feedback methods of Vis-FB, WP-FB, and a combination of Vis-FB and WP-FB (VP-FB). These tests were conducted by asking six able-bodied subjects to perform 20 movement combinations of five target positions. The WP-FB was transiently activated with five vibrating motors embedded in an armband to stimulate the arm stump when the prosthetic wrist rotates to the target positions. Our experimental results showed that when WP-FB was added to the prosthetic control, the absolute angular error (AAE) of the prosthetic wrist declined from 4.50° to 1.08° while the success rate 3 (SR3) increased from 0.34 to 0.84, respectively. This study demonstrates the importance of WP-FB to the effective control of the arm prosthesis.

Abstract Background Neuroprosthetic devices controlled by persons with standard limb amputation often lack the dexterity of the physiological limb due to limitations of both the user’s ability to output accurate control signals and the control system’s ability to formulate dynamic trajectories from those signals. To restore full limb functionality to persons with amputation, it is necessary to first deduce and quantify the motor performance of the missing limbs, then meet these performance requirements through direct, volitional control of neuroprosthetic devices. Methods We develop a neuromuscular modeling and optimization paradigm for the agonist-antagonist myoneural interface, a novel tissue architecture and neural interface for the control of myoelectric prostheses, that enables it to generate virtual joint trajectories coordinated with an intact biological joint at full physiologically-relevant movement bandwidth. In this investigation, a baseline of performance is first established in a population of non-amputee control subjects ( $$n = 8$$ n = 8 ). Then, a neuromuscular modeling and optimization technique is advanced that allows unilateral AMI amputation subjects ( $$n = 5$$ n = 5 ) and standard amputation subjects ( $$n = 4$$ n = 4 ) to generate virtual subtalar prosthetic joint kinematics using measured surface electromyography (sEMG) signals generated by musculature within the affected leg residuum. Results Using their optimized neuromuscular subtalar models under blindfolded conditions with only proprioceptive feedback, AMI amputation subjects demonstrate bilateral subtalar coordination accuracy not significantly different from that of the non-amputee control group (Kolmogorov-Smirnov test, $$P \ge 0.052$$ P ≥ 0.052 ) while standard amputation subjects demonstrate significantly poorer performance (Kolmogorov-Smirnov test, $$P < 0.001$$ P < 0.001 ). Conclusions These results suggest that the absence of an intact biological joint does not necessarily remove the ability to produce neurophysical signals with sufficient information to reconstruct physiological movements. Further, the seamless manner in which virtual and intact biological joints are shown to coordinate reinforces the theory that desired movement trajectories are mentally formulated in an abstract task space which does not depend on physical limb configurations.

Abstract Background The loss of a hand is a traumatic experience that substantially compromises an individual’s capability to interact with his environment. The myoelectric prostheses are state-of-the-art (SoA) functional replacements for the lost limbs. Their overall mechanical design and dexterity have improved over the last few decades, but the users have not been able to fully exploit these advances because of the lack of effective and intuitive control. Bimanual tasks are particularly challenging for an amputee since prosthesis control needs to be coordinated with the movement of the sound limb. So far, the bimanual activities have been often neglected by the prosthetic research community. Methods We present a novel method to prosthesis control, which uses a semi-autonomous approach in order to simplify bimanual interactions. The approach supplements the commercial SoA two-channel myoelectric control with two additional sensors. Two inertial measurement units were attached to the prosthesis and the sound hand to detect the movement of both limbs. Once a bimanual interaction is detected, the system mimics the coordination strategies of able-bodied subjects to automatically adjust the prosthesis wrist rotation (pronation, supination) and grip type (lateral, palmar) to assist the sound hand during a bimanual task. The system has been evaluated in eight able-bodied subjects performing functional uni- and bi-manual tasks using the novel method and SoA two-channel myocontrol. The outcome measures were time to accomplish the task, semi-autonomous system misclassification rate, subjective rating of intuitiveness, and perceived workload (NASA TLX). Results The results demonstrated that the novel control interface substantially outperformed the SoA myoelectric control. While using the semi-autonomous control the time to accomplish the task and the perceived workload decreased for 25 and 27%, respectively, while the subjects rated the system as more intuitive then SoA myocontrol. Conclusions The novel system uses minimal additional hardware (two inertial sensors) and simple processing and it is therefore convenient for practical implementation. By using the proposed control scheme, the prosthesis assists the user’s sound hand in performing bimanual interactions while decreasing cognitive burden.

Abstract Background Despite the technological advancements in myoelectric prostheses, body-powered prostheses remain a popular choice for amputees, in part due to the natural sensory advantage they provide. Research on haptic feedback in myoelectric prostheses has delivered mixed results. Furthermore, there is limited research comparing various haptic feedback modalities in myoelectric prostheses. In this paper, we present a comparison of the feedback intrinsically present in body-powered prostheses (joint-torque feedback) to a commonly proposed feedback modality for myoelectric prostheses (vibrotactile feedback). In so doing, we seek to understand whether the advantages of kinesthetic feedback present in body-powered prostheses translate to myoelectric prostheses, and whether there are differences between kinesthetic and cutaneous feedback in prosthetic applications. Methods We developed an experimental testbed that features a cable-driven, voluntary-closing 1-DoF prosthesis, a capstan-driven elbow exoskeleton, and a vibrotactile actuation unit. The system can present grip force to users as either a flexion moment about the elbow or vibration on the wrist. To provide an equal comparison of joint-torque and vibrotactile feedback, a stimulus intensity matching scheme was utilized. Non-amputee participants (n=12) were asked to discriminate objects of varying stiffness with the prosthesis in three conditions: no haptic feedback, vibrotactile feedback, and joint-torque feedback. Results Results indicate that haptic feedback increased discrimination accuracy over no haptic feedback, but the difference between joint-torque feedback and vibrotactile feedback was not significant. In addition, our results highlight nuanced differences in performance depending on the objects’ stiffness, and suggest that participants likely pay less attention to incidental cues with the addition of haptic feedback. Conclusion Even when haptic feedback is not modality matched to the task, such as in the case of vibrotactile feedback, performance with a myoelectric prosthesis can improve significantly. This implies it is possible to achieve the same benefits with vibrotactile feedback, which is cheaper and easier to implement than other forms of feedback.

Abstract Background Prosthetic hands impose a high cognitive burden on the user that often results in fatigue, frustration and prosthesis rejection. However, efforts to directly measure this burden are sparse and little is known about the mechanisms behind it. There is also a lack of evidence-based training interventions designed to improve prosthesis hand control and reduce the mental effort required to use them. In two experiments, we provide the first direct evaluation of this cognitive burden using measurements of EEG and eye-tracking (Experiment 1), and then explore how a novel visuomotor intervention (gaze training; GT) might alleviate it (Experiment 2). Methods In Experiment 1, able-bodied participants (n = 20) lifted and moved a jar, first using their anatomical hand and then using a myoelectric prosthetic hand simulator. In experiment 2, a GT group (n = 12) and a movement training (MT) group (n = 12) trained with the prosthetic hand simulator over three one hour sessions in a picking up coins task, before returning for retention, delayed retention and transfer tests. The GT group received instruction regarding how to use their eyes effectively, while the MT group received movement-related instruction typical in rehabilitation. Results Experiment 1 revealed that when using the prosthetic hand, participants performed worse, exhibited spatial and temporal disruptions to visual attention, and exhibited a global decrease in EEG alpha power (8-12 Hz), suggesting increased cognitive effort. Experiment 2 showed that GT was the more effective method for expediting prosthesis learning, optimising visual attention, and lowering conscious control – as indexed by reduced T7-Fz connectivity. Whilst the MT group improved performance, they did not reduce hand-focused visual attention and showed increased conscious movement control. The superior benefits of GT transferred to a more complex tea-making task. Conclusions These experiments quantify the visual and cortical mechanisms relating to the cognitive burden experienced during prosthetic hand control. They also evidence the efficacy of a GT intervention that alleviated this burden and promoted better learning and transfer, compared to typical rehabilitation instructions. These findings have theoretical and practical implications for prosthesis rehabilitation, the development of emerging prosthesis technologies and for the general understanding of human-tool interactions.

Pattern recognition using surface Electromyography (sEMG) applied on prosthesis control has attracted much attention in these years. In most of the existing methods, the sEMG signal during the firmly grasped period is used for grasp classification because good performance can be achieved due to its relatively stable signal. However, using the only the firmly grasped period may cause a delay to control the prosthetic hand gestures. Regarding this issue, we explored how grasp classification accuracy changes during the reaching and grasping process, and identified the period that can leverage the grasp classification accuracy and the earlier grasp detection. We found that the grasp classification accuracy increased along the hand gradually grasping the object till firmly grasped, and there is a sweet period before firmly grasped period, which could be suitable for early grasp classification with reduced delay. On top of this, we also explored corresponding training strategies for better grasp classification in real-time applications.

Abstract Background Sensory feedback is critical for grasping in able-bodied subjects. Consequently, closing the loop in upper-limb prosthetics by providing artificial sensory feedback to the amputee is expected to improve the prosthesis utility. Nevertheless, even though amputees rate the prospect of sensory feedback high, its benefits in daily life are still very much debated. We argue that in order to measure the potential functional benefit of artificial sensory feedback, the baseline open-loop performance needs to be established. Methods The myoelectric control of naïve able-bodied subjects was evaluated during modulation of electromyographic signals (EMG task), and grasping with a prosthesis (Prosthesis task). The subjects needed to activate the wrist flexor muscles and close the prosthesis to reach a randomly selected target level (routine grasping). To assess the baseline performance, the tasks were performed with a different extent of implicit feedback (proprioception, prosthesis motion and sound). Finally, the prosthesis task was repeated with explicit visual force feedback. The subjects’ ability to scale the prosthesis command/force was assessed by testing for a statistically significant increase in the median of the generated commands/forces between neighboring levels. The quality of control was evaluated by computing the median absolute error (MAE) with respect to the target. Results The subjects could successfully scale their motor commands and generated prosthesis forces across target levels in all tasks, even with the least amount of implicit feedback (only muscle proprioception, EMG task). In addition, the deviation of the generated commands/forces from the target levels decreased with additional feedback. However, the increase in implicit feedback, from proprioception to prosthesis motion and sound, seemed to have a more substantial effect than the final introduction of explicit feedback. Explicit feedback improved the performance mainly at the higher target-force levels. Conclusions The study establishes the baseline performance of myoelectric control and prosthesis grasping force. The results demonstrate that even without additional feedback, naïve subjects can effectively modulate force with good accuracy with respect to that achieved when increasing the amount of feedback information.

A muscular synergy is a theory suggesting that the central nervous system uses few commands to activate a group of muscles to produce a given movement. Here, we investigate how a muscle synergy extracted from a single muscle can be at the origin of different signals which could facilitate the control of modern upper limb myoelectric prostheses with many degrees of freedom. Five pairs of surface electrodes were positioned across the biceps of 12 normal subjects and electromyographic (EMG) signals were collected while their upper limbs were in eight different static postures. Those signals were used to move, within a virtual cube, a small red sphere toward different targets. With three muscular synergies extracted from the five EMG signals, a classifier was trained to identify which synergy pattern was associated with a given static posture. Later, when a posture was recognized, the result was a displacement of a red sphere toward a corner of a virtual cube presented on a computer screen. The axes of the cube were assigned to the shoulder, elbow and wrist joint while each of its the corners was associated with a static posture. The goal for subjects was to reach, one at a time, the four targets positioned at different locations and heights in the virtual cube with different sequences of postures. The results of 12 normal subjects indicate that with the muscular synergies of the biceps brachii, it was possible, but not easy for an untrained person, to reach a target on each trial. Thus, as a proof of concept, we show that features of the biceps muscular synergy have the potential to facilitate the control of upper limb myoelectric prostheses. To our knowledge, this has never been shown before.

Myoelectric signals can be used to control prostheses or exoskeletons as well as robots, i.e., devices assisting the user or replacing a missing part of the body. A typical application of myoelectric prostheses is the human hand. Here, the development of a low-cost myoelectric thumb is described, which can either be used as an additional finger or as prosthesis. Combining 3D printing with inexpensive sensors, electrodes, and electronics, the recent project offers the possibility to produce an individualized myoelectric thumb at significantly lower costs than commercial myoelectric prostheses. Alternatively, a second thumb may be supportive for people with special manual tasks. These possibilities are discussed together with disadvantages of a second thumb and drawbacks of the low-cost solution in terms of mechanical properties and wearing comfort. The study shows that a low-cost customized myoelectric thumb can be produced in this way, but further research on controlling the thumb as well as improving motorization are necessarily to make it fully usable for daily tasks.

Abstract Background Myoelectric pattern recognition systems can decode movement intention to drive upper-limb prostheses. Despite recent advances in academic research, the commercial adoption of such systems remains low. This limitation is mainly due to the lack of classification robustness and a simultaneous requirement for a large number of electromyogram (EMG) electrodes. We propose to address these two issues by using a multi-modal approach which combines surface electromyography (sEMG) with inertial measurements (IMs) and an appropriate training data collection paradigm. We demonstrate that this can significantly improve classification performance as compared to conventional techniques exclusively based on sEMG signals. Methods We collected and analyzed a large dataset comprising recordings with 20 able-bodied and two amputee participants executing 40 movements. Additionally, we conducted a novel real-time prosthetic hand control experiment with 11 able-bodied subjects and an amputee by using a state-of-the-art commercial prosthetic hand. A systematic performance comparison was carried out to investigate the potential benefit of incorporating IMs in prosthetic hand control. Results The inclusion of IM data improved performance significantly, by increasing classification accuracy (CA) in the offline analysis and improving completion rates (CRs) in the real-time experiment. Our findings were consistent across able-bodied and amputee subjects. Integrating the sEMG electrodes and IM sensors within a single sensor package enabled us to achieve high-level performance by using on average 4-6 sensors. Conclusions The results from our experiments suggest that IMs can form an excellent complimentary source signal for upper-limb myoelectric prostheses. We trust that multi-modal control solutions have the potential of improving the usability of upper-extremity prostheses in real-life applications.

Myoelectric prostheses help amputees to regain independence and a higher quality of life. These prostheses are controlled by electromyography, which measures an electrical signal at the skin surface during muscle contractions. In this contribution, the electromyography is measured with innovative flexible insulated sensors, which separate the skin and the sensor area by a dielectric layer. Electromyography sensors, and biosignal sensors in general, are striving for higher robustness against motion artifacts, which are a major obstacle in real-world environment. The motion artifact suppression algorithms presented in this article, prevent the activation of the prosthesis drive during artifacts, thereby achieving a substantial performance boost. These algorithms classify the signal into muscle contractions and artifacts. Therefore, new time domain features, such as Mean Crossing Rate are introduced and well-established time domain features (e.g., Zero-Crossing Rate, Slope Sign Change) are modified and implemented. Various artificial intelligence models, which require low calculation resources for an application in a wearable device, were investigated. These models are neural networks, recurrent neural networks, decision trees and logistic regressions. Although these models are designed for a low-power real-time embedded system, high accuracies in discriminating artifacts to contractions of up to 99.9% are achieved. The models were implemented and trained for fast response leading to a high performance in real-world environment. For highest accuracies, recurrent neural networks are suggested and for minimum runtime (0.99−1.15 μ s), decision trees are preferred.

Myoelectric prostheses provide upper limb amputees with hand and arm movement control using muscle activity of the residual limb, but require intensive training to effectively operate. The result is that many amputees abandon their prosthesis before mastering control of their device. In the present study, we examine a novel, mobile, game-based approach to myoelectric prosthesis training. Using the non-dominant limb in a group of able-bodied participants to model amputee pre-prosthetic training, a significant improvement in factors underlying successful myoelectric prosthesis use, including muscle control, sequencing, and isolation were observed. Participants also reported high levels of usability, and motivation with the game-based approach to training. Given fiscal or geographic constraints that limit pre-prosthetic amputee care, mobile myosite training, as described in the current study, has the potential to improve rehabilitation success rates by providing myosite training outside of the clinical environment. Future research should include longitudinal studies in amputee populations to evaluate the impact of pre-prosthetic training methods on prosthesis acceptance, wear time, abandonment, functional outcomes, quality of life, and return to work.

Electromyogram (EMG) contains rich information for motion decoding. As one of its major applications, EMG-pattern recognition (PR)-based control of prostheses has been proposed and investigated in the field of rehabilitation robotics for decades. These prostheses can offer a higher level of dexterity compared to the commercially available ones. However, limited progress has been made toward clinical application of EMG-PR-based prostheses, due to their unsatisfactory robustness against various interferences during daily use. These interferences may lead to misclassifications of motion intentions, which damage the control performance of EMG-PR-based prostheses. A number of studies have applied methods that undergo a postprocessing stage to determine the current motion outputs, based on previous outputs or other information, which have proved effective in reducing erroneous outputs. In this study, we proposed a postprocessing strategy that locks the outputs during the constant contraction to block out occasional misclassifications, upon detecting the motion onset using a threshold. The strategy was investigated using three different motion onset detectors, namely mean absolute value, Teager–Kaiser energy operator, or mechanomyogram (MMG). Our results indicate that the proposed strategy could suppress erroneous outputs, during rest and constant contractions in particular. In addition, with MMG as the motion onset detector, the strategy was found to produce the most significant improvement in the performance, reducing the total errors up to around 50% (from 22.9 to 11.5%) in comparison to the original classification output in the online test, and it is the most robust against threshold value changes. We speculate that motion onset detectors that are both smooth and responsive would further enhance the efficacy of the proposed postprocessing strategy, which would facilitate the clinical application of EMG-PR-based prosthetic control.

Modern robotic hands/upper limbs may replace multiple degrees of freedom of extremity function. However, their intuitive use requires a high number of control signals, which current man-machine interfaces do not provide. Here, we discuss a broadband control interface that combines targeted muscle reinnervation, implantable multichannel electromyographic sensors, and advanced decoding to address the increasing capabilities of modern robotic limbs. With targeted muscle reinnervation, nerves that have lost their targets due to an amputation are surgically transferred to residual stump muscles to increase the number of intuitive prosthetic control signals. This surgery re-establishes a nerve-muscle connection that is used for sensing nerve activity with myoelectric interfaces. Moreover, the nerve transfer determines neurophysiological effects, such as muscular hyper-reinnervation and cortical reafferentation that can be exploited by the myoelectric interface. Modern implantable multichannel EMG sensors provide signals from which it is possible to disentangle the behavior of single motor neurons. Recent studies have shown that the neural drive to muscles can be decoded from these signals and thereby the user's intention can be reliably estimated. By combining these concepts in chronic implants and embedded electronics, we believe that it is in principle possible to establish a broadband man-machine interface, with specific applications in prosthesis control. This perspective illustrates this concept, based on combining advanced surgical techniques with recording hardware and processing algorithms. Here we describe the scientific evidence for this concept, current state of investigations, challenges, and alternative approaches to improve current prosthetic interfaces.

Patients suffering from upper limb deficiency all experience a significant reduction in their ability to interact with their environment. The primary method used to restore this lost function is the implementation of a prosthesis. However, a significant proportion of users abandon their devices—citing reasons such as cost, weight, functional control and aesthetics. This paper will discuss the use of myoelectric control technology in the control of an additive manufactured myoelectric transradial prosthesis. This prosthesis should be low cost, lightweight, easily controlled and has a morphology that mimics a human hand. As a part of this study, a single channel electromyogram controlled hand model was developed using an Arduino Uno microcontroller to control a single degree of freedom. Preliminary testing and debugging has indicated that a single input channel is adequate for relatively simple open/close protocols. However, in order to allow for the more fine control desired by patients, new preprocessing boards will need to be developed for the Arduino in order to gain access to more input channels. This will allow us to truly explore the Arduino as a budget option for implementing higher complexity control structures.

Aim of this study was to investigate the feasibility of electrotactile feedback in closed loop training of force control during the routine grasping task. The feedback was provided using an array electrode and a simple six-level spatial coding, and the experiment was conducted in three amputee subjects. The psychometric tests confirmed that the subjects could perceive and interpret the electrotactile feedback with a high success rate. The subjects performed the routine grasping task comprising 4 blocks of 60 grasping trials. In each trial, the subjects employed feedforward control to close the hand and produce the desired grasping force (four levels). First (baseline) and the last (validation) session were performed in open loop, while the second and the third session (training) included electrotactile feedback. The obtained results confirmed that using the feedback improved the accuracy and precision of the force control. In addition, the subjects performed significantly better in the validation vs. baseline session, therefore suggesting that electrotactile feedback can be used for learning and training of myoelectric control.