Search

Aim: Limb loss is a dramatic event with a devastating impact on a person's quality of life. Prostheses have been used to restore lost motor abilities and cosmetic appearance. Closing the loop between the prosthesis and the amputee by providing somatosensory feedback to the user might improve the performance, confidence of the amputee, and embodiment of the prosthesis. Recently, a minimally invasive method, in which the electrodes are placed subdermally, was presented and psychometrically evaluated. The present study aimed to assess the quality of online control with subdermal stimulation and compare it to that achieved using surface stimulation (common benchmark) as well as to investigate the impact of training on the two modalities. Methods: Ten able-bodied subjects performed a PC-based compensatory tracking task. The subjects employed a joystick to track a predefined pseudorandom trajectory using feedback on the momentary tracking error, which was conveyed via surface and subdermal electrotactile stimulation. The tracking performance was evaluated using the correlation coefficient (CORR), root mean square error (RMSE), and time delay between reference and generated trajectories. Results: Both stimulation modalities resulted in good closed-loop control, and surface stimulation outperformed the subdermal approach. There was significant difference in CORR (86 vs 77%) and RMSE (0.23 vs 0.31) between surface and subdermal stimulation (all p < 0.05). The RMSE of the subdermal stimulation decreased significantly in the first few trials. Conclusion: Subdermal stimulation is a viable method to provide tactile feedback. The quality of online control is, however, somewhat worse compared to that achieved using surface stimulation. Nevertheless, due to minimal invasiveness, compactness, and power efficiency, the subdermal interface could be an attractive solution for the functional application in sensate prostheses. [ABSTRACT FROM AUTHOR]

This manuscript reviews historical and recent studies that focus on supplementary sensory feedback for use in upper limb prostheses. It shows that the inability of many studies to speak to the issue of meaningful performance improvements in real-life scenarios is caused by the complexity of the interactions of supplementary sensory feedback with other types of feedback along with other portions of the motor control process. To do this, the present manuscript frames the question of supplementary feedback from the perspective of computational motor control, providing a brief review of the main advances in that field over the last 20 years. It then separates the studies on the closed-loop prosthesis control into distinct categories, which are defined by relating the impact of feedback to the relevant components of the motor control framework, and reviews the work that has been done over the last 50+ years in each of those categories. It ends with a discussion of the studies, along with suggestions for experimental construction and connections with other areas of research, such as machine learning. [ABSTRACT FROM AUTHOR]

Among most challenging open issues in prosthetic research is the development of a robust bidirectional interface between a prosthesis and its user. Commercially available prosthetic systems are mechanically advanced, but they do not provide somatosensory feedback. Here, we present a novel non-invasive interface for multichannel electrotactile feedback, comprising a matrix of 24 pads, and we investigate the ability of able-bodied human subjects to localize the electrotactile stimulus delivered through the matrix. For this purpose, we tested conventional stimulation (same frequency for all pads) and a novel dual-parameter modulation scheme (interleaved frequency and intensity) designed to facilitate the spatial localization over the electrode. Electrotactile stimulation was also compared to mechanical stimulation of the same locations on the skin. Experimental results on eight able-bodied subjects demonstrated that the proposed interleaved coding substantially improved the spatial localization compared to same-frequency stimulation. The results also showed that same-frequency stimulation was equivalent to mechanical stimulation, whereas the performance with dual-parameter modulation was significantly better. These are encouraging outcomes for the application of a multichannel interface for the restoration of feedback in prosthetics. The high-resolution augmented interfaces might be used to explore novel scenarios for effective communication with the prosthesis user enabled by maximizing information transmission. [ABSTRACT FROM AUTHOR]

Electrotactile stimulation has been suggested as a modality for providing sensory feedback in upper limb prostheses. This study investigates the multiday variability of subdermal and surface stimulation. Electrical stimulation was delivered using either surface or fine wire electrodes placed right under the skin in eight amputees for seven consecutive days. The variability of psychophysical measurements, including detection threshold (DT), pain threshold (PT), dynamic range (DR), just noticeable difference (JND), Weber fraction (WF) and quality of evoked sensations, was evaluated using the coefficient of variation (CoV). In addition, the systematic change in the mean of the parameters across days was assessed in both stimulation modalities. In the case of DT, PT, DR, and perceived intensity at 100 Hz, the CoV of surface stimulation was significantly smaller than that of subdermal stimulation. Only PT showed a significant systematic change in the mean value across days for both modalities. The outcome of this study has implications for the choice of modality in delivering sensory feedback, though the significance of the quantified variability needs to be evaluated using usability tests with user feedback. [ABSTRACT FROM AUTHOR]

This paper evaluated the psychophysical properties of subdermal electrical stimulation to investigate its feasibility in providing sensory feedback for limb prostheses. The detection threshold (DT), pain threshold (PT), just noticeable difference (JND), as well as the elicited sensation quality, comfort, intensity, and location were assessed in 16 healthy volunteers during stimulation of the ventral and dorsal forearm with subdermal electrodes. Moreover, the results were compared with those obtained from transcutaneous electrical stimulation. Despite a lower DT and PT, subdermal stimulation attained a greater relative dynamic range (i.e., PT/DT) and significantly smaller JNDs for stimulation amplitude. Muscle twitches and movements were more commonly elicited by surface stimulation, especially at the higher stimulation frequencies, whereas the pinprick sensation was more often reported with subdermal stimulation. Less comfort was perceived in subdermal stimulation of the ventral forearm at the highest tested stimulation frequency of 100 Hz. In summary, subdermal electrical stimulation was demonstrated to be able to produce similar sensation quality as transcutaneous stimulation and outperformed the latter in terms of energy efficiency and sensitivity. These results suggest that stimulation through implantable subdermal electrodes may lead to an efficient and compact sensory feedback system for substituting the lost sense in amputees. [ABSTRACT FROM AUTHOR]

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 coding 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. [ABSTRACT FROM AUTHOR]

Background: Active hand prostheses controlled using electromyography (EMG) signals have been used for decades to restore the grasping function, lost after an amputation. Although myocontrol is a simple and intuitive interface, it is also imprecise due to the stochastic nature of the EMG recorded using surface electrodes. Furthermore, the sensory feedback from the prosthesis to the user is still missing. In this study, we present a novel concept to close the loop in myoelectric prostheses. In addition to conveying the grasping force (system output), we provided to the user the online information about the system input (EMG biofeedback). Methods: As a proof-of-concept, the EMG biofeedback was transmitted in the current study using a visual interface (ideal condition). Ten able-bodied subjects and two amputees controlled a state-of-the-art myoelectric prosthesis in routine grasping and force steering tasks using EMG and force feedback (novel approach) and force feedback only (classic approach). The outcome measures were the variability of the generated forces and absolute deviation from the target levels in the routine grasping task, and the root mean square tracking error and the number of sudden drops in the force steering task. Results: During the routine grasping, the novel method when used by able-bodied subjects decreased twofold the force dispersion as well as absolute deviations from the target force levels, and also resulted in a more accurate and stable tracking of the reference force profiles during the force steering. Furthermore, the force variability during routine grasping did not increase for the higher target forces with EMG biofeedback. The trend was similar in the two amputees. Conclusions: The study demonstrated that the subjects, including the two experienced users of a myoelectric prosthesis, were able to exploit the online EMG biofeedback to observe and modulate the myoelectric signals, generating thereby more consistent commands. This allowed them to control the force predictively (routine grasping) and with a finer resolution (force steering). The future step will be to implement this promising and simple approach using an electrotactile interface. A prosthesis with a reliable response, following faithfully user intentions, would improve the utility during daily-life use and also facilitate the embodiment of the assistive system. [ABSTRACT FROM AUTHOR]

Closing the control loop by providing sensory feedback to the user of a prosthesis is an important challenge, with major impact on the future of prosthetics. Developing and comparing closed-loop systems is a difficult task, since there are many different methods and technologies that can be used to implement each component of the system. Here, we present a test bench developed in Matlab Simulink for configuring and testing the closed-loop human control system in standardized settings. The framework comprises a set of connected generic blocks with normalized inputs and outputs, which can be customized by selecting specific implementations from a library of predefined components. The framework is modular and extensible and it can be used to configure, compare and test different closed-loop system prototypes, thereby guiding the development towards an optimal system configuration. The use of the test bench was demonstrated by investigating two important aspects of closed-loop control: performance of different electrotactile feedback interfaces (spatial versus intensity coding) during a pendulum stabilization task and feedforward methods (joystick versus myocontrol) for force control. The first experiment demonstrated that in the case of trained subjects the intensity coding might be superior to spatial coding. In the second experiment, the control of force was rather poor even with a stable and precise control interface (joystick), demonstrating that inherent characteristics of the prosthesis can be an important limiting factor when considering the overall effectiveness of the closed-loop control. The presented test bench is an important instrument for investigating different aspects of human manual control with sensory feedback. [ABSTRACT FROM AUTHOR]

Electro- or vibro-tactile stimulations were used in the past to provide sensory information in many different applications ranging from human manual control to prosthetics. The two modalities were used separately in the past, and we hypothesized that a hybrid vibro-electrotactile (HyVE) stimulation could provide two afferent streams that are independently perceived by a subject, although delivered in parallel and through the same skin location. We conducted psychophysical experiments where healthy subjects were asked to recognize the intensities of electro- and vibro-tactile stimuli during hybrid and single modality stimulations. The results demonstrated that the subjects were able to discriminate the features of the two modalities within the hybrid stimulus, and that the cross-modality interaction was limited enough to allow better transmission of discrete information (messages) using hybrid versus single modality coding. The percentages of successful recognitions (mean ± standard deviation) for nine messages were 56 ±11% and 72 ±8% for two hybrid coding schemes, compared to 29 ±7% for vibrotactile and 44 ±4% for electrotactile coding. The HyVE can be therefore an attractive solution in numerous application for providing sensory feedback in prostheses and rehabilitation, and it could be used to increase the resolution of a single variable or to simultaneously feedback two different variables. [ABSTRACT FROM AUTHOR]