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https://www.readbyqxmd.com/read/29747672/two-ways-to-improve-myoelectric-control-for-a-transhumeral-amputee-after-targeted-muscle-reinnervation-a-case-study
#1
Yang Xu, Dingguo Zhang, Yang Wang, Juntao Feng, Wendong Xu
BACKGROUND: Myoelectric control of multifunctional prostheses is challenging for individuals with high-level amputations due to insufficient surface electromyography (sEMG) signals. A surgical technique called targeted muscle reinnervation (TMR) has achieved impressive improvements in myoelectric control by providing more sEMG control signals. In this case, some channels of sEMG signals are coupled after TMR, which limits the performance of conventional amplitude-based control for upper-limb prostheses...
May 10, 2018: Journal of Neuroengineering and Rehabilitation
https://www.readbyqxmd.com/read/29742031/case-studies-in-neuroscience-sensations-elicited-and-discrimination-ability-from-nerve-cuff-stimulation-in-an-amputee-over-time
#2
Rochelle Ackerley, Helena Backlund Wasling, Max Ortiz Catalan, Rickard Brånemark, Johan Wessberg
The present case study details sensations elicited by electrical stimulation of peripheral nerve axons using an implanted nerve cuff electrode, in a participant with a transhumeral amputation. The participant uses an osseointegrated electromechanical interface, which enables skeletal attachment of the prosthesis and long-term, stable, bidirectional communication between the implanted electrodes and prosthetic arm. We focused on evoking somatosensory percepts, where we tracked and quantified the evolution of perceived sensations in the missing hand, which were evoked from electrical stimulation of the nerve, for over 2 years...
May 9, 2018: Journal of Neurophysiology
https://www.readbyqxmd.com/read/29565293/towards-control-of-a-transhumeral-prosthesis-with-eeg-signals
#3
D S V Bandara, Jumpei Arata, Kazuo Kiguchi
Robotic prostheses are expected to allow amputees greater freedom and mobility. However, available options to control transhumeral prostheses are reduced with increasing amputation level. In addition, for electromyography-based control of prostheses, the residual muscles alone cannot generate sufficiently different signals for accurate distal arm function. Thus, controlling a multi-degree of freedom (DoF) transhumeral prosthesis is challenging with currently available techniques. In this paper, an electroencephalogram (EEG)-based hierarchical two-stage approach is proposed to achieve multi-DoF control of a transhumeral prosthesis...
March 22, 2018: Bioengineering
https://www.readbyqxmd.com/read/29555246/functional-outcomes-18-months-after-total-and-midarm-transplantation-a-case-report
#4
M Iglesias, M Ramírez-Berumen, P Butrón, J Alberú-Gómez, F Salazar-Hernández, J Macias-Gallardo, R P Leal-Villalpando, J Zamudio-Bautista, V Acosta, L Jauregui, A Hernández-Campos, V Espinosa-Cruz, J Vázquez-Lamadrid, J González-Sánchez, J Cuellar-Rodriguez, J G Sierra-Madero, R Gaytan-Cervantes, S Contreras-Barbosa, A Navarro-Lara, J Guzman-Gonzalez, J Domínguez-Cherit, M Vilatoba, S Toussaint-Caire, F Vega-Boada, F J Gómez-Pérez, M Mayorquin-Ruiz
BACKGROUND: The function reported after arm transplantation is deemed beneficial relative to the marked disability that upper arm amputation causes. OBJECTIVE: We report a 51-year-old man with a Disabilities of the Arm, Shoulder and Hand (DASH) score of 75.83 who underwent bilateral arm transplantation in October 2015. PROCEDURE: The right arm was transplanted at the glenohumeral joint level, including transplantation of the humeral head, joint capsule, and rotator cuff ligaments and tendons...
April 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29456499/can-we-achieve-intuitive-prosthetic-elbow-control-based-on-healthy-upper-limb-motor-strategies
#5
Manelle Merad, Étienne de Montalivet, Amélie Touillet, Noël Martinet, Agnès Roby-Brami, Nathanaël Jarrassé
Most transhumeral amputees report that their prosthetic device lacks functionality, citing the control strategy as a major limitation. Indeed, they are required to control several degrees of freedom with muscle groups primarily used for elbow actuation. As a result, most of them choose to have a one-degree-of-freedom myoelectric hand for grasping objects, a myoelectric wrist for pronation/supination, and a body-powered elbow. Unlike healthy upper limb movements, the prosthetic elbow joint angle, adjusted prior to the motion, is not involved in the overall upper limb movements, causing the rest of the body to compensate for the lack of mobility of the prosthesis...
2018: Frontiers in Neurorobotics
https://www.readbyqxmd.com/read/29432114/synergistic-elbow-control-for-a-myoelectric-transhumeral-prosthesis
#6
Nasser A Alshammary, Daniel A Bennett, Michael Goldfarb
This paper presents a control approach for a myoelectric transhumeral prostheses that supplements a typical two-site electromyograms (EMG) input with the inertial measurement of arm motion. The inertial measurement is employed to: 1) provide synergistic movement between the prosthetic elbow joint and intact upper arm and 2) to switch control between the myoelectric elbow and hand. In order to assess the prospective efficacy of the control method, experiments were conducted on six healthy subjects who performed a series of pick-and-place tasks within a virtual environment...
February 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/29422484/spiral-sockets-for-various-types-of-stumps-in-transhumeral-amputees-a-case-series
#7
Yukiyo Shimizu, Hirotaka Mutsuzaki, Hiroyuki Torishima, Kenichi Yoshikawa, Daisuke Katane, Ryoko Takeuchi, Yuki Mataki, Kayo Tokeji, Yasuyoshi Wadano
BACKGROUND: Fitting a stump prosthesis is difficult in transhumeral amputees because of the stump's conical form. Shoulder harnesses for suspension can cause neck and shoulder pain. We developed a novel spiral socket transhumeral prosthesis to overcome these difficulties. We investigated its safety and effects in transhumeral amputees. CASE REPORT: Five transhumeral amputees with a mean age of 50.8 ± 23.8 (range, 19-75 years) were fitted with the spiral socket between April 2013 and February 2017...
February 7, 2018: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29261703/transhumeral-loading-during-advanced-upper-extremity-activities-of-daily-living
#8
Alex J Drew, Morgan T Izykowski, Kent N Bachus, Heath B Henninger, K Bo Foreman
Percutaneous osseointegrated (OI) implants for direct skeletal attachment of upper extremity prosthetics represent an alternative to traditional socket suspension that may yield improved patient function and satisfaction. This is especially true in high-level, transhumeral amputees where prosthetic fitting is challenging and abandonment rates remain high. However, maintaining mechanical integrity of the bone-implant interface is crucial for safe clinical introduction of this technology. The collection of population data on the transhumeral loading environment will aid in the design of compliance and overload protection devices that mitigate the risk of periprosthetic fracture...
2017: PloS One
https://www.readbyqxmd.com/read/29188681/targeted-muscle-reinnervation-for-improved-control-of-myoelectric-upper-limb-prostheses
#9
G Vadalà, G Di Pino, L Ambrosio, L Diaz Balzani, V Denaro
Targeted muscle reinnervation (TMR) is a novel surgical technique developed to improve the control of myoelectric upper limb prostheses. Nerves transected by the amputation, which retain their original motor pathways even after being severed, are redirected to residual denervated muscles that serve as target for consequent reinnervation. Once the process is complete, reinnervated muscles will contract upon voluntary activation of transferred nerves while attempting to move missing regions of the amputated limb, generating EMG signals that can be recorded and used to control a prosthetic device...
October 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29062019/myoelectric-pattern-recognition-outperforms-direct-control-for-transhumeral-amputees-with-targeted-muscle-reinnervation-a-randomized-clinical-trial
#10
Levi J Hargrove, Laura A Miller, Kristi Turner, Todd A Kuiken
Recently commercialized powered prosthetic arm systems hold great potential in restoring function for people with upper-limb loss. However, effective use of such devices remains limited by conventional (direct) control methods, which rely on electromyographic signals produced from a limited set of muscles. Targeted Muscle Reinnervation (TMR) is a nerve transfer procedure that creates additional recording sites for myoelectric prosthesis control. The effects of TMR may be enhanced when paired with pattern recognition technology...
October 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29060523/motor-imagery-classification-of-upper-limb-movements-based-on-spectral-domain-features-of-eeg-patterns
#11
Oluwarotimi Williams Samuel, Xiangxin Li, Yanjuan Geng, Pang Feng, Shixiong Chen, Guanglin Li
Surface electromyography pattern recognition methods have been widely applied to decode limb movement intentions for prosthesis control. These methods generally require amputees to provide sufficient myoelectric signals from their residual limb muscles. Previous studies have shown that amputees with high level amputation or neuromuscular disorder usually do not have sufficient residual limb muscles to provide enough myoelectric signals for accurate identification of limb movements. Electroencephalography (EEG), another bioelectric signal associated with limb movements has also been proposed and used for decoding the limb motion intents of humans...
July 2017: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28728864/development-of-a-multi-dof-transhumeral-robotic-arm-prosthesis
#12
D S V Bandara, R A R C Gopura, K T M U Hemapala, Kazuo Kiguchi
An anthropomorphic transhumeral robotic arm prosthesis is proposed in this study. It is capable of generating fifteen degrees-of-freedom, seven active and eight passive. In order to realize wrist motions, a parallel manipulator-based mechanism is proposed. It simulates the human anatomical structure and generates motions in two axes. The hand-of-arm prosthesis consists of under-actuated fingers with intrinsic actuation. The finger mechanism is capable of generating three degrees of freedom, and it exhibits the capability of adjusting the joint angles passively according to the geometry of the grasping object...
July 17, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28628623/use-of-the-deka-arm-for-amputees-with-brachial-plexus-injury-a-case-series
#13
Linda Resnik, Christopher Fantini, Gail Latlief, Samuel Phillips, Nicole Sasson, Eve Sepulveda
OBJECTIVE: Patients with upper limb amputation and brachial plexus injuries have high rates of prosthesis rejection. Study purpose is to describe experiences of subjects with transhumeral amputation and brachial plexus injury, who were fit with, and trained to use, a DEKA Arm. METHODS: This was a mixed-methods study utilizing qualitative (e.g. interview, survey) and quantitative data (e.g. self-report and performance measures). Subject 1, a current prosthesis user, had a shoulder arthrodesis...
2017: PloS One
https://www.readbyqxmd.com/read/28624687/estimation-of-distal-arm-joint-angles-from-emg-and-shoulder-orientation-for-transhumeral-prostheses
#14
Aadeel Akhtar, Navid Aghasadeghi, Levi Hargrove, Timothy Bretl
In this paper, we quantify the extent to which shoulder orientation, upper-arm electromyography (EMG), and forearm EMG are predictors of distal arm joint angles during reaching in eight subjects without disability as well as three subjects with a unilateral transhumeral amputation and targeted reinnervation. Prior studies have shown that shoulder orientation and upper-arm EMG, taken separately, are predictors of both elbow flexion/extension and forearm pronation/supination. We show that, for eight subjects without disability, shoulder orientation and upper-arm EMG together are a significantly better predictor of both elbow flexion/extension during unilateral (R2 =0...
August 2017: Journal of Electromyography and Kinesiology
https://www.readbyqxmd.com/read/28575025/perceptions-of-satisfaction-usability-and-desirability-of-the-deka-arm-before-and-after-a-trial-of-home-use
#15
COMPARATIVE STUDY
Linda J Resnik, Matthew L Borgia, Frantzy Acluche
OBJECTIVES: To: 1) describe perceptions of satisfaction with and usability of the DEKA Arm and preferences for the DEKA Arm or personal prosthesis; 2) compare perceptions of satisfaction and usability by DEKA Arm configuration level; and 3) evaluate satisfaction and usability for study completers and non-completers; and for those who did and did not want to receive a DEKA Arm. METHODS: The study had 2 phases: in-laboratory (Part A) and home trial (Part B). 32 participants with amputation, (50% transradial, 38% transhumeral and 13% shoulder) completed Part A and 18 completed Part B 16 (89%) of whom were prosthesis users at baseline...
2017: PloS One
https://www.readbyqxmd.com/read/28575012/characterization-of-interfacial-socket-pressure-in-transhumeral-prostheses-a-case-series
#16
Jonathon S Schofield, Katherine R Schoepp, Heather E Williams, Jason P Carey, Paul D Marasco, Jacqueline S Hebert
One of the most important factors in successful upper limb prostheses is the socket design. Sockets must be individually fabricated to arrive at a geometry that suits the user's morphology and appropriately distributes the pressures associated with prosthetic use across the residual limb. In higher levels of amputation, such as transhumeral, this challenge is amplified as prosthetic weight and the physical demands placed on the residual limb are heightened. Yet, in the upper limb, socket fabrication is largely driven by heuristic practices...
2017: PloS One
https://www.readbyqxmd.com/read/28526166/transhumeral-anterior-radial-nerve-transposition-to-simplify-anticipated-future-humeral-reconstruction
#17
REVIEW
David A Muzykewicz, Reid A Abrams
Anterior transhumeral radial nerve transposition has been described in the treatment of humeral shaft fracture to protect the nerve from implant irritation or callus entrapment. Transposing the radial nerve through a facilitating humeral defect also simplifies revision surgery should nonunion result. Here we describe a surgical technique for anterior transhumeral radial nerve transposition for complex humeral reconstruction when subsequent revision surgery is anticipated. Three cases are used for illustration: (1) revision of a total elbow arthroplasty with periprosthetic fracture; (2) revision of a total elbow arthroplasty after aseptic loosening from an allograft/prosthesis composite; and (3) septic humeral nonunion with substantial bone loss...
May 16, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28470463/-the-endo-exo-prosthesis-treatment-concept-improvement-in-quality-of-life-after-limb-amputation
#18
REVIEW
T Hoffmeister, F Schwarze, H H Aschoff
Osseointegrated, percutaneous implants as the force bearer for exoprosthetics after limb amputation have been used in individual cases for clinical rehabilitation of amputees during the past years. Most experience in this field in Germany has been accumulated at the Sana Klinik in Lübeck with the so-called endo-exo prosthesis (EEP) system. The two-step implantation procedure can now be considered as reliable. Following a well-documented learning curve initial soft tissue problems concerning the cutaneous stoma can now be regarded as exceptions...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28396957/-transcutaneous-osseointegrated-prosthesis-top-after-limb-amputation-status-quo-and-perspectives
#19
REVIEW
Christian Willy, Christian Krettek
The majority of transfemoral and transtibial amputees can be functionally fitted with conventional suspension sockets; however, due to socket problems using conventional stump care, 60% of the patients have limited function and even in younger patients approximately one sixth are unable to wear the prosthesis daily. After the introduction of transcutaneous osseointegrated prostheses (TOP) the inherent problems of socket-stump care can be avoided for these patients. Against this background this article reviews the recent clinical development of TOP in Sweden, Germany, the Netherlands, Australia and USA currently in nine centers...
May 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28229193/osseointegrated-prostheses-for-rehabilitation-following-amputation-the-pioneering-swedish-model
#20
REVIEW
Yan Li, Rickard Brånemark
The direct attachment of osseointegrated (OI) prostheses to the skeleton avoids the inherent problems of socket suspension. It also provides physiological weight bearing, improved range of motion in the proximal joint, as well as osseoperceptive sensory feedback, enabling better control of the artificial limbs by amputees. The present article briefly reviews the pioneering efforts on extremity osseointegration surgeries in Sweden and the development of the OPRA (Osseointegrated Prostheses for the Rehabilitation of Amputees) program...
April 2017: Der Unfallchirurg
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