Motorized Biomechatronic Upper and Lower Limb Prostheses—Clinically Relevant Outcomes

Abstract

People with major limb amputations are severely impaired when it comes to activity, body structure and function, as well as participation. Demographic statistics predict a dramatic increase of this population and additional challenges with their increasing age and higher levels of amputation. Prosthetic use has been shown to have a positive impact on mobility and depression, thereby affecting the quality of life. Biomechatronic prostheses are at the forefront of prosthetic development. Actively powered designs are now regularly used for upper limb prosthetic fittings, whereas for lower limbs the clinical use of actively powered prostheses has been limited to a very low number of applications. Actively powered prostheses enhance restoration of the lost physical functions of an amputee but are yet to allow intuitive user control. This paper provides a review of the status of biomechatronic developments in upper and lower limb prostheses in the context of the various challenges of amputation and the clinically relevant outcomes. Whereas most of the evidence regarding lower limb prostheses addresses biomechanical issues, the evidence for upper limb prostheses relates to activities of daily living (ADL) and instrumental ADL through diverse outcome measures and tools.

Extracting impedance changes from a frequency multiplexed signal during neural activity in sciatic nerve of rat: preliminary study in vitro

“…The Tukey window significantly reduced ringing from Gibbs phenomena at the window edge compared to rectangular window, Fig 5c, [19], respectively. However, windowing introduces a delay between occurrence of the neural event and its extraction, which, in the context of neural prosthetics, has direct influence on user experience through intentional binding effects [29], and practical repercussions on prosthetics control and user acceptance rates [30].…”

Frontiers of Brachial Plexus Injury: Future Revolutions in the Field

“…In these additional readings, one can learn more about upper limb prosthetics [46] including an advanced prosthetic called the DEKA arm [47,48] and other advances funded by defense advanced research projects agency (DARPA), [49] interfaces involved in control of prosthetics, [50][51][52][53][54] exoskeletons, [55] and considerations for different levels of amputation [56].…”

“…Topic overview [46] A review including technological advances in prosthetics for upper limb amputees [47] A case series studying the DEKA arm-a prosthetic upper limb with active wrist control [48] An article exploring the various DEKA arm models created through funding from DARPA [49] A review discussing DARPA-funded peripheral nerve interfaces including a focus on provision of motor control and sensory feedback to prosthetic limbs [50] A review summarizing biosignal processing of BMIs that utilize EEG and EMG signals, as well as a discussion of sensors, features, and classifiers for upper limb prosthetics [51] A review investigating the impact of biomechatronic technology on amputee rehabilitation outcomes, including upper limb amputees [52] This book chapter discusses the way electromyography (EMG) is used to create pattern-based myoelectric movements of upper limb prosthetics [53] A clinical trial studying the use of Utah Slanted Electrode Arrays (USEAs) to provide more degrees of freedom in movement and increased proprioception for prosthetic hand users [54] A review of the state-of-the-art and the limitations of myoelectric signal control methods of upper limb prostheses [55] A systematic review of EEG used in BMIs for control of human limb exoskeletons, including background on upper limb exoskeletons [56] A review exploring exoprosthetic limb replacement considering different severities of amputation to the upper limb…”

Performance of the CYBERLEGs motorized lower limb prosthetic device during simulated daily activities

“…Recent technological breakthroughs have evolved toward motorized prostheses (Martinez-Villalpando et al, 2011;Simon et al, 2013Simon et al, , 2014Takahashi et al, 2015;Wu et al, 2017). Although some devices (e.g., the Power Knee from Össur, Reykjavik, Iceland) already reached the market, they are still underprescribed and under-utilized due to the large costs of product development and customization (Lechler et al, 2018). Moreover, current motorized prostheses mainly focus on improving walking abilities, whereas emphasis on other daily activities is also of highly importance (Ghillebert et al, 2019).…”