Toward higher-performance bionic limbs for wider clinical use

Abstract

Most prosthetic limbs can autonomously move with dexterity, yet they are not perceived by the user as belonging to their own body. Robotic limbs can convey information about the environment with higher precision than biological limbs, but their actual performance is substantially limited by current technologies for the interfacing of the robotic devices with the body and for transferring motor and sensory information bidirectionally between the prosthesis and the user. In this Perspective, we argue that direct skeletal attachment of bionic devices via osseointegration, the amplification of neural signals by targeted muscle innervation, improved prosthesis control via implanted muscle sensors and advanced algorithms, and the provision of sensory feedback by means of electrodes implanted in peripheral nerves, should all be leveraged toward the creation of a new generation of highperformance bionic limbs. These five technologies have been clinically tested in humans, and alongside mechanical redesigns and adequate rehabilitation training should facilitate the wider clinical use of bionic limbs.Prosthetics aim to substitute the loss of an extremity via technological means. Missing a limb leads to significant impairments in the capacity to move and to interact with the environment. This deficiency is associated with the actual functional loss of a body part and with the loss of sensation, and it can also

Biorealistic Control of Hand Prosthesis Augments Functional Performance of Individuals With Amputation

“…Although the assessment tasks conducted here showed promising benefits of proprioceptive afferent in functional grasping tasks for prosthetic hands, individuals with amputation mainly relied on visual feedback ( Winges et al, 2003 ; Saunders and Knill, 2004 ) to guide the motion and to exert grasping force of the prosthetic hand. In the follow-up work, it is necessary to introduce tactile feedback into prosthetic hands ( Tan et al, 2014 ; George et al, 2019 ; Zollo et al, 2019 ; Bensmaia et al, 2020 ; Hao et al, 2020 ; Micera et al, 2020 ; Farina et al, 2021 ; Raspopovic et al, 2021 ) to construct a fully biorealistic hand prosthesis ( Lan et al, 2021 ). Further tests in a larger scale study with more users are required to confirm the long-term reliability, robustness, embodiment and acceptability in activities of daily living.…”

Survey of transfemoral amputee experience and priorities for the user-centered design of powered robotic transfemoral prostheses

“…The relationships between key TFP design parameters in all of these domains (hardware, sensing, and control), user preferences, and functional/clinical outcomes should be further explored, as Clites, Rouse, and colleagues have recently investigated for the parameter of prosthetic ankle stiffness [ 59 ]. Finally, to make such research relevant to ongoing advancements in neuroprosthesis technology, the relative benefits of various TFP design features and performance settings should also be investigated in the context of advanced neuromuscular integration approaches such as targeted muscle reinnervation and intramuscular electrodes for both prosthesis control and sensory feedback, including the case of osseointegrated prostheses as well [ 60 ].…”

Editorial: Somatosensory Integration in Human Movement: Perspectives for Neuromechanics, Modelling and Rehabilitation

“…Enhancing efficacy of rehabilitation technologies through use of engaging human-machine interfaces, has been an ongoing research pursuit (Lagoda et al, 2012;Vujaklija, 2018). To that end, Electromyography (EMG) and Electroencephalography (EEG) have been the two most considered interfacing modalities, as they offer a chance for an intimate observation of the underlying neural activity while remaining non-invasive and minimally intrusive (Farina et al, 2021). However, establishing robust controllers of assistive devices based on these interfaces, is difficult and many of the proposed approaches have failed to meet their clinical promises.…”