Extended home use of an advanced osseointegrated prosthetic arm improves function, performance, and control efficiency.
Autor: | Osborn LE; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Moran CW; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Johannes MS; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Sutton EE; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Wormley JM; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Dohopolski C; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Nordstrom MJ; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, United States of America.; Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America.; Center for Rehabilitation Sciences Research (CRSR), Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America., Butkus JA; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, United States of America., Chi A; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America.; Department of Surgery, Oregon Health & Science University, Portland, OR, United States of America., Pasquina PF; Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, United States of America.; Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America.; Center for Rehabilitation Sciences Research (CRSR), Uniformed Services University of the Health Sciences, Bethesda, MD, United States of America., Cohen AB; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Wester BA; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Fifer MS; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America., Armiger RS; Johns Hopkins University Applied Physics Laboratory, Laurel, MD, United States of America. |
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Jazyk: | angličtina |
Zdroj: | Journal of neural engineering [J Neural Eng] 2021 Mar 08; Vol. 18 (2). Date of Electronic Publication: 2021 Mar 08. |
DOI: | 10.1088/1741-2552/abe20d |
Abstrakt: | Objective. Full restoration of arm function using a prosthesis remains a grand challenge; however, advances in robotic hardware, surgical interventions, and machine learning are bringing seamless human-machine interfacing closer to reality. Approach. Through extensive data logging over 1 year, we monitored at-home use of the dexterous Modular Prosthetic Limb controlled through pattern recognition of electromyography (EMG) by an individual with a transhumeral amputation, targeted muscle reinnervation, and osseointegration (OI). Main results. Throughout the study, continuous prosthesis usage increased (1% per week, p < 0.001) and functional metrics improved up to 26% on control assessments and 76% on perceived workload evaluations. We observed increases in torque loading on the OI implant (up to 12.5% every month, p < 0.001) and prosthesis control performance (0.5% every month, p < 0.005), indicating enhanced user integration, acceptance, and proficiency. More importantly, the EMG signal magnitude necessary for prosthesis control decreased, up to 34.7% ( p < 0.001), over time without degrading performance, demonstrating improved control efficiency with a machine learning-based myoelectric pattern recognition algorithm. The participant controlled the prosthesis up to one month without updating the pattern recognition algorithm. The participant customized prosthesis movements to perform specific tasks, such as individual finger control for piano playing and hand gestures for communication, which likely contributed to continued usage. Significance. This work demonstrates, in a single participant, the functional benefit of unconstrained use of a highly anthropomorphic prosthetic limb over an extended period. While hurdles remain for widespread use, including device reliability, results replication, and technical maturity beyond a prototype, this study offers insight as an example of the impact of advanced prosthesis technology for rehabilitation outside the laboratory. (© 2021 IOP Publishing Ltd.) |
Databáze: | MEDLINE |
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