The Functional Importance of Powered Wrist Flexion/Extension and Simultaneous Control for Upper Limb Prostheses

上肢假肢动力手腕屈曲/伸展和同步控制的功能重要性

• 批准号: 10165765
• 负责人: Levi John Hargrove
• 金额: $ 56.58万
• 依托单位: REHABILITATION INSTITUTE OF CHICAGO D/B/A SHIRLEY RYAN ABILITYLAB
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-12 至 2023-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10165765
• 关键词: Academy; Activities of Daily Living; Address; Algorithms; Amputation; Artificial Arm; Bathing; Clinical; Cross-Over Studies; Data; Devices; Female; Fingers; Freedom; Hand; Home; Human; Individual; Intuition; Joint Prosthesis; Length; Limb Prosthesis; Limb structure; Manuals; Measurement; Methods; Movement; Orthotic Devices; Outcome; Outcome Measure; Participant; Pattern Recognition; Pattern Recognition Systems; Performance; Phase I Clinical Trials; Positioning Attribute; Prosthesis; Protocols documentation; Quality of life; Radial; Randomized; Recommendation; Research; Rotation; Science; Self Care; Signal Transduction; System; Testing; Time; Training; Upper Extremity; Work; Wrist; Writing; arm; base; clinical implementation; commercialization; dexterity; disability; experience; feeding; flexibility; functional improvement; functional outcomes; grasp; improved; improved functioning; limb amputation; myoelectric control; novel; powered prosthesis; prosthesis control; prosthesis wearer; psychologic; recruit; residual limb; social; technology development; tool

Project Abstract The human wrist, which positions the hand to accomplish many essential tasks of daily living, provides three degrees of freedom (DOFs): rotation, flexion/extension, and ulnar/radial deviation. Current powered prosthetic wrists provide only wrist rotation; no available powered device provides wrist extension/flexion, which likely reduces the functional ability of individuals with transradial amputations. We have developed a robust 2-DOF wrist that provides independently controlled rotation and extension/flexion; we proposed to conduct a phase 1 clinical trial to determine whether this wrist provides better functional performance than a 1-DOF wrist (rotation only). In addition, we have developed a pattern recognition (PR)-based control system, now commercially available, which will be used to control devices in this trial. PR of electromyographic (EMG) signals from the residual limb provides seamless sequential control of arm DOFs, making control easier and more intuitive than conventional myoelectric control systems that require the user to switch the prosthesis into different modes to control different DOFs. However, current PR systems do not allow the simultaneous control of DOFs provided by an intact arm. We have developed a new PR algorithm, based on a novel control method called probabilistic weighted regression that, in preliminary studies, has demonstrated robust control of a multi-DOF prosthesis. Thus we will also evaluate the functional benefits of simultaneous PR control compared to sequential PR control. We will recruit up to 20 individuals with mid-length, unilateral transradial amputations to participate in the trial, anticipating that at least 14 subjects will complete all three aims. For Aim 1 we will fit participants with a prosthesis comprising a 1-DOF wrist and either a single- or a multi-DOF terminal device. For each test condition, we will train participants to use sequential PR control and perform initial functional testing using a comprehensive toolbox of outcome measures, compiled based on recommendations from the Academy of Prosthetics and Orthotics and our prior research experience. Participants will then take the prosthesis home and use it for everyday tasks for six weeks, allowing extensive practice to optimize their functional control of the device. At the end of the home trial, participants will perform the same outcome measures to assess function. We will repeat this sequence for Aim 2, where participants will evaluate the same two prostheses except with the 2-DOF wrist. Finally, for Aim 3, we will follow the same protocol to compare sequential and simultaneous PR control of a prosthesis with a 1-DOF hand and a 2-DOF wrist. We expect that both the 2-DOF wrist and the simultaneous PR control system will provide improved function over the 1-DOF wrist and sequential control, respectively. This study will provide a quantitative assessment of the benefits of a 2-DOF wrist and of simultaneous PR control, which is necessary for commercialization and further development of these technologies to improve prosthetic options, and functional ability, for individuals with transradial amputations.

项目摘要 人手腕将手放置在完成日常生活的许多基本任务中，提供了三个 自由度（DOFS）：旋转，屈曲/延伸和尺/径向偏差。当前的动力假肢 手腕仅提供腕部旋转；没有可用的动力设备提供腕部伸展/屈曲，这可能 降低具有跨性截肢的个体的功能能力。我们已经开发了一个强大的二线 提供独立控制的旋转和伸展/屈曲的手腕；我们提议进行1阶段 临床试验以确定该手腕是否比1多手腕提供更好的功能性能（旋转 仅有的）。此外，我们已经开发了一个基于模式识别（PR）的控制系统，现在是商业上的 可用，该试验将用于控制设备。来自肌电图的PR（EMG）信号 残留的肢体提供了对臂DOF的无缝顺序控制，使控制更容易，更直观 传统的肌电控制系统，要求用户将假体切换为不同的模式 控制不同的DOF。但是，当前的PR系统不允许同时控制DOF 通过完整的手臂。我们已经基于一种称为概率的新型控制方法开发了一种新的PR算法 在初步研究中，加权回归证明了对多道假体的强大控制。 因此，与顺序PR对照相比，我们还将评估同时PR对照的功能益处。 我们将招募多达20个具有中段，单方面跨拉截肢的人参加试验， 预计至少有14名受试者将完成所有三个目标。对于目标1，我们将适合参与者的假体 包括1多腕手腕以及单个或多道末端设备。对于每个测试条件，我们将 培训参与者使用顺序PR控制，并使用全面执行初始功能测试 根据假肢学院的建议和成果措施的工具箱 矫形器和我们先前的研究经验。然后，参与者将把假体带回家并将其用于 日常任务六个星期，允许广泛的练习来优化其对设备的功能控制。在 家庭试验的结束，参与者将采取相同的结果指标来评估功能。我们将重复 这是AIM 2的序列，其中参与者将评估相同的两个假体，除了二线手腕。 最后，对于AIM 3，我们将遵循相同的协议，以比较A的顺序和同时PR控制 假肢，有一只手和二线手腕。我们期望二线手腕和同时 PR控制系统将分别超过1-DOF手腕和顺序控制的改进功能。这 研究将对2多手腕和同时PR控制的益处进行定量评估， 这对于这些技术的商业化和进一步发展是必要的，以改善假肢 对于具有跨性截肢的个体的选项和功能能力。