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 人类的手腕负责定位手以完成日常生活中的许多基本任务，它提供了三种功能： 自由度 (DOF)：旋转、屈曲/伸展和尺骨/桡骨偏差。当前动力假肢 手腕仅提供手腕旋转；没有可用的供电设备提供手腕伸展/弯曲，这可能 降低经桡动脉截肢者的功能能力。我们开发了强大的 2-DOF 提供独立控制旋转和伸展/弯曲的手腕；我们建议进行第一阶段 临床试验，以确定该手腕是否比 1-DOF 手腕（旋转 仅有的）。此外，我们还开发了基于模式识别（PR）的控制系统，现已商用 可用，它将用于控制本次试验中的设备。肌电图 (EMG) 信号的 PR 残肢提供手臂自由度的无缝顺序控制，使控制比 传统的肌电控制系统需要用户将假肢切换到不同的模式以 控制不同的自由度。然而，当前的 PR 系统不允许同时控制所提供的 DOF 由完好无损的手臂。我们开发了一种新的 PR 算法，基于一种称为概率的新型控制方法 加权回归在初步研究中已经证明了对多自由度假体的稳健控制。 因此，我们还将评估同时 PR 控制与序贯 PR 控制相比的功能优势。 我们将招募最多 20 名接受中长、单侧经桡动脉截肢的患者参加试验， 预计至少 14 名受试者将完成所有三个目标。对于目标 1，我们将为参与者安装假肢 包括一个一自由度手腕和一个单自由度或多自由度终端设备。对于每个测试条件，我们将 培训参与者使用顺序 PR 控制并使用综合性方法执行初始功能测试 结果测量工具箱，根据假肢学会的建议编制 矫形器和我们之前的研究经验。然后参与者将把假肢带回家并使用它 六周的日常任务，允许广泛的练习来优化他们对设备的功能控制。在 家庭试验结束后，参与者将执行相同的结果测量来评估功能。我们将重复 这是目标 2 的序列，参与者将评估相同的两个假肢（除了 2 自由度手腕）。 最后，对于目标 3，我们将遵循相同的协议来比较顺序和同时 PR 控制 具有 1-DOF 手和 2-DOF 手腕的假肢。我们期望 2-DOF 手腕和同步 PR 控制系统将分别提供比 1-DOF 手腕和顺序控制更好的功能。这 研究将对 2-DOF 手腕和同时 PR 控制的好处进行定量评估， 这对于这些技术的商业化和进一步发展以改善假肢是必要的 经桡动脉截肢患者的选择和功能能力。