EMG pattern recognition compared to foot control of the DEKA Arm

Introduction EMG pattern recognition control (EMG-PR) is a promising option for control of upper limb prostheses with multiple degrees of freedom (DOF). The purposes of this study were to 1) evaluate outcomes of EMG-PR and inertial measurement units (IMU) control of the DEKA Arm as compared to personal prosthesis; and 2) compare outcomes of EMG-PR to IMU control of DEKA Arm. Methods This was a quasi-experimental, multi-site study with repeated measures that compared non-randomized groups using two types of controls: EMG-PR and IMUs. Subjects (N = 36) were transradial (TR) and transhumeral (TH) amputees. Outcomes were collected at Baseline (using personal prosthesis), and after in-laboratory training (Part A), and home use (Part B). Data was compared to personal prosthesis, stratified by amputation level and control type. Outcomes were also compared by control type. Results The EMG-PR group had greater prosthesis use after Part A, but worse dexterity, lower satisfaction, and slower activity performance compared to Baseline; the IMU group had slower activity performance. After Part B, the EMG-PR group had less perceived activity difficulty; the IMU group had improved activity performance, improved disability and activity difficulty, but slower performance. No differences were observed for TH group by control type in Part A or B. The TR group using EMG-PR had worse dexterity (Parts A & B), and activity performance (Part A) as compared to IMU users. Discussion/Conclusion Findings suggest that for the TR group that IMUs are a more effective control method for the DEKA Arm as compared to the EMG-PR prototypes employed in this study. Further research is needed to refine the EMG-PR systems for multi-DOF devices. Future studies should include a larger sample of TH amputees. Trial registration ClinicalTrials.gov NCT01551420.

[1]  G. Rayan,et al.  Functional assessment of bilateral wrist arthrodeses. , 1987, The Journal of hand surgery.

[2]  E. Stern,et al.  Commercial wrist extensor orthoses. Hand function, comfort, and interference across five styles. , 1994, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[3]  K. M. Chan,et al.  The Impact of Ulnar Nerve Compression at the Elbow on the Hand Function of Heavy Manual Workers , 2003, Neurorehabilitation and neural repair.

[4]  A. Heinemann,et al.  Development and measurement properties of the Orthotics and Prosthetics Users’ Survey (OPUS): A comprehensive set of clinical outcome instruments , 2003, Prosthetics and orthotics international.

[5]  Robert A. Virzi,et al.  Refining the Test Phase of Usability Evaluation: How Many Subjects Is Enough? , 1992 .

[6]  Paul W. Stratford,et al.  Assessing Disability and Change on Individual Patients: A Report of a Patient Specific Measure , 1995 .

[7]  R. H. Jebsen,et al.  An objective and standardized test of hand function. , 1969, Archives of physical medicine and rehabilitation.

[8]  C. Häger-Ross,et al.  Hand function in Charcot Marie Tooth: test retest reliability of some measurements , 2006, Clinical rehabilitation.

[9]  M. Hackel,et al.  Changes in hand function in the aging adult as determined by the Jebsen Test of Hand Function. , 1992, Physical therapy.

[10]  D. Stuppy,et al.  The Faces Pain Scale: reliability and validity with mature adults. , 1998, Applied nursing research : ANR.

[11]  P. Stratford,et al.  The Patient-Specific Functional Scale: measurement properties in patients with knee dysfunction. , 1997, Physical therapy.

[12]  J. Ricker,et al.  Application of the oral trail making test to a mixed clinical sample , 1996 .

[13]  T. Kuiken,et al.  Improved Myoelectric Prosthesis Control Using Targeted Reinnervation Surgery: A Case Series , 2008, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[14]  L. Resnik,et al.  Research update: VA study to optimize DEKA arm. , 2010, Journal of rehabilitation research and development.

[15]  Robert D. Lipschutz,et al.  The use of targeted muscle reinnervation for improved myoelectric prosthesis control in a bilateral shoulder disarticulation amputee , 2004, Prosthetics and orthotics international.

[16]  Panagiotis K. Artemiadis,et al.  Proceedings of the first workshop on Peripheral Machine Interfaces: going beyond traditional surface electromyography , 2014, Front. Neurorobot..

[17]  Anna T. Winslow,et al.  Evaluation of EMG pattern recognition for upper limb prosthesis control: a case study in comparison with direct myoelectric control , 2018, Journal of NeuroEngineering and Rehabilitation.

[18]  Frantzy Acluche,et al.  User experience of controlling the DEKA Arm with EMG pattern recognition , 2018, PloS one.

[19]  R. Hébert,et al.  Validation of the Box and Block Test as a measure of dexterity of elderly people: reliability, validity, and norms studies. , 1994, Archives of physical medicine and rehabilitation.

[20]  A. Heinemann,et al.  Validation of the orthotics and prosthetics user survey upper extremity functional status module in people with unilateral upper limb amputation. , 2008, Journal of rehabilitation medicine.

[21]  L. Cohen,et al.  Influence of electric somatosensory stimulation on paretic-hand function in chronic stroke. , 2006, Archives of physical medicine and rehabilitation.

[22]  T. Kuiken,et al.  Myoelectric Pattern Recognition Outperforms Direct Control for Transhumeral Amputees with Targeted Muscle Reinnervation: A Randomized Clinical Trial , 2017, Scientific Reports.

[23]  Linda Resnik,et al.  Using virtual reality environment to facilitate training with advanced upper-limb prosthesis. , 2011, Journal of rehabilitation research and development.

[24]  C. Randolph,et al.  The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. , 1998, Journal of clinical and experimental neuropsychology.

[25]  G. Kraft,et al.  Techniques to improve function of the arm and hand in chronic hemiplegia. , 1992, Archives of physical medicine and rehabilitation.

[26]  Wayne Dite,et al.  Additional task-related practice improves mobility and upper limb function early after stroke: a randomised controlled trial. , 2004, The Australian journal of physiotherapy.

[27]  A. Jette,et al.  Development of CRIS: measure of community reintegration of injured service members. , 2009, Journal of rehabilitation research and development.

[28]  D. Wong,et al.  Smiling face as anchor for pain intensity scales , 2001, Pain.

[29]  Cherisse McKay,et al.  Reliability and validity of the RBANS in a traumatic brain injured sample. , 2007, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[30]  Alexander W Dromerick,et al.  Effect of training on upper-extremity prosthetic performance and motor learning: a single-case study. , 2008, Archives of physical medicine and rehabilitation.

[31]  L. Resnik,et al.  Reliability, Validity, and Responsiveness of the QuickDASH in Patients With Upper Limb Amputation. , 2015, Archives of physical medicine and rehabilitation.

[32]  P. Stratford,et al.  The patient-specific functional scale: validation of its use in persons with neck dysfunction. , 1998, The Journal of orthopaedic and sports physical therapy.

[33]  Malcolm MacLachlan,et al.  Factor Structure of the Trinity Amputation and Prosthesis Experience Scales (TAPES) with Individuals with Acquired Upper Limb Amputations , 2005, American journal of physical medicine & rehabilitation.

[34]  J. Poole,et al.  Functional implications of ipsilesional motor deficits after unilateral stroke. , 2005, Archives of physical medicine and rehabilitation.

[35]  Linda Resnik,et al.  The DEKA Arm: Its features, functionality, and evolution during the Veterans Affairs Study to optimize the DEKA Arm , 2014, Prosthetics and orthotics international.

[36]  Jeffrey Jutai,et al.  Evaluation of the validity of the prosthetic upper extremity functional index for children. , 2003, Archives of physical medicine and rehabilitation.

[37]  M. J. Highsmith,et al.  Differences in myoelectric and body-powered upper-limb prostheses: Systematic literature review. , 2015, Journal of rehabilitation research and development.

[38]  L. Resnik,et al.  Development and evaluation of the activities measure for upper limb amputees. , 2013, Archives of Physical Medicine and Rehabilitation.

[39]  Tanja Stamm,et al.  Mapping hand functioning in hand osteoarthritis: comparing self-report instruments with a comprehensive hand function test. , 2007, Arthritis and rheumatism.

[40]  C. Burckhardt,et al.  The Quality of Life Scale (QOLS): Reliability, Validity, and Utilization , 2003, Health and quality of life outcomes.

[41]  Christopher Lake,et al.  Effects of Prosthetic Training on Upper‐Extremity Prosthesis Use , 1997 .

[42]  R. Reitan Validity of the Trail Making Test as an Indicator of Organic Brain Damage , 1958 .

[43]  Linda Resnik,et al.  Controlling a multi-degree of freedom upper limb prosthesis using foot controls: user experience , 2014, Disability and rehabilitation. Assistive technology.

[44]  L. Resnik,et al.  Reliability of Outcome Measures for People With Lower-Limb Amputations: Distinguishing True Change From Statistical Error , 2011, Physical Therapy.

[45]  F. V. Wright,et al.  Measurement of Functional Outcome With Individuals Who Use Upper Extremity Prosthetic Devices: Current and Future Directions , 2006 .

[46]  Linda Resnik,et al.  Training protocol for a powered shoulder prosthesis. , 2014, Journal of rehabilitation research and development.

[47]  L. Resnik,et al.  Timed activity performance in persons with upper limb amputation: A preliminary study. , 2017, Journal of hand therapy : official journal of the American Society of Hand Therapists.

[48]  M E Neistadt,et al.  The effects of different treatment activities on functional fine motor coordination in adults with brain injury. , 1994, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[49]  H. Krug,et al.  Finger dexterity and hand function: effect of three commercial wrist extensor orthoses on patients with rheumatoid arthritis. , 1996, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[50]  L. Resnik,et al.  Brief activity performance measure for upper limb amputees: BAM-ULA , 2018, Prosthetics and orthotics international.