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Permanent link (DOI): https://doi.org/10.7939/R3MW28V0P

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Engineering Kinesthetic Perceptions: The Restoration of Movement Sense in Upper Limb Prosthetic Use Open Access

Descriptions

Other title
Subject/Keyword
Prostheses
Kinesthesia
Prosthetic Sockets
Sensory Feedback
Type of item
Thesis
Degree grantor
University of Alberta
Author or creator
Schofield, Jonathon S
Supervisor and department
Jason Carey (Mechanical Engineering)
Jacqueline Hebert (Division of Physical Medicine & Rehabilitation)
Examining committee member and department
Hossein Rouhani (Mechanical Engineering)
Ron Triolo (Biomedical Engineering - Case Western Reserve University)
Ming Chan (Department of Medicine)
Department
Department of Mechanical Engineering
Specialization

Date accepted
2017-09-06T14:16:45Z
Graduation date
2017-11:Fall 2017
Degree
Doctor of Philosophy
Degree level
Doctoral
Abstract
Upper limb movement yields rich streams of sensory information that are cortically integrated with motor commands. This is drastically altered in those with upper limb (UL) amputation as sensations of touch and movement are inherently lost. This absence impedes prosthetic control by forcing reliance on visual cues and other indirect means to effectively operate one’s prosthesis. This increases the cognitive burden placed on the user as the prosthesis requires continual attention. While advanced prostheses have been developed, 23-39% of users still reject their devices. A major factor is the absence of physiologically relevant sensation. A unique approach to address this challenge is targeted reinnervation (TR) surgery, which reroutes residual nerves that once serviced a patient’s amputated hand to strategic muscles in the residual limb (RL). This restores sensation in the missing limb and aids in intuitive control of prostheses. While the return of cutaneous sensations has been reported, an equally vital component to limb control, movement (kinesthetic) sensibility, has yet to be investigated. In this thesis, we highlight an approach for providing kinesthetic sensory feedback communicated to prosthetic users through the existing sensory channels once present in their missing limb. Our approach leveraged the reinnervated anatomy of participants who had previously undergone TR surgery, and the kinesthetic illusion. The latter is a phenomenon whereby vibration of musculotendinous regions of a limb induces sensations of limb movement. Through able-bodied trials, we developed an applied understanding of the kinesthetic illusion in preparation for translation into an amputee population. In a group of participants who have undergone transhumeral amputation and TR surgery, we demonstrated that we could purposefully elicit sensations of missing hand movement and link these sensations to the movement of commercially available prosthetic components. Integrating these techniques into functional prostheses required the development of novel prosthetic sockets allowing vibration stimulators access to the RL, while maintaining socket fit, security and suspension. The engineering challenges of this task necessitated the development of foundational information that is largely absent, such as understanding the socket interfaces mechanics of transhumeral prostheses. A novel socket design was fabricated to incorporate our feedback system, and the RL-socket contact pressures were evaluated. Through comparison to the traditional socket data, it was determined that the novel socket not only successfully integrated a kinesthetic feedback system, but allowed investigators to target specific anatomical locations on the RL for the application of contact pressures. Lastly, a numerical predictive model was developed as a foundation for a future clinical socket design tool. Through the application of finite element analysis, we demonstrated a proof-of-concept model that is capable of predicting the locations and magnitudes of contact pressures occurring between the RL and socket. Applications of this model may allow for the evaluation of novel sensory-integrated prosthetic socket prior to their physical fabrication. Taken together, this work addresses very real, practical challenges associated with UL prosthetic use. It provides foundational information for the advancement of sensory-motor integrated prosthesis and holds the potential to help restore sensation, and improve prosthetic function.
Language
English
DOI
doi:10.7939/R3MW28V0P
Rights
This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for the purpose of private, scholarly or scientific research. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.
Citation for previous publication
Schofield JS, Evans KR, Carey JP, Hebert JS. (2014). Applications of sensory feedback in motorized upper extremity prosthesis: a review. Expert Reviews of Medical Devices. 11(5): 499-511.Schofield JS, Dawson MR, Carey JP, Hebert JS. (2015). Characterizing the effects of amplitude, frequency and limb position on vibration induced movement illusions: Implications in sensory-motor rehabilitation. Technology and Healthcare. 23(2): 129-41.Schofield JS, Evans KR, Hebert JS, and Carey JP. (2016). The Effect of Biomechanical Variables on Force Sensitive Resistor Error: Implications for Calibration and Improved Accuracy. Journal of Biomechanics. 49(5): 786-792Schofield JS, Schoepp KR, Williams HE, Carey JP, Marasco PD, Hebert JS. (2017). Characterization of interfacial socket pressure in transhumeral prostheses: a case series. PLOS one.  https://doi.org/10.1371/journal.pone.0178517

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