The functional assessment of myoelectric control algorithms by persons with amputation promotes the overarching goal of the field of prosthetic limb design: to replace what was lost. However, many studies use experimental paradigms with virtual interfaces and able-bodied subjects that do not capture the challenges of a clinical implementation with an amputee population. A myoelectric control system must be robust to variable physiology, loading effects of the prosthesis on the limb, and limb position effects during dynamic tasks. Here persons with transradial limb loss performed activities of daily living using a postural controller and multi-functional prosthetic hand in order to verify that the postural controller was robust to these clinical challenges. The Southampton Hand Assessment Procedure was performed by persons with limb loss and able-bodied subjects. The results indicate that persons with limb loss and able-limbed subjects achieved the same performance and therefore that the clinical challenges were overcome. Persons with limb loss achieved 55% of physiological hand function on average. Also, the postural controller is compared to other state of the art myoelectric controllers and prosthetic hands previously tested. This work confirms that the postural controller is potentially a clinically-viable method to control myoelectric multi-functional prosthetic hands.
Imaging phantoms are used to calibrate and validate the performance of magnetic resonance imaging (MRI) systems. Many new materials have been developed for additive manufacturing (three-dimensional [3D] printing) processes that may be useful in the direct printing or casting of dimensionally accurate, anatomically accurate, patient-specific, and/or biomimetic MRI phantoms. The T1, T2, and T2* spin relaxation times of polymer samples were tested to discover materials for use as tissue mimics and structures in MRI phantoms. This study included a cohort of polymer compounds that was tested in cured form. The cohort consisted of 101 standardized polymer samples fabricated from: two-part silicones and polyurethanes used in commercial casting processes; one-part optically cured polyurethanes used in 3D printing; and fused deposition thermoplastics used in 3D printing. The testing was performed at 3 T using inversion recovery, spin echo, and gradient echo sequences for T1, T2, and T2*, respectively. T1, T2, and T2* values were plotted with error bars to allow the reader to assess how well a polymer matches a tissue for a specific application. A correlation was performed between T1, T2 , T2* values and material density, elongation, tensile strength, and hardness. Two silicones, SI_XP-643 and SI_P-45, may be usable mimics for reported liver values; one silicone, SI_XP-643, may be a useful mimic for muscle; one silicone, SI_XP-738, may be a useful mimic for white matter; and four silicones, SI_P-15, SI_GI-1000, SI_GI-1040, and SI_GI-1110, may be usable mimics for spinal cord. Elongation correlated to T2 (p = 0.0007), tensile strength correlated to T1 (p = 0.002), T2 (p = 0.0003), and T2* (p = 0.003). The 80 samples not providing measurable signal with T1, T2, T2* relaxation values too short to measure with the standard sequences, may be useful for MRI-invisible fixturing and medical devices at 3 T.
Partial hand loss accounts for the overwhelming majority of upper limb deficiencies. Despite this, individuals with partial hand loss have a limited number of prosthetic options at their disposal. Existing externally powered devices typically house both motor and gear transmission in the proximal phalanx, which provides function at the expense of anthropomorphism. We present a novel design for an externally powered finger prosthesis with a custom gear transmission that is capable of higher intermittent torques compared to commercial gearheads of equivalent volume. We manufacture a fully functional transmission using a high-strength maraging steel alloy and direct laser metal sintering. The transmission consists of multiple planetary and spur gear stages arranged in a stackable (or laminar) configuration and accommodates joint movement at the proximal interphalangeal joint. The powered finger is equivalent in size to a 50th percentile female index finger and is capable of generating pinch forces comparable to those of commercial powered fingers at flexion speeds that exceed those of existing devices. While there are several practical and functional improvements for future iterations, our design represents a viable option for a powered finger capable of accommodating a wide range of individuals with partial hand loss.
Imaging phantoms are used to calibrate and validate the performance of medical computed tomography (CT) systems. Many new materials developed for three-dimensional (3D) printing processes may be useful in the direct printing or casting of biomimetic and geometrically accurate CT and X-ray phantoms. The X-ray linear attenuation coefficients of polymer samples were measured to discover materials for use as tissue mimics in phantoms. This study included a cohort of polymer compounds that were tested in cured form. The cohort consisted of 101 standardized polymer samples fabricated from: two-part silicones and polyurethanes used in commercial casting processes; one-part optically cured polyurethanes used in 3D printing; and fused deposition thermoplastics used in 3D printing. The testing was performed with a commercial micro-CT imaging system from 40 kVp to 140 kVp. The X-ray linear coefficients of the samples and human tissues were plotted with error bars to allow the reader to identify suitable mimics. The X-ray linear attenuation coefficients of the tested material samples spanned a wide range of values, with a small number of them overlapping established human tissue mimic values. Twenty 3D printer materials and one castable polyurethane tracked nylon and polymethyl methacrylate (PMMA) as established X-ray mimics for fat. Five 3D printer materials tracked water as an established X-ray mimic for muscle.
Introduction People with partial hand loss represent the largest population of upper limb amputees by a factor of 10. The available prosthetic componentry for people with digit loss provide various methods of control, kinematic designs, and functional abilities. Here, the Point Digit II is empirically tested and a discussion is provided comparing the Point Digit II with the existing commercially available prosthetic fingers. Materials and Methods Benchtop mechanical tests were performed using prototype Point Digit II prosthetic fingers. The battery of tests included a static load test, a static mounting tear-out test, a dynamic load test, and a dynamic cycle test. These tests were implemented to study the mechanisms within the digit and the ability of the device to withstand heavy-duty use once out in the field. Results The Point Digit II met or exceeded all geometric and mechanical specifications. The device can withstand over 300 lbs of force applied to the distal phalange and was cycled over 250,000 times without an adverse event representing 3 years of use. Multiple prototypes were utilized across all tests to confirm the ability to reproduce the device in a reliable manner. Conclusions The Point Digit II presents novel and exciting features to help those with partial hand amputation return to work and regain ability. The use of additive manufacturing, unique mechanism design, and clinically relevant design features provides both the patient and clinician with a prosthetic digit, which improves upon the existing devices available.
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