Objectives-To fit and evaluate the control of a complex prosthesis for a shoulder disarticulation level amputee subject with targeted muscle reinnervation.Design-One participant who had targeted muscle reinnervation surgery was fit with an advanced prosthesis and usage with this device was compared to the device used in the home setting.Setting-The experiments were completed within a laboratory setting. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. We certify that we have affiliations with or financial involvement (eg, employment, consultancies, honoraria, stock ownership or options, expert testimony, grants and patents received or pending, royalties) with an organization or entity with a financial interest in, or financial conflict with, the subject matter or materials discussed in the manuscript AND all such affiliations and involvements are disclosed on the title page of the manuscript. T. Walley Williams III is an employee of Liberating Technologies, Inc, maker of the Boston Digital Arm, used in this study. This component was purchased by the Neural Engineering Center for Artificial Limbs from Liberating Technologies, Inc for this study. The Neural Engineering Center for Artificial Limbs and Liberating Technologies, Inc have applied for an SBIR together. We certify that no other party has a direct interest in the results of the research supporting this article has or will confer a benefit on us or on any organization with which we are associated AND, if applicable, we certify that all financial and material support for this research (eg, NIH or NHS grants) and work are clearly identified. A commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a financial benefit on the author or one or more of the authors. Williams III is an employee of Liberating Technologies, Inc, maker of the Boston Digital Arm, used in this study. This component was purchased by the Neural Engineering Center for Artificial Limbs from Liberating Technologies, Inc for this study. Participants-The first recipient of targeted muscle reinnervation: a bilateral shoulder disarticulation level amputee. Suppliers NIH Public AccessInterventions-Two years after surgery, the subject was fit with a 6 degree of freedom (DOF) prosthesis (shoulder flexion, humeral rotation, elbow flexion, wrist rotation, wrist flexion, and hand control). Control of this device was compared to his commercially available 3 DOF system (elbow, wrist rotation, and powered hook terminal device).Main Outcome Measure-In order to assess performanc...
Abstract-A prosthetist makes a conventional socket by wrapping plaster bandage around the residual limb and using the resulting shell to create a positive model. After he or she modifies the plaster, it is used to create a laminated socket. Such sockets are almost perfect cylinders that encapsulate the limb. The bone is centered in soft, compressible tissue that must move aside before the bone can push against the socket to transmit force or torque to the prosthesis. In a compression/release stabilized (CRS) socket, three or more longitudinal depressions compress and displace tissue between the socket wall and the bone to reduce lost motion when the bone is moved with respect to the socket. Release areas between depressions are opened to accommodate displaced tissue. Without these openings provided, the CRS socket will not function as intended. Often, the release areas of compression are the struts of a carbon-fiber frame, and the regions between struts are left open. A frame with openings may be modified by the prosthetist adding a thin membrane fully surrounding the limb but allowing the membrane and underlying tissue to enter the release openings. The membrane may contain electrodes, and it may constitute a roll-on liner that helps suspend the prosthesis. We introduce three socket designs: transradial, transfemoral, and transhumeral.
Myoelectric pickups (electrodes and processors for detecting the signal that is recorded as an electromyogram) are the most important human-machine interface for controlling powered upper-extremity prostheses. This article presents a simple explanation of myoelectric signal acquisition and then discusses how these signals are used to control the small motors in electric hands, elbows, wrist rotators, and other similar equipment. The less-familiar switch-based and proportional position-sensing controls are also explained. A complete listing of the major suppliers and products available will aid in understanding a discussion of the criteria for using external power instead of, or along with, body power to control and activate prosthetic function.
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