Prosthesis Control with an Implantable Multichannel Wireless Electromyography System for High-Level Amputees

Bergmeister, Konstantin D.; Hader, Marie; Lewis, Soeren; Russold, Michael-Friedrich; Schiestl, Martina; Roche, Aidan D.; Salminger, Stefan; Dietl, H.

doi:10.1097/prs.0000000000001926

Cited by 20 publications

(22 citation statements)

References 33 publications

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“…Implantable EMG electrodes are able to record stable signals from the muscle without many of the limitations of a surface electrode . These electrodes can either be implanted into the muscle or mounted epimysially onto the muscle and provide a strong and reliable interface. This solves the problems associated to electrode replacement, lifting, and skin‐electrode contact but does not substantially extend the amount of information associated to the neural control with respect to surface electrodes.…”

Section: Prosthetic Interfacementioning

confidence: 99%

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Bionic hand as artificial organ: Current status and future perspectives

et al. 2019

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Even though the hand comprises only 1% of our body weight, about 30% of our central nervous systems (CNS) capacity is related to its control. The loss of a hand thus presents not only the loss of the most important tool allowing us to interact with our environment, but also leaves a dramatic sensory-motor deficit that challenges our CNS. Reconstruction of hand function is therefore not only an essential part of restoring body integrity and functional wholeness but also closes the loop of our neural circuits diminishing phantom sensation and neural pain. If biology fails to restore meaningful function, today we can resort to complex mechatronic replacement that have functional capabilities that in some respects even outperform biological alternatives, such as hand transplantation. As with replantation and transplantations, the challenge of bionic replacement is connecting the target with the CNS to achieve natural and intuitive control. In recent years, we have developed a number of strategies to improve neural interfacing, signal extraction, interpretation and stable mechanical attachment that are important parts of our current research. This work gives an overview of recent advances in bionic reconstruction, surgical refinements over technological interfacing, skeletal fixation, and modern rehabilitation tools that allow quick integration of prosthetic replacement. K E Y W O R D Sbionic reconstruction, hybrid fitting, interface, osseointegration, prostheses, rehabilitation, targeted muscle reinnervation 110 | AMAN et Al. meets the supreme principle to reconstruct "like with like" best, as it offers a hand of flesh and blood with immediate, intuitive proprioceptive motor control, sensory feedback, and a sense of ownership that at this time cannot be achieved by any prosthetic device.Aside from bionic reconstruction with myoelectric prostheses, controlled by at least 2 electromyography (EMG) signals from remnant stump muscles, also passive, bodypowered devices are used in prosthetic reconstruction. Passive prostheses range from stable or adjustable cosmetic hands, with silicone cover and natural appearance, to prosthetic tools, which are mainly hooks or grasping devices. 5 Socalled body-powered prostheses can perform simple grasping tasks by external cables attached to the prosthetic arm, driven by body movement. This serves as an assistant hand to the dominant hand, but it is obviously not capable of performing different grasps or hand movements.

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Section: Prosthetic Interfacementioning

confidence: 99%

“…To overcome the limitations of superficial electrodes and to provide a stable connection, implantation of electrodes is a potential big advance . Thereby, impedance changes by sweating, relative limb movements with signal interference and other reasons for loosing contact between electrode and skin can be avoided …”

Section: Conclusion and Future Outlookmentioning

confidence: 99%

Bionic hand as artificial organ: Current status and future perspectives

et al. 2019

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“…The performance of the IMES system has been tested in a first clinical trial with implantation of eight electrodes in transradial amputees showing safe application and simple yet efficient control over multiple DoFs (Weir et al, 2003; Baker et al, 2010; Pasquina et al, 2014). The MyoPlant system has been successfully tested in extensive pre-clinical large animal trials, showing good biocompatibility and stable electrode impedance over the course of several months, and reliable acquisition of multiple adjacent EMG signals (Poppendieck et al, 2011; Lewis et al, 2013a; Bergmeister K. D. et al, 2016). In view of a chronic application, further investigations are needed for longer-term periods.…”

Section: Multichannel Emg Systemsmentioning

confidence: 99%

Broadband Prosthetic Interfaces: Combining Nerve Transfers and Implantable Multichannel EMG Technology to Decode Spinal Motor Neuron Activity

et al. 2017

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Modern robotic hands/upper limbs may replace multiple degrees of freedom of extremity function. However, their intuitive use requires a high number of control signals, which current man-machine interfaces do not provide. Here, we discuss a broadband control interface that combines targeted muscle reinnervation, implantable multichannel electromyographic sensors, and advanced decoding to address the increasing capabilities of modern robotic limbs. With targeted muscle reinnervation, nerves that have lost their targets due to an amputation are surgically transferred to residual stump muscles to increase the number of intuitive prosthetic control signals. This surgery re-establishes a nerve-muscle connection that is used for sensing nerve activity with myoelectric interfaces. Moreover, the nerve transfer determines neurophysiological effects, such as muscular hyper-reinnervation and cortical reafferentation that can be exploited by the myoelectric interface. Modern implantable multichannel EMG sensors provide signals from which it is possible to disentangle the behavior of single motor neurons. Recent studies have shown that the neural drive to muscles can be decoded from these signals and thereby the user's intention can be reliably estimated. By combining these concepts in chronic implants and embedded electronics, we believe that it is in principle possible to establish a broadband man-machine interface, with specific applications in prosthesis control. This perspective illustrates this concept, based on combining advanced surgical techniques with recording hardware and processing algorithms. Here we describe the scientific evidence for this concept, current state of investigations, challenges, and alternative approaches to improve current prosthetic interfaces.

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“…Hereby, several approaches are used, including implantable electrodes connected to muscle or nerve tissue to optimize signal quality for control and feedback. This approach becomes particularly interesting with fully implantable devices using wireless data transmission, through the skin, since this avoids percutaneous cables with their associated infection risks and aesthetic concerns (Weir et al, 2009;Pasquina et al, 2015;Bergmeister et al, 2016b). Percutaneous leads have been used for diaphragm pacing for decades as a life-saving procedure, thus justifying the above-mentioned risks.…”

Section: Introductionmentioning

confidence: 99%

Experimental Testing of Bionic Peripheral Nerve and Muscle Interfaces: Animal Model Considerations

et al. 2020

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Introduction: Man-machine interfacing remains the main challenge for accurate and reliable control of bionic prostheses. Implantable electrodes in nerves and muscles may overcome some of the limitations by significantly increasing the interface's reliability and bandwidth. Before human application, experimental preclinical testing is essential to assess chronic in-vivo biocompatibility and functionality. Here, we analyze available animal models, their costs and ethical challenges in special regards to simulating a potentially life-long application in a short period of time and in non-biped animals. Methods:We performed a literature analysis following the PRISMA guidelines including all animal models used to record neural or muscular activity via implantable electrodes, evaluating animal models, group size, duration, origin of publication as well as type of interface. Furthermore, behavioral, ethical, and economic considerations of these models were analyzed. Additionally, we discuss experience and surgical approaches with rat, sheep, and primate models and an approach for international standardized testing. Results:Overall, 343 studies matched the search terms, dominantly originating from the US (55%) and Europe (34%), using mainly small animal models (rat: 40%). Electrode placement was dominantly neural (77%) compared to muscular (23%). Large animal models had a mean duration of 135 ± 87.2 days, with a mean of 5.3 ± 3.4 animals per trial. Small animal models had a mean duration of 85 ± 11.2 days, with a mean of 12.4 ± 1.7 animals.Discussion: Only 37% animal models were by definition chronic tests (>3 months) and thus potentially provide information on long-term performance. Costs for large animals were up to 45 times higher than small animals. However, costs are relatively small compared to complication costs in human long-term applications. Overall, we believe a combination of small animals for preliminary primary electrode testing and large animals to investigate long-term biocompatibility, impedance, and tissue regeneration parameters provides sufficient data to ensure long-term human applications.

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Prosthesis Control with an Implantable Multichannel Wireless Electromyography System for High-Level Amputees

Abstract: This study shows the implantation of this electromyography device as a promising alternative to surface electromyography, providing a potentially powerful wireless interface for high-level amputees.

Cited by 20 publications

References 33 publications

Bionic hand as artificial organ: Current status and future perspectives

Bionic hand as artificial organ: Current status and future perspectives

Broadband Prosthetic Interfaces: Combining Nerve Transfers and Implantable Multichannel EMG Technology to Decode Spinal Motor Neuron Activity

Experimental Testing of Bionic Peripheral Nerve and Muscle Interfaces: Animal Model Considerations

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