Self-reported and performance-based outcomes using DEKA Arm

Abstract

Abstract-Mechanical properties of the DEKA Arm and associated engineering innovations are easy to observe. What is less clear is how these advances translate into functional benefits for the user with amputation. Study aims were to (1) quantify outcomes including dexterity, performance of daily activities, and prosthetic skill and spontaneity of users of the DEKA Arm and (2) compare outcomes when using the DEKA Arm with scores using the existing prosthesis. This was a quasi-experimental study. Descriptive analyses examined outcomes by DEKA Arm configuration level. Of the 39 subjects fit with a DEKA Arm, 32 were trained in use and completed end-of-study testing. Data from 26 prosthetic users were used to compare outcomes using existing prostheses with outcomes with the DEKA Arm. Dexterity and activity performance with the DEKA Arm varied by amputation level (p < 0.01). Self-reported function and number of activities performed using the prosthesis were similar across levels. Comparisons with existing prostheses showed the effect on dexterity varied by level. Activity performance and spontaneity of prosthetic use improved for users of the shoulder configuration level, while use of the prosthesis to perform activities and perceived difficulty performing self-selected tasks improved for all levels.

Targeted box and blocks test: Normative data and comparison to standard tests

“…One of the most common measures used for such evaluation in the stroke population is the Box and Blocks Test (BBT) [1–3]. In addition to patients who have suffered stroke, the BBT has been utilized in a variety of other clinical populations such as those with multiple sclerosis[2], traumatic brain injury[2], fibromyalgia[4], and upper limb amputation [5–7], as well as the elderly [8]. In the BBT, one hundred and fifty 2.5cm 3 wooden blocks in many different orientations are placed on the side of the partition with the testing hand.…”

Multisession, noninvasive closed-loop neuroprosthetic control of grasping by upper limb amputees

“…Recent advances in robotic prosthetics for the upper limb potentially allow amputees to control a multitude of dexterous tasks (Cipriani et al, 2011a;Resnik et al, 2012Resnik et al, , 2014. In addition to positioning the arm in space, an important challenge is to be able to control the preshaping of fingers during grasping.…”

“…In addition to positioning the arm in space, an important challenge is to be able to control the preshaping of fingers during grasping. Targeted muscle reinnervation (TMR; Kuiken et al, 2009) and myoelectric control using residual limb muscle activity offer exciting possibilities (Cipriani et al, 2011a(Cipriani et al, , 2014Resnik et al, 2014). Brain-machine interfaces (BMIs), which directly translate neural activity in the cortex to control external devices, may increase the level of natural control currently available in myoelectric prostheses (Contreras-Vidal et al, 2012;Lebedev and Nicolelis, 2006).…”

“…Subject MN was able to achieve, in the course of 57 consecutive sessions over 9 months, BMI control of 2D cursor movement that MN used to open and close e-mail, operate devices such as a television, and open/close a prosthetic hand to grasp and transport an object from one location to another. More recently, results from two tetraplegics demonstrating their ability to control 3D reach and grasp movements with the DEKA robotic arm (Resnik et al, 2014) were published (Hochberg et al, 2012). Collinger et al (2012) showed that over a period of 13 weeks, a tetraplegic could learn to control a robotic arm with seven dof (including one for grasping) in 3D space.…”

Control interfaces to actively support the arm function of men with Duchenn Muscular Dystrophy

“…In active lower-extremity prostheses, hybrid interfaces combine EMG and mechanical inputs to identify the phase of the gait cycle and actions like sitting or standing [199,200,201]. Other examples include the combination of EMG with foot switches [202], IMUs [203] and video cameras [204].…”