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Robotic Technology and Artificial Intelligence in Rehabilitation Medicine
Published in Lawrence S. Chan, William C. Tang, Engineering-Medicine, 2019
To improve the precision of myoelectric recording, the Alfred Mann Foundation developed and deployed implantable wireless EMG electrodes (Merrill et al. 2011, Pasquina et al. 2015). These Implantable Myoelectric Sensors (IMESR) are small cylindrical devices, 2.5 by 16 mm, that sample EMG signals via multi-channels. The IMES system is durable, accurate, and provides improved usability and functionality. Other implantable signal recording systems, such as Longitudinal Intrafasicular Electrodes (LIFEs) (Rossini et al. 2010), Transverse Intrafasicular Electrodes (TIMEs) (Raspopovic et al. 2014), the Utah Slant Array, and the Flat Interface Electrode (FINE), can be inserted into the peripheral nerves and nerve cuff. To bypass poor reliability and unsatisfying long term stability issues of implantable devices, Ortiz-Catalan and colleagues (Ortiz-Catalan et al. 2014) pioneered a percutaneous osseointegrated (bone-anchored) interface system that allows a permanent and bidirectional communication of the prosthesis with user’s body. The osseointegrated electrodes were able to provided more precise and reliable control than surface electrodes. The stability of myoelectric recording serves as a foundation for pattern recognition and sensory feedback, therefore more closely mimicking natural and intuitive limb movements.
Identifying the benefits and risks of emerging integration methods for upper limb prosthetic devices in the United States: an environmental scan
Published in Expert Review of Medical Devices, 2019
Marcella A Kelley, Heather Benz, Susannah Engdahl, John F P Bridges
Peripheral nervous integration relies on regenerative, intraneural or extraneural electrodes connecting to the peripheral nervous system (PNS) (Figure 2(c)). A more invasive electrode used in PNS integration of externally-powered prostheses is correlated to greater electrode selectivity [36]. The tradeoff for a potential end-user is between the risk of an invasive procedure and the benefit of greater selectivity. Besides electrode selectivity, peripherally integrated upper limb prosthetic devices have less training time, less maintenance and more control of digits than typical myoelectric devices [29,36,37]. Given its reliance on previously used pathways to signal the limb, this method has not been studied in individuals with congenital limb loss [36]. The major risk of PNS-integrated upper limb prosthetic devices is nerve damage, particularly with regenerative electrodes that require a nerve to regrow before the electrode communicates [28]. Peripheral muscle integration relies on implantable myoelectric sensors in the residual muscles to detect and amplify EMG signals to control the prosthetic device [38]. Compared to surface EMG sensors, implantable myoelectric sensors (IMES) offer an increased number of control signals and increased degrees of freedom for the hand and wrist but do not detect global signaling [39]. However, the signal accuracy of implantable versus surface sensors has not shown significant differences when using multiple sensors [40]. Limited human testing has been done regarding peripheral muscle control systems [38].