1
|
Thomas RL, Howes R, McMenemy L, Hindle P, Wordsworth M, Staruch R. Delivery of UK military upper limb prosthetics: current concepts and future directions. BMJ Mil Health 2023:e002485. [PMID: 37879645 DOI: 10.1136/military-2023-002485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 09/24/2023] [Indexed: 10/27/2023]
Abstract
Upper limb prosthetics have a challenging task. A natural upper limb combines strength, coordination and dexterity to accomplish daily activities such as eating, writing, working and social interaction. Artificially replicating these functions requires a prosthetic with composite, synchronous motor function while maintaining sensory feedback and skeletal stability. Achieving these functions requires interfaces between biology and machine across nerve, muscle, bone and skin. This leads to issues related to infection, foreign material encapsulation and implant stability, and electrical signal transduction and interpretation. Over the last 20 years the advent of technologies such as osseointegration, targeted muscle reinnervation, implantable myoelectric sensors, peripheral nerve interfaces and pattern recognition technology has sought to address these problems.Due to many advances in prehospital care, truncated timelines to damage control surgery and improved combat personal protective equipment, the numbers of amputees have increased with more patients surviving injury. From October 2001 to March 2019 there were 333 amputees from Afghanistan and Iraq compared with 457 fatalities over a similar period. Over a third of these were significant multiple amputees. With a functional, robust upper limb prosthetic which mirrors or exceeds normal function, injured service personnel could be returned to an active combat role. This has benefits for their physical and mental health, improves employability prospects and allows Defence to retain some of its most highly motivated and skilled people who represent significant financial investment.
Collapse
Affiliation(s)
| | - R Howes
- Burns, Plastic and Reconstructive Surgery, Salisbury NHS Foundation Trust, Salisbury, UK
| | - L McMenemy
- Academic Department of Military Surgery and Trauma (ADMST), Royal Centre for Defence Medicine, Birmingham, UK
- Centre for Blast Injury Studies, Imperial College London, London, UK
| | - P Hindle
- Trauma and Orthopaedic Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Wordsworth
- Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
| | - R Staruch
- Department of Plastic Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| |
Collapse
|
2
|
Sariyildiz E, Hanss F, Zhou H, Sreenivasa M, Armitage L, Mutlu R, Alici G. Experimental Evaluation of a Hybrid Sensory Feedback System for Haptic and Kinaesthetic Perception in Hand Prostheses. SENSORS (BASEL, SWITZERLAND) 2023; 23:8492. [PMID: 37896585 PMCID: PMC10611249 DOI: 10.3390/s23208492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/05/2023] [Accepted: 10/12/2023] [Indexed: 10/29/2023]
Abstract
This study proposes a new hybrid multi-modal sensory feedback system for prosthetic hands that can provide not only haptic and proprioceptive feedback but also facilitate object recognition without the aid of vision. Modality-matched haptic perception was provided using a mechanotactile feedback system that can proportionally apply the gripping force through the use of a force controller. A vibrotactile feedback system was also employed to distinguish four discrete grip positions of the prosthetic hand. The system performance was evaluated with a total of 32 participants in three different experiments (i) haptic feedback, (ii) proprioceptive feedback and (iii) object recognition with hybrid haptic-proprioceptive feedback. The results from the haptic feedback experiment showed that the participants' ability to accurately perceive applied force depended on the amount of force applied. As the feedback force was increased, the participants tended to underestimate the force levels, with a decrease in the percentage of force estimation. Of the three arm locations (forearm volar, forearm ventral and bicep), and two muscle states (relaxed and tensed) tested, the highest accuracy was obtained for the bicep location in the relaxed state. The results from the proprioceptive feedback experiment showed that participants could very accurately identify four different grip positions of the hand prosthesis (i.e., open hand, wide grip, narrow grip, and closed hand) without a single case of misidentification. In experiment 3, participants could identify objects with different shapes and stiffness with an overall high success rate of 90.5% across all combinations of location and muscle state. The feedback location and muscle state did not have a significant effect on object recognition accuracy. Overall, our study results indicate that the hybrid feedback system may be a very effective way to enrich a prosthetic hand user's experience of the stiffness and shape of commonly manipulated objects.
Collapse
Affiliation(s)
- Emre Sariyildiz
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia; (H.Z.); (M.S.); (L.A.); (G.A.)
| | - Fergus Hanss
- Orora, 109 Burwood Rd., Hawthorn, VIC 3122, Australia;
| | - Hao Zhou
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia; (H.Z.); (M.S.); (L.A.); (G.A.)
| | - Manish Sreenivasa
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia; (H.Z.); (M.S.); (L.A.); (G.A.)
| | - Lucy Armitage
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia; (H.Z.); (M.S.); (L.A.); (G.A.)
| | - Rahim Mutlu
- Faculty of Engineering and Information Sciences, University of Wollongong in Dubai, Dubai P.O. Box 20183, United Arab Emirates;
- The Intelligent Robotics & Autonomous Systems Co. (iR@SC), Shellharbour, NSW 2529, Australia
| | - Gursel Alici
- School of Mechanical, Materials, Mechatronic and Biomedical Engineering, University of Wollongong, Wollongong, NSW 2522, Australia; (H.Z.); (M.S.); (L.A.); (G.A.)
| |
Collapse
|
3
|
Evaluating Virtual Hand Illusion through Realistic Appearance and Tactile Feedback. MULTIMODAL TECHNOLOGIES AND INTERACTION 2022. [DOI: 10.3390/mti6090076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We conducted a virtual reality study to explore virtual hand illusion through three levels of appearance (Appearance dimension: realistic vs. pixelated vs. toon hand appearances) and two levels of tactile feedback (Tactile dimension: no tactile vs. tactile feedback). We instructed our participants to complete a virtual assembly task in this study. Immediately afterward, we asked them to provide self-reported ratings on a survey that captured presence and five embodiment dimensions (hand ownership, touch sensation, agency and motor control, external appearance, and response to external stimuli). The results of our study indicate that (1) tactile feedback generated a stronger sense of presence, touch sensation, and response to external stimuli; (2) the pixelated hand appearance provided the least hand ownership and external appearance; and (3) in the presence of the pixelated hand, prior virtual reality experience of participants impacted their agency and motor control and their response to external stimuli ratings. This paper discusses our findings and provides design considerations for virtual reality applications with respect to the realistic appearance of virtual hands and tactile feedback.
Collapse
|