Clinical results of an investigation of paediatric upper limb myoelectric prosthesis fitting at the Quebec rehabilitation institute

2001 ◽  
Vol 25 (2) ◽  
pp. 119-131 ◽  
Author(s):  
F. Routhier ◽  
C. Vincent ◽  
M-J. Morissette ◽  
L. Desaulniers
Keyword(s):  
Upper Limb ◽  
Dropout Rate ◽  
Clinical Results ◽  
User Evaluation ◽  
Rehabilitation Centre ◽  
Myoelectric Prosthesis ◽  
Myoelectric Prostheses ◽  
Prosthesis Fitting ◽  
Children And Parents

This study was designed to investigate the satisfaction level of young users of myoelectric prostheses who received an upper limb myoelectric prosthesis, to assess their dropout rate and to identify which factors influence the use or non-use of the upper limb myoelectric prosthesis in the eastern part of Quebec (Canada). The users were fitted between 1990 and 1999 at the Quebec Rehabilitation Institute, a major rehabilitation centre located in the province of Quebec. This rehabilitation centre provides cutting-edge expertise not only for the eastern part of Quebec, but also across the entire province, because it is one of only two highly specialised centres serving all of Quebec.A literature review was completed to compile the results obtained in other rehabilitation centres and to identify factors influencing the use or non-use of paediatric upper limb myoelectric prostheses. The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) was used in order to assess the degree to which the children were satisfied with their prostheses.Eighteen (18) children were fitted and trained to use an upper limb myoelectric prosthesis. A total of 10 children and parents agreed to participate. Some 80% of participants said that they were satisfied with their prostheses. A dropout rate of 53% for the overall group (participants and non-participants) seems high compared with that of other studies. Recommendations linked to factors identified in the literature are made. The authors conclude that a multidisciplinary team and structured training and follow-up can improve the clinical results pertaining to all the factors proposed in the literature.

scholarly journals Myoelectric Prosthesis Users and Non-Disabled Individuals Wearing A Simulated Prosthesis Exhibit Similar Compensatory Movement Strategies

2020 ◽  
Author(s):  
Heather E. Williams ◽  
Craig S. Chapman ◽  
Patrick M. Pilarski ◽  
Albert H. Vette ◽  
Jacqueline S. Hebert
Keyword(s):  
Upper Limb ◽  
Performance Metrics ◽  
Upper Body ◽  
Kinematic Data ◽  
Myoelectric Prosthesis ◽  
Myoelectric Prostheses ◽  
Compensatory Movement ◽  
Upper Limb Prosthesis ◽  
Movement Strategies ◽  
Shoulder Motion

Abstract Background: Research studies on upper limb prosthesis function often rely on the use of simulated myoelectric prostheses (attached to and operated by individuals with intact limbs), primarily to increase participant sample size. However, it is not known if these devices elicit the same movement strategies as myoelectric prostheses (operated by individuals with amputation). The objective of this study was to compare compensatory movement strategies, measured by hand and upper body kinematics, of twelve non-disabled individuals wearing a simulated prosthesis to those of three individuals with transradial amputation using their custom-fitted myoelectric devices. Methods: Motion capture was used to obtain kinematic data as participants performed a standardized functional task. Performance metrics, end effector movements and angular kinematics were analyzed. Results: Results show that participants using a simulated or actual myoelectric prosthesis had similar differences in phase durations, hand velocities, hand trajectories, movement units, grip aperture plateaus, and trunk and shoulder motion when compared to normative behaviour. Conclusions: This study suggests that the use of a simulated device in upper limb research offers a reasonable approximation of compensatory movement strategies employed by a novice to mid-skilled transradial myoelectric prosthesis user.

scholarly journals Myoelectric prosthesis users and non-disabled individuals wearing a simulated prosthesis exhibit similar compensatory movement strategies

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Heather E. Williams ◽  
Craig S. Chapman ◽  
Patrick M. Pilarski ◽  
Albert H. Vette ◽  
Jacqueline S. Hebert
Keyword(s):  
Task Performance ◽  
Upper Limb ◽  
Performance Metrics ◽  
Upper Body ◽  
Myoelectric Prosthesis ◽  
Myoelectric Prostheses ◽  
Upper Limb Prosthesis ◽  
Movement Strategies ◽  
Upper Limb Movements ◽  
Participant Group

Abstract Background Research studies on upper limb prosthesis function often rely on the use of simulated myoelectric prostheses (attached to and operated by individuals with intact limbs), primarily to increase participant sample size. However, it is not known if these devices elicit the same movement strategies as myoelectric prostheses (operated by individuals with amputation). The objective of this study was to address the question of whether non-disabled individuals using simulated prostheses employ the same compensatory movements (measured by hand and upper body kinematics) as individuals who use actual myoelectric prostheses. Methods The upper limb movements of two participant groups were investigated: (1) twelve non-disabled individuals wearing a simulated prosthesis, and (2) three individuals with transradial amputation using their custom-fitted myoelectric devices. Motion capture was used for data collection while participants performed a standardized functional task. Performance metrics, hand movements, and upper body angular kinematics were calculated. For each participant group, these measures were compared to those from a normative baseline dataset. Each deviation from normative movement behaviour, by either participant group, indicated that compensatory movements were used during task performance. Results Results show that participants using either a simulated or actual myoelectric prosthesis exhibited similar deviations from normative behaviour in phase durations, hand velocities, hand trajectories, number of movement units, grip aperture plateaus, and trunk and shoulder ranges of motion. Conclusions This study suggests that the use of a simulated prosthetic device in upper limb research offers a reasonable approximation of compensatory movements employed by a low- to moderately-skilled transradial myoelectric prosthesis user.

Fabrication and application of an adjustable myoelectric transhumeral prosthetic socket

2019 ◽  
Vol 43 (5) ◽  
pp. 564-567 ◽  
Author(s):  
Jonathon S Schofield ◽  
Katherine R Schoepp ◽  
Michael Stobbe ◽  
Paul D Marasco ◽  
Jacqueline S Hebert
Keyword(s):  
Upper Limb ◽  
Residual Limb ◽  
Critical Factors ◽  
Myoelectric Prostheses ◽  
Prosthetic Socket ◽  
Electrode Contact ◽  
And Control ◽  
Critical Challenge

Background and Aim: Although upper limb myoelectric prostheses can offer improved functionality and dexterity over body-powered systems, abandonment rates remain high. User dissatisfaction in comfort and control are among the top contributors. The design of the prosthetic socket must be comfortable, while maintaining contact of control electrodes with the residual limb throughout the day. We present a myoelectric socket design that provides user-adjustable compression over electrode control sites to promote consistent control, while maintaining comfort and fit. Technique: A cable tensioning system was threaded through a series of paneled windows in the socket wall over electrode sites. Adjusting tension provided tuning of electrode contact. Discussion: A case study of a single transhumeral prosthetic user with a follow-up interview 11 months post delivery suggests that our adjustable design has the potential to address control and comfort challenges, critical factors in myoelectric prosthetic use, and abandonment. Clinical relevance Achieving consistent electrode contact with muscle control sites in traditional rigid sockets is a critical challenge for myoelectric prostheses. We present a unique solution via user-adjustable electrode contacts built into the socket.

Myoelectric Prostheses in the Management of Poland’s Syndrome

1994 ◽  
Vol 19 (5) ◽  
pp. 659-661 ◽  
Author(s):  
D. DATTA ◽  
J. E. KINGSTON
Keyword(s):  
Upper Limb ◽  
Pectoralis Major ◽  
Poland’S Syndrome ◽  
Myoelectric Prosthesis ◽  
Myoelectric Prostheses ◽  
Published Report ◽  
Poland's Syndrome ◽  
Limb Deficiency

Two cases of Poland’s syndrome are reported in whom myoelectric prostheses have been used. The rare congenital sporadic disorder of Poland’s syndrome characterized by absence of pectoralis major and varying degrees of ipsilateral upper limb deficiency has been reported by various authors (Rasjad and Sutiaksa, 1991, Gausewitz et al, 1984; David, 1982; Ireland et al, 1976). Management of the upper limb deficiency depends on the degree of functional and cosmetic disability. We report two cases of Poland’s syndrome where myoelectric prostheses have been successfully used. We have been unable to find any published report of the use of a myoelectric prosthesis in Poland’s syndrome.

scholarly journals Sensorimotor upper limb therapy does not improve somatosensory function and may negatively interfere with motor recovery: a randomized controlled trial in the early rehabilitation phase after stroke

2020 ◽  
Author(s):  
Nele De Bruyn ◽  
Leen Saenen ◽  
Liselot Thijs ◽  
Annick Van Gils ◽  
Eva Ceulemans ◽  
...  
Keyword(s):  
Upper Limb ◽  
Controlled Trial ◽  
Motor Impairment ◽  
Motor Recovery ◽  
Early Rehabilitation ◽  
Rehabilitation Centre ◽  
Post Intervention ◽  
Therapy Design ◽  
Somatosensory Function

Question: Is sensorimotor upper limb (UL) therapy of more benefit for motor and somatosensory outcome than motor therapy? Design: Randomised assessor- blinded multi-centre controlled trial with block randomization stratified for neglect, severity of motor impairment, and type of stroke. Participants: 40 first-ever stroke patients with UL sensorimotor impairments admitted to the rehabilitation centre Intervention: Both groups received 16 hours of additional therapy over four weeks consisting of sensorimotor (N=22) or motor (N=18) UL therapy. Outcome measures: Action Research Arm test (ARAT) as primary outcome, and other motor and somatosensory measures were assessed at baseline, post-intervention and after four weeks follow-up. Results: No significant between-group differences were found for change scores in ARAT or any somatosensory measure between the three time points. For UL impairment (Fugl-Meyer assessment), a significant greater improvement was found for the motor group compared to the sensorimotor group from baseline to post-intervention (mean (SD) improvement 14.65 (2.19) versus 5.99 (2.06); p=0.01) and from baseline to follow-up (17.38 (2.37) versus 6.75 (2.29); p=0.003). Conclusion: UL motor therapy may improve motor impairment more than UL sensorimotor therapy in patients with sensorimotor impairments in the early rehabilitation phase post stroke. For these patients, integrated sensorimotor therapy may not improve somatosensory function and may negatively influence motor recovery.

Prosthetic management of children in the Netherlands with upper limb deficiencies

2001 ◽  
Vol 25 (3) ◽  
pp. 228-234 ◽  
Author(s):  
M-A. Kuyper ◽  
M. Breedijk ◽  
A. H. M. Mulders ◽  
M. W. M. Post ◽  
A. J. H. Prevo
Keyword(s):  
The Netherlands ◽  
Upper Limb ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Congenital Defects ◽  
Rehabilitation Centre ◽  
Follow Up Study ◽  
Limb Deficiencies

The aim of the study was to assess which children with congenital and acquired upper limb deficiencies were fitted with prostheses, what types of prostheses were prescribed as first, second and third prostheses, at what age prostheses were first prescribed and how long the children wore their prostheses.The design was a retrospective chart review at De Hoogstraat Rehabilitation Centre, Utrecht (The Netherlands). Medical files of all patients with congenital or acquired upper limb deficiencies who visited the outpatient clinic between 1972 and 1996 were reviewed, collecting data on patient characteristics, prosthesis prescription and use of prostheses.The group included 224 children, of whom 206 (92%) had congenital deficiencies. Of all children with unilateral congenital deficiencies, 54% had been fitted with prostheses, against 3% of all children with bilateral congenital deficiencies and 67% of all children with acquired deficiencies. In the congenital group, it was children with transverse defects of one-third or two-thirds of the forearm who had most frequently had prostheses fitted (85% of the children). Most of the children with unilateral congenital deficiencies had received passive prostheses as their first prostheses (80 of the 90 prescribed prostheses); children with acquired defects usually had active prostheses (8 of the 12 prescribed prostheses). Body-powered prostheses were most commonly prescribed as the second type of prosthesis.In the group of 119 children who had been seen before the age of 4 years and had been followed for at least three years, 63 had been fitted with one or more prostheses at a mean age of 2.6 (SD 2.5) years. Of the 46 children with congenital defects, 30 had been fitted with prostheses, and at the age of 12, two-thirds of them still used their prostheses (63%, 19/30).“De Hoogstraat” rehabilitation centre uses a restrained prosthesis prescription policy, depending on the type of deficiency and the expected functional benefits. Data on prosthesis use are encouraging, although a follow-up study is required to determine the functional outcome for prosthesis users and non-users.

scholarly journals Differential experiences of embodiment between body-powered and myoelectric prosthesis users

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Susannah M. Engdahl ◽  
Sean K. Meehan ◽  
Deanna H. Gates
Keyword(s):  
Upper Limb ◽  
Functional Recovery ◽  
Body Schema ◽  
Direct Consequence ◽  
The Body ◽  
Prosthesis Design ◽  
Patient Specific ◽  
Myoelectric Prosthesis ◽  
Myoelectric Prostheses ◽  
Length Estimation

Abstract Prosthesis embodiment, the perception of a prosthesis as part of one’s body, may be an important component of functional recovery for individuals with upper limb absence. This work determined whether embodiment differs between body-powered and myoelectric prosthesis users. In a sample of nine individuals with transradial limb absence, embodiment was quantified using a survey regarding prosthesis ownership and agency. The extent to which the prosthesis affected the body schema, the representation of the body’s dimensions, was assessed using limb length estimation. Because body-powered prostheses offer proprioceptive feedback that myoelectric prostheses do not, it was hypothesized that both measures would reveal stronger embodiment of body-powered prostheses. However, our results did not show differences across the two prosthesis designs. Instead, body schema was influenced by several patient-specific characteristics, including the cause of limb absence (acquired or congenital) and hours of daily prosthesis wear. These results indicate that regular prosthesis wear and embodiment are connected, regardless of the actual prosthesis design. Identifying whether embodiment is a direct consequence of regular prosthesis use would offer insight on how individuals with limb absence could modify their behavior to more fully embody their prosthesis.

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

The Development of a Myoelectric Training Tool for Above-Elbow Amputees

2012 ◽  
Vol 6 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Michael R Dawson ◽  
Farbod Fahimi ◽  
Jason P Carey
Keyword(s):  
Degrees Of Freedom ◽  
Learning Task ◽  
Robotic Arm ◽  
Signal Acquisition ◽  
Myoelectric Prosthesis ◽  
Training Tool ◽  
Myoelectric Prostheses ◽  
Training Systems ◽  
Targeted Muscle Reinnervation

The objective of above-elbow myoelectric prostheses is to reestablish the functionality of missing limbs and increase the quality of life of amputees. By using electromyography (EMG) electrodes attached to the surface of the skin, amputees are able to control motors in myoelectric prostheses by voluntarily contracting the muscles of their residual limb. This work describes the development of an inexpensive myoelectric training tool (MTT) designed to help upper limb amputees learn how to use myoelectric technology in advance of receiving their actual myoelectric prosthesis. The training tool consists of a physical and simulated robotic arm, signal acquisition hardware, controller software, and a graphical user interface. The MTT improves over earlier training systems by allowing a targeted muscle reinnervation (TMR) patient to control up to two degrees of freedom simultaneously. The training tool has also been designed to function as a research prototype for novel myoelectric controllers. A preliminary experiment was performed in order to evaluate the effectiveness of the MTT as a learning tool and to identify any issues with the system. Five able-bodied participants performed a motor-learning task using the EMG controlled robotic arm with the goal of moving five balls from one box to another as quickly as possible. The results indicate that the subjects improved their skill in myoelectric control over the course of the trials. A usability survey was administered to the subjects after their trials. Results from the survey showed that the shoulder degree of freedom was the most difficult to control.

scholarly journals Evaluation of Optimal Vibrotactile Feedback for Force-Controlled Upper Limb Myoelectric Prostheses

Sensors ◽  
2019 ◽  
Vol 19 (23) ◽  
pp. 5209 ◽  
Author(s):  
Andrea Gonzalez-Rodriguez ◽  
Jose L. Ramon ◽  
Vicente Morell ◽  
Gabriel J. Garcia ◽  
Jorge Pomares ◽  
...  
Keyword(s):  
Real Time ◽  
Upper Limb ◽  
Closed Loop ◽  
Fine Tuning ◽  
Vibrotactile Feedback ◽  
Loop Control ◽  
Myoelectric Prostheses ◽  
Amplitude Level ◽  
Real Time Application ◽  
Selection Of

The main goal of this study is to evaluate how to optimally select the best vibrotactile pattern to be used in a closed loop control of upper limb myoelectric prostheses as a feedback of the exerted force. To that end, we assessed both the selection of actuation patterns and the effects of the selection of frequency and amplitude parameters to discriminate between different feedback levels. A single vibrotactile actuator has been used to deliver the vibrations to subjects participating in the experiments. The results show no difference between pattern shapes in terms of feedback perception. Similarly, changes in amplitude level do not reflect significant improvement compared to changes in frequency. However, decreasing the number of feedback levels increases the accuracy of feedback perception and subject-specific variations are high for particular participants, showing that a fine-tuning of the parameters is necessary in a real-time application to upper limb prosthetics. In future works, the effects of training, location, and number of actuators will be assessed. This optimized selection will be tested in a real-time proportional myocontrol of a prosthetic hand.

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