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Restoring Sensation in Human Upper Extremity Amputees using Chronic Peripheral Nerve Interfaces

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2014, Doctor of Philosophy, Case Western Reserve University, Biomedical Engineering.
We restored normal sensation for up to two years in the perceived hands of amputees. The sense of touch is essential to experience and manipulate the world around us. Despite increasingly sophisticated mechatronics, prosthetics still do not convey sensation back to amputees. Sensory perception is important for control of the prosthetic limb, a sense of embodiment, and in the reduction of phantom pain. Those with limb loss rely primarily on visual feedback for control. Chronically-implanted, single-channel nerve cuff electrodes have produced sensation in the perceived hand with perceptions such as fist clenching, vibration, and paresthesia, and sensations was over large regions of the hand. Intrafascicular electrodes have produced discrete, tactile sensation but were only implanted for four weeks or less and paresthesia was associated with 30% - 50% of the stimulating channels. A need exists to provide natural, discrete, tactile sensation in a stable, long-term neural interface. We implanted multi-channel cuff electrodes, the spiral and FINE, on the peripheral nerves of two upper-limb amputees. Discrete, tactile sensory perception was recruited from 97% of the electrode channels. Long-term stability was demonstrated with up to two years of stable stimulation threshold and impedance measures. Stimulation pulse charge and frequency modulated the size of the percept area and intensity, respectively. Moreover, we discovered patterned stimulation intensity elicited natural tactile modalities of pressure, light moving touch, and vibration, while avoiding paresthesia. The functional benefit of sensory feedback was evaluated through functional and activities of daily living (ADL) tests. Sensors mounted on the prosthetic hand provided grip pressure and opening span feedback through sensory stimulation to the subjects. We found sensory feedback improved success rates in blinded object detection, object localization, and controlled pressure manipulation tasks. Performance with sensory feedback while blindfolded was similar to performance while sighted. Results from a standardized ADL test, the Southampton Hand Assessment Procedure (SHAP), show that the sensory feedback does not degrade myoelectric control. Sensory feedback reduces reliance on visual feedback when using prosthesis.
Dustin Tyler, PhD (Committee Chair)
Kenneth Gustafson, PhD (Committee Member)
Robert Kirsch, PhD (Committee Member)
Grover Gilmore, PhD (Committee Member)
156 p.

Recommended Citations

Citations

  • Tan, D. (2014). Restoring Sensation in Human Upper Extremity Amputees using Chronic Peripheral Nerve Interfaces [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1405070015

    APA Style (7th edition)

  • Tan, Daniel. Restoring Sensation in Human Upper Extremity Amputees using Chronic Peripheral Nerve Interfaces. 2014. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1405070015.

    MLA Style (8th edition)

  • Tan, Daniel. "Restoring Sensation in Human Upper Extremity Amputees using Chronic Peripheral Nerve Interfaces." Doctoral dissertation, Case Western Reserve University, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=case1405070015

    Chicago Manual of Style (17th edition)