ReviewControl of neural prostheses for grasping and reaching
Introduction
Reaching, grasping, and releasing (RGR) functions belong to so-called goal-directed movements. A goal-directed movement can be defined as a planned tuning of the body segments’ position, ultimately leading to the accomplishment of a task [1], [2], [3]. This movement is a highly complex, perceptually driven dynamical process [4] that comprises two essentials: (1) planning, and (2) execution. An injury or disease of the central nervous system (CNS) diminishes the ability to execute effectively goal-directed movements. Humans with CNS lesion are anxious to regain ability to reach and grasp; thus, return to independent life style in the easiest, simplest and fastest possible manner. Motor Neural Prostheses (NPs) are devices that could restore the RGR functions, that is, contribute to execution of goal-directed movements.
During the last 40 years several Functional Electrical Stimulation (FES) based NPs for grasping were developed [5]. Most of these devices use surface stimulation, although there are effective implantable systems. NPs were frequently combined with mechanical bracing and/or surgical procedures in order to constraint more proximal joints. Recently, the evidence was gained that NPs, in addition to orthotic, have substantial therapeutic effects, that is, they promote the long-term recovery of functions [6]. This evidence was summarized from studies [6], [7], [8] where NPs were applied in hemiplegic subjects.
This paper reviews the existing control paradigms used in NPs for reaching and grasping, especially considering possible therapeutic applications where NP has to be integrated into the preserved natural mechanisms of control.
Section snippets
Synergistic control of grasping
The simplest synergy for opening and closing of the hand is the tenodesis. The tenodesis uses the intrinsic anatomic feature of the human arm/hand complex. When the wrist extends, the finger flexors passively pull the fingers to flex, and vice versa, when the wrist flexes, the finger extensors passively pull fingers to extend; thus, the wrist flexion/extension generates weak grasping.
The Bionic Glove [9] is a NP that enhances the tenodesis in patients who have preserved voluntary control of
Synergistic control of reaching
Methods to control the whole arm, that is, to assist manipulation (reaching) in humans lacking voluntary shoulder, elbow, and wrist movements control have received a great deal of attention [23], [24], [25], [26].
Miller et al. [27] suggested the stimulation of the Triceps Brachii in order to restore elbow extension in C5 tetraplegic subjects who had preserved shoulder movement and elbow flexion. The control system used a look-up table, and included three input signals (flexion/extension and
Discussion
Neural prostheses are currently being applied to control paretic or paralysed upper extremities in humans after CNS injury or disease with limited success. There are several reasons impeding the efficacy of the application of NPs. One of the major limitations is the difficulty to drive complex movements in a way that is controllable volitionally by the user. The body of knowledge how to control a single muscle and a single joint is remarkable, yet the acceptable control of multi-segmental
Acknowledgements
This work was partly supported by the Danish National Research Foundation, Denmark. I would like to acknowledge Dr. Francisco Sepulveda for valuable comments and suggestions.
References (43)
- et al.
eurorehabilitation of upper extremities in humans with sensory-motor impairment
Neuromod.
(2002) - et al.
Clinical evaluation of the bionic glove
Arch. Phys. Med. Rehabil.
(1999) - et al.
A new approach to reaching control for tetraplegic subjects
J. Electromyog. Kinesiol.
(1994) - Jeannerod M. The neural and behavioural organization of goal-directed movements. Oxford Psychology Series, No. 15,...
- MacKenzie, C., Iberall, T. The grasping hand. Series Advances in Psychology No. 104. North-Holland,...
- et al.
Planning an action
Exp. Brain Res.
(1997) - et al.
Neuroprostheses for grasping
Neurol. Res.
(2002) - et al.
Neuromuscular stimulation for upper extremity motor and functional recovery in acute hemiplegia
Stroke
(1998) - et al.
Electrophysiological orthosis for the upper extremity in hemiplegia: feasibility study
Arch. Phys. Med. Rehabil.
(1975)
The bionic glove: an electrical stimulator garment that provides controlled grasp and hand opening in quadriplegia
Arch. Phys. Med. Rehab.
Upper limb functions regained in quadriplegia: a hybrid computerized neuromuscular stimulation system
Arch. Phys. Med. Rehabil.
Belgrade grasping system
J. Electronics
Tuning of a nonanalytical hierarchical control system for reaching with FES
IEEE Trans.
An EMG controlled FES system for grasping in tetraplegics
J. Rehabil. Res. Dev.
A multichannel FES system for the restoration of motor functions in high spinal cord injury patients: a respiration-controlled system for multijoint upper extremity
IEEE Trans. Biomed. Eng.
Synthesis of hand grasp using functional neuromuscular stimulation
IEEE Trans. Biomed. Eng.
Grasp synthesis for upper-extremity FNS, Part 2: evaluation of the influence of electrode recruitment properties
Med. Biol. Eng. Comp.
Grasp synthesis for upper-extremity FNS, Part 1: Automated method for synthesising the stimulus map
Med. Biol. Eng. Comp.
Input–output nonlinearities and time delays increase tracking errors in hand grasp neuroprostheses
IEEE Trans. Rehabil. Eng.
Automated tuning of a closed-loop hand grasp neuroprosthesis
IEEE Trans. Biomed. Eng.
Cited by (48)
40th Anniversary Issue: Reflections on papers from the archive on “Rehabilitation Engineering”
2019, Medical Engineering and PhysicsBrain-computer interfaces for neurorehabilitation: Enhancing functional electrical stimulation
2018, Smart Wheelchairs and Brain-computer Interfaces: Mobile Assistive TechnologiesHybrid robotic systems for upper limb rehabilitation after stroke: A review
2016, Medical Engineering and PhysicsCitation Excerpt :However, this technique imposes some challenges that limit its widespread use for upper limb rehabilitation. The high complexity and non-linearity of the musculoskeletal system preclude the accurate and reliable control of movements [10–12]. Also, the non-physiological recruitment of motor unit causes high metabolic costs, yielding a fast and sudden occurrence of muscle fatigue [13], which in turn prevents a favorable evolution of the therapy.
Neuro-fuzzy models for hand movements induced by functional electrical stimulation in able-bodied and hemiplegic subjects
2016, Medical Engineering and PhysicsCitation Excerpt :Westerveld et al. [20] and Soska et al. [21] were based on fixed electrode configurations, and [22] was based on multi-field electrodes, but focused on isometric finger forces. Main challenges in hand FES models include the musculoskeletal complexity of the forearm and hand, the number of DOFs involved in the wrist, thumb and finger movements and the large variability among different subjects with different pathologies [29–32]. In this work, a RFNN approach for modeling an upper-limb FES system was presented, which was based on data collected from three healthy and three brain injured subjects.
Polymeric C-shaped cuff electrode for recording of peripheral nerve signal
2015, Sensors and Actuators, B: ChemicalCitation Excerpt :These systems can significantly improve the quality of life of those patients with diverse neurological disabilities as complement of traditional therapeutic approaches. Frequent applications of peripheral nerve prostheses include pain relief [1,2], walk rehabilitation by activation of muscles involved in gait [3,4], and, more recently, control of hand prostheses in amputees [5,6]. Commonly, electrodes are placed in segments with remaining functionality of injured or transacted nerves serving as a nerve interface to enable a communication between the device and the nervous system [7,8].
Advances in functional electrical stimulation (FES)
2014, Journal of Electromyography and Kinesiology