Francesco Clemente

Decoding human motor intentions by processing electrophysiological signals is a crucial, yet unsolved, challenge for the development of effective upper limb prostheses. Pattern recognition of continuous myoelectric (EMG) signals represents the state-of-art for multi-DoF prosthesis control. However, this approach relies on the unreliable assumption that repeatable muscular contractions produce repeatable patterns of steady-state EMGs. Here, we propose an approach for decoding wrist and hand movements by processing the signals associated with the onset of contraction (transient EMG). Specifically, we extend the concept of a transient EMG controller for the control of both wrist and hand, and tested it online. We assessed it with one transradial amputee and 15 non-amputees via the Target Achievement Control test. Non-amputees successfully completed 95% of the trials with a median completion time of 17 seconds, showing a significant learning trend ( p < 0.001). The transradial amputee completed about the 80% of the trials with a median completion time of 26 seconds. Although the performance proved comparable with earlier studies, the long completion times suggest that the current controller is not yet clinically viable. However, taken collectively, our outcomes reinforce earlier hypothesis that the transient EMG could represent a viable alternative to steady-state pattern recognition approaches.

Objective. Proprioception is the sense of one’s position, orientation, and movement in space, and it is of fundamental importance for motor control. When proprioception is impaired or absent, motor execution becomes error-prone, leading to poorly coordinated movements. The kinaesthetic illusion, which creates perceptions of limb movement in humans through non-invasively applying vibrations to muscles or tendons, provides an avenue for studying and restoring the sense of joint movement (kinaesthesia). This technique, however, leaves ambiguity between proprioceptive percepts that arise from muscles versus those that arise from skin receptors. Here we propose the concept of a stimulation system to activate kinaesthesia through the untethered application of localized vibration through implanted magnets. Approach. In this proof-of-concept study, we use two simplified one-DoF systems to show the feasibility of eliciting muscle-sensory responses in an animal model across multiple frequencies, including those that activate the kinaesthetic illusion (70–115 Hz). Furthermore, we generalized the concept by developing a five-DoF prototype system capable of generating directional, frequency-selective vibrations with desired displacement profiles. Main results. In-vivo tests with the one-DoF systems demonstrated the feasibility to elicit muscle sensory neural responses in the median nerve of an animal model. Instead, in-vitro tests with the five-DoF prototype demonstrated high accuracy in producing directional and frequency selective vibrations along different magnet axes. Significance. These results provide evidence for a new technique that interacts with the native neuro-muscular anatomy to study proprioception and eventually pave the way towards the development of advanced limb prostheses or assistive devices for the sensory impaired.

Magnetic tracking systems have been widely investigated in biomedical engineering due to the transparency of the human body to static magnetic fields. We recently proposed a novel human-machine interface for prosthetic application, namely the myokinetic interface. This controls multi-articulated prostheses by tracking magnets implanted in the residual muscles of individuals with amputation. Previous studies in this area focused solely on the choice and tuning of the localization algorithm. Here, we addressed the role of the intrinsic properties of the sensors, by analysing their effects on the tracking accuracy and on the computation time of the localization algorithm, through experimentally-verified computer simulations. We observed that the tracking accuracy is primarily affected by the localization rate, which is directly related to the sampling frequency of the sensors, and less significantly affected by the sensor resolution. The computation time, instead, proved positively correlated to the number of MMs, and negatively correlated with the localization rate. Our results may contribute to the development of novel human-machine interfaces for prosthetic limbs and could be extended to a broad range of applications involving magnetic tracking.

Myoelectric upper limb prostheses are controlled using information from the electrical activity of residual muscles (i.e. the electromyogram, EMG). EMG patterns at the onset of a contraction (transient phase) have shown predictive information about upcoming grasps. However, decoding this information for the estimation of the grasp force was so far overlooked. In a previous offline study, we proved that the transient phase of the EMG indeed contains information about the grasp force and determined the best algorithm to extract this information. Here we translated those findings into an online platform to be tested with both non-amputees and amputees. The platform was tested during a pick and lift task (tri-digital grasp) with light objects (200 g – 1 kg), for which fine control of the grasp force is more important. Results show that, during this task, it is possible to estimate the target grasp force with an absolute error of 2.06 (1.32) % and 2.04 (0.49) % the maximum voluntary force for non-amputee and amputees, respectively, using information from the transient phase of the EMG. This approach would allow for a biomimetic regulation of the grasp force of a prosthetic hand. Indeed, the users could contract their muscles only once before the grasp begins with no need to modulate the grasp force for the whole duration of the grasp, as required with continuous classifiers. These results pave the way to fast, intuitive and robust myoelectric controllers of limb prostheses.

Objective. Understanding the neurophysiological signals underlying voluntary motor control and decoding them for prosthesis control are among the major challenges in applied neuroscience and bioengineering. Usually, information from the electrical activity of residual forearm muscles (i.e. the electromyogram, EMG) is used to control different functions of a prosthesis. Noteworthy, forearm EMG patterns at the onset of a contraction (transient phase) have shown to contain predictive information about upcoming grasps. However, decoding this information for the estimation of grasp force (GF) was so far overlooked. Approach. High density-EMG signals (192 channels) were recorded from twelve participants performing a pick-and-lift task. The final GF was estimated offline using linear regressors, with four subsets of channels and ten features obtained using three channels-features selection methods. Two different evaluation metrics (absolute error and R ²), complemented with statistical analysis, were used to select the optimal configuration of the parameters. Different windows of data starting at the GF onset were compared to determine the time at which the GF can be ascertained from the EMG signals. Main results. The prediction accuracy improved by increasing the window length from the moment of the onset and kept improving until the steady state at which a plateau of performances was reached. With our methodology, estimations of the GF through 16 EMG channels reached an absolute error of 2.52% the maximum voluntary force using only transient information and 1.99% with the first 500 ms of data following the onset. Significance. The final GF estimation from transient EMG was comparable to the one obtained using steady state data, confirming our hypothesis that the transient phase contains information about the final GF. This result paves the way to fast online myoelectric controllers capable of decoding grasp strength from the very early portion of the EMG signal.

Objective: The quest for an intuitive and physiologically appropriate human-machine interface for the control of dexterous prostheses is far from being completed. To control a hand prosthesis, a possible approach could consist in using information related to the displacement of forearm muscles of an amputee during contraction. We recently proposed that muscle displacement could be monitored by implanting passive magnetic markers (MMs - i.e. permanent magnets) in them. We dubbed this the myokinetic interface. However, besides the system feasibility, how much its accuracy, precision and computation time are affected by the number and distribution of both the MMs and the sensors used to record the MF was not quantified. Methods: Here we investigated, through simulations validated with a physical system, the performance of a system capable to track position and orientation of up to 9 MMs using information from up to 112 sensors in a volume resembling the dimensions of the human forearm. Results: The system was able to track up to 7 MMs in 450ms, demonstrating position/orientation accuracies in the range of 1mm/5°. The comparison with the experimental recordings demonstrated a median difference with the simulations in the order of 0.45mm. Conclusion: We were able to formulate general guidelines for the implementation of magnetic tracking systems. Significance: Our results pave the way towards the development of new human-machine interfaces for the control of artificial limbs, but they are also interesting for the whole range of biomedical engineering applications exploiting magnetic tracking.

The quest for an intuitive and physiologically appropriate human machine interface for the control of dexterous prostheses is far from being completed. In the last decade, much effort has been dedicated to explore innovative control strategies based on the electrical signals generated by the muscles during contraction. In contrast, a novel approach, dubbed myokinetic interface, derives the control signals from the localization of multiple magnetic markers (MMs) directly implanted into the residual muscles of the amputee. Building on this idea, here we present an embedded system based on 32 magnetic field sensors and a real time computation platform. We demonstrate that the platform can simultaneously localize in real-time up to five MMs in an anatomically relevant workspace. The system proved highly linear (R² = 0.99) and precise (1% repeatability), yet exhibiting short computation times (4 ms) and limited cross talk errors (10% the mean stroke of the magnets). Compared to a previous PC implementation, the system exhibited similar precision and accuracy, while being ~75% faster. These results proved for the first time the viability of using an embedded system for magnet localization. They also suggest that, by using an adequate number of sensors, it is possible to increase the number of simultaneously tracked MMs while introducing delays that are not perceivable by the human operator. This could allow to control more degrees of freedom than those controllable with current technologies.

Replacement of a lost limb by an artificial substitute is not yet ideal. Resolution and coordination of motor control approximating that of a biological limb could dramatically improve the functionality of prosthetic devices, and thus reduce the gap towards a suitable limb replacement. In this study, we investigated the control resolution and coordination exhibited by subjects with transhumeral amputation who were implanted with epimysial electrodes and an osseointegrated interface that provides bidirectional communication in addition to skeletal attachment (e-OPRA Implant System). We assessed control resolution and coordination in the context of routine and delicate grasping using the Pick and Lift and the Virtual Eggs Tests. Performance when utilizing implanted electrodes was compared with the standard-of-care technology for myoelectric prostheses, namely surface electrodes. Results showed that implanted electrodes provide superior controllability over the prosthetic terminal device compared to conventional surface electrodes. Significant improvements were found in the control of the grip force and its reliability during object transfer. However, these improvements failed to increase motor coordination, and surprisingly decreased the temporal correlation between grip and load forces observed with surface electrodes. We found that despite being more functional and reliable, prosthetic control via implanted electrodes still depended highly on visual feedback. Our findings indicate that incidental sensory feedback (visual, auditory, and osseoperceptive in this case) is insufficient for restoring natural grasp behavior in amputees, and support the idea that supplemental tactile sensory feedback is needed to learn and maintain the motor tasks internal model, which could ultimately restore natural grasp behavior in subjects using prosthetic hands.

Objective . Tactile afferents in the human hand provide fundamental information about hand-environment interactions, which is used by the brain to adapt the motor output to the physical properties of the object being manipulated. A hand amputation disrupts both afferent and efferent pathways from/to the hand, completely invalidating the individual’s motor repertoire. Although motor functions may be partially recovered by using a myoelectric prosthesis, providing functionally effective sensory feedback to users of prosthetics is a largely unsolved challenge. While past studies using invasive stimulation suggested that sensory feedback may help in handling fragile objects, none explored the underpinning, relearned, motor coordination during grasping. In this study, we aimed at showing for the first time that intraneural sensory feedback of the grip force (GF) improves the sensorimotor control of a transradial amputee controlling a myoelectric prosthesis. Approach . We performed a longitudinal study testing a single subject (clinical trial registration number NCT02848846). A stacking cups test (CUP) performed over two weeks aimed at measuring the subject’s ability to finely regulate the GF applied with the prosthesis. A pick and lift test (PLT), performed at the end of the study, measured the level of motor coordination, and whether the subject transferred the motor skills learned in the CUP to an alien task. Main results . The results show that intraneural sensory feedback increases the subject’s ability in regulating the GF and allows for improved performance over time. Additionally, the PLT demonstrated that the subject was able to generalize and transfer her manipulation skills to an unknown task and to improve her motor coordination. Significance . Our findings suggest that intraneural sensory feedback holds the potential of restoring functionally effective tactile feedback. This opens up new possibilities to improve the quality of life of amputees using a neural prosthesis.