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Tsu AP, Burish MJ, GodLove J, Ganguly K. Cortical neuroprosthetics from a clinical perspective. Neurobiol Dis 2015; 83:154-60. [PMID: 26253606 DOI: 10.1016/j.nbd.2015.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 07/23/2015] [Accepted: 07/31/2015] [Indexed: 12/13/2022] Open
Abstract
Recent pilot clinical studies have demonstrated that subjects with severe disorders of movement and communication can exert direct neural control over assistive devices using invasive Brain-Machine Interface (BMI) technology, also referred to as 'cortical neuroprosthetics'. These important proof-of-principle studies have generated great interest among those with disability and clinicians who provide general medical, neurological and/or rehabilitative care. Taking into account the perspective of providers who may be unfamiliar with the field, we first review the clinical goals and fundamentals of invasive BMI technology, and then briefly summarize the vast body of basic science research demonstrating its feasibility. We emphasize recent translational progress in the target clinical populations and discuss translational challenges and future directions.
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Affiliation(s)
- Adelyn P Tsu
- Neurology & Rehabilitation Service, San Francisco VA Medical Center, United States
| | - Mark J Burish
- Department of Neurology, University of California, San Francisco, United States
| | - Jason GodLove
- Neurology & Rehabilitation Service, San Francisco VA Medical Center, United States; Department of Neurology, University of California, San Francisco, United States
| | - Karunesh Ganguly
- Neurology & Rehabilitation Service, San Francisco VA Medical Center, United States; Department of Neurology, University of California, San Francisco, United States; Center for Neural Engineering and Prosthetics, University of California, San Francisco & University of California, Berkeley, United States.
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102
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Wininger M, Williams DJ. More with less: A comparative kinematical analysis of Django Reinhardt's adaptations to hand injury. Prosthet Orthot Int 2015; 39:238-43. [PMID: 24570018 DOI: 10.1177/0309364614523173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 01/16/2014] [Indexed: 02/03/2023]
Abstract
BACKGROUND At the age of 18 years, jazz guitarist Django Reinhardt (1910-1953) sustained significant burns to his left-hand ring and little fingers; yet, subsequently, he relearned to play and achieved international fame, despite his injuries. CASE DESCRIPTION AND METHODS Archive film footage and novel motion analysis software were used to compare movements of Django's fretting hand with that of six other guitarists of the same genre. FINDINGS AND OUTCOMES Django employed greater abduction of index and middle fingers (-9.11 ± 6.52° vs -5.78 ± 2.41°; p < 0.001) and more parallel alignment of fingers to the guitar neck (157.7 ± 3.37° vs 150.59 ± 2.67°; p < 0.001) compared to controls. CONCLUSION In response to debilitating hand injury, Django developed quantifiable compensatory adaptation of function of his remaining functional fingers by developing an original playing technique. CLINICAL RELEVANCE Hand function following injury may be optimized by maximizing latent degrees of freedom in remaining digits, rather than through extensive surgical reconstruction or complex prostheses. Further study of adaptation strategies may inform prosthesis design.
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Affiliation(s)
- Michael Wininger
- Prosthetics & Orthotics Program, University of Hartford, West Hartford, CT, USA VA Cooperative Studies Program, Department of Veterans Affairs, West Hartford, CT, USA
| | - David J Williams
- Department of Anaesthetics/Welsh Centre for Burns, Morriston Hospital ABMU NHS Trust, Swansea, UK
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103
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Bhuiyan MSH, Choudhury IA, Dahari M. Development of a control system for artificially rehabilitated limbs: a review. BIOLOGICAL CYBERNETICS 2015; 109:141-162. [PMID: 25491411 DOI: 10.1007/s00422-014-0635-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 10/28/2014] [Indexed: 06/04/2023]
Abstract
Development of an advanced control system for prostheses (artificial limbs) is necessary to provide functionality, effectiveness, and preferably the feeling of a sound living limb. The development of the control system has introduced varieties of control strategies depending on the application. This paper reviews some control systems used for prosthetics, orthotics, and exoskeletons. The advantages and limitations of different control systems for particular applications have been discussed and presented in a comparative manner to help in deciding the appropriate method for pertinent application.
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Affiliation(s)
- M S H Bhuiyan
- Manufacturing System Integration, Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, 50603, Kuala Lumpur, Malaysia,
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104
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Williams MR, Walter W. Development of a prototype over-actuated biomimetic prosthetic hand. PLoS One 2015; 10:e0118817. [PMID: 25790306 PMCID: PMC4366331 DOI: 10.1371/journal.pone.0118817] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 12/03/2014] [Indexed: 11/24/2022] Open
Abstract
The loss of a hand can greatly affect quality of life. A prosthetic device that can mimic normal hand function is very important to physical and mental recuperation after hand amputation, but the currently available prosthetics do not fully meet the needs of the amputee community. Most prosthetic hands are not dexterous enough to grasp a variety of shaped objects, and those that are tend to be heavy, leading to discomfort while wearing the device. In order to attempt to better simulate human hand function, a dexterous hand was developed that uses an over-actuated mechanism to form grasp shape using intrinsic joint mounted motors in addition to a finger tendon to produce large flexion force for a tight grip. This novel actuation method allows the hand to use small actuators for grip shape formation, and the tendon to produce high grip strength. The hand was capable of producing fingertip flexion force suitable for most activities of daily living. In addition, it was able to produce a range of grasp shapes with natural, independent finger motion, and appearance similar to that of a human hand. The hand also had a mass distribution more similar to a natural forearm and hand compared to contemporary prosthetics due to the more proximal location of the heavier components of the system. This paper describes the design of the hand and controller, as well as the test results.
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Affiliation(s)
- Matthew R. Williams
- Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland Functional Electrical Stimulation Center, Cleveland, Ohio, United States of America
| | - Wayne Walter
- Department of Mechanical Engineering, Rochester Institute of Technology, Rochester, New York, United States of America
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105
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Pilarski PM, Dick TB, Sutton RS. Real-time prediction learning for the simultaneous actuation of multiple prosthetic joints. IEEE Int Conf Rehabil Robot 2014; 2013:6650435. [PMID: 24187253 DOI: 10.1109/icorr.2013.6650435] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Integrating learned predictions into a prosthetic control system promises to enhance multi-joint prosthesis use by amputees. In this article, we present a preliminary study of different cases where it may be beneficial to use a set of temporally extended predictions--learned and maintained in real time--within an engineered or learned prosthesis controller. Our study demonstrates the first successful combination of actor-critic reinforcement learning with real-time prediction learning. We evaluate this new approach to control learning during the myoelectric operation of a robot limb. Our results suggest that the integration of real-time prediction and control learning may speed control policy acquisition, allow unsupervised adaptation in myoelectric controllers, and facilitate synergies in highly actuated limbs. These experiments also show that temporally extended prediction learning enables anticipatory actuation, opening the way for coordinated motion in assistive robotic devices. Our work therefore provides initial evidence that realtime prediction learning is a practical way to support intuitive joint control in increasingly complex prosthetic systems.
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106
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Vargas MADO, Ferrazzo S, Schoeller SD, Drago LC, Ramos FRS. Rede de atenção à saúde à pessoa amputada. ACTA PAUL ENFERM 2014. [DOI: 10.1590/1982-0194201400086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objetivo Analisar a rede de atenção à pessoa amputada na perspectiva dos profissionais de saúde inseridos nos serviços de alta complexidade. Métodos Pesquisa qualitativa com coleta de dados mediante entrevista semi-estruturada com profissionais de diferentes áreas de atuação envolvidos no cuidado à pessoa amputada. Resultados Observou-se que uma parte dos profissionais entrevistados conhece e atua em uma perspectiva de encaminhamento para reabilitação, enquanto outros desconhecem o fluxo de encaminhamento bem como a rede de atenção que ampara estes usuários. Conclusão Os dados evidenciaram como grande fortaleza no contexto da reabilitação o trabalho multiprofissional e inter-instituicional ocorrido em alguns espaços. Como principal fragilidade aponta a falta de conhecimento dos profissionais sobre a alta complexidade das redes de atenção à saúde, assim como a maneira como a reabilitação é vista, não sendo inserida em um contexto de cuidado desde que exista a possibilidade ou ocorrência da amputação.
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107
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Deeny S, Chicoine C, Hargrove L, Parrish T, Jayaraman A. A simple ERP method for quantitative analysis of cognitive workload in myoelectric prosthesis control and human-machine interaction. PLoS One 2014; 9:e112091. [PMID: 25402345 PMCID: PMC4234315 DOI: 10.1371/journal.pone.0112091] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 10/12/2014] [Indexed: 12/03/2022] Open
Abstract
Common goals in the development of human-machine interface (HMI) technology are to reduce cognitive workload and increase function. However, objective and quantitative outcome measures assessing cognitive workload have not been standardized for HMI research. The present study examines the efficacy of a simple event-related potential (ERP) measure of cortical effort during myoelectric control of a virtual limb for use as an outcome tool. Participants trained and tested on two methods of control, direct control (DC) and pattern recognition control (PRC), while electroencephalographic (EEG) activity was recorded. Eighteen healthy participants with intact limbs were tested using DC and PRC under three conditions: passive viewing, easy, and hard. Novel auditory probes were presented at random intervals during testing, and significant task-difficulty effects were observed in the P200, P300, and a late positive potential (LPP), supporting the efficacy of ERPs as a cognitive workload measure in HMI tasks. LPP amplitude distinguished DC from PRC in the hard condition with higher amplitude in PRC, consistent with lower cognitive workload in PRC relative to DC for complex movements. Participants completed trials faster in the easy condition using DC relative to PRC, but completed trials more slowly using DC relative to PRC in the hard condition. The results provide promising support for ERPs as an outcome measure for cognitive workload in HMI research such as prosthetics, exoskeletons, and other assistive devices, and can be used to evaluate and guide new technologies for more intuitive HMI control.
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Affiliation(s)
- Sean Deeny
- Rehabilitation Institute of Chicago, Center for Bionic Medicine, Chicago, IL, United States of America
- Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America
| | - Caitlin Chicoine
- Rehabilitation Institute of Chicago, Center for Bionic Medicine, Chicago, IL, United States of America
| | - Levi Hargrove
- Rehabilitation Institute of Chicago, Center for Bionic Medicine, Chicago, IL, United States of America
| | - Todd Parrish
- Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America
| | - Arun Jayaraman
- Rehabilitation Institute of Chicago, Center for Bionic Medicine, Chicago, IL, United States of America
- Northwestern University, Feinberg School of Medicine, Chicago, IL, United States of America
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108
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Razak NAA, Osman NAA, Gholizadeh H, Ali S. Prosthetics socket that incorporates an air splint system focusing on dynamic interface pressure. Biomed Eng Online 2014; 13:108. [PMID: 25085005 PMCID: PMC4120006 DOI: 10.1186/1475-925x-13-108] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 07/22/2014] [Indexed: 11/18/2022] Open
Abstract
Background The interface pressure between the residual limb and prosthetic socket has a significant effect on an amputee’s satisfaction and comfort. This paper presents the design and performance of a new prosthetic socket that uses an air splint system. Methods The air splint prosthetic socket system was implemented by combining the air splint with a pressure sensor that the transhumeral user controls through the use of a microcontroller. The modular construction of the system developed allows the FSR pressure sensors that are placed inside the air splint socket to determine the required size and fitting for the socket used. Fifteen transhumeral amputees participated in the study. Results The subject’s dynamic pressure on the socket that’s applied while wearing the air splint systems was recorded using F-socket transducers and microcontroller analysis. The values collected by the F-socket sensor for the air splint prosthetic socket system were determined accordingly by comparing the dynamic pressure applied using statically socket. The pressure volume of the air splint fluctuated and was recorded at an average of 38 kPa (2.5) to 41 kPa (1.3) over three hours. Conclusion The air splint socket might reduce the pressure within the interface of residual limb. This is particularly important during the daily life activities and may reduce the pain and discomfort at the residual limb in comparison to the static socket. The potential development of an auto-adjusted socket that uses an air splint system as the prosthetic socket will be of interest to researchers involved in rehabilitation engineering, prosthetics and orthotics.
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Affiliation(s)
- Nasrul Anuar Abd Razak
- Department of Biomedical Engineering, Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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109
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Development of Upper Limb Prostheses: Current Progress and Areas for Growth. Arch Phys Med Rehabil 2014; 95:1013-4. [DOI: 10.1016/j.apmr.2013.11.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Revised: 11/29/2013] [Accepted: 11/29/2013] [Indexed: 11/19/2022]
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110
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Mathieu L, Bertani A, Gaillard C, Chaudier P, Ollat D, Bauer B, Rigal S. Combat-related upper extremity injuries: Surgical management specificities on the theatres of operations. ACTA ACUST UNITED AC 2014; 33:174-82. [DOI: 10.1016/j.main.2014.02.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2013] [Revised: 02/11/2014] [Accepted: 02/23/2014] [Indexed: 01/26/2023]
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111
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Etter K, Borgia M, Resnik L. Prescription and repair rates of prosthetic limbs in the VA healthcare system: implications for national prosthetic parity. Disabil Rehabil Assist Technol 2014; 10:493-500. [DOI: 10.3109/17483107.2014.921246] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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112
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Lambrecht JM, Kirsch RF. Miniature low-power inertial sensors: promising technology for implantable motion capture systems. IEEE Trans Neural Syst Rehabil Eng 2014; 22:1138-47. [PMID: 24846651 DOI: 10.1109/tnsre.2014.2324825] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Inertial and magnetic sensors are valuable for untethered, self-contained human movement analysis. Very recently, complete integration of inertial sensors, magnetic sensors, and processing into single packages, has resulted in miniature, low power devices that could feasibly be employed in an implantable motion capture system. We developed a wearable sensor system based on a commercially available system-in-package inertial and magnetic sensor. We characterized the accuracy of the system in measuring 3-D orientation-with and without magnetometer-based heading compensation-relative to a research grade optical motion capture system. The root mean square error was less than 4° in dynamic and static conditions about all axes. Using four sensors, recording from seven degrees-of-freedom of the upper limb (shoulder, elbow, wrist) was demonstrated in one subject during reaching motions. Very high correlation and low error was found across all joints relative to the optical motion capture system. Findings were similar to previous publications using inertial sensors, but at a fraction of the power consumption and size of the sensors. Such ultra-small, low power sensors provide exciting new avenues for movement monitoring for various movement disorders, movement-based command interfaces for assistive devices, and implementation of kinematic feedback systems for assistive interventions like functional electrical stimulation.
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113
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Fisher LE, Ayers CA, Ciollaro M, Ventura V, Weber DJ, Gaunt RA. Chronic recruitment of primary afferent neurons by microstimulation in the feline dorsal root ganglia. J Neural Eng 2014; 11:036007. [DOI: 10.1088/1741-2560/11/3/036007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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114
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Motor performance benefits of matched limb imitation in prosthesis users. Exp Brain Res 2014; 232:2143-54. [PMID: 24643547 DOI: 10.1007/s00221-014-3904-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 03/03/2014] [Indexed: 10/25/2022]
Abstract
Our previous work demonstrated that the action encoding parietofrontal network, which is crucial in planning and executing motor tasks, is less active in prosthesis users who imitate movements of intact actors (mismatched limb) versus prosthesis users (matched limb). Such activation could have behavioral consequences in prosthesis users rehabilitating with intact therapists. The goal was to identify behavioral effects of matched versus mismatched limb action imitation in naïve users of prostheses. Intact subjects donned a specially adapted prosthetic device to simulate the wrist and forearm movement that transradial amputees experience. While electrogoniometry was recorded, non-amputated prosthesis users (NAPUs) observed and imitated demonstrations of a skillful motor task performed by either an intact actor or NAPU. We hypothesized that NAPUs would elicit less motion variability when performing matched versus mismatched imitation. Matched imitation resulted in a significant decrease in shoulder motion variability compared with mismatched imitation. The matched group also developed elbow motion patterns similar to the NAPU demonstrator, while the mismatched group attempted patterns similar to the intact demonstrator. This suggests a behavioral advantage to matched imitation when adapting to a prosthetic device, as it yielded more consistent movements and facilitated development of new motor patterns. Further, these results suggest that when prosthesis users are faced with the impossible task of imitating movements of an intact hand, they perform this action with greater variability and poorer technique. This work has implications on how prosthetic device operation is conveyed to persons with amputation as their clinical interactions often involve mismatched limb imitation.
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115
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Webster JB, Poorman CE, Cifu DX, Webster JB, Poorman CE, Cifu DX. Department of Veterans Affairs Amputation System of Care: 5 years of accomplishments and outcomes. ACTA ACUST UNITED AC 2014. [DOI: 10.1682/jrrd.2014.01.0025] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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116
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Resnik L, Borgia M, Latlief G, Sasson N, Smurr-Walters L. Self-reported and performance-based outcomes using DEKA Arm. ACTA ACUST UNITED AC 2014; 51:351-62. [DOI: 10.1682/jrrd.2013.08.0180] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 10/30/2013] [Indexed: 11/05/2022]
Affiliation(s)
- Linda Resnik
- Providence Department of Veterans Affairs (VA) Medical Center, Providence, RI
| | - Matthew Borgia
- Providence Department of Veterans Affairs (VA) Medical Center, Providence, RI
| | | | | | - Lisa Smurr-Walters
- Center for the Intrepid, Brooke Army Medical Center, Fort Sam Houston, TX
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Whelan L, Flinn S, Wagner N. Individualizing goals for users of externally powered partial hand prostheses. ACTA ACUST UNITED AC 2014; 51:885-94. [DOI: 10.1682/jrrd.2013.08.0181] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Revised: 02/12/2014] [Indexed: 11/05/2022]
Affiliation(s)
| | - Sharon Flinn
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH
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