Changes in Sensorimotor Cortical Activation in Children Using Prostheses and Prosthetic Simulators

A multiarticulate pediatric prosthetic hand for clinical and research applications

Although beginning to emerge, multiarticulate upper limb prostheses for children remain sparse despite the continued advancement of mechatronic technologies that have benefited adults with upper limb amputations. Upper limb prosthesis research is primarily focused on adults, even though rates of pediatric prosthetic abandonment far surpass those seen in adults. The implicit goal of a prosthesis is to provide effective functionality while promoting healthy social interaction. Yet most current pediatric devices offer a single degree of freedom open/close grasping function, a stark departure from the multiple grasp configurations provided in advanced adult devices. Although comparable child-sized devices are on the clinical horizon, understanding how to effectively translate these technologies to the pediatric population is vital. This includes exploring grasping movements that may provide the most functional benefits and techniques to control the newly available dexterity. Currently, no dexterous pediatric research platforms exist that offer open access to hardware and programming to facilitate the investigation and provision of multi-grasp function. Our objective was to deliver a child-sized multi-grasp prosthesis that may serve as a robust research platform. In anticipation of an open-source release, we performed a comprehensive set of benchtop and functional tests with common household objects to quantify the performance of our device. This work discusses and evaluates our pediatric-sized multiarticulate prosthetic hand that provides 6 degrees of actuation, weighs 177 g and was designed specifically for ease of implementation in a research or clinical-research setting. Through the benchtop and validated functional tests, the pediatric hand produced grasping forces ranging from 0.424–7.216 N and was found to be comparable to the functional capabilities of similar adult devices. As mechatronic technologies advance and multiarticulate prostheses continue to evolve, translating many of these emerging technologies may help provide children with more useful and functional prosthesis options. Effective translation will inevitably require a solid scientific foundation to inform how best to prescribe advanced prosthetic devices and control systems for children. This work begins addressing these current gaps by providing a much-needed research platform with supporting data to facilitate its use in laboratory and clinical research settings.

Reimagining Prosthetic Control: A Novel Body-Powered Prosthetic System for Simultaneous Control and Actuation

Globally, the most popular upper-limb prostheses are powered by the human body. For body-powered (BP) upper-limb prostheses, control is provided by changing the tension of (Bowden) cables to open or close the terminal device. This technology has been around for centuries, and very few BP alternatives have been presented since. This paper introduces a new BP paradigm that can overcome certain limitations of the current cabled systems, such as a restricted operation space and user discomfort caused by the harness to which the cables are attached. A new breathing-powered system is introduced to give the user full control of the hand motion anywhere in space. Users can regulate their breathing, and this controllable airflow is then used to power a small Tesla turbine that can accurately control the prosthetic finger movements. The breathing-powered device provides a novel prosthetic option that can be used without limiting any of the user’s body movements. Here we prove that it is feasible to produce a functional breathing-powered prosthetic hand and show the models behind it along with a preliminary demonstration. This work creates a step-change in the potential BP options available to patients in the future.