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Review
. 2023 Mar;48(3):182-190.
doi: 10.1177/17531934221131756. Epub 2023 Jan 17.

Upper limb prostheses: bridging the sensory gap

Aidan D Roche  1   2 , Zachary K Bailey  3 , Michael Gonzalez  4 , Philip P Vu  5   6 , Cynthia A Chestek  5   6   7   8 , Deanna H Gates  4   5   9 , Stephen W P Kemp  5   6 , Paul S Cederna  5   6 , Max Ortiz-Catalan  10   11   12   13 , Oskar C Aszmann  14   15
Affiliations
Review

Upper limb prostheses: bridging the sensory gap

Aidan D Roche et al. J Hand Surg Eur Vol. 2023 Mar.

Abstract

Replacing human hand function with prostheses goes far beyond only recreating muscle movement with feedforward motor control. Natural sensory feedback is pivotal for fine dexterous control and finding both engineering and surgical solutions to replace this complex biological function is imperative to achieve prosthetic hand function that matches the human hand. This review outlines the nature of the problems underlying sensory restitution, the engineering methods that attempt to address this deficit and the surgical techniques that have been developed to integrate advanced neural interfaces with biological systems. Currently, there is no single solution to restore sensory feedback. Rather, encouraging animal models and early human studies have demonstrated that some elements of sensation can be restored to improve prosthetic control. However, these techniques are limited to highly specialized institutions and much further work is required to reproduce the results achieved, with the goal of increasing availability of advanced closed loop prostheses that allow sensory feedback to inform more precise feedforward control movements and increase functionality.

Keywords: Prostheses; bioelectronics; motor control; sensory feedback; signal processing.

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Conflict of interest statement

M.O-C. has consulted for a company developing neuromusculoskeletal interfaces.

Figures

Figure 1.
Figure 1.
Comparison of implanted subdermal electrodes. (a) Nerve cuff. (b) Flat interface nerve electrode (FINE). (c) Longitudinal intrafascicular electrode (LIFE). (d) Transverse intrafascicular multiple electrode (TIME) and (e) Utah slanted electrode array (USEA).
Figure 2.
Figure 2.
Case studies comparison – electrode implantation. (a) Cuff electrodes providing sensory feedback as part of a neuromusculoskeletal interface in which bidirectional communication is enabled via an osseointegrated implant and (b) Transcutaneous electromyographic (EMG) electrodes on regenerative peripheral nerve interfaces (RPNIs) providing sensory feedback.
Figure 3.
Figure 3.
regenerative peripheral nerve interface (RPNI)-enabled sensation outcomes. (a) Locations of perceived location when P1’s RPNIs were stimulated. (b) Perception and discomfort thresholds for P1 on each RPNI and (c) Discrimination curves for each RPNI. The reference amplitude (0%) was different for each RPNI based on the average of their respective perception and discomfort thresholds.
See this image and copyright information in PMC

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