19 Participants Needed

Sensory Feedback for Prosthetics in Amputees

(NISRL Trial)

PR
JL
Overseen ByJacob L Segil, PhD MS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: VA Office of Research and Development
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

Trial Summary

What is the purpose of this trial?

Today, prosthetic hands are numb. They provide no tactile or proprioceptive sensory information back to the user. The lack of sensory feedback has been shown to reduce the utility of a prosthesis by half. The prosthesis is seen as a tool, not as an incorporated part of the body schema. Only now are there chronically-implantable technologies which can provide physiologically appropriate sensory feedback to upper limb amputees to recreate tactile and proprioceptive percepts. These sensations are the building blocks to enable the embodiment of the device. Furthermore, newly developed outcome measures are now available which can detail the improved embodiment such neural interfaces can create. The investigator's mission is to enable the embodiment of artificial devices using peripheral nerve stimulation and thereby close the gap between the experience of our intact physiological systems and those using prosthetic remedies. This investigation of embodiment for upper limb amputees is organized into three main areas of work including 1) normative data collection, 2) device development, and 3) characterization of embodiment using peripheral nerve stimulation. The normative data collection will quantify the embodiment of conventional cosmetic, body-powered, and myoelectric prosthetic hand options using a modified Rubber Hand Illusion protocol (Specific Aim 1). This thrust will ask how does the amount of embodiment vary among conventional prosthetic hands as well as probe the relationship between agency and embodiment. The device development project entails the design of multi-modal sensors in order to study full-hand embodiment (Specific Aim 2). The ability to measure and then elicit sensation on the passive surfaces of the hand (palm, ulnar border, and dorsal surface) has never been explored. Here, a multi-modal sensor which can detect proximity, contact, and force will be integrated into a commercially available prosthetic hand in order to provide detailed measurements across the palm, ulnar border, and dorsal surfaces in order to study embodiment in more depth. Finally, the characterization of embodiment using peripheral nerve stimulation will take place over a multiple subject factorial experiment which quantifies the effects of quantity and spatial parameters of the peripheral nerve stimulation on the embodiment of prosthetic hands (Specific Aim 3). This study asks what somatosensory percepts from the hand are most critical for embodiment by varying the parameters of the peripheral nerve stimulation (quantity and spatiality) and measuring the level of embodiment in each case.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment for sensory feedback in prosthetics for amputees?

Research shows that providing sensory feedback to prosthetic limbs helps amputees feel like the prosthesis is part of their body, which can improve their acceptance and use of the prosthetic. Studies have demonstrated that sensory feedback can reduce phantom pain and enhance the feeling of ownership and control over the prosthetic limb.12345

Is sensory feedback for prosthetics safe for human use?

Research on sensory feedback for prosthetics, including invasive methods like implanted nerve interfaces, shows potential benefits but also involves risks. While non-invasive methods are generally safer, invasive techniques have been less explored due to inherent risks, though they have shown some success in restoring sensation.35678

How does the treatment 'Sensory Feedback for Prosthetics in Amputees' differ from other treatments for upper limb amputees?

This treatment is unique because it provides amputees with a sense of touch by connecting pressure sensors on a prosthetic hand to the nerves that once served the lost limb, helping the prosthetic feel like a natural part of the body. Unlike other treatments, it uses targeted reinnervation to create a more integrated and intuitive experience, potentially improving the user's acceptance and control of the prosthetic.3691011

Research Team

JL

Jacob L. Segil, PhD MS

Principal Investigator

Rocky Mountain Regional VA Medical Center, Aurora, CO

Eligibility Criteria

This trial is for both veterans and non-veterans who have an upper limb amputation or are able-bodied. It's not open to individuals with other musculoskeletal injuries.

Inclusion Criteria

Both people who have served in the military and those who haven't are allowed to participate.
I am either fully able-bodied or have a difference in my upper limb.

Exclusion Criteria

I have no other injuries to my bones or muscles.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Normative Data Collection

Quantify the embodiment of conventional prosthetic hand options using a modified Rubber Hand Illusion protocol

12 weeks
4 visits (in-person)

Device Development

Design of multi-modal sensors to study full-hand embodiment

16 weeks

Characterization of Embodiment

Quantify the effects of peripheral nerve stimulation on the embodiment of prosthetic hands

20 weeks
6 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Treatment Details

Interventions

  • Investigation of Embodiment for Upper Limb Amputees
  • Peripheral Nerve Interface
  • Prosthetic hand
Trial Overview The study tests a new way of making prosthetic hands feel more like real ones by using peripheral nerve interfaces. It aims to make the prosthesis embody sensation, measuring how well it works through three main tasks: collecting data on current prosthetics, developing sensors for full-hand feeling, and experimenting with nerve stimulation effects.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Aim 3Experimental Treatment1 Intervention
Data from Specific Aim 3 will be used to test the following hypotheses: H3a. The maximum number of channels elicits more embodiment than the minimum number. H3b. The sensory feedback from passive spatial locations of the hand increases the embodiment compared to sensory feedback just from the grasping spatial locations.
Group II: Aim 1Experimental Treatment1 Intervention
Data from Specific Aim 1 will be used to test the following hypotheses: H1a. The body-powered prosthetic devices are embodied more than passive and myoelectric prosthetic devices. H1b. Passive cosmetic devices are embodied less than actuated cosmetic devices (agency). H1c. Body-powered terminal devices are embodied less than myoelectric terminal devices (agency).

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+

Findings from Research

Current prostheses for individuals with upper limb amputation or congenital limb difference are inadequate, leading to issues like rejection and pain, highlighting the need for improved solutions.
Emerging technologies such as robotic limbs and osseointegrated prostheses show promise in meeting user needs, but they also introduce new risks that must be carefully evaluated through user perspectives and feedback.
Upper extremity prosthesis user perspectives on unmet needs and innovative technology.Benz, HL., Jia Yao, ., Rose, L., et al.[2022]
The paper reviews various techniques for restoring sensory function in upper limb amputees, focusing on sensory substitution and modality-matched feedback methods.
These methods aim to provide amputees with sensory feedback, each having unique advantages and disadvantages, which can enhance the functionality and user experience of prosthetic devices.
Sensory feedback in upper limb prosthetics.Antfolk, C., D'Alonzo, M., Rosén, B., et al.[2013]

References

Sensory- and Action-Oriented Embodiment of Neurally-Interfaced Robotic Hand Prostheses. [2023]
Motor Control and Sensory Feedback Enhance Prosthesis Embodiment and Reduce Phantom Pain After Long-Term Hand Amputation. [2023]
Robotic touch shifts perception of embodiment to a prosthesis in targeted reinnervation amputees. [2022]
An investigation into the perceptual embodiment of an artificial hand using transcutaneous electrical nerve stimulation (TENS) in intact-limbed individuals. [2014]
Mechanotactile Sensory Feedback Improves Embodiment of a Prosthetic Hand During Active Use. [2020]
A review of invasive and non-invasive sensory feedback in upper limb prostheses. [2018]
Upper extremity prosthesis user perspectives on unmet needs and innovative technology. [2022]
Learning of Artificial Sensation Through Long-Term Home Use of a Sensory-Enabled Prosthesis. [2020]
Direct neural sensory feedback and control of a prosthetic arm. [2022]
Referral of sensation to an advanced humanoid robotic hand prosthesis. [2016]
Sensory feedback in upper limb prosthetics. [2013]
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