An Osseo-Neural Transtibial Prosthesis with Efferent-Afferent Neural Control
Abstract
Proprioception, the sense of the relative position of neighboring parts of the body and strength of effort being employed, is critical for natural movement. Currently, the manner in which amputations are performed does not allow for proprioception to be preserved, and, as such, severely limits the degree to which normal movement can be restored in persons with amputation. The plan outlined in this proposal directly addresses this issue and provides a combination of leading-edge technologies and approaches and sets forth a clear trajectory for the future of functional prosthetic devices. Specifically, the proposed bionic limb will offer new capabilities to persons needing transtibial amputation. Such a next-generation bionic limb offers hope that limb amputees will have the opportunity to lead physically active lives while enjoying a distinct improvement in artificial limb controllability and perception. We seek to develop the most advanced clinically viable artificial limb. Our objective is to demonstrate volitional control of a 3 degree-of-freedom ankle-foot prosthesis in two people with a transtibial amputation. With cutaneous and proprioceptive feedback as part of the design, we seek to demonstrate that a person with a transtibial amputation can exhibit full volitional control over a neuro-mechanical prosthetic system. To reach this objective, we here propose a novel bionic limb with direct control of an external prosthesis comprising three separate joints. When combined with state-of-the-art surgical procedures allowing for proprioception and direct skeletal integration, we hypothesize that the proposed platform will allow an amputee to (1) demonstrate improved volitional control of a robotic prosthesis, (2) experience increased neural feedback of the positions, velocities, and torques of the external prosthetic joints, and (3) utilize this control and sensation to demonstrate improved balance and increased gait normalization. The research outlined in this proposal will be of immediate and long-term benefit to Service members, Veterans, and their family members. In the United States, over half a million people live with lower extremity loss and 130,000 lower extremity amputations (LEAs) are carried out annually. The lifetime healthcare cost after LEA is estimated to be $649,953, and the U.S. Department of Veterans Affairs estimates LEA to account for more than $250 million in direct expenditures each year, not including civilian cases. Over 1,100 major, lower-extremity amputations have been performed on Warriors injured in the Iraqi Freedom and Enduring Freedom combat operations. Recent studies suggest that only 16.5% of these wounded Warriors return to active duty. With the combat Soldier training investment in excess of $250,000, the financial loss represented by this low return-to-duty rate is over $200 million dollars — a staggering financial cost. These Warriors are challenged in the short term by limitations imposed on work and family activities and in the long term with comorbid conditions, such as back pain and joint osteoarthritis, that often arise from the irregular gait mechanics caused by deficiencies in current prosthetic technology. The proposed bionic limb will offer new capabilities to veterans living with transtibial amputation. Such a next-generation bionic limb offers hope that limb amputees will have the opportunity to lead physically active lives while enjoying a distinct improvement in artificial limb controllability and perception. This study, a Phase 1 clinical trial, will be divided into 3 years. Year 1 will be comprised of bionic hardware development, IDA/IRB approvals, neuromusculoskeletal model development, and patient recruitment. Year 2 will involve the human surgical intervention, rehabilitation, system integration, and subject training. Finally, in Year 3, we will demonstrate the impact of the different control modalities on the patients’ ability to control the
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jul 16, 2019
- Source ID
- W81XWH1910151
Entities
People
- Hugh Herr
Organizations
- Massachusetts Institute of Technology
- United States Army