This paper represents an ongoing investigation of dexterous and natural control of upper extremity prostheses using the myoelectric signal (MES). The scheme described within uses pattern recognition to process four channels of MES, with the task of discriminating multiple classes of limb movement. The method does not require segmentation of the MES data, allowing a continuous stream of class decisions to be delivered to a prosthetic device. It is shown in this paper that, by exploiting the processing power inherent in current computing systems, substantial gains in classifier accuracy and response time are possible. Other important characteristics for prosthetic control systems are met as well. Due to the fact that the classifier learns the muscle activation patterns for each desired class for each individual, a natural control actuation results. The continuous decision stream allows complex sequences of manipulation involving multiple joints to be performed without interruption. Finally, minimal storage capacity is required, which is an important factor in embedded control systems.

A robust, real-time control scheme for multifunction myoelectric control

Mechanotransduction plays a crucial role in the physiology of many tissues including bone. Mechanical loading can inhibit bone resorption and increase bone formation in vivo. In bone, the process of mechanotransduction can be divided into four distinct steps: (1) mechanocoupling, (2) biochemical coupling, (3) transmission of signal, and (4) effector cell response. In mechanocoupling, mechanical loads in vivo cause deformations in bone that stretch bone cells within and lining the bone matrix and create fluid movement within the canaliculae of bone. Dynamic loading, which is associated with extracellular fluid flow and the creation of streaming potentials within bone, is most effective for stimulating new bone formation in vivo. Bone cells in vitro are stimulated to produce second messengers when exposed to fluid flow or mechanical stretch. In biochemical coupling, the possible mechanisms for the coupling of cell-level mechanical signals into intracellular biochemical signals include force transduction through the integrin-cytoskeleton-nuclear matrix structure, stretch-activated cation channels within the cell membrane, G protein-dependent pathways, and linkage between the cytoskeleton and the phospholipase C or phospholipase A pathways. The tight interaction of each of these pathways would suggest that the entire cell is a mechanosensor and there are many different pathways available for the transduction of a mechanical signal. In the transmission of signal, osteoblasts, osteocytes, and bone lining cells may act as sensors of mechanical signals and may communicate the signal through cell processes connected by gap junctions. These cells also produce paracrine factors that may signal osteoprogenitors to differentiate into osteoblasts and attach to the bone surface. Insulin-like growth factors and prostaglandins are possible candidates for intermediaries in signal transduction. In the effector cell response, the effects of mechanical loading are dependent upon the magnitude, duration, and rate of the applied load. Longer duration, lower amplitude loading has the same effect on bone formation as loads with short duration and high amplitude. Loading must be cyclic to stimulate new bone formation. Aging greatly reduces the osteogenic effects of mechanical loading in vivo. Also, some hormones may interact with local mechanical signals to change the sensitivity of the sensor or effector cells to mechanical load.

Mechanotransduction and the functional response of bone to mechanical strain

Manual of internal fixation , Manual of internal fixation , کتابخانه دیجیتال جندی شاپور اهواز

Manual of internal fixation

This review presents an analytical and comparative survey of upper limb prosthesis acceptance and abandonment as documented over the past 25 years, detailing areas of consumer dissatisfaction and ongoing technological advancements. English-language articles were identified in a search of Ovid, PubMed, and ISI Web of Science (1980 until February 2006) for key words upper limb and prosthesis. Articles focused on upper limb prostheses and addressing: (i) Factors associated with abandonment; (ii) Rejection rates; (iii) Functional analyses and patterns of wear; and (iv) Consumer satisfaction, were extracted with the exclusion of those detailing tools for outcome measurement, case studies, and medical procedures. Approximately 200 articles were included in the review process with 40 providing rates of prosthesis rejection. Quantitative measures of population characteristics, study methodology, and prostheses in use were extracted from each article. Mean rejection rates of 45% and 35% were observed in the literature for body-powered and electric prostheses respectively in pediatric populations. Significantly lower rates of rejection for both body-powered (26%) and electric (23%) devices were observed in adult populations while the average incidence of non-wear was similar for pediatric (16%) and adult (20%) populations. Documented rates of rejection exhibit a wide range of variance, possibly due to the heterogeneous samples involved and methodological differences between studies. Future research should comprise of controlled, multifactor studies adopting standardized outcome measures in order to promote comprehensive understanding of the factors affecting prosthesis use and abandonment. An enhanced understanding of these factors is needed to optimize prescription practices, guide design efforts, and satiate demand for evidence-based measures of intervention.

https://journals.sagepub.com/doi/pdf/10.1080/03093640600994581

Upper limb prosthesis use and abandonment: A survey of the last 25 years:

Critical-sized defects in bone, whether induced by primary tumor resection, trauma, or selective surgery have in many cases presented insurmountable challenges to the current gold standard treatment for bone repair. The primary purpose of a tissue-engineered scaffold is to use engineering principles to incite and promote the natural healing process of bone which does not occur in critical-sized defects. A synthetic bone scaffold must be biocompatible, biodegradable to allow native tissue integration, and mimic the multidimensional hierarchical structure of native bone. In addition to being physically and chemically biomimetic, an ideal scaffold is capable of eluting bioactive molecules (e.g., BMPs, TGF-betas, etc., to accelerate extracellular matrix production and tissue integration) or drugs (e.g., antibiotics, cisplatin, etc., to prevent undesired biological response such as sepsis or cancer recurrence) in a temporally and spatially controlled manner. Various biomaterials including ceramics, metals, polymers, and composites have been investigated for their potential as bone scaffold materials. However, due to their tunable physiochemical properties, biocompatibility, and controllable biodegradability, polymers have emerged as the principal material in bone tissue engineering. This article briefly reviews the physiological and anatomical characteristics of native bone, describes key technologies in mimicking the physical and chemical environment of bone using synthetic materials, and provides an overview of local drug delivery as it pertains to bone tissue engineering is included.

https://aiche.onlinelibrary.wiley.com/doi/pdf/10.1002/btpr.246

Bone tissue engineering: A review in bone biomimetics and drug delivery strategies

Induction of bone formation in rat tail vertebrae by mechanical loading.

The design of prosthetic hands is constrained by a series of strict conditions. Despite this, many different design strategies have been explored. One particular form is the Southampton Hand system. This is a hierarchically controlled, electrically driven hand, with multiple axes, in an anthropomorphic form. This paper details the range of mechanical solutions adopted to address the conditions. It also compares them with other solutions.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/S0263574701003538

The design of anthropomorphic prosthetic hands: A study of the Southampton Hand

A non-rigid bone fracture fixator comprising first and second bone pins for connection either side of a bone fracture and primary and secondary supports clamped to the bone pins by respective fixed and guide clamps. The second support and the guide clamps are connected slidably to the primary support such that the supports may execute a controlled degree of movement with respect to one another. A compression spring is arranged to bias apart the supports longitudinally of a fixated limb. In use the fixator is applied to the limb with the fracture in slight compression. Exercise of the limb then produces varying degrees of fracture compression stimulating bone callus formation and rapid healing. The fixator may include actuating means to provide passive fracture exercise for immobilized patients.

Apparatus for external fixation of bone fractures

The current designs of commercial artificial hands have a low level of innovation. As feedback to the user is difficult to achieve reliably, most devices are simple in design and operation, and limited in functional range. If information on the state of the hand, the forces and any slippage that is occurring is fed back to a microcontroller then more than one degree of freedom can be controlled and a greater and more natural functional range is possible. This paper describes the development of such a device. It outlines the design requirements, the methods of detection of the signals and the training required to operate the hand.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/613AF88D734005B49DF71D7738F654F5/S0263574798000691a.pdf/div-class-title-an-intelligent-anthropomorphic-hand-with-automatic-grasp-div.pdf

An Intelligent Anthropomorphic Hand, with Automatic Grasp

Natural interfragmentary motion was measured in tibial fractures during normal patient activity, and the results were interpreted using correlations from the literature to examine the influence of natural motion on healing. Ten patients were selected with reduced, diaphyseal tibial fractures stabilized with Orthofix external fixators. Three-dimensional motion was monitored with an instrumented spatial linkage during walking, standing, and muscle activities at 2 and 4 weeks postfixation. Fracture motion arising from dorsal to plantar flexion while supine produced peak cyclic displacements of the same order of magnitude as that seen during weightbearing activity. Thus, therapeutic exercise may be used to provide a stimulus to osteogenic repair processes in patients who are unable to bear weight. In 3 patients, maximum amplitudes of axial motion during walking were 1 mm or greater. This implied regular gap closure and high tissue strains within the 1 mm +/- 0.5 mm gaps. In 3 patients, axial motion was less than 0.25 mm. These 2 extremes may indicate a range of displacement relative to gap size that embraces inhibitive and stimulative influences on healing. Transverse shear displacements also varied greatly from between 0.6 and 0.75 mm in 3 patients to less than 0.2 mm in 5 patients.

Mervyn Evans

Papers

Induction of bone formation in rat tail vertebrae by mechanical loading.

The design of anthropomorphic prosthetic hands: A study of the Southampton Hand

Apparatus for external fixation of bone fractures

An Intelligent Anthropomorphic Hand, with Automatic Grasp

Dynamic interfragmentary motion in fractures during routine patient activity.