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  1. Article ; Online: Sensory feedback for limb prostheses in amputees.

    Raspopovic, Stanisa / Valle, Giacomo / Petrini, Francesco Maria

    Nature materials

    2021  Volume 20, Issue 7, Page(s) 925–939

    Abstract: Commercial prosthetic devices currently do not provide natural sensory information on the interaction with objects or movements. The subsequent disadvantages include unphysiological walking with a prosthetic leg and difficulty in controlling the force ... ...

    Abstract Commercial prosthetic devices currently do not provide natural sensory information on the interaction with objects or movements. The subsequent disadvantages include unphysiological walking with a prosthetic leg and difficulty in controlling the force exerted with a prosthetic hand, thus creating health issues. Restoring natural sensory feedback from the prosthesis to amputees is an unmet clinical need. An optimal device should be able to elicit natural sensations of touch or proprioception, by delivering the complex signals to the nervous system that would be produced by skin, muscles and joints receptors. This Review covers the various neurotechnological approaches that have been proposed for the development of the optimal sensory feedback restoration device for arm and leg amputees.
    MeSH term(s) Amputees ; Artificial Limbs ; Feedback, Sensory/physiology ; Humans ; Prosthesis Design
    Language English
    Publishing date 2021-04-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2088679-2
    ISSN 1476-4660 ; 1476-1122
    ISSN (online) 1476-4660
    ISSN 1476-1122
    DOI 10.1038/s41563-021-00966-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Sensitivity to temporal parameters of intraneural tactile sensory feedback.

    Valle, Giacomo / Strauss, Ivo / D'Anna, Edoardo / Granata, Giuseppe / Di Iorio, Riccardo / Stieglitz, Thomas / Rossini, Paolo Maria / Raspopovic, Stanisa / Petrini, Francesco Maria / Micera, Silvestro

    Journal of neuroengineering and rehabilitation

    2020  Volume 17, Issue 1, Page(s) 110

    Abstract: Background: Recent studies have shown that neural stimulation can be used to provide artificial sensory feedback to amputees eliciting sensations referred on the amputated hand. The temporal properties of the neural stimulation modulate aspects of ... ...

    Abstract Background: Recent studies have shown that neural stimulation can be used to provide artificial sensory feedback to amputees eliciting sensations referred on the amputated hand. The temporal properties of the neural stimulation modulate aspects of evoked sensations that can be exploited in a bidirectional hand prosthesis.
    Methods: We previously collected evidence that the derivative of the amplitude of the stimulation (intra-digit temporal dynamics) allows subjects to recognize object compliance and that the time delay among stimuli injected through electrodes implanted in different nerves (inter-digit temporal distance) allows to recognize object shapes. Nevertheless, a detailed characterization of the subjects' sensitivity to variations of intra-digit temporal dynamic and inter-digit temporal distance of the intraneural tactile feedback has not been executed. An exhaustive understanding of the overall potentials and limits of intraneural stimulation to deliver sensory feedback is of paramount importance to bring this approach closer and closer to the natural situation. To this aim, here we asked two trans-radial amputees to identify stimuli with different temporal characteristics delivered to the same active site (intra-digit temporal Dynamic Recognition (DR)) or between two active sites (inter-digit Temporal distance Recognition (TR)). Finally, we compared the results achieved for (simulated) TR with conceptually similar experiments with real objects with one subject.
    Results: We found that the subjects were able to identify stimuli with temporal differences (perceptual thresholds) larger than 0.25 s for DR and larger than 0.125 s for TR, respectively. Moreover, we also found no statistically significant differences when the subjects were asked to identify three objects during simulated 'open-loop' TR experiments or real 'closed-loop' tests while controlling robotic hand.
    Conclusions: This study is a new step towards a more detailed analysis of the overall potentials and limits of intraneural sensory feedback. A full characterization is necessary to develop more advanced prostheses capable of restoring all lost functions and of being perceived more as a natural limb by users.
    MeSH term(s) Adult ; Amputees/rehabilitation ; Artificial Limbs ; Electric Stimulation Therapy/methods ; Feedback, Sensory/physiology ; Female ; Hand/physiology ; Humans ; Middle Aged ; Robotics ; Touch/physiology
    Language English
    Publishing date 2020-08-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2164377-5
    ISSN 1743-0003 ; 1743-0003
    ISSN (online) 1743-0003
    ISSN 1743-0003
    DOI 10.1186/s12984-020-00737-8
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  3. Article ; Online: Biomimetic Intraneural Sensory Feedback Enhances Sensation Naturalness, Tactile Sensitivity, and Manual Dexterity in a Bidirectional Prosthesis.

    Valle, Giacomo / Mazzoni, Alberto / Iberite, Francesco / D'Anna, Edoardo / Strauss, Ivo / Granata, Giuseppe / Controzzi, Marco / Clemente, Francesco / Rognini, Giulio / Cipriani, Christian / Stieglitz, Thomas / Petrini, Francesco Maria / Rossini, Paolo Maria / Micera, Silvestro

    Neuron

    2018  Volume 100, Issue 1, Page(s) 37–45.e7

    Abstract: Peripheral intraneural stimulation can provide tactile information to amputees. However, efforts are still necessary to identify encoding strategy eliciting percepts that are felt as both natural and effective for prosthesis control. Here we compared the ...

    Abstract Peripheral intraneural stimulation can provide tactile information to amputees. However, efforts are still necessary to identify encoding strategy eliciting percepts that are felt as both natural and effective for prosthesis control. Here we compared the naturalness and efficacy of different encoding strategies to deliver neural stimulation to trans-radial amputees implanted with intraneural electrodes. Biomimetic frequency modulation was perceived as more natural, while amplitude modulation enabled better performance in tasks requiring fine identification of the applied force. Notably, the optimal combination of naturalness and sensitivity of the tactile feedback can be achieved with "hybrid" encoding strategies based on simultaneous biomimetic frequency and amplitude neuromodulation. These strategies improved the gross manual dexterity of the subjects during functional task while maintaining high levels of manual accuracy. They also improved prosthesis embodiment, reducing abnormal phantom limb perceptions ("telescoping effect"). Hybrid strategies are able to provide highly sensitive and natural percepts and should be preferred. VIDEO ABSTRACT.
    MeSH term(s) Amputees ; Artificial Limbs ; Electric Stimulation Therapy/methods ; Electrodes, Implanted ; Feedback, Sensory/physiology ; Female ; Hand Strength/physiology ; Humans ; Male ; Models, Neurological ; Phantom Limb/prevention & control ; Proprioception/physiology ; Touch/physiology
    Language English
    Publishing date 2018-09-20
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 808167-0
    ISSN 1097-4199 ; 0896-6273
    ISSN (online) 1097-4199
    ISSN 0896-6273
    DOI 10.1016/j.neuron.2018.08.033
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Sensory feedback restoration in leg amputees improves walking speed, metabolic cost and phantom pain.

    Petrini, Francesco Maria / Bumbasirevic, Marko / Valle, Giacomo / Ilic, Vladimir / Mijović, Pavle / Čvančara, Paul / Barberi, Federica / Katic, Natalija / Bortolotti, Dario / Andreu, David / Lechler, Knut / Lesic, Aleksandar / Mazic, Sanja / Mijović, Bogdan / Guiraud, David / Stieglitz, Thomas / Alexandersson, Asgeir / Micera, Silvestro / Raspopovic, Stanisa

    Nature medicine

    2019  Volume 25, Issue 9, Page(s) 1356–1363

    Abstract: Conventional leg prostheses do not convey sensory information about motion or interaction with the ground to above-knee amputees, thereby reducing confidence and walking speed in the users that is associated with high mental and physical ... ...

    Abstract Conventional leg prostheses do not convey sensory information about motion or interaction with the ground to above-knee amputees, thereby reducing confidence and walking speed in the users that is associated with high mental and physical fatigue
    MeSH term(s) Adult ; Amputees/rehabilitation ; Artificial Limbs ; Biomechanical Phenomena ; Feedback, Sensory ; Humans ; Knee/innervation ; Knee/physiopathology ; Male ; Middle Aged ; Phantom Limb/physiopathology ; Phantom Limb/prevention & control ; Walking Speed/physiology
    Language English
    Publishing date 2019-09-09
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1220066-9
    ISSN 1546-170X ; 1078-8956
    ISSN (online) 1546-170X
    ISSN 1078-8956
    DOI 10.1038/s41591-019-0567-3
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  5. Article ; Online: Enhancing functional abilities and cognitive integration of the lower limb prosthesis.

    Petrini, Francesco Maria / Valle, Giacomo / Bumbasirevic, Marko / Barberi, Federica / Bortolotti, Dario / Cvancara, Paul / Hiairrassary, Arthur / Mijovic, Pavle / Sverrisson, Atli Örn / Pedrocchi, Alessandra / Divoux, Jean-Louis / Popovic, Igor / Lechler, Knut / Mijovic, Bogdan / Guiraud, David / Stieglitz, Thomas / Alexandersson, Asgeir / Micera, Silvestro / Lesic, Aleksandar /
    Raspopovic, Stanisa

    Science translational medicine

    2019  Volume 11, Issue 512

    Abstract: Lower limb amputation (LLA) destroys the sensory communication between the brain and the external world during standing and walking. Current prostheses do not restore sensory feedback to amputees, who, relying on very limited haptic information from the ... ...

    Abstract Lower limb amputation (LLA) destroys the sensory communication between the brain and the external world during standing and walking. Current prostheses do not restore sensory feedback to amputees, who, relying on very limited haptic information from the stump-socket interaction, are forced to deal with serious issues: the risk of falls, decreased mobility, prosthesis being perceived as an external object (low embodiment), and increased cognitive burden. Poor mobility is one of the causes of eventual device abandonment. Restoring sensory feedback from the missing leg of above-knee (transfemoral) amputees and integrating the sensory feedback into the sensorimotor loop would markedly improve the life of patients. In this study, we developed a leg neuroprosthesis, which provided real-time tactile and emulated proprioceptive feedback to three transfemoral amputees through nerve stimulation. The feedback was exploited in active tasks, which proved that our approach promoted improved mobility, fall prevention, and agility. We also showed increased embodiment of the lower limb prosthesis (LLP), through phantom leg displacement perception and questionnaires, and ease of the cognitive effort during a dual-task paradigm, through electroencephalographic recordings. Our results demonstrate that induced sensory feedback can be integrated at supraspinal levels to restore functional abilities of the missing leg. This work paves the way for further investigations about how the brain interprets different artificial feedback strategies and for the development of fully implantable sensory-enhanced leg neuroprostheses, which could drastically ameliorate life quality in people with disability.
    MeSH term(s) Activities of Daily Living ; Amputees ; Artificial Limbs ; Cognition/physiology ; Humans ; Knee Joint/physiopathology ; Knee Joint/surgery ; Lower Extremity/physiopathology ; Lower Extremity/surgery ; Prosthesis Design
    Language English
    Publishing date 2019-10-02
    Publishing country United States
    Document type Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2518854-9
    ISSN 1946-6242 ; 1946-6234
    ISSN (online) 1946-6242
    ISSN 1946-6234
    DOI 10.1126/scitranslmed.aav8939
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  6. Article ; Online: Multisensory bionic limb to achieve prosthesis embodiment and reduce distorted phantom limb perceptions.

    Rognini, Giulio / Petrini, Francesco Maria / Raspopovic, Stanisa / Valle, Giacomo / Granata, Giuseppe / Strauss, Ivo / Solcà, Marco / Bello-Ruiz, Javier / Herbelin, Bruno / Mange, Robin / D'Anna, Edoardo / Di Iorio, Riccardo / Di Pino, Giovanni / Andreu, David / Guiraud, David / Stieglitz, Thomas / Rossini, Paolo Maria / Serino, Andrea / Micera, Silvestro /
    Blanke, Olaf

    Journal of neurology, neurosurgery, and psychiatry

    2018  Volume 90, Issue 7, Page(s) 833–836

    MeSH term(s) Artificial Limbs ; Bionics/instrumentation ; Feedback, Sensory ; Forearm ; Humans ; Phantom Limb/psychology ; Surveys and Questionnaires
    Language English
    Publishing date 2018-08-12
    Publishing country England
    Document type Letter ; Research Support, Non-U.S. Gov't
    ZDB-ID 3087-9
    ISSN 1468-330X ; 0022-3050
    ISSN (online) 1468-330X
    ISSN 0022-3050
    DOI 10.1136/jnnp-2018-318570
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  7. Article ; Online: Restoring natural sensory feedback in real-time bidirectional hand prostheses.

    Raspopovic, Stanisa / Capogrosso, Marco / Petrini, Francesco Maria / Bonizzato, Marco / Rigosa, Jacopo / Di Pino, Giovanni / Carpaneto, Jacopo / Controzzi, Marco / Boretius, Tim / Fernandez, Eduardo / Granata, Giuseppe / Oddo, Calogero Maria / Citi, Luca / Ciancio, Anna Lisa / Cipriani, Christian / Carrozza, Maria Chiara / Jensen, Winnie / Guglielmelli, Eugenio / Stieglitz, Thomas /
    Rossini, Paolo Maria / Micera, Silvestro

    Science translational medicine

    2014  Volume 6, Issue 222, Page(s) 222ra19

    Abstract: Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an ...

    Abstract Hand loss is a highly disabling event that markedly affects the quality of life. To achieve a close to natural replacement for the lost hand, the user should be provided with the rich sensations that we naturally perceive when grasping or manipulating an object. Ideal bidirectional hand prostheses should involve both a reliable decoding of the user's intentions and the delivery of nearly "natural" sensory feedback through remnant afferent pathways, simultaneously and in real time. However, current hand prostheses fail to achieve these requirements, particularly because they lack any sensory feedback. We show that by stimulating the median and ulnar nerve fascicles using transversal multichannel intrafascicular electrodes, according to the information provided by the artificial sensors from a hand prosthesis, physiologically appropriate (near-natural) sensory information can be provided to an amputee during the real-time decoding of different grasping tasks to control a dexterous hand prosthesis. This feedback enabled the participant to effectively modulate the grasping force of the prosthesis with no visual or auditory feedback. Three different force levels were distinguished and consistently used by the subject. The results also demonstrate that a high complexity of perception can be obtained, allowing the subject to identify the stiffness and shape of three different objects by exploiting different characteristics of the elicited sensations. This approach could improve the efficacy and "life-like" quality of hand prostheses, resulting in a keystone strategy for the near-natural replacement of missing hands.
    MeSH term(s) Adult ; Artificial Limbs ; Computer Systems ; Electric Stimulation ; Feedback, Sensory/physiology ; Hand/innervation ; Hand/physiology ; Hand Strength ; Humans ; Male ; Peripheral Nerves/physiology
    Language English
    Publishing date 2014-02-05
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2518854-9
    ISSN 1946-6242 ; 1946-6234
    ISSN (online) 1946-6242
    ISSN 1946-6234
    DOI 10.1126/scitranslmed.3006820
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