000257271 001__ 257271
000257271 005__ 20190617200536.0
000257271 0247_ $$a10.5075/epfl-thesis-8887$$2doi
000257271 037__ $$aTHESIS
000257271 041__ $$aeng
000257271 088__ $$a8887
000257271 245__ $$aDesigning sensory feedback approaches for restoring touch and position feedback in upper limb amputees
000257271 260__ $$aLausanne$$bEPFL$$c2018
000257271 269__ $$a2018
000257271 300__ $$a126
000257271 336__ $$aTheses
000257271 502__ $$aProf. Dimitri Nestor Alice Van De Ville (président) ; Prof. Silvestro Micera (directeur de thèse) ; Prof. Diego Ghezzi, Dr Kianoush Nazarpour, Prof. SLIMAN BENSMAIA (rapporteurs)
000257271 520__ $$aUpper limb amputation disrupts most daily activities and reduces the quality of life of affected individuals. Building a suitable prosthetic limb, which can restore at least some of the lost capabilities, is a goal which has been pursued for centuries. In the last few decades, our rapidly expanding understanding of the human nervous system has unlocked impressive advances in artificial limbs. Today, commercial prosthetic hands can be controlled intuitively through voluntary muscle contractions. Nevertheless, despite leaps in the quality of modern prostheses, sensory feedback remains one of the major omissions, forcing users to rely on vision to accomplish basic tasks, such as holding a plastic cup without crushing it. Several sensory feedback strategies have recently been developed to restore tactile and proprioceptive feedback to amputees, demonstrating benefits in important areas, such as higher functional performance and increases in the sense of prosthesis ownership. Sensory feedback strategies can be distinguished based on whether the sensation they restore matches the quality (homologous feedback) or the location (somatotopic feedback) of the original sensation. Despite promising results, somatotopic tactile feedback strategies often result in unnatural sensations (e.g. electricity). Furthermore, restoration of more than a single sensory modality is rarely reported, despite being necessary to create artificial limbs capable of delivering realistic sensorimotor experiences during use. In this work, I proposed three novel and complementary strategies to improve sensory feedback restoration in upper limb prostheses.

I begin by describing a non-invasive transcutaneous electrical nerve stimulation (TENS) approach aimed at restoring somatotopic tactile sensations, which is potentially applicable to all trans-radial amputees. This stimulation strategy was shown to lead to high performance during functional tasks, and compared favorably to more invasive approaches, despite a few key differences. Considering that there is no such thing as a one-size-fits-all solution for amputees, I concluded that TENS represents a viable alternative to invasive systems, especially in cases where an implant is not possible or desirable.

In the second part, I proposed a sensory substitution approach to multimodal feedback, which delivered somatotopic tactile and remapped proprioceptive feedback simultaneously. This stimulation strategy relied entirely on implantable electrodes, simplifying the overall system by delivering two streams of sensory information with the same device. Using this feedback system, two amputees were able to perform interesting functional tasks, such as understanding the size and compliance of various objects, with high accuracy.

Finally, I proposed a novel stimulation technique for sensory feedback designed to desynchronize induced neural activity during electrical stimulation, leading to more biomimetic patterns of activity. I discussed how this strategy could be combined with the results obtained in a recent study which I contributed to, in which we demonstrated that a model based encoding strategy resulted in more natural sensations of touch.

This thesis provides evidence that advances in electrical stimulation protocols can lead to more capable prosthetic limbs. These new methods enable the delivery of multimodal, biomimetic sensory feedback and will help bridge the gap between scientific discovery and clinical translation.
000257271 592__ $$b2018
000257271 6531_ $$aneuroprostheses
000257271 6531_ $$aperipheral nerve stimulation
000257271 6531_ $$aupper limb amputation
000257271 6531_ $$aprosthetic hand
000257271 6531_ $$asensory feedback
000257271 6531_ $$asensory substitution
000257271 6531_ $$atouch
000257271 6531_ $$aproprioception
000257271 6531_ $$abiomimetic
000257271 6531_ $$abiomimicry
000257271 700__ $$0248504$$aD'Anna, Edoardo$$g195184
000257271 720_2 $$aMicera, Silvestro$$edir.$$g218366
000257271 8564_ $$uhttps://infoscience.epfl.ch/record/257271/files/EPFL_TH8887.pdf$$s13376730
000257271 909C0 $$pTNE
000257271 909CO $$qGLOBAL_SET$$pthesis$$pSTI$$pDOI$$ooai:infoscience.epfl.ch:257271$$qthesis-public
000257271 918__ $$aSTI$$cIBI-STI$$dEDEE
000257271 919__ $$aTNE
000257271 920__ $$a2018-10-12$$b2018
000257271 970__ $$a8887/THESES
000257271 973__ $$sPUBLISHED$$aEPFL
000257271 980__ $$aTHESIS