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Enhancing functional abilities and cognitive integration of the lower limb prosthesis.

  • Petrini FM Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland.
  • Valle G Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, CH-1015 Switzerland.
  • Bumbasirevic M Orthopaedic Surgery Department, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
  • Barberi F SensArs Neuroprosthetics, Lausanne CH-1004, Switzerland.
  • Bortolotti D SensArs Neuroprosthetics, Lausanne CH-1004, Switzerland.
  • Cvancara P Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg-IMTEK, 79110 Freiburg, Germany.
  • Hiairrassary A INRIA Camin Team, University of Montpellier-LIRMM, F-34095 Montpellier, France.
  • Mijovic P mBrainTrain d.o.o., 11000 Belgrade, Serbia.
  • Sverrisson AÖ Össur hf., R&D, 110 Reykjavik, Iceland.
  • Pedrocchi A NearLab-Neuroengineering and Medical Robotics Laboratory Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, 20133 Milano, Italy.
  • Divoux JL Axonic, 06220 Vallauris, France.
  • Popovic I Specialized hospital for rehabilitation and orthopaedic prosthetics, 11000 Belgrade, Serbia.
  • Lechler K Össur hf., R&D, 110 Reykjavik, Iceland.
  • Mijovic B mBrainTrain d.o.o., 11000 Belgrade, Serbia.
  • Guiraud D INRIA Camin Team, University of Montpellier-LIRMM, F-34095 Montpellier, France.
  • Stieglitz T Laboratory for Biomedical Microtechnology, Department of Microsystems Engineering, University of Freiburg-IMTEK, 79110 Freiburg, Germany.
  • Alexandersson A Össur hf., R&D, 110 Reykjavik, Iceland.
  • Micera S Bertarelli Foundation Chair in Translational Neuroengineering, Centre for Neuroprosthetics and Institute of Bioengineering, School of Engineering, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, CH-1015 Switzerland.
  • Lesic A Orthopaedic Surgery Department, School of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
  • Raspopovic S Laboratory for Neuroengineering, Department of Health Sciences and Technology, Institute for Robotics and Intelligent Systems, ETH Zürich, 8092 Zürich, Switzerland. stanisa.raspopovic@hest.ethz.ch.
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  • 2019-10-04
Published in:
  • Science translational medicine. - 2019
Activities of Daily Living
Amputees
Artificial Limbs
Cognition
Humans
Knee Joint
Lower Extremity
Prosthesis Design
English 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.
Language
  • English
Open access status
green
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Persistent URL
https://folia.unifr.ch/global/documents/136336
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