Hand prosthesis

Here we present technical aspects of the available externally powered orthoses and prostheses that interface directly or indirectly with the human neuro-musculo-skeletal system. We elaborate here two methods for the restoration of movements in humans with paralysis functional activation of paralyzed muscles termed functional electrical stimulation (FES) or functional neuromuscular stimulation (FNS or NMS), and parallel application of FES and a mechanical orthosis called hybrid assistive system (HAS). We also describe externally controlled and powered leg and arm/hand prostheses. 

Kinematic models are also used in designs of smart hand and hand prostheses in order to track independently the motion in each degree of freedom. For example, fingers as a part of serial kinematic chain are composed of revolute joints. Different motions are considered, such as abduction/adduction and flexion/extension, together with pronation/ supination of the wrist and fingers for the better manipulation and grasping motion of the hand [31-33]. Most of actual motion-tracking models represent the joint as a spherical joint. 

EMG potentials are today largely used as control inputs for myoelectrically based powered systems designed for different body parts. Focusing our attention on the hand, the hterature offers a large number of studies concerned with EMG controlled hand orthoses (see, for instance, [23-25]), in addition to the equally relevant (although not of interest in this chapter) hand prostheses (see, for instance, [26-28]). 

Lee MJ, Jung SH, Mun MS, Lee S, Moon I (2006) Control of IPMC-based artificial muscle for myoelectric hand prosthesis. Proceedings 1st lEEE/RAS-EMBS international conference on biomedical robotics and biomechatronics, pp 1172-1177. doi 10.1109/BIOROB.2006. 1639251... 

FIGURE 68.10 The Southampton hand prosthesis with four degrees of freedom in a power grip. An optical/acoustic sensor is mounted on the thumb. (Reprinted from Chappell, P.H. and Kyberd, P.J. 1991. /. Biomed. Eng. 13 363, Figure 1.)... 

Chappell, P.H. and Kyberd, P.J. 1991. Prehensile control of a hand prosthesis by a microcontroller. 

Kyberd, P.J., Holland, O.E., Chappel, P.H. et al, MARCUS a two degree of freedom hand prosthesis with hierarchical grip control, IEEE Trans. Rehab. Eng. TRE-3 70-76,1995. 

Dynamic cosmesis is firequently the more important of the two forms of cosmesis, but it is frequently overlooked because it is difficult to achieve. Dynamic cosmesis can be enhanced by preserving as much of the person s residual motion as possible. For example, a partial hand prosthesis should not interfere with residual wrist motion because the wrist is used extensively in the positioning of the hand in space. Finally, a device can be considered to be functionally cosmetic if at a glance it is not immediately recognizable as an artificial hand regardless of whether it is in motion or not or whether it is or is not handlike when stationary. 

Cool, J. C., and Van Hooieweder, G. J. O. (1971). Hand prosthesis with adaptive internally powered fingers. Medical and Biological Engineering, vol. 9, pp. 33-36. 

Kato, I., et al. (1970). Multifunctional myoelectric hand prosthesis with pressure sensory feedback system-Wasada Hand-4P. In Advances in External Control of Human Extremities, Proceedings cfthe Third International Symposium on External Comrol of Human Extremities, Dubrovnik, Yugoslavia, 1969, Yugoslav Committee for Electronics and Automation (CTAN), Belgrade, Yugoslavia, pp. 155-170. 

Soede, M. (1982). Mental control load and acceptance of arm prostheses. Automedica, no. 4, pp. 183-191. Stojiljkovic, Z. V., and Saletic, D. Z. (1975). Tactile pattern recognition by belgrade hand prosthesis. In Advances in External Control of Human Extremities, Proceedings of the Fifth International Symposium on Exterruil... 

Duraisamy, K., Isebor, O., Perez, A., Schoen, M.P., and Naidu, D.S., Kinematic synthesis for smart hand prosthesis. First lEEE/RAS-EMBS Int. Conf. Biomed. Robot. Biomechatronics, 2006 BioRob 2006, IEEE, pp. 1135-1140, 2006. 

A. Mingrino, P. Dario, and A. Sabatini. A hand prosthesis with slippage control by tactile sensors. 15th Annual lot. Cemf. IEEE Med. Bud Soc.. San Diego. CA. 1993, p. 1276. 

Mitchell, W. R., M. (2008). Development of a clinically viable multifunctional hand prosthesis. In MyoElectric Controls/Powered Prosthetics Sym-... 

Keywords— Computer Aided Design (CAD), IronCad, mechanical design, hand prosthesis, prosthesis, and phalange. 

R. Vinet, Y. Lozac, N. Beaudry, and G. Drouin, Design methodology for multifunctional hand prosthesis, Journal of Rehabilitation Research and Development., vol. 32 (4), pp. 316-324, November 1995. 

L. Ungureanu, A. Stanciu, and K. Menyhardt, Actuating a human hand prosthesis model study, presented at 2nd WSEAS International Conference on Dynamical Systems and Control., Bucharest Romania, Oct 2006. 

Table 1. Comparison of the respective evolution of the compliancies of a natural artery on the one hand and of an expanded polytetrafluoroethylene prosthesis on the other hand when the blood pressure increases...

Movement of powered prosthetic devices such as arms, hands, and legs can be controlled with the surface myoelectric signal (MES) in a very natural way. The person with the prosthesis only has to attempt to make the intended movement and this produces minute contractions of residual muscles similar to contractions in an intact limb. 

An orthopedic prosthesis is an internal or external device that replaces lost parts or functions of the neuroskeletomotor system. In contrast, a orthopedic orthosis is a device that augments a function of the skeletomotor system by controlling motion or altering the shape of body tissue. For example, an artificial leg or hand is a prosthesis, whereas a calliper (or brace) is an orthosis. This chapter addresses only orthoses and external orthopedic prostheses internal orthopedic prostheses, such as artificial joints, are a subject on their own. 

The power for active hand and arm prostheses can come form the body (Body-powered Prosthesis), or from external sources (Externally-powered prosthesis) [90-97]. Gross body movement controls a body-powered prosthesis. The movement of the shoulder, upper arm, or chest is captured by a harness system, which is attached to a cable that is connected to a terminal device (hook or hand). For some levels of amputation or deficiency, an elbow system can be added to provide the amputee additional function. An amputee must possess at least one or more of the foUowing gross body movements glenohumeral flexion, scapular abduction or adduction, shoulder depression and elevation, and chest expansion in order to control body-powered prosthesis. In addition, sufficient residual limb length and sufficient musculature must exist. 

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