Ashok Muzumdar (Editor)

Powered Upper Limb Prostheses

Control.lrnplernentatlonand Clinical Application

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Springer-Verlag Berlin Heidelberg GmbH

Ashok Muzumdar (Editor)

MB, BS, FRCPC, FACP, AFCASI, DAAPM, LM

Powered UpperLimb Prostheses

Control, Implementationand Clinical Application

With 154 Figures and 11 Tables

i Springer

Ashok Muzumdar Ottawa, Canada

TSBN 978-3-642-62302-8

Library of Congress Cataloging-in-Publication Data Muzumdar, Ashok, 1940- . Powered upper limb prosthesesl Ashok Muzumdar. p.j cm. Includes bibliographical references andindex.

ISBN 978-3-642-62302-8 ISBN 978-3-642-18812-1 (eBook)

DOI 10.1007/978-3-642-18812-1 l.Arti­

ficiallimbs. 2. Myoelectric prosthesis. 3. Prosthesis. 4. Human engineering. 5. Amputees-Rehabilitation. I. Title. [DNLM: 1. Artificial Limbs. 2. Arm. 3. Prosthesis Design. WE 172 M994p 2004] RD756.M892004 617.5'7403-dc22

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specif­ically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks. Duplication of this pub­lication or parts thereof is permitted only under the provisions of the German Copyright Law of September 9, 1965, in its cur­rent version, and permission for use must always be obtained from Springer-Verlag. Violations are liable for prosecution under the German Copyright Law.

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© Springer-Verlag Berlin Heidelberg 2004 OriginaIly published by Springer-Verlag Berlin Heidelberg New York in 2004

Softcover reprint of the hardcover 1 st edition 2004

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Product liability: The publishers cannot guarantee the accu­racy of any information about dosage and application con­tained in this book. In every individual case the user must check such information by consulting the relevant literature.

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21/3150 - 5 4 3 2 1 O Printed on acid-free paper

Powered Upper Limb Prostheses represents, in myview, a concise yet comprehensive book on the sub­ject of myoelectrically controlled externally poweredprostheses for both child and adult upper limb ampu­tees. It is a natural successor to the series of mono­graphs on myoelectric prostheses produced by theInstitute of Biomedical Engineering and publishedby the University of New Brunswick in Canada. TheUNB monographs have been out of print for someyears now. Therefore, this body of work on poweredupper limb prostheses not only fills that void but, inaddition, provides new and updated information onthe many facets of powered prostheses for patientswith upper limb loss or absence.

There are various factors that determine the suc­cess of the application, fit and function of a poweredupper limb prosthesis. Selecting the appropriate pre­scription for any patient, client or user requires theknowledge, experience and skills of a multidisciplin­ary team of professionals. Expertise for such a spe­cialized amputee clinic team comes from a wide vari­ety of specialities and sub-specialities of health careand engineering.

The flow pattern of the book follows the philoso­phy of informing the reader of the past, present andfuture of powered upper limb prostheses.The text be­gins with a historical perspective followed by basicmuscle anatomy and electrophysiology as well as theorigins, acquisition and processing of the myoelec­tric signal. With the intention of remaining unbiased,analysis is made of the commercially available com­ponents for upper extremity prostheses for young

Preface

children, adolescents and adults. The clinical chap­ters deal with the prevalence, psychosocial issues andoutcomes pertaining to upper limb deficiencies alongwith assessment and prosthetic fitting of paediatricand adult amputees. This is followed by trainingwhich includes the pre- and post-prosthetic phasesand subsequent rehabilitative care. The book reviewsthe current research on the subject and examines thefuture of myoelectric upper extremity prosthetics. Itconcludes with a bibliography which is in addition tothe suggested reading and references provided at theend of the chapters.

While there is general consensus among academ­ics and practitioners on the many aspects of poweredupper limb prostheses in children and adults, in somecentres prevailing philosophy and practices may dif­fer from those outlined in this book by various au­thors. In order to present a broad spectrum of view­points in a balanced manner, this book brings togeth­er authors who are experienced practitioners, aca­demics and researchers in the field from Canada,Great Britain and the United States. The bibliographyallows the reader to pursue their own ideas and fur­ther their search on specific topics of interest to them.

This book should serve as a foundation for stu­dents as well as a resource for professionals in relateddisciplines of engineering and medicine. It is myhope that the confluence of information presented bythe contributing authors of this book will provide theknowledge for those involved in the field of poweredupper limb prosthetics to progress well into the twen­ty-first century.

Ashok Muzumdar

Disclaimer

While the advice and information in this book are be­lieved to be true and accurate at the time of submis­sion for publication, neither the authors nor the edi­tor and publisher can accept any legal responsibilityfor any errors or omissions made in any part of thisbook. The material presented in this volume is not in­tended to represent the only method or applicationappropriate for the medical situations discussed, butrather is intended to present an approach, viewpoint,statement or opinion of the author or authors, whichmay be helpful to others who encounter similar clin­ical situations.

The opinions expressed, suggestions made and ad­vice given in this book are those of the respective au­thor or authors and not necessarily those of the edi­tor or the publisher. The publisher and the editormake no warranty, express or implied, with respect toany material contained herein.

Chapter 1

Table of Contents

The Early History of Myoelectric Controlof Prosthetic Limbs (1945-1970) .

Chapter 2 The Origins and Natureof the Myoelectric Signal . . . . . . . . . . . 17

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Signals and Signal Processingfor Myoelectric Control . . . . . . . . . . . . 35

Commercial Hardware for theImplementation of Myoelectric Control . . 55

Meeting the Clients: An OverviewFocuson Prevalence, Psychosocial Issues,Outcomes . . . . . . . . . . . . . . . . . . . . 73

Powered Upper Limb ProstheticPractice in Paediatrics . . . . . . . . . . . . . 85

Powered Upper Limb Prostheticsin Adults. . . . . . . . . . . . . . . . . . . . . 117

Training 147

Chapter 9 Research and the Futureof Myoelectric Prosthetics 175

Chapter 10 A Bibliography on Myoelectric Controlof Upper Limb Prostheses . . . . . . . . . . 191

Index 205

Randall D. Alley BSc, CP, FAAOPClinicalResearchand BusinessDevelopmentUpper Extremity Prosthetic Program, HPO, IncThousand Oakes,California,USA

Robert R. Caldwell Dip E Eng, CETManager,Institute of Bio-Medical EngineeringUniversityof NewBrunswickFredericton,NewBrunswick, Canada

Paul H. Chappell BSc, PhD, CEng, MIEE,MIPEM,ILTMLecturer, MedicalEngineering,Electronicsand Computer ScienceUniversityof SouthamptonSouthampton, UK

Shane Glasford CP(c)Prosthetic and Myoelectric ServicesBloorview MacMillan Children's CentreToronto, Ontario, Canada

David Gow BSc Hons,CEng, SRCSDirector,RehabilitationEngineering Services,Lothian Primary Care NHS TrustEastern General HospitalEdinburgh, Scotland,UK

Hanna Heger BA,OT Reg(Ont)St.John'sRehabilitationHospital andSunnybrook Centre for Independent LivingToronto, Ontario, Canada

Contributing Authors

Winfried Heim CP(c)Prosthetic and Myoelectric ServicesBloorviewMacMillan Children'sCentreToronto, Ontario, Canada

Sheila A. Hubbard BSc PT, OTReg(Ont)Manager,Amputee TeamBloorviewMacMillan Children'sCentreToronto, Ontario, Canada

Peter J. Kyberd BSc, MSc, PhDLecturer,Cybernetics DepartmentUniversityof ReadingWhiteknights, Reading, Berkshire,UK

DennisF. Lovely BSc, PhD,PEngProfessor, Dept.of Electricaland Computing EngineeringUniversityof NewBrunswickFredericton, NewBrunswick,Canada

Linda McLean BSc(PT), MScE, PhDAssistant Professor, PhysicalTherapySchoolof RehabilitationTherapyQueen'sUniversityKingston,Ontario, Canada

Gert Montgomery BScN, MSW, RSWSocialWorker& ProfessionalAdvisorfor SocialWork,Chaplaincy & Creative Arts ServiceBloorviewMacMillan Children'sCentreToronto, Ontario, Canada

Stephen Naumann PhD, PEngDirector, Rehabilitation Engineering DepartmentBloorview MacMillan Children's CentreToronto, Ontario, Canada

Sandra Ramdia l CP(c)Manager, Custom Silicone Services,Otto BockOakville, Ontario, Canada

Robert N. Scott BSc,DSc, PEngProfessor EmeritusDepartment of Electrical EngineeringUniversity of New BrunswickFredericton, New Brunswick, Canada

ContributingAuthors

Harold H. Sears BS, MS,PhDGeneral ManagerMotion Control IncSalt Lake City, Utah, USA

Heather Smart BA,Dip Lib, MIInfScInformation Officer, RECAL Information ServicesNational Centre for Training and Educationin Prosthetics and OrthoticsUniversity of StrathclydeGlasgow, Scotland, UK

Dinah Stocker MEd, BSc OTInstitute of Bio-Medical EngineeringUniversity of New BrunswickFredericton, New Brunswick, Canada