Proprioception After Upper Extremity Agonist Antagonist Myoneural Interface and Development of a Force Myography System for Prosthesis Control
Date
2024-12-15
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Abstract
Purpose: Agonist-antagonist myoneural interface (AMI) is a surgical procedure
hypothesized to improve proprioception after amputation. We aimed to translate this
procedure to transradial hand amputation and develop a quantitative assessment of
proprioception in amputees for a pilot study.
Methods: The transradial AMI technique was performed and described as a surgical
case study. We developed a pilot experiment for quantitative assessment of
proprioception in amputees based on surface force myography (sFMG) of remnant
forearm muscle force using a custom designed force sensor optimized for sFMG.
Results: The surgical procedure was technically successful with radiographic evidence
of a functioning AMI with 15-21 mm of tendon excursion at 18-month follow up. The
AMI amputee’s performance at a force-matching task was similar to non-amputees,
whereas the standard amputee was an outlier with worse performance (p=0.015).
Conclusion: The AMI technique is feasible and safe for transradial amputation. The
pilot results suggest that a functioning AMI may improve force-matching accuracy.
Description
This work investigated the feasibility and safety of the agonist-antagonist myoneural interface (AMI) procedure for transradial amputation and its impact on sense of effort proprioception compared to non-amputees and a standard transradial amputee. The AMI procedure is described as a surgical case report. The functioning of the AMI was radiographically assessed using fluoroscopy and ultrasound, and force transmission between the agonist and antagonist muscle groups was demonstrated with tendon excursion of 15-21mm. In order to assess proprioception after amputation, an experimental method assessing sense of effort proprioception was developed utilizing a force matching task. A surface force myography system using a custom designed optimized force sensor was developed and characterized. A pilot experiment was done determine the effect size comparing the AMI amputee's performance at the force matching task to non-amputees (n=7) and a standard transradial amputee. The AMI amputee was not a statistically significant outlier and had similar force matching performance compared to the non-amputee group. The standard amputee was a statistically significant outlier with more force matching errors and higher variability in applied force.
Keywords
Amputation, Prosthetics, Sensors, Proprioception, Surgery