Tag Archives: ITAP

Mind-controlled prostheses ready for real world activities

There’s some exciting news from Sweden’s Chalmers University of Technology about prosthetics. From an Oct. 8, 2014 news item on ScienceDaily,

For the first time, robotic prostheses controlled via implanted neuromuscular interfaces have become a clinical reality. A novel osseointegrated (bone-anchored) implant system gives patients new opportunities in their daily life and professional activities.

In January 2013 a Swedish arm amputee was the first person in the world to receive a prosthesis with a direct connection to bone, nerves and muscles. …

An Oct. 8, 2014 Chalmers University press release (also on EurekAlert), which originated the news item, provides more details about the research and this ‘real world’ prosthetic device,

“Going beyond the lab to allow the patient to face real-world challenges is the main contribution of this work,” says Max Ortiz Catalan, research scientist at Chalmers University of Technology and leading author of the publication.

“We have used osseointegration to create a long-term stable fusion between man and machine, where we have integrated them at different levels. The artificial arm is directly attached to the skeleton, thus providing mechanical stability. Then the human’s biological control system, that is nerves and muscles, is also interfaced to the machine’s control system via neuromuscular electrodes. This creates an intimate union between the body and the machine; between biology and mechatronics.”

The direct skeletal attachment is created by what is known as osseointegration, a technology in limb prostheses pioneered by associate professor Rickard Brånemark and his colleagues at Sahlgrenska University Hospital. Rickard Brånemark led the surgical implantation and collaborated closely with Max Ortiz Catalan and Professor Bo Håkansson at Chalmers University of Technology on this project.

The patient’s arm was amputated over ten years ago. Before the surgery, his prosthesis was controlled via electrodes placed over the skin. Robotic prostheses can be very advanced, but such a control system makes them unreliable and limits their functionality, and patients commonly reject them as a result.

Now, the patient has been given a control system that is directly connected to his own. He has a physically challenging job as a truck driver in northern Sweden, and since the surgery he has experienced that he can cope with all the situations he faces; everything from clamping his trailer load and operating machinery, to unpacking eggs and tying his children’s skates, regardless of the environmental conditions (read more about the benefits of the new technology below).

The patient is also one of the first in the world to take part in an effort to achieve long-term sensation via the prosthesis. Because the implant is a bidirectional interface, it can also be used to send signals in the opposite direction – from the prosthetic arm to the brain. This is the researchers’ next step, to clinically implement their findings on sensory feedback.

“Reliable communication between the prosthesis and the body has been the missing link for the clinical implementation of neural control and sensory feedback, and this is now in place,” says Max Ortiz Catalan. “So far we have shown that the patient has a long-term stable ability to perceive touch in different locations in the missing hand. Intuitive sensory feedback and control are crucial for interacting with the environment, for example to reliably hold an object despite disturbances or uncertainty. Today, no patient walks around with a prosthesis that provides such information, but we are working towards changing that in the very short term.”

The researchers plan to treat more patients with the novel technology later this year.

“We see this technology as an important step towards more natural control of artificial limbs,” says Max Ortiz Catalan. “It is the missing link for allowing sophisticated neural interfaces to control sophisticated prostheses. So far, this has only been possible in short experiments within controlled environments.”

The researchers have provided an image of the patient using his prosthetic arm in the context of his work as a truck driver,

[downloaded from http://www.chalmers.se/en/news/Pages/Mind-controlled-prosthetic-arms-that-work-in-daily-life-are-now-a-reality.aspx]

[downloaded from http://www.chalmers.se/en/news/Pages/Mind-controlled-prosthetic-arms-that-work-in-daily-life-are-now-a-reality.aspx]

The news release offers some additional information about the device,

The new technology is based on the OPRA treatment (osseointegrated prosthesis for the rehabilitation of amputees), where a titanium implant is surgically inserted into the bone and becomes fixated to it by a process known as osseointegration (Osseo = bone). A percutaneous component (abutment) is then attached to the titanium implant to serve as a metallic bone extension, where the prosthesis is then fixated. Electrodes are implanted in nerves and muscles as the interfaces to the biological control system. These electrodes record signals which are transmitted via the osseointegrated implant to the prostheses, where the signals are finally decoded and translated into motions.

There are also some videos of the patient demonstrating various aspects of this device available here (keep scrolling) along with more details about what makes this device so special.

Here’s a link to and a citation for the research paper,

An osseointegrated human-machine gateway for long-term sensory feedback and motor control of artificial limbs by Max Ortiz-Catalan, Bo Håkansson, and Rickard Brånemark. Sci Transl Med 8 October 2014: Vol. 6, Issue 257, p. 257re6 Sci. Transl. Med. DOI: 10.1126/scitranslmed.3008933

This article is behind a paywall and it appears to be part of a special issue or a special section in an issue, so keep scrolling down the linked to page to find more articles on this topic.

I have written about similar research in the past. Notably, there’s a July 19, 2011 post about work on Intraosseous Transcutaneous Amputation Prosthesis (ITAP) and a May 17, 2012 post featuring a video of a woman reaching with a robotic arm for a cup of coffee using her thoughts alone to control the arm.

Growing into your prosthetics

Fusing skin to metal is the secret to making prosthetics more comfortable and usable. In a July 13, 2011 posting, GrrlScientist at the Guardian Science blogs highlights this pioneering research,

… thanks to the work of Professor Gordon Blunn, Head of University College London’s Centre for Bio-Medical Engineering, and his colleagues, including Dr Noel Fitzpatrick, a veterinary surgeon. Professor Blunn has been developing groundbreaking metal prosthetic implants that provide comfort and improved mobility for amputee humans and animals.

… They found that in antlers, the bone structure under the skin is very different to that of the exposed bone.

“It was very porous, with lots of tiny holes, which the dermis [the inner layer of skin] webs its way into”, explained Professor Blunn. [emphasis mine]

This observation led to their breakthrough development, known as Intraosseous Transcutaneous Amputation Prosthesis (ITAP), which uses a layer of porous and bioactive (hydroxyapatite-coated) surfaces that encourage adhesion by living tissues. This living “seal” prevents bacterial infections, thereby allowing surgeons to provide amputees with securely-attached limbs that carry weight in a natural way.

Currently, battery-powered sensors allow human amputees to consciously control the movement of downstream portions of the prosthetic limb, such as flexing the hand on a prosthetic arm.

As an excuse for including this item here on the blog and until I hear otherwise, I choose to think of those tiny holes as being at the nanoscale . Plus, I’ve written about prosthetics and human enhancement a number of times.  Here’s the first in a four-part series on Robots and Human Enhancement, July 22, 2009 posting.

As for Blunn’s work, GrrlScientist includes a video and pictures as well as more details about it.