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Christian Phan

Hamza Usman
Zachary Murray
The Implementation of Tactile Sensation in
Neural Prosthetics to Provide Sensory Feedback and Improve Motor Control
BME 333T, MWF 12pm Lecture; Friday 1 pm Workshop
The University of Texas at Austin
11/25/2015

Table of Contents
1

Executive Summary...3

The Implementation of Tactile Sensation in Neural Prosthetics to Provide Sensory


Feedback and Improve Motor Control....4

2.1

Introduction......4

2.1.1

Statement of Problem.......4

2.2

Proposed Solution........5

2.2.1

Current and Advancing State of the Art......5

2.2.2

Sensory Prosthetics Using Tactile Sensors..........5

2.2.2.1 Description.......5
2.2.2.2 Application.......6
2.2.2.3 Limitations.......6
2.2.2.4 Ethical Implications.............6
2.3

Conclusion...6

References.......8

Executive Summary

Providing tactile feedback in neuroprosthetics is the next major step in the development of trueto-life prosthetic limbs. This feedback would not only return the users lost sense of touch, but
would enhance the users dexterity and intuition when operating the device. Given sensation of
touch, the users brain is able to better adapt to the synthetic limb and judge where something is
or how hard to grip skills that take months to develop without haptic feedback. By using
biologically integrated materials that can sense tactile pressure, current neuroprosthetics can
provide the user with sensations of touch, vastly improving their quality of life.

The Implementation of Tactile Sensation in Neural Prosthetics to Provide Sensory


Feedback and Improve Motor Control

2.1

Introduction
One of the most detrimental and traumatic experiences a person can have is the loss of a

limb, resulting in disability and an extensive period of rehabilitation adjusting to a prosthetic.


According to a study published in 2008 by Doctor Kathryn Ziegler-Graham, 1 in 190 Americans
currently lives with the loss of a limb and this number may double by 2050.[1] For people who
have lost a limb, even the simplest of tasks becomes arduous. As a result, prosthetics have been
implemented, but the ones in circulation today offer nowhere near the dexterity of a human hand.
This is due to the fact that they dont allow the user to accurately feel what theyre doing. This
paper presents a possible solution that allows the user to receive haptic feedback from the
prosthetic far more sensitively than any current methods.
2.1.1

Statement of Problem
Currently, most prosthetics do not allow for patients to receive any tactile response. In

other words, patients in use of prosthetics cant physically feel anything through their artificial
limbs. This may seem trivial, but its an intuitive part of the living system that is a limb. Without
the sensation of touch, it becomes exceedingly difficult to judge how firm to grip an object. It
also takes a completely different thought to process the mechanical operation of the prosthetic
which is cumbersome and unintuitive. Modern prosthetics simply mimic the mechanical motion
of the missing limb and some dont even have functionality serving only to mimic the look of an
arm or a hand. Only recently have there been prosthetics that enable users to fully control the
limb(s) through purely neural means, but they can also take nearly 2 years for patients to learn to

use adeptly.[2] However, with the ability to feel what theyre touching, all of these problems
would diminish for the patient.
2.2

Proposed Solution

2.2.1

Current and Advancing State of the Art


While recent advancements in the field of prosthetics have attempted to solve the

inadequacy of current prosthetics, none have found the ideal solution. Dr. Todd Kuiken et al.
describes in his paper, Targeted reinnervation for enhanced prosthetic arm function in a woman
with a proximal amputation, an attempt to add sensory functionality to prosthetics. This process
involves a surgical method called Targeted Sensory Reinnervation (TSR). During TSR, the
residual nerves from an amputated limb are transferred
onto alternative muscle groups that are not
biomechanically functional since they are no longer
attached to the missing arm.[3] In this procedure, the
residual nerves left over from the amputation of a
patients arm are sewn into the muscles of their chest.
When the patient thinks of flexing their elbow, hand, or
fingers, the nerves cause the respective muscles in her
chest to flex instead. The resulting contraction is then
quantified by an EMG and used to control the
prosthetic, as depicted to the right.[3]

This makes the use of the prosthetic more natural, as the user only has to think of what they want
to do, and the correct response from the prosthetic occurs.[4]
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When they examined this ability for the nerves to activate different muscle groups, they
found that not only could the reinnervated tissue
be used to control a prosthetic; it could feel
again. The nerves had regenerated, so when
pressure was applied to the reinnervated muscles
in certain areas on the chest (shown in the image
to the right) the patient felt that pressure was
being applied to the fingers of her missing limb.
Reinnervation can be purposefully implemented to provide a discrete sensation of touch
in the missing limb.[5] However, even though this method brings back a sense of touch, it
doesnt provide a sensitive enough gradient to let the patient discern between objects.

2.2.2

Sensory Prosthetics Using Tactile Sensors

2.2.2.1 Description
Sensory prosthetics, devices with the tactile sensors, would allow the user to actually feel
what they are touching through the artificial limb. Implementing the sensation of touch vastly
improves the functionality of the device since the user can physically feel what theyre
doing. Judging pressure and feeling response from a prosthetic are integral parts of this solution.
Since grasping and manipulating objects based on how they feel is a regular process for the
brain, patients can adapt to sensory prosthetics much more easily because the prosthetics provide

a feel that is natural and familiar while previous prosthetics feel unnatural and involve a lot of
guesswork using visual clues. [7]
One model designed by Dr. Nicholas
Wettel from the University of Southern
California is the Biomimetic Tactile Sensor
Array.[8] This device is designed to be an
inexpensive solution to enhancing the
performance on prosthetic hands in
unstructured environments. While current
prosthetic hands are good for specific
situations, the lack of tactile feedback makes
gripping irregular objects difficult or
impossible. This sensor array tackles the issue
by mimicking the mechanical properties and
distributed touch receptors of human fingers.
Similar to a human finger, the device has a rigid core, surrounded by a deformable shell.
The shell is composed of a weakly conductive fluid contained within an elastomeric skin. The
core has many electrodes attached to it. These electrodes measure the impedance changes within
the fluid around them. External forces deform the fluid path, resulting in impedance changes that
the electrodes detect. The inside of the core houses the electrical circuitry necessary to read the
signal and convert it into electrical signal.

This device has many applications. It can be used in robotics to allow autonomous
movement and detailed feedback for a robot to make informed decisions, an automated
prosthetic with programmed reflexes for specific stimuli, or in our case electrical signals directly
fed to nerves to produce haptic feedback to allow a patient to feel what they are touching.

2.2.2.2 Application
Several schools including Stanford University and Johns Hopkins University have
succeeded in producing artificial skin-like materials that can transduce tactical sensations into
electrical signals which then can be transmitted to the brain as they would in human skin.[9] This
means that the very act of transmitting an external stimulus into a biocompatible reading has
been made possible. In the case of the aforementioned TSR surgery, the patient claimed that her
experimental sensory prosthetic was much easier and more natural to use, stating that [her]
original prosthesis wasn't worth wearingthis one is.[3]
The Biomimetic Tactile Sensor Array has a variety of factors that affect its sensitivity.
The entire device functions based on the impedance of the current as well as the fluid flow. The
fluid flow is affected by how thick the skin layer is and how easily it is deformed by any stimuli.
The graph analyzes the impedance based on different thicknesses and grittiness of skin used for
the outer layer.[8] If the skin is very thin with no texture, the membrane is hypersensitive to
small changes in force. As the normal force increases, the impedance rapidly diverges until it is
not measurable. However, with a thicker skin and higher grit texture, the impedance increases
predictably, which allows a plotting of force vs. impedance. This can be used to sense touch at
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about 0.5N to 100N, the physiological force range ideal for a sensory prosthetic. Based upon
different types of force (i.e shear, normal,
diagonal, etc), the patterns of impedance
change in a consistent manner. An analysis of
these impedance patterns yields a prosthetic
that can differentiate between the shape of the
object and possible slipping.
This is a huge improvement over TSR (Targeted Sensory Reinnervation) as TSR cannot
sense qualities of forces: it is binary. TSR can only detect whether a force is present with limited
information about strength and provide binary feedback to the user while this sensor array can
detect direction and strength with accuracy.[3] The components of this device themselves are
very easy to manufacture and the materials are equally inexpensive. However, future use of this
prosthetic would require surgery to connect it either directly to nerves, or integrate an electric
stimulator able to transmit signal to neurons.

2.2.2.3 Limitations
The Biomimetic Tactile Sensor Array by itself is an inexpensive solution, but associated
costs of surgery, implementation into a working prosthetic and scaling up would quickly increase
the cost. The creation of sensory prosthetics may have been proven possible, but the cost of
producing these devices still drastically limits their widespread use in society. Materials that
allow for biologically-integrated sensations are still in early development which means that
theyre designed to work effectively but not yet designed to be cost effective. The few devices
that have succeeded in using such materials to provide feedback sensations are hardly affordable.
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A single myoelectric prosthetic arm can cost around $100,000 at the University of California San
Francisco Medical Center.[10][11] Not to mention the cost of surgery to even attach a device that
integrates external data with the bodys own electrical network. All of these barriers lead to a
high cost for the use of sensory prosthetics. Because of their immense costs, sensory prosthetics
are not readily available to the public. Until the cost of these new prosthetics decrease, they will
not be a viable solution to the majority of amputees in the world.
2.2.2.4 Ethical Implications
A major issue concerning ethical controversy is the use of animal research in the study of
both sensory feedback and locomotive response. Before such related technologies can be applied
to human clinical trials, they must first be explored and observed in research model animals.
Many activists object to subjecting these beings to contained lives and abnormal bodily
modifications. Animals of distinct intelligence are mainly the topic of such concerns. In the
specific research done related to sensory neuroprosthetics, cats and monkeys have been subjected
to tests that require invasive observation, i.e. surgery, in order to obtain neural networking data.
[12], [13] Protocols do however exist to maintain the safety and painless accrual of data from
these animals, e.g. anesthesia.[13]
2.3

Conclusion
Prosthetics were originally intended to be a replacement of a lost limb. However, no

prosthetic to date has ever come close to fully replacing it. All we can hope to accomplish is to
mimic or design a prosthetic that can come close to the real thing. In recent years, design choices
have favored moving towards allowing the prosthetic to function without sensory feedback to the
user, which takes away the human element and moves further from what prosthetics were
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originally intended to do: act as a replacement of an actual limb. The integral part of a limb is its
ability to feel. The limbs movements, no matter how minute, are only effective when the user
can feel those movements and adjust accordingly without guesswork. The addition of tactile
sensors to prosthetics will ensure that the human element of the lost limb remains intact,
improving the quality of life of the patient and ensuring greater satisfaction.

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References

[1]
K. Ziegler-Graham, E. J. MacKenzie, P. L. Ephraim, T. G. Travison, and R. Brookmeyer,
Estimating the Prevalence of Limb Loss in the United States: 2005 to 2050, Arch. Phys. Med.
Rehabil., vol. 89, no. 3, pp. 422429, Mar. 2008.
[2]
S. Watve, G. Dodd, R. MacDonald, and E. R. Stoppard, Upper limb prosthetic
rehabilitation, Orthop. Trauma, vol. 25, no. 2, pp. 135142, Apr. 2011.
[3]
T. A. Kuiken, L. A. Miller, R. D. Lipschutz, B. A. Lock, K. Stubblefield, P. D. Marasco,
P. Zhou, and G. A. Dumanian, Targeted reinnervation for enhanced prosthetic arm function in a
woman with a proximal amputation: a case study, The Lancet, vol. 369, no. 9559, pp. 371380,
Feb. 2007.
[4]
I. Iturrate, R. Chavarriaga, L. Montesano, J. Minguez, and J. del R. Milln, Teaching
brain-machine interfaces as an alternative paradigm to neuroprosthetics control, Sci. Rep., vol.
5, p. 13893, Sep. 2015.
[5]
M. F. Casanova, Canonical circuits of the cerebral cortex as enablers of
neuroprosthetics, Front. Syst. Neurosci., vol. 7, Nov. 2013.
[6]
R. Kwok, Neuroprosthetics: Once more, with feeling, Nature, vol. 497, no. 7448, pp.
176178, May 2013.
[7]
N. Wettels, V. J. Santos, R. S. Johansson, and G. E. Loeb, Biomimetic Tactile Sensor
Array, Adv. Robot., vol. 22, no. 8, pp. 829849, Jan. 2008.
[8]

Artificially intelligent synthetic skin interacts with brain cells., Healthinnovations. .

[9]
D. K. Blough, S. Hubbard, L. V. McFarland, D. G. . Smith, J. M. Gambel, and G. E.
Reiber, Prosthetic cost projections for servicemembers with major limb loss from Vietnam and
OIF/OEF, J. Rehabil. Res. Dev., vol. 47, no. 4, p. 387, 2010.
[10] G. McGimpsey and T. C. Bradford, Limb Prosthetics Services and Devices. Gaithersburg,
MD: National Institute of Science and Technology, 2008.
[11] M. C. Dadarlat, J. E. ODoherty, and P. N. Sabes, A learning-based approach to artificial
sensory feedback leads to optimal integration, Nat Neurosci, vol. 18, no. 1, pp. 138144, Jan.
2015.
[12] K. A. Mazurek, B. J. Holinski, D. G. Everaert, R. B. Stein, R. Etienne-Cummings, and V.
K. Mushahwar, Feed forward and feedback control for over-ground locomotion in anaesthetized
cats, J. Neural Eng., vol. 9, no. 2, p. 026003, Apr. 2012.
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