User experience of controlling the DEKA Arm with EMG pattern recognition.

INTRODUCTION: A commercially available EMG Pattern Recognition (EMG-PR) control system was adapted to interface with the multi-degree of freedom (DOF) DEKA Arm. PURPOSE: To describe users' experience of controlling the DEKA Arm using EMG-PR. METHODS: Sample: Twelve persons with upper limb amputation participated, 10 with transradial (TR), 2 with transhumeral (TH) level amputation. Ten were male, and 11 were users of a prosthesis at baselines. Design: This was a two-part study consisting of in-laboratory prosthetic training (Part A) and up to 12 weeks of home use of the prosthesis (Part B). Data collection: Qualitative data were collected through open-ended survey questions and semi-structured interviews. Data Analysis: The study used a qualitative case series design with a constant comparative approach to identify common categories of experience. Coding categories were iteratively refined until saturation of categories was achieved. The data were organized in a primary category, major categories of experience, factors impacting experience, and broader contextual factors. RESULTS: Users had mixed perspectives on the desirability of the EMG-PR control system in combination with the DEKA Arm. Major aspects of user experience related to the system complexity, process of calibrating, and functional benefits. Factors influencing user experience included training and acclimation, fatigue, prosthesis design, technical issues and control changes. Broader contextual factors, both personal and environmental, also impacted users' experience. DISCUSSION/CONCLUSION: This study provided an in-depth description of user experience operating the DEKA Arm using EMG-PR control. The majority of participants expressed a preference for the controls of their personal prosthesis and controls rather than the iteration of EMG-PR controlled DEKA Arm used in this study. Most were positive about the future potential of EMG-PR as a control method. An understanding of patient experience will assist clinicians and patients choosing prosthetic options.

Does the DEKA Arm substitute for or supplement conventional prostheses.

BACKGROUND: Research on home use of advanced upper limb prostheses is needed. OBJECTIVES: To describe and compare DEKA Arm usage patterns during the last 4 weeks of a home trial for participants with a personal prosthesis and those without. To compare usage patterns during home trial to those of the personal prosthesis prior to home trial. To evaluate user activity preferences for the DEKA Arm and personal prosthesis after a trial of home use. STUDY DESIGN: Quasi-experimental, time-series design. METHODS: Data from 17 participants were analyzed. At baseline, prosthesis users reported days and hours they wore and used personal device(s). Home trial diaries documented days and hours of wear and use for the DEKA Arm and personal device(s), if applicable. Questionnaires asked prosthesis users to list activities they could do with the DEKA Arm but not with their current prosthesis and vice versa and activities they preferred doing with either devices. RESULTS: The DEKA Arm was worn 81% and used 73% of functioning days, averaging 4.2 h worn and 2.4 h used on days worn. During home trial, prosthesis users used personal devices and any prosthesis for fewer hours/day than at baseline. CONCLUSION: The DEKA supplemented but did not substitute for the personal prosthesis. Clinical relevance Findings strongly suggest that given the limitations of the DEKA Arm and conventional prosthesis, persons with upper limb amputation would be best served and would be able to perform the widest range of activities if they had several types of devices.

Advanced upper limb prosthetic devices: implications for upper limb prosthetic rehabilitation.

The number of catastrophic injuries caused by improvised explosive devices in the Afghanistan and Iraq Wars has increased public, legislative, and research attention to upper limb amputation. The Department of Veterans Affairs (VA) has partnered with the Defense Advanced Research Projects Agency and DEKA Integrated Solutions to optimize the function of an advanced prosthetic arm system that will enable greater independence and function. In this special communication, we examine current practices in prosthetic rehabilitation including trends in adoption and use of prosthetic devices, financial considerations, and the role of rehabilitation team members in light of our experiences with a prototype advanced upper limb prosthesis during a VA study to optimize the device. We discuss key challenges in the adoption of advanced prosthetic technology and make recommendations for service provision and use of advanced upper limb prosthetics. Rates of prosthetic rejection are high among upper limb amputees. However, these rates may be reduced with sufficient training by a highly specialized, multidisciplinary team of clinicians, and a focus on patient education and empowerment throughout the rehabilitation process. There are significant challenges emerging that are unique to implementing the use of advanced upper limb prosthetic technology, and a lack of evidence to establish clinical guidelines regarding prosthetic prescription and treatment. Finally, we make recommendations for future research to aid in the identification of best practices and development of policy decisions regarding insurance coverage of prosthetic rehabilitation.