DOCSLIB.ORG

Finger and Penile Tactile Sensitivity in Sexually Functional and Dysfunctional Diabetic Men

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Finger and Penile Tactile Sensitivity in Sexually Functional and Dysfunctional Diabetic Men Diabetologia (1999) 42: 336±342 Ó Springer-Verlag 1999 Finger and penile tactile sensitivity in sexually functional and dysfunctional diabetic men D.L. Morrissette1, M.K.Goldstein2, D.B.Raskin1, D.L. Rowland3 1 Department of Molecular and Cellular Physiology, Stanford University, Stanford, California, USA 2 Veterans Affairs Palo Alto Health Care System (182B), Palo Alto, California, USA 3 Department of Psychology, Valparaiso University, Valparaiso, Indiana, USA Summary Tactile sensitivity of the penis is related to threshold for the sexually dysfunctional group was sexual functioning, however its role in diabetic erec- also marginally higher compared with the functional tile problems is unclear. We evaluated penile sensitiv- diabetic group (p < 0.052) but did not differ from con- ity in 10 diabetic men with erectile dysfunction, 17 trol subjects (p = 0.09). Diabetic men with erectile sexually functional diabetic men and 14 control sub- dysfunction exhibited different response patterns jects. Finger and penile thresholds and ratings of in- than sexually functional men on dimensions of inten- tensity and pleasantness for finger and penis were as- sity and pleasantness to penile stimulation. Although sessed using vibrotactile stimulation. Glycosylated these data do not directly implicate subjective re- haemoglobin and total and bioavailable testosterone sponse to penile stimulation in diabetic erectile measurements were determined and subjects comple- problems, they suggest such anomalous response ted self-reports on sexual function. Diabetic men with could be one contributing factor. [Diabetologia erectile problems had higher values of glycosylated (1999) 42: 336±342] haemoglobin than sexually functional diabetic men (p = 0.02) and both groups had lower bioavailable Keywords Diabetic erectile dysfunction, penile sensi- testosterone than control subjects (p K 0.05). Sexual- tivity, penile threshold, glycosylated haemoglobin, ly dysfunctional diabetic men had a higher finger testosterone. threshold than the other two groups (p < 0.01). Penile Although not all men with diabetes mellitus report not presumed to be the primary cause of erectile difficulty achieving and maintaining erections, fac- problems, such diminished sensitivity could com- tors that differentiate sexually functional from dys- pound the ischaemic, metabolic and other effects of functional diabetic men have not been explored ex- various pathophysiological states such as diabetes. tensively. Previous research has shown that penile vi- Diabetic men with erectile dysfunction have been bratory thresholds are related to male sexual func- shown to have higher penile thresholds (i.e., de- tioning [1]. Furthermore, ageing and pathophysiology creased sensitivity) than young non-diabetic men [3]. related to vascular function have been associated Subjective cutaneous thresholds, however, represent with decreased penile sensitivity and diminished abil- only the most basic of sensory processes. Equally im- ity to achieve and maintain erections [2]. Although portant to sexual functioning is the perceived intensi- ty and pleasantness of penile stimulation. Endocrine factors could also be involved in diabet- Received: 28 April 1998 and in final revised form: 30 October ic erectile dysfunction. Varying methodologies have 1998 yielded conflicting results regarding the association between testosterone concentrations and diabetic Corresponding author: D.Morrissette, Ph.D., Department of Molecular and Cellular Physiology, Stanford University, Stan- erectile capacity [4±7], with at least one study indicat- ford, CA 94305-5426, USA ing lower testosterone in men with diabetes. Because Abbreviations: NPT, Nocturnal penile tumescence. testosterone concentrations have been implicated in D.L.Morrissette et al.: Tactile sensitivity in diabetic men 337 penile thresholds, with testosterone deficiency associ- values above 13% or self-reports of erectile function- ated with penile hypersensitivity [8], perception of pe- ing not confirmed by nocturnal penile tumescence nile stimulation in both diabetic and non-diabetic men (NPT) testing; 18 other subjects declined after learn- might be modulated by circulating testosterone. ing more about the study or failed to appear for the In this study we 1) determined penile and finger vi- screening. Two control subjects dropped out for per- brotactile thresholds, 2) assessed finger and penile in- sonal reasons unrelated to the study. tensity and pleasantness to seven suprathreshold vi- We interviewed diabetic subjects to obtain details bratory levels of stimulation, and 3) determined total of the diabetic history and to look for causes of erec- and bioavailable testosterone concentrations. We ex- tile dysfunction other than diabetes. History of anxi- amined these variables in men of similar age: sexually ety, depression and sexual function were also ob- functional diabetic men, diabetic men with erectile tained. The physical examination included heart, dysfunction and healthy control subjects. We hypo- lung, thyroid, skin, arterial pulses by palpation and thesized sexually dysfunctional diabetic men would auscultation, abdomen, deep tendon reflexes, pro- exhibit higher thresholds than men in the other two prioception, light touch, and capillary filling of toes. groups and give lower ratings of intensity and pleas- The genital examination included palpation of the antness. We also investigated the extent that total penis for plaques or fibrosis, palpation of the testes and bioavailable testosterone vary according to dia- for size and irregularity, sensory exam of the peri- betic status to explore their possible role in differen- neum, rectal sphincter tone, palpation of the prostate, ces to our response variables. and tests of anal wink and bulbocavernoses reflexes. Assignment to the diabetic erectile dysfunction group was based initially on self-reported inability to Subjects and methods achieve and maintain an erection in 75% or more of intercourse or masturbation or both in the preceding Subjects. We studied 41 men (Table 1): 10 diabetic month and a diagnosis of diabetes preceding erectile subjects with erectile dysfunction, 17 sexually func- dysfunction. Sexually functional diabetic and control tional diabetic subjects and 14 control subjects. The subjects were those reporting no erectile dysfunction protocol was approved by our institutional review in 25% or less of sexual activity in the preceding board. Selection criteria included: age range of month. To objectively confirm erectile functioning, 29±52 years and diagnosis of diabetes for a minimum NPT [11±12] was assessed for 1 to 3 nights using ei- of 4 years (diabetic subjects). Exclusion criteria were: ther the RigiScan or Penile Tumescence portable obesity (greater than 20% over ideal body weight for home monitors (Dacomed Corp., Minneapolis, Min- height according to the Metropolitan Life Insurance nesota, USA; Event Systems, Moorestown, New Jer- Tables); mild-moderate to severe depression scores sey, USA, respectively). Subjects were considered on the Beck Depression Inventory [9]; medication sexually functional when NPT data showed three or (prescription, over-the-counter and illicit), surgery or more erections a night with a 15 mm increase above history of medical conditions (except diabetes for the baseline for a minimum of 15 min and penile rigidity diabetic groups) that could affect sexual function: (RigiScan only) of 60% or greater. Subjects not both low total and bioavailable testosterone; glycosy- meeting these criteria were confirmed as sexually lated haemoglobin values above 13%; retarded or dysfunctional. No subject was reclassified into a dif- premature ejaculation; and substance abuse. ferent group because of NPT results. Men were recruited via media announcements, a diabetes newsletter, local diabetologists and word of Assays. Glycosylated haemoglobin was determined mouth. Over a 26-month period, 178 subjects volun- by affinity chromatography using the Isolab (Akron, teered. During a telephone screening, 75 subjects Ohio, USA) minicolumn method (normal range, failed to meet the criteria (e.g. age, obesity) and 16 4.0±8.0%; slightly increased, 8.1±10.5%; mildly declined to participate. We screened 87 subjects in increased, 10.6±13.0%; moderately increased, person: they gave informed consent and completed 13.0±15.5%; greatly increased, 15.6% and above). the Beck Depression Inventory, a demographics ques- Testosterone was measured by radioimmunoassay tionnaire, a health and sexual function questionnaire as described by Anderson et al. [13] (normal values: and a semistructured interview. One blood sample mean = 21.11 nmol/l; range = 12.24±38.1 nmol/l). was drawn to determine glycosylated haemoglobin Bioavailable testosterone was measured using the and two additional samples were drawn, approxi- method of Tremblay and Dube [14] (normal values: mately 1 week apart (between 0900 and 1700 hours), mean = 7.87 nmol/l; range = 3.4±12.93 nmol/l). In- to assess total and bioavailable [10] testosterone traassay coefficients of reliability for total testoster- concentrations. For gonadal hormones, the mean val- one and bioavailable testosterone were 3.0% and ue of the two samples was used for statistical analysis. 5.8%, respectively. Interassay coefficients of reliabil- Screenings resulted in the rejection of 26 volun- ity were total testosterone, 5.0% and bioavailable teers, mainly because of glycosylated haemoglobin testosterone, 6.0%. 338 D.L.Morrissette et al.: Tactile sensitivity in diabetic
Load more

Recommended publications
  • PE2260 Five-Finger Exercise
    The Five-Finger Exercise The 5-finger exercise is helpful for relaxation and calming your system. It does not take long, but can help you feel much more peaceful and relaxed and help you feel better about yourself. Try it any time you feel tension. What are the steps to the 5-finger exercise? On one hand, touch your thumb to your index finger. Think back to a time you felt tired after exercise or some other fun physical activity. Touch your thumb to your middle finger. Go back to a time when you had a loving experience. You might recall a loving day with your family or a good friend, a warm hug from a parent or a time you had a really good conversation with someone. Touch your thumb to your ring finger. Remember the nicest compliment anyone ever gave you. Try to accept it now fully. When you do this, you are showing respect for the person who said it. You are really paying them a compliment in return. Touch your thumb to your little finger. Go back in your mind to the most beautiful and relaxing place you have ever been. Spend some time thinking of being there. To Learn More Free Interpreter Services • Adolescent Medicine • In the hospital, ask your nurse. 206-987-2028 • From outside the hospital, call the toll-free Family Interpreting Line, • Ask your healthcare provider 1-866-583-1527. Tell the interpreter • seattlechildrens.org the name or extension you need. Seattle Children’s offers interpreter services for Deaf, hard of hearing or non-English speaking patients, family members and legal representatives free of charge.
    [Show full text]
  • Female Pelvic Relaxation
    FEMALE PELVIC RELAXATION A Primer for Women with Pelvic Organ Prolapse Written by: ANDREW SIEGEL, M.D. An educational service provided by: BERGEN UROLOGICAL ASSOCIATES N.J. CENTER FOR PROSTATE CANCER & UROLOGY Andrew Siegel, M.D. • Martin Goldstein, M.D. Vincent Lanteri, M.D. • Michael Esposito, M.D. • Mutahar Ahmed, M.D. Gregory Lovallo, M.D. • Thomas Christiano, M.D. 255 Spring Valley Avenue Maywood, N.J. 07607 www.bergenurological.com www.roboticurology.com Table of Contents INTRODUCTION .................................................................1 WHY A UROLOGIST? ..........................................................2 PELVIC ANATOMY ..............................................................4 PROLAPSE URETHRA ....................................................................7 BLADDER .....................................................................7 RECTUM ......................................................................8 PERINEUM ..................................................................9 SMALL INTESTINE .....................................................9 VAGINAL VAULT .......................................................10 UTERUS .....................................................................11 EVALUATION OF PROLAPSE ............................................11 SURGICAL REPAIR OF PELVIC PROLAPSE .....................15 STRESS INCONTINENCE .........................................16 CYSTOCELE ..............................................................18 RECTOCELE/PERINEAL LAXITY .............................19
    [Show full text]
  • Mallet Finger Advice Information for Patients Page 2 This Information Leaflet Is for People Who Have Had a Mallet Finger Injury
    Oxford University Hospitals NHS Trust Emergency Department Mallet finger advice Information for patients page 2 This information leaflet is for people who have had a mallet finger injury. It describes the injury, symptoms and treatment. What is a mallet finger? A mallet finger is where the end joint of the finger bends towards the palm and cannot be straightened. This is usually caused by an injury to the end of the finger which has torn the tendon that straightens the finger. Sometimes a flake of bone may have been pulled off from where the tendon should be attached to the end bone. An X-ray will show whether this has happened. In either case, without the use of this tendon the end of your finger will remain bent. What are the symptoms? • pain • swelling • inability to straighten the tip of your finger. page 3 How is it treated? Your finger will be placed in a plastic splint to keep it straight. The end joint will be slightly over extended (bent backwards). The splint must be worn both day and night for 6 to 8 weeks. This allows the two ends of the torn tendon or bone to stay together and heal. The splint will be taped on, allowing you to bend the middle joint of your finger. The splint should only be removed for cleaning (see below). Although you can still use your finger, you should keep your hand elevated (raised) in a sling for most of the time, until the doctor sees you in the outpatient clinic. This will help to reduce any swelling and pain.
    [Show full text]
  • Palm Reading
    Palm Reading Also known as palmistry or chiromancy, palm reading is practiced all over the world with roots in Indian astrology and gypsy fortune-telling. The objective is to evaluate a person’s character and aspects of their life by studying the palm of their hand. There is no substantiate evidence of correlation between palm features and psychological traits; palm reading is for entertainment purposes. Getting Started Which hand to read? There are two main practices: For males, the left hand is what you’re born with, and the right is what you’ve accumulated throughout your life. For females, it’s the opposite. Your dominant hand (the hand you use most often) determines your future and your other, non-dominant hand, is used to determine the past or hidden traits Take these into consideration when choosing which hand to read. Reading the Primary Lines of your Hand 1. Interpret the Heart Line This line is believed to indicate emotional stability, romantic perspectives, depression, and cardiac health. Begins below the index finger = content with love life Begins below the middle finger = selfish when it comes to love Begins in-between the middle and index fingers = caring and understanding Is straight and short = less interest in romance Touches life line = heart is broken easily Is long and curvy = freely expresses emotions and feelings Is straight and parallel to the head line = good handle on emotions Is wavy = many relationships, absence of serious relationships Circle on the line = sad or depressed Broken line = emotional trauma 2. Examine the Head Line This line represents learning style, communication style, intellectualism, and thirst for knowledge.
    [Show full text]
  • Stretching and Positioning Regime for Upper Limb
    Information for patients and visitors Stretching and Positioning Regime for Upper Limb Physiotherapy Department This leaflet has been designed to remind you of the exercises you Community & Therapy Services have been taught, the correct techniques and who to contact with any queries. For more information about our Trust and the services we provide please visit our website: www.nlg.nhs.uk Information for patients and visitors Muscle Tone Muscle tone is an unconscious low level contraction of your muscles while they are at rest. The purpose of this is to keep your muscles primed and ready to generate movement. Several neurological causes may change a person’s muscle tone to increase or decrease resulting in a lack of movement. Over time, a lack of movement can cause stiffness, pain, and spasticity. In severe cases this may also lead to contractures. Spasticity Spasticity can be defined as a tightening or stiffness of the muscle due to increased muscle tone. It can interfere with normal functioning. It can also greatly increase fatigue. However, exercise, properly done, is vital in managing spasticity. The following tips may prove helpful: • Avoid positions that make the spasticity worse • Daily stretching of muscles to their full length will help to manage the tightness of spasticity, and allow for optimal movement • Moving a tight muscle to a new position may result in an increase in spasticity. If this happens, allow a few minutes for the muscles to relax • When exercising, try to keep head straight • Sudden changes in spasticity may
    [Show full text]
  • The Indications for Toe Transfer After ''Minor
    ARTICLE IN PRESS Invited personal view article THE INDICATIONS FOR TOE TRANSFER AFTER ‘‘MINOR’’ FINGER INJURIES F DEL PINAL* From the Institute for Hand and Plastic Surgery, Private Practice, and Mutua Montan*esa, Santander, Spain Toe-to-hand transfer is widely considered to be unjustified for ‘‘minor’’ finger injuries. In this invited personal view article the indications for toe-to-hand transfer for finger amputation and neurocutaneous and major pulp defects are discussed, and a classification of multidigital injury that has both prognostic and decision-making value is presented. In the author’s opinion a toe transfer should always be considered as an option when reconstructing ‘‘minor’’ finger injuries, as it can reproduce significant long-term benefit to the hand and the patient’s sense of well being. The procedure should be carried out in the acute period, not only because it is technically easier and better for hand function, but above all because the surgeon can save structures that will be lost if the transfer is delayed. Journal of Hand Surgery (British and European Volume, 2004) 29B: 2: 120–129 Keywords: microsurgery, toe-to-hand, finger amputation Since the hand is always naked and exposed, even if reconstruction. In this personal view article only the only the fingertip is lost, it presents a very large most ‘‘typical’’ indications will be discussed. The handicap for the patient. (Hirase! et al., 1997) metacarpal hand (Tan et al., 1999; Wei et al., 1997, 1999; Yu and Huang, 2000), congenital reconstruction There was a time when only loss of the thumb was (Kay and Wiberg, 1996; Shibata et al., 1998; Van Holder considered an acceptable indication for toe-to-hand et al., 1999), joint transfer (Dautel and Merle 1997; transfer (Buncke et al., 1973; Cobbett, 1969).
    [Show full text]
  • Self Range of Motion Exercises for Arm and Hand
    Self-Range of Motion Exercises for the Arm and Hand After a stroke, it is important to do the exercises in this handout for your affected arm and hand. You can do them on your own by using your unaffected arm and hand. These gentle movements are called “self-range of motion” exercises, and they help to maintain your movement, prevent stiffness, improve blood flow, and increase awareness of your affected arm and hand. Complete the exercises slowly and do not force movements. Stop if you feel pain. If you have any questions or concerns, please contact your Occupational Therapist: _______________________________ Do the exercises in this handout _____ times each day. Page - 1 Self-range of motion exercises for the arm and hand 1. Shoulder: Forward Arm Lift Interlock your fingers, or hold your wrist. With your elbows straight and thumbs facing the ceiling, lift your arms to shoulder height. Slowly lower your arms to starting position. Hold for ____ seconds. Repeat ____ times. Page - 2 Self-range of motion exercises for the arm and hand 2. Shoulder: “Rock the Baby” Stretch Hold your affected arm by supporting the elbow, forearm and wrist (as if cradling a baby). Slowly move your arms to the side, away from your body, lifting to shoulder height. Repeat this motion in the other direction. Slowly rock your arms side-to-side, and keep your body from turning. Repeat ____ times. Page - 3 Self-range of motion exercises for the arm and hand 3. Shoulder: Rotation Stretch Interlock your fingers, or hold your wrist. With your elbows bent at 90 degrees, keep your affected arm at your side.
    [Show full text]
  • Upper Limb Electrical Stimulation Exercises. P Taylor, G Mann, C Johnson, L Malone
    Salisbury FES Newsletter Jan 2002 Upper limb electrical stimulation exercises. P Taylor, G Mann, C Johnson, L Malone In this article we wish to document some of the electrical stimulation techniques we use for the upper limb, primarily with hemiplegics, in the Salisbury FES clinic. There is a growing body evidence for the effectiveness of the use of electrical stimulation in the upper limb but it is not the intention that it is reviewed here. Instead, we refer you to the excellent recent review articles by John Chae et. al1, 2 and the comprehensive review in the Rancho Book.3 The Rancho Book also includes a very useful description of electrical stimulation techniques and treatment regimes. Electrical stimulation can be used for the following purposes: For strengthening weak muscle As with any repetitive exercise, muscle bulk and strength will be increased. This will also lead to greater capillary density and therefore improved local blood supply and tissue condition. For increasing ROM Electrical stimulation can provide regular stretching, similar to passive stretching but performed over a more extended period. Be careful that some joints are not over stretched while trying to increase the range of others. For example it is sometimes useful to use MCP joint extension blocking splint to protect the MCP joints and improve the effectiveness of the action on the PIP and DIP joints. Another example might be the use of wrist flexion blocking splints when exercising finger flexors. Care must be taken that repetitive movement does not lead to skin marking. For enhancing the effect of botulinum toxin.
    [Show full text]
  • Cubital Tunnel Syndrome
    Oxford University Hospitals NHS Trust Hand & Plastics Physiotherapy Department Cubital Tunnel Syndrome Information for patients This leaflet has been developed to answer any questions you may have regarding your recent diagnosis of cubital tunnel syndrome. What is the Cubital Tunnel? The cubital tunnel is made up of the bones in your elbow and the forearm muscles which run across the elbow joint. Your ulnar nerve passes through the tunnel to supply sensation to your fingers, and information to the muscles to help move your hand. What causes Cubital Tunnel Syndrome? Symptoms occur when the nerve becomes restricted by pressure within the tunnel. The reason is usually unknown, but possible causes can include: swelling of the lining of the tendons, joint dislocation, fractures or arthritis. Fluid retention during pregnancy can also sometimes cause swelling in the tunnel. Symptoms are made worse by keeping the elbow bent for long periods of time. What are the symptoms? Symptoms include numbness, tingling and/or pain in the arm, hand and/or fingers of the affected side. The symptoms are often felt during the night, but may be noticed during the day when the elbow is bent for long periods of time. You may have noticed a weaker grip, or clumsiness when using your hand. In severe cases sensation may be permanently lost, and some of the muscles in the hand and base of the little finger may reduce in size. page 2 Diagnosis A clinician may do a test such as tapping along the line of the nerve or bending your elbow to see if your symptoms are brought on.
    [Show full text]
  • Rotator Cuff Tendinitis Shoulder Joint Replacement Mallet Finger Low
    We would like to thank you for choosing Campbell Clinic to care for you or your family member during this time. We believe that one of the best ways to ensure quality care and minimize reoccurrences is through educating our patients on their injuries or diseases. Based on the information obtained from today's visit and the course of treatment your physician has discussed with you, the following educational materials are recommended for additional information: Shoulder, Arm, & Elbow Hand & Wrist Spine & Neck Fractures Tears & Injuries Fractures Diseases & Syndromes Fractures & Other Injuries Diseases & Syndromes Adult Forearm Biceps Tear Distal Radius Carpal Tunnel Syndrome Cervical Fracture Chordoma Children Forearm Rotator Cuff Tear Finger Compartment Syndrome Thoracic & Lumbar Spine Lumbar Spine Stenosis Clavicle Shoulder Joint Tear Hand Arthritis of Hand Osteoporosis & Spinal Fx Congenital Scoliosis Distal Humerus Burners & Stingers Scaphoid Fx of Wrist Dupuytren's Comtracture Spondylolysis Congenital Torticollis Shoulder Blade Elbow Dislocation Thumb Arthritis of Wrist Spondylolisthesis Kyphosis of the Spine Adult Elbow Erb's Palsy Sprains, Strains & Other Injuries Kienböck's Disease Lumbar Disk Herniation Scoliosis Children Elbow Shoulder Dislocation Sprained Thumb Ganglion Cyst of the Wrist Neck Sprain Scoliosis in Children Diseases & Syndromes Surgical Treatments Wrist Sprains Arthritis of Thumb Herniated Disk Pack Pain in Children Compartment Syndrome Total Shoulder Replacement Fingertip Injuries Boutonnière Deformity Treatment
    [Show full text]
  • Relaxation of the Supporting Structures of the Female Pelvis
    Relaxation of the Supporting Structures of the Female Pelvis DAVID H. NICHOLS, M.D. Professor of Obstetrics and Gynecology, School of Medicine, State University of New Yori< at Buffalo, Buffalo, New Yori<, and Head of the Department of Obstetrics and Gynecology, Buffalo General Hospital, Buffalo, New Yori< The purpose of this discussion is to share and Shoemaker (Fig 1). and notice that the va­ with you some thoughts about pelvic relaxation, gina in this instance has an almost vertical axis. its mysteries, some technical minutiae helpful in Is that then the goal we seek when we reposi­ identifying them and some of the surgical prob­ tion a misplaced vagina? Or is the vagina being lems involved. Thus, by looking at a number of displaced anteriorly by a full rectum, which was these diagnostic challenges, you may be stimu­ full at the time of death, as this illustration obvi­ lated to some diagnostic thinking in an office ously was from a cadaver dissection? setting. To resolve the issue, the vaginas of nulli­ Let me start with a few of the more decep­ parous young women can be lightly painted tively simple challenges in pelvic relaxation, the with a barium paste. This would not distort the goals we seek to achieve, and how to accom­ vagina but would render it radio-opaque. Lateral plish them. colpograms taken of these women demonstrate We have seen within my generation a re­ that the vagina does have an S-shaped curve examination of sexual thinking whereby aging with a horizontal inclination to the axis of the up­ persons presume to continue a reasonably per vagina (Fig 2) If we were to ask these nul­ comfortable and satisfactory coital relationship liparous patients to bear down, as by a Valsalva well into their senior years.
    [Show full text]
  • Relating Forearm Muscle Electrical Activity to Finger Forces
    RELATING FOREARM MUSCLE ELECTRICAL ACTIVITY TO FINGER FORCES by Jennifer Keating A Thesis Submitted to the Faculty of the WORCESTER POLYTECHNIC INSTITUTE in partial fulfillment of the requirements for the Degree of Master of Science in Electrical and Computer Engineering May 2014 APPROVED: _________________________________________ Professor Edward A. Clancy, Major Advisor _________________________________________ Professor Gregory S. Fischer, Committee Member _________________________________________ Professor Donald R. Brown, Committee Member Keating, 1 Abstract The electromyogram (EMG) signal is desired to be used as a control signal for applications such as multifunction prostheses, wheelchair navigation, gait generation, grasping control, virtual keyboards, and gesture-based interfaces [25]. Several research studies have attempted to relate the electromyogram (EMG) activity of the forearm muscles to the mechanical activity of the wrist, hand and/or fingers [41], [42], [43]. A primary interest is for EMG control of powered upper-limb prostheses and rehabilitation orthotics. Existing commercial EMG-controlled devices are limited to rudimentary control capabilities of either discrete states (e.g. hand close/open), or one degree of freedom proportional control [4], [36]. Classification schemes for discriminating between hand/wrist functions and individual finger movements have demonstrated accuracy up to 95% [38], [39], [29]. These methods may provide for increased amputee function, though continuous control of movement is not generally achieved. This thesis considered proportional control via EMG-based estimation of finger forces with the goal of identifying whether multiple degrees of freedom of proportional control information are available from the surface EMG of the forearm. Electromyogram (EMG) activity from the extensor and flexor muscles of the forearm was sensed with bipolar surface electrodes and related to the force produced at the four fingertips during constant-posture, slowly force-varying contractions from 20 healthy subjects.
    [Show full text]