TheThe BionicBionic ArmArm

ByBy LeslieLeslie ChatawayChataway andand ChristineChristine HoneyHoney BIONICBIONIC ARMARM

„„ MechanicsMechanics „„ ControlControl „„ CurrentCurrent „„ NewNew DevelopmentsDevelopments „„ FutureFuture Directions…Directions…

2 JOINTSJOINTS // ArticulationsArticulations

Classification Structure/ Examples Movement

Synarthrodial Bones fused Cranial bones (immovable) together Amphiarthrodial Slight movement, Vertebrae (slightly moveable) fibrocartilage disk Tibiofibular separates bones Sacroiliac joint Diarthrodial Inelastic All other (freely moveable) cross and hold joint in body! in place SynovialSynovial Joints!Joints!

„ Freely moveable joints „ Important in study of Human Kinetics „ Cartilage surfaces bone, reduces friction and absorbs shock „ Joint enclosed by articular capsule that holds . „ Six types: hinge, ball and socket, pivot, condyloid, plane and saddle.

4 SynovialSynovial JointsJoints inin thethe HumanHuman ArmArm

Type Movement Example Pivot Rotation, uniaxial Radioulnar

Hinge Uniaxial Elbow movement

Condyloid Angular biaxial movement (metacarpophalangeal joint)

Ball and Socket Triaxial Shoulder movement with great ROM

ROM: Range Of Motion 5 ClassificationClassification ofof MovementMovement

„„ LinearLinear -- simplestsimplest movementmovement thatthat cancan occuroccur inin aa joint.joint. OccursOccurs inin glidinggliding synovialsynovial joints.joints.

„„ AngularAngular -- motionmotion occursoccurs betweenbetween thethe longlong bonesbones ofof thethe arm,arm, andand spinalspinal column.column. -- angleangle betweenbetween twotwo bonesbones isis increasedincreased oror decreaseddecreased

6 33 CardinalCardinal PlanesPlanes

Frontal Plane

7 LinearLinear MotionMotion inin CardinalCardinal PlanesPlanes

„„ SidewardSideward motionmotion –– traveltravel alongalong xx axisaxis (movement(movement inin transversetransverse plane)plane) „„ VerticalVertical motionmotion –– traveltravel alongalong yy axisaxis (movement(movement inin frontalfrontal plane)plane)

„„ For/AftFor/Aft motionmotion –– traveltravel alongalong Y zz axisaxis

(movement(movement inin sagittalsagittal plane)plane) X Z

8 AngularAngular MovementMovement inin CardinalCardinal Planes:Planes:

„ AngularAngular MovementMovement occursoccurs inin thethe cardinalcardinal planesplanes aboutabout anan axis.axis.

Flexion/Flexion/ Abduction/Abduction/ Medial/Medial/ CircumductionCircumduction ExtensionExtension AdductionAdduction LateralLateral RotationRotation

„Forward and „Sideward raising and „Arm rotates inward „Involves flexion/extension backward movement lowering of the arm in the and outward in abduction and adduction of the arm in the frontal plane about a transverse plane about performed in sequence in sagittal plane, about sagittal axis. a longitudinal axis. both sagittal and frontal a frontal axis. plane „Horizontal occurs in transverse plane about a longitudinal axis. 9 UNIAXIAL:UNIAXIAL: TheThe ElbowElbow A Only movement in one plane of motion is possible. Can create a simple vector diagram to resolve the components of a force and measure the torque at the joint.

Torque is the rotational force Torque = r x F = moment arm x Force 10 TheThe Elbow:Elbow: TheThe LeverLever

„ Third Class Lever - Muscle Force falls between Resistance and Axis

FORCE

Contrary to first and second class levers, the force to generate an output is greater for third class levers. Tasks are made easier because the effort only moves through a smaller distance to generate work.

11 ForceForce DiagramDiagram The biceps force is broken down into a tangential and a radial force, these move and stabilize the joint respectively.

12 BIAXIAL:BIAXIAL: TheThe WristWrist

AA CONDYLOIDCONDYLOID JOINTJOINT

Movements of the wrist joint are flexion, extension, hyperextension, abduction, adduction and circumduction

Inertia is a measure of the resistance of a body to a change in rotary motion. Inertia = mr2

13 TRIAXIAL:TRIAXIAL: TheThe ShoulderShoulder

AA BALLBALL ANDAND SOCKETSOCKET JOINTJOINT

Large range of motion exists for the shoulder girdle. Movements combine to create diagonal motion as well as segmental movements in the cardinal planes.

14 TheThe Shoulder:Shoulder:

„ TheThe ForceForce DiagramDiagram forfor aa LeverLever cancan bebe extendedextended toto measuremeasure angularangular motion.motion. „ 44 SpatialSpatial componentscomponents ofof AngularAngular MotionMotion are:are: direction,direction, radius,radius, angleangle turnedturned through,through, arc.arc. „ AngularAngular MotionMotion :: ‘Amount‘Amount ofof Rotation’Rotation’

15 ""WeWe aren'taren't doingdoing aa realreal greatgreat jobjob withwith upperupper--limblimb prostheses.prostheses. OurOur challengechallenge isis toto restorerestore functionfunction forfor peoplepeople whowho havehave sufferedsuffered limblimb loss."loss." Dr. Todd Kuiken, director of neuroengineering at the Center for Artificial Limbs at the Rehabilitation Institute of Chicago

16 ““CODMAN’SCODMAN’S PARADOX”PARADOX”

„„ AttemptingAttempting movementsmovements ofof flexion,flexion, extension,extension, abductionabduction andand adductionadduction throughthrough largelarge rangesranges ofof motionmotion isis accompaniedaccompanied byby rotationrotation ofof thethe upperupper extremityextremity (shoulder(shoulder inin thisthis case)case) aroundaround itsits longitudinallongitudinal axisaxis (z).(z).

17 WhatWhat wewe learnlearn fromfrom Codman’sCodman’s ParadoxParadox „„ FromFrom thethe realizationrealization thatthat nonenone ofof thethe shouldershoulder movementsmovements inin thethe saggitalsaggital andand frontalfrontal planesplanes cancan bebe classifiedclassified asas onlyonly oneone typetype ofof angularangular motion.motion. ItIt isis nownow thethe goalgoal ofof thethe BiomedicalBiomedical engineerengineer toto createcreate aa prosthesisprosthesis thatthat duplicatesduplicates thethe skeletalskeletal framework,framework, andand allowsallows rotationrotation ofof thethe shouldershoulder jointjoint throughthrough hyperhyper-- movementsmovements ofof thethe upperupper andand lowerlower arm.arm.

18 NervesNerves

„ DendritesDendrites -- cellcell bodybody -- axonaxon -- collateralscollaterals -- terminalterminal branchesbranches -- terminalterminal buttonsbuttons „ RefractoryRefractory periodperiod afterafter actionaction potentialpotential inin whichwhich nono otherother potentialpotential cancan bebe generatedgenerated

19 TheThe BrainBrain

„ VisualVisual fieldfield -- prefrontalprefrontal cortexcortex -- premotorpremotor cortexcortex -- motormotor cortexcortex -- spinalspinal cordcord -- motormotor neuronsneurons -- musclesmuscles „ SensorySensory receptorsreceptors -- spinalspinal cordcord -- basalbasal gangliaganglia && cerebellumcerebellum -- sensorysensory cortexcortex

20 AA TetanusTetanus

„ A twitch = a single action potential – Fast Twitch – Slow Twitch „ A tetanus = a series of action potentials „ Max force that can be exerted by a motor unit occurs during a fused tetanus

21 FatigueFatigue

„ ResistanceResistance toto fatiguefatigue = the ability of a motor unit to withstand the decrease of the maximum force produced when a motor unit is required to produce a series of tetani „ FatigueFatigue IndexIndex - used to determine classification of motor unit (Type S, FR or FF)

22 TyingTying itit allall togethertogether

„„ MuscleMuscle forceforce isis alsoalso increasedincreased byby increasingincreasing thethe numbernumber ofof motormotor unitsunits involvedinvolved „„ NeedNeed toto understandunderstand howhow andand whywhy thethe signalsignal cancan increaseincrease fromfrom thethe brainbrain „„ NowNow focusfocus inin onon thethe brachialbrachial plexusplexus nervenerve (exits(exits C5C5--C8C8 && T1)T1) whichwhich innervatesinnervates thethe armarm andand upperupper backback

23 TheThe HumanHuman ArmArm

„ The arm can be broken into Osteofascial compartments „ The arm is divided by a fascial layer that separates the muscles into an anterior and posterior compartments. The compartments contain muscles which are innervated by the same nerve and perform the same action. „ RADIAL NERVE: Posterior Compartment „ MUSCULOCUTANEOUS NERVE: Anterior Compartment „ MEDIAN NERVE: „ ULNAR NERVE:

24 RADIALRADIAL NERVE:NERVE: PosteriorPosterior CompartmentCompartment

• Also known as the “Extensor Compartment”. • The muscles in this compartment are the triceps brachii, and anconeus muscle.

• The Radial nerve also controls the Extensor Carpi Radialis. The deep branch of the Radial nerve controls the extensor carpi radialis brevis, and the supinator. The posterior interosseous nerve controls the extensors of the hand.

25 MUSCULOCUTANEOUSMUSCULOCUTANEOUS NERVE:NERVE: AnteriorAnterior CompartmentCompartment

• Supplies the muscles in the anterior compartment, also known as the “Flexor Compartment”. The muscles in this compartment are the biceps brachii, brachialis, and the coracobrachialis.

• The large Deltoid muscle is believed to have part of its body in the anterior compartment, the deltoid is the main adductor muscle. The protagonist of the deltoid muscle is the pectoralis muslces found in the chest.

26 MEDIANMEDIAN NERVE:NERVE:

„ TheThe MedianMedian NerveNerve controlscontrols thethe PrPronatoronator TeresTeres,, palmarispalmaris longuslongus,, flexorflexor carpalcarpal radialisradialis.. „ TheThe UlnarUlnar NerveNerve controlscontrols flexorflexor carpalcarpal ulnarisulnaris,, flexorflexor digitorumdigitorum profundusprofundus inin thethe forearmforearm andand continuescontinues toto thethe handhand toto controlcontrol variousvarious functionsfunctions ofof thethe fingers.fingers.

27 PROSTHESIS PAST

„ LimbLimb ProsthesesProstheses areare usedused asas aa substitutesubstitute forfor aa missingmissing limb.limb. CurrentlyCurrently amputeesamputees willwill decide,decide, basedbased onon theirtheir levellevel ofof amputation,amputation, whichwhich typetype ofof prostheticprosthetic device:device: mechanicalmechanical oror electrical,electrical, willwill bestbest suitsuit thethe demandsdemands ofof theirtheir lifestyle.lifestyle.

28 MechanicalMechanical vsvs ElectricalElectrical

„ EachEach hashas itsits ownown advantagesadvantages andand disadvantages.disadvantages. „ ForFor higherhigher levelslevels ofof amputationamputation aa hybridhybrid designdesign isis oftenoften recommended.recommended.

29 MechanicalMechanical vsvs Electrical:Electrical:

„„ TerminalTerminal devicesdevices playplay aa largelarge rolerole inin whetherwhether anan amputeeamputee decidesdecides toto choosechoose aa mechanicalmechanical oror electricalelectrical prosthesis.prosthesis. „„ TerminalTerminal devicesdevices addadd functionalityfunctionality toto thethe prosthesis.prosthesis. IE:IE: myoelectricmyoelectric hand,hand, mechanicalmechanical cablecable--operatedoperated elbow,elbow, switchswitch controlledcontrolled electricelectric wristwrist andand aa passivepassive mechanicalmechanical frictionfriction humeralhumeral rotationrotation unit.unit.

30 Mechanical:Mechanical:

„ ADVANTAGES: – Limb can be used in a variety of physical environments without enduring damage. – High level of speed and accuracy „ DISADVANTAGES: – Friction beneath holding harness can cause discomfort. – Non-aesthetic

31 LTILTI LockingLocking ShoulderShoulder JointJoint

„ More Strength/Greater Resistance to wear „ Biomaterial: high strength aerospace allalloys.oys. „ 172 grams „ Natural gait, ability to lock every 10 degrees through a range of motion of 360 degrees. „ Second hinge allows for Ab/Adduction „ Joint frees manually, or by nudge control (use your imagination!) „ Available for use in both skeletal prosthetic systems.

32 Electrical:Electrical:

„ ADVANTAGES: – Increased comfort due to suspension method. – Higher level of pinch force (x5 of mechanical) – Terminal devices can be introduced for increased functionality of prosthesis. „ DISADVANTAGES: – Non-durable in many environments – Slower operation than that of mechanical

33 TheThe ElectricElectric ElbowElbow

„ CloseClose hookhook usingusing humeralhumeral flexionflexion andand bibi--scapularscapular abduction.abduction. „ LowLow LevelLevel AmputeeAmputee

CanCan bebe usedused with…with…

34 BostonBoston DigitalDigital ArmArm

„ Prosthetic system incorporating microprocessor technology „ Most torque of any prosthetic on the market. „ Controls up to four additional prosthetic devices (hands, grippers, wrist rotators, shoulder lock actuators etc) sequentially through co-contraction switching. „ On board microprocessor allows for suitable and unique control to be found at patients most optimal muscle site. „ Boston arm delivers more than 10ft-lbs of torque – 2 pound hand device = 8 lbs active lift. „ Can lift 50 lbs while device is locked. „ Low level amputee

35 Prosthetics:Prosthetics: aa growinggrowing field!field!

From Current to Future…

36 TheThe BionicBionic ArmArm

„ By the Rehabilitation Institute of Chicago NECAL department - Dr. Todd Kuiken „ Successfully attached to four people „ Jesse Sullivan and Claudia Mitchell are our main focus

37 JesseJesse SullivanSullivan

„ RequiredRequired bilateralbilateral shouldershoulder disarticulationdisarticulation amputationsamputations „ InitiallyInitially fittedfitted withwith bodybody--poweredpowered rightright arm,arm, externallyexternally poweredpowered leftleft armarm „ SkinSkin graftsgrafts becamebecame hyperhyper--estheticesthetic

38 MotorMotor--UnitsUnits ofof FocusFocus Nerve Muscles Affected Movement New Chest Muscle

Musculocutaneous Bicep Flexing elbow Clavicular head of pectoralis major median Pronator teres, flexor Opening and Upper segment carpi radialis, closing of the of the sternal palmaris longus & hand head of the flexor digitorum pectoralis major superficialis radial Triceps brachii, Extend the Lower segment brachioradialis, the elbow and wrist of the sternal extensor muscles of head of the fingers and wrist pectoralis major ulnar Flexor carpi ulnaris, Finger dexterity Pectoralis minor flexor digitorum profundus & the intrinsic muscles of the hand 39 TheThe InnervationInnervation ResultsResults

„ Strong contraction of musculocutaneous motor- unit „ 2 moderate contractions of median motor-unit „ weak contraction of radial motor unit „ no contraction of ulnar motor-unit 40 TheThe ProstheticProsthetic

„ LTILTI--CollierCollier shouldershoulder jointjoint (touch(touch padpad controlled)controlled) „ BostonBoston digitaldigital armarm (64(64 bitbit computercomputer inin forearmforearm forfor signalsignal processing)processing) „ wristwrist rotatorrotator „ GrieferGriefer terminalterminal devicedevice 41 TheThe OutcomeOutcome

„ BlockBlock movementmovement testtest „ ClothesClothes pinpin testtest „ OverallOverall preferredpreferred „ OnlyOnly drawbackdrawback -- doesdoes notnot functionfunction properlyproperly whenwhen JesseJesse sweatssweats

42 AnAn AddedAdded BonusBonus ofof ReinnervationReinnervation

„ Touching different parts of the chest feels like touching different parts of the phantom limb „ Currently feel pressure through the prosthetic „ Trying to acquire remaining sensations through the prosthetic 43 ClaudiaClaudia MitchellMitchell

„ World’s first bionic woman „ More issues with adipose cells creating cross-talk in women than in men „ Implemented shielding and insulation on top of removal of fat cells

44 CurrentCurrent ProjectsProjects

„ Natural arm is capable of 22 discrete movements - prosthetic is currently at four „ Helps with further research on the plasticity of the brain „ Dr. Miguel Nicolelis is trying similar research with implantations as opposed to surface

electrodes 45 PROSTHESISPROSTHESIS FUTUREFUTURE

46 RobotRobot--aidedaided GaitGait andand ArmArm TherapyTherapy

Task-oriented repetitive movements can improve muscular strength and movement coordination in patients with neurological disabilities.

47 Current work is focused on the development and evaluation

of patient-cooperative control strategies.

48 ConclusionConclusion

„„ RealityReality ofof thethe ExoskeletalExoskeletal robotrobot meetingmeeting thethe BionicBionic armarm (not(not inin battle)battle) creatingcreating aa hybridhybrid ofof thethe twotwo isis notnot tootoo farfar off.off. TheThe UnitedUnited StatesStates ArmyArmy hashas theirtheir handhand inin bothboth operations,operations, andand thethe fusingfusing ofof bothboth projectsprojects isis aa possibilitypossibility inin thethe nearnear future.future.

49