Interface Inserm : stimulation médullaire et neurale
Thomas Guiho, David Guiraud, Orateur à déterminer
CO192
Utilisation originale du signal neural pour une commande optimisée et intuitive des prothèses d'amputés de membres : rôle de sensations fantômes indolores
Jozina
DE GRAAF
(Marseille, France),
Lisa
Bachini
(Marseille, France),
Claire
Mahé
(Marseille, France),
Jean
Paysant
(Nancy, France),
Amélie
Touillet
(Nancy, France)
Objective :
Amputees face substantial difficulties in using their prostheses, partly caused by unnatural control of the prosthesis and lack of somatosensory feedback. Current proposed solutions involve adding artificial devices through invasive or non-invasive methods, but natural abilities of amputees are put aside. For instance, after amputation, phantom mobility is systematically associates with muscle activities measured on the surface of the residual limb that are specific to the type of movement and can be classified and used for natural and intuitive control of poly-articulated hand prostheses, thereby avoiding unnatural on-off strategies and sequential control. This shows that the signals resulting from patient's natural plasticity can be exploited before opting for artificial solutions. The aim of this pilot study was to explore whether phantom sensations can influence gait characteristics.
Material / Patients and Methods :
We measured with Physilog (Gait up©) sensors gait characteristics for (1) a participant walking with and without phantom sensations, (2) a participant walking with different sockets, leading to modifications in phantom sensations, and (3) a participant walking while acting on their phantom sensations by mobilizing their phantom foot. Phantom sensations were assessed by semi-directed interviews.
Results :
Several gait characteristics (e.g., % double support phase, see Fig1) were modified by phantom sensations, whether naturally present or induced.
Discussion - Conclusion :
Phantom sensations must be seriously considered during rehabilitation, both in rehabilitation methods and in the design of prostheses, rather than being ignored or feared. Future research should be focused on analyzing and using natural peripheral reorganizations rather than capturing signals directly on the nervous system.
Keywords :
Amputation - prosthesis control - phantom sensations